How to Start a Home Care Service in Texas

Starting a home care service in Texas can be one of the most rewarding ventures in healthcare. With an aging population and a growing preference for in-home care, the demand for qualified home care providers continues to rise.

However, establishing a compliant and successful home care agency requires more than compassion. It demands a thorough understanding of state regulations, careful documentation, and the ability to navigate the Texas Health and Human Services Commission (HHSC) licensing process.

This guide explains each step in detail, using proven insights from 123 Consulting Solutions, a trusted Texas partner for home care startups.

Summary

Starting a home care agency in Texas can be a rewarding venture, but success depends on strict compliance with the Texas Health and Human Services Commission (HHSC).

This guide walks new agency owners through every stage of the process, from choosing between PAS and Home Health licenses to completing required administrator training and preparing for the initial HHSC survey.

It highlights key costs including the $2,625 state application fee, $800 policy manual, and training courses from $79–$197 and explains how careful documentation prevents licensing delays.

Readers also learn the value of partnering with a home care consultant, who ensures accuracy, prepares staff for inspections, and keeps policies compliant with evolving HHSC rules.

With the right preparation and professional support, entrepreneurs can launch a fully licensed, compliant, and sustainable home care agency that meets Texas standards and earns client trust.

 

Table of Contents

1. Introduction

2. Why Home Care Services Are Growing in Texas

3. Step 1: Understand the Types of Home Care Services in Texas

4. Step 2: Research HHSC Licensing Requirements

5. Step 3: Step-by-Step Process to Start a Home Care Service

6. Step 4: Estimate the Total Startup Cost

7. Step 5: Common Mistakes to Avoid

8. Step 6: Build a Sustainable Operational Framework

9. Step 7: Why Work With a Home Care Consultant

10. Step 8: How 123 Consulting Solutions Helps Texas Startups

11. Step 9: Building a Compliant Future

12. Conclusion

13. Frequently Asked Questions

 

Why Home Care Services Are Growing in Texas

Texas ranks among the top states for senior population growth. As more families prefer to care for loved ones at home, the demand for home care agencies has expanded rapidly across cities like Dallas, Houston, and San Antonio.

This growth has also increased the need for regulatory oversight. HHSC ensures that all home care providers operate according to established safety and care standards. For new agencies, this means meeting strict licensing requirements before beginning operations.

Understanding these requirements, and planning ahead, can make the difference between a smooth approval and a costly delay.

Step 1: Understand the Types of Home Care Services in Texas

Before you apply for a license, it is important to determine which type of home care service best fits your business model. In Texas, the two main categories are:

Personal Assistance Services (PAS)

• Provides non-medical care, such as grooming, bathing, meal preparation, and companionship.

• Ideal for entrepreneurs without a clinical background.

• Requires HHSC licensing but not clinical staff.

Home Health Agencies

• Provide skilled medical services such as nursing care, physical therapy, and medication management.

• Require licensed healthcare professionals on staff.

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

Choosing the correct type early prevents costly reapplications and ensures that your documentation aligns with HHSC regulations.

Step 2: Research HHSC Licensing Requirements

The HHSC governs all home and community support service agencies under Texas Administrative Code, Title 26, Part 1, Chapter 558.

To qualify for a license, your agency must have:

• A registered Texas business entity (LLC, Corporation, or Sole Proprietorship).

• A governing body that meets HHSC’s structural standards.

• A qualified Administrator and Alternate Administrator.

• A physical office location within Texas.

• Complete policy and procedure manuals that comply with HHSC standards.

• Completed background checks for owners and staff.

• Payment of the $2,625 HHSC licensing fee.

Having these items prepared before submission minimizes errors and reduces turnaround time.

Step 3: Step-by-Step Process to Start a Home Care Service

The process can seem complex, but with a structured approach, each stage becomes manageable.

1. Choose a Business Structure

Form your business as an LLC or Corporation through the Texas Secretary of State. This provides legal protection and defines ownership clearly.

2. Obtain an EIN

Apply for an Employer Identification Number (EIN) from the IRS. You will need it for taxes and payroll.

3. Appoint an Administrator and an Alternate Administrator

Both roles must be filled before applying for a license. Each must complete HHSC-approved training courses.

4. Complete Required Training

Administrators are required to complete initial training hours depending on their role and experience.
At 123 Consulting Solutions, you can fulfill these requirements through affordable online courses:

• 8-Hour Initial Administrator Training – $79

• 12-Hour Texas HCSSA Administrator Course – $189

• 16-Hour Initial Administrator Training – $197

5. Prepare Your Policy and Procedure Manual

HHSC requires each agency to have written policies describing operations, recordkeeping, and client care procedures.
123 Consulting Solutions offers state-compliant manuals for $800, customized for PAS and Home Health agencies.

6. Submit the License Application

Complete the HHSC application through the Texas Provider Licensing Portal and attach your supporting documents. Pay the $2,625 state fee upon submission.

