How to Start a Home Care Service Business

Starting a home care service business gives you the opportunity to make a real difference in people’s lives while building a stable, community-based company. In Texas, demand for home care continues to rise as more seniors and families prefer in-home assistance over traditional care facilities.

However, before launching your agency, you must complete several critical steps, including licensing, training, compliance documentation, and planning. This guide outlines each stage clearly and provides verified cost details and expert recommendations from 123 Consulting Solutions, a trusted home care consultant in Texas.

Summary

Starting a home care service business in Texas is both rewarding and in-demand. This guide walks you through every step, from understanding HHSC licensing requirements to training, documentation, and startup costs.

You’ll learn how to choose the right license (PAS or Home Health), prepare compliant policies, complete your application, and get ready for your initial survey. Verified costs, training options, and best practices from 123 Consulting Solutions are included to help new agency owners launch confidently and compliantly.

 

Table of Contents

1. Introduction

2. Why Start a Home Care Service Business?

3. Step 1: Understand the Texas Home Care Industry

4. Step 2: Choose Your License Type (PAS vs Home Health)

5. Step 3: Register Your Business Entity

6. Step 4: Appoint an Administrator and Alternate Administrator

7. Step 5: Complete HHSC-Approved Administrator Training

8. Step 6: Prepare Policies and Procedures

9. Step 7: Submit the HHSC License Application

10. Step 8: Get Ready for the Initial Survey

11. Step 9: Estimate the Total Startup Cost

12. Step 10: Build a Strong Operational and Compliance Framework

13. Step 11: Market and Grow Your Agency

14. Common Mistakes to Avoid

15. How a Home Care Consultant Can Help

16. Conclusion

17. Frequently Asked Questions

 

Why Start a Home Care Service Business?

The home care industry in Texas is one of the fastest-growing sectors in healthcare. With an aging population and increasing preference for in-home care, the need for qualified providers continues to expand.

Starting a home care business offers several benefits:

• High demand: The number of seniors in Texas is projected to double by 2040.

• Low overhead: You can start small with minimal equipment.

• Flexible ownership: PAS agencies don’t require a medical background.

• Meaningful work: You’re directly improving clients’ quality of life.

With the right preparation, a home care service can grow into a sustainable, community-trusted business.

Step 1: Understand the Texas Home Care Industry

All home and community support service agencies in Texas are regulated by the Texas Health and Human Services Commission (HHSC) under the Texas Administrative Code, Title 26, Chapter 558.

To operate legally, every agency must obtain an HHSC license, follow staffing requirements, and maintain updated compliance records. Understanding these rules early helps you avoid delays and costly corrections later.

Step 2: Choose Your License Type (PAS vs Home Health)

Texas offers two main license categories:

Personal Assistance Services (PAS)

• Provides non-medical support such as bathing, meal preparation, mobility assistance, and companionship.

• Ideal for entrepreneurs without a healthcare background.

• Requires HHSC licensing but not clinical staff.

Home Health Agencies

• Provide medical care including nursing, therapy, and wound care.

• Require licensed medical professionals on staff.

• Must meet both state and federal (CMS) standards.

Choosing the correct license before you apply ensures your documentation, staffing, and policies match HHSC requirements.

Step 3: Register Your Business Entity

Before you apply for a license, you must legally establish your business:

• Register with the Texas Secretary of State as an LLC or Corporation.

• Obtain an EIN from the IRS for tax purposes.

• Set up a business bank account for all financial transactions.

• Verify your business name matches the name on your HHSC application.

Proper registration demonstrates credibility and keeps your records organized for licensing.

Step 4: Appoint an Administrator and Alternate Administrator

Every home care agency must have both an Administrator and an Alternate Administrator before applying for a license. These individuals oversee operations, compliance, and client care.

Requirements:

• Must complete HHSC-approved Administrator Training.

• Must meet experience qualifications outlined in Texas Administrative Code §558.244.

Your application cannot be submitted until both positions are filled with trained, qualified personnel.

Step 5: Complete HHSC-Approved Administrator Training

Administrator training is mandatory before submitting your license application. 123 Consulting Solutions offers affordable, HHSC-approved online courses that meet these requirements: 

Completing the right course ensures you’re fully qualified to manage day-to-day operations and HHSC surveys.

Step 6: Prepare Policies and Procedures

All agencies must maintain a complete, written Policy and Procedure Manual detailing how care is delivered, records are maintained, and compliance is monitored.

Using generic templates often causes delays during surveys. Instead, opt for Texas-specific manuals customized for your agency type. 123 Consulting Solutions provides HHSC-compliant manuals for $800, tailored to PAS or Home Health requirements.

A well-prepared manual is not only required for licensing, it also serves as a vital reference for training and quality control.

Step 7: Submit the HHSC License Application

Once you’ve completed training and documentation:

• Visit the Texas Provider Licensing Portal.

• Complete the online HHSC Home and Community Support Service Agency Application.

• Attach all required documentation, including:
  Policy manual
  Training certificates
  Ownership details
  Office address verification

• Pay the $2,625 state application fee to HHSC.

Ensure every form is signed and complete missing attachments can delay approval by weeks.

Step 8: Get Ready for the Initial Survey

After your application is approved, HHSC will schedule an initial on-site survey. This inspection verifies that your agency meets all operational, documentation, and safety standards.

A consultant can help you prepare by:

• Conducting a mock survey to identify potential issues.

• Reviewing your manuals and staff files.

• Training your administrator and staff on how to respond confidently to HHSC surveyors.

Agencies that complete a mock survey usually pass inspection on their first attempt.

Step 9: Estimate the Total Startup Cost

Estimated Total Startup Range: $4,500–$7,000

This estimate covers licensing and administrative setup but excludes payroll and marketing.

Step 10: Build a Strong Operational and Compliance Framework

Once licensed, focus on maintaining compliance and efficiency. Create systems for:

• Employee scheduling and documentation.

• Client care plans and progress tracking.

• Incident reporting and quality audits.

• Ongoing staff education and retraining.

A structured operational framework ensures you stay compliant and prepared for unannounced HHSC inspections.

Step 11: Market and Grow Your Agency

After licensing, the next challenge is client acquisition. Ethical marketing focuses on trust and education, not sales.

• Develop a professional website that clearly explains your services.

• Partner with hospitals, rehabilitation centers, and senior living communities.

• Attend community events to share free caregiving tips or home-safety guides.

• Ask satisfied clients for testimonials and referrals.

Consistency and transparency in marketing help families see your agency as credible and compassionate.

Common Mistakes to Avoid

Many first-time agency owners face delays or denials due to avoidable errors. Some of these errors include:

• Submitting incomplete or unsigned forms.

• Using non-compliant, generic policy manuals.

• Failing to meet training requirements.

• Ignoring HHSC correction notices.

• Operating from a residential address (not permitted).

Attention to detail prevents long delays and ensures smooth approval.

How a Home Care Consultant Can Help

Navigating HHSC licensing can be overwhelming, but an experienced consultant simplifies the process.

123 Consulting Solutions helps new and existing agencies by:

• Guiding you through the entire HHSC application process.

• Providing ready-to-use, compliant policy manuals.

• Delivering affordable, HHSC-approved administrator training.

• Conducting mock surveys to ensure readiness for inspections.

• Offering post-licensing compliance and growth support.
  
  

Client Success Story:

"123 Consulting Solutions is incredible! My favourite part was the 1 on 1 training and the marketing crash course. I gained valuable insights that not only helped grow my home healthcare business but can also be applied to my other ventures. Thanks so much Shae!" — Alexander Oladele • Dallas, TX.

Conclusion

Starting a home care service business in Texas requires commitment, compliance, and clear planning. With the right approach, you can complete licensing quickly and start serving clients confidently.

Whether you’re opening a PAS or Home Health agency, expert guidance can make the difference between success and delay.

123 Consulting Solutions is a trusted home care consultant in Texas, offering licensing assistance, policy manuals, HHSC-approved training, and ongoing compliance support to help agencies start strong and grow sustainably.

Frequently Asked Questions

Q1. How long does it take to get a home care license in Texas?

Usually between 45–90 days, depending on application accuracy and HHSC review time.

Q2. Do I need medical experience to start a PAS agency?

No. PAS agencies provide non-medical care and can be owned by individuals without healthcare backgrounds.

Q3. Can I run my home care agency from home?

No. HHSC requires a physical business location in Texas.

Q4. What’s the minimum cost to start a home care service?

Approximately $4,500–$7,000, depending on training and consulting support.

Q5. Does HHSC require ongoing training?

Yes. Administrators must complete continuing education to maintain compliance.

Q6. Can a consultant help after I’m licensed?

Absolutely. Consultants provide ongoing compliance updates, training refreshers, and operational audits to keep your agency inspection-ready.