7. Prepare for the Initial Survey

Once your application is accepted, HHSC will schedule an on-site inspection. This survey ensures your agency meets all compliance requirements. Consultants can help by conducting mock surveys and training staff in advance.

8. Begin Operations

After HHSC approval, you will receive your license and may officially begin providing home care services.

Step 4: Estimate the Total Startup Cost

Starting a home care agency requires planning for both administrative and operational expenses. Below is an estimate based on actual prices from 123 Consulting Solutions and HHSC:

 

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

This range excludes marketing and payroll but covers the key steps needed for HHSC compliance and licensing.

Step 5: Common Mistakes to Avoid

Many first-time agency owners face licensing delays due to small but critical errors. Below are the most common pitfalls and how to prevent them.

• Submitting Incomplete Documentation

Leaving out required documents or missing signatures can delay approval for months. Review all attachments carefully before submitting.

• Using Non-Compliant Policies

Generic templates not aligned with HHSC standards often lead to survey deficiencies. Use Texas-specific manuals approved for your agency type.

• Unqualified Administrators

Administrators who have not completed HHSC-approved training cannot be listed on applications. Always verify their credentials before submission.

• Ignoring HHSC Requests

Failure to respond promptly to correction notices can halt your application. Track all communication until approval is received.

Step 6: Build a Sustainable Operational Framework

Licensing is only the beginning. Agencies that succeed long term develop strong operational systems from day one.

Consultants can assist with:

• Internal audits and compliance tracking.

• Employee scheduling and documentation systems.

• Client assessment forms and care plans.

• Corrective action planning and survey readiness.

Building these systems early creates consistency and strengthens your compliance record during HHSC reviews.

Step 7: Why Work With a Home Care Consultant

A professional consultant guides you through the licensing process efficiently and accurately. For most new agencies, this partnership prevents the delays and errors that come from navigating HHSC requirements alone.

Benefits of Working with a Consultant:

• Ensures documentation meets HHSC standards.

• Simplifies the application process.

• Prepares staff for surveys through mock inspections.

• Keeps policies and training up to date with regulation changes.

One agency owner who worked with 123 Consulting Solutions shared the following experience:

“Working with Shae and his team at 123 Consulting Solutions was incredibly helpful. They guided me through licensing, policies, and operations with clear, practical direction. Every conversation was focused and honest. Their support was key to helping me get my agency off the ground, and it made the entire process far more manageable.” — Jasmine Castle, San Antonio, TX

Step 8: How 123 Consulting Solutions Helps Texas Startups

123 Consulting Solutions provides complete support for new and existing Texas home care agencies.

Their services include:

• HHSC Licensing Assistance: Personalized guidance through the entire process.

• Compliant Policy Manuals: Ready-to-use documentation for PAS or Home Health agencies.

• Training Courses: Affordable HHSC-approved programs starting at $79.

• Mock Surveys and Inspections: Practical preparation for HHSC site visits.

• Ongoing Compliance Support: Regular policy updates and regulatory briefings.

A home care agency owner reflected on their startup experience with 123 Consulting Solutions, she mentioned:

"123 Consulting Solutions made life easier by streamlining and guiding me through establishing my home care agency. I was confused and didn't know where to begin the process. They came in and walked me through every step I needed to start. They are very professional, effective, efficient, and reliable. Thank you once more." — Temitope Aremu, El Paso, TX

Step 9: Building a Compliant Future

Starting your agency is only the beginning of your compliance journey. HHSC regulations evolve frequently, and maintaining your license requires continuous education, documentation updates, and staff training.

Partnering with experienced professionals ensures that your agency remains compliant, audit-ready, and trusted by clients and regulators alike.

Conclusion

Starting a home care service in Texas requires dedication, attention to detail, and a commitment to compliance. With the right preparation and expert support, you can complete the HHSC licensing process efficiently and confidently.

123 Consulting Solutions offers the structure, training, and documentation tools to help you launch your agency on a strong foundation. Their team of Texas-based consultants has helped hundreds of agencies achieve licensing success without unnecessary delays.

Learn more about how 123 Consulting Solutions help Texas agencies stay compliant: Home Care Consultant in Texas

Frequently Asked Questions

Q. How long does the HHSC licensing process take?

Typically 45–90 days, depending on documentation accuracy and survey scheduling.

Q. Do I need a medical background to open a home care agency?

No. PAS agencies are non-medical and can be owned by individuals without clinical    experience.

Q. Can I operate a home care agency from home?

No. HHSC requires a physical office location within Texas.

Q. Is training mandatory for home care agency administrators?

Yes. All administrators must complete approved 8, 12, or 16-hour courses.

Q. What is the difference between PAS and Home Health agencies?

PAS agencies provide personal care and daily living assistance, while Home Health agencies deliver skilled nursing and therapy services.

Q. Do consultants help after my home care agency license is issued?

Yes. Ongoing compliance, survey prep, and document updates are part of long-term consulting support.