A well-executed business plan, and subsequently a well-prepared application, are the keys to navigating the complex process of obtaining a license to operate a home health care agency through the state of Texas' Department of Aging and Disability Services (DADS). Standards for home and community support services agencies (HCSSAs) are set out in 40 Texas Administrative Code, Chapter 97. Your agency's policies and procedures must conform to these standards.

Getting Started

Establish an agency as either a corporation, a limited or general partnership or a sole proprietorship. Comply with all business registration requirements of the Texas secretary of state (see Resources). Check city or county ordinances that may affect the business and obtain legal counsel if necessary.

Prepare a list of services the agency will provide. Some agencies provide skilled nursing services. Other agencies may provide social services or personal care. Obtaining Medicare certification for your agency is a separate certification process involving DADS and federal agencies.

Obtain a national provider identifier (NPI), required for Medicare services, through the national provider enumeration system (see Resources).

Identify all executives and owners. Designate an experienced administrator and supervisory nurse, and an alternate for each position. Write detailed job descriptions for each position. Maintain a resume of all key employees and owners on file.

Establish procedures to conform with best practices in care-related issues. Institute a policy to deal with continuity of services in the event of business interruption or closing of business. Put in place a policy and procedure for providing continuing education to employees and ensuring that all employees know and adhere to DADS requirements.

Collect detailed information concerning owners, administrators, financial officers and other partners. DADS regulations require disclosure of any liens or judgments and unpaid child support involving key personnel.

Complete required pre-licensing computer-based training through DADS for administrators and nursing supervisors. (see Resources).


Complete DADS Form 2021, Home and Community Support Services Agency License. Provide any supporting documentation requested.

Submit a certificate of good standing from the Texas state comptroller. Certificates are available via email or fax or directly from the comptroller. Instructions are on the comptroller's website (see Resources).

Complete a Criminal History Check on all owners, administrators, alternate administrators and chief financial officers by filing DADS Form 2022.

Assemble supporting documentation to submit with Forms 2021 and 2022 and the certificate of good standing. This information includes an organizational chart of the agency, showing lines of authority down to the patient contact level; detailed resumes for the administrator, alternate administrator, supervising nurse and alternate supervising nurse; certificates of completion for continuing education and pre-survey computer-based training; the agency's national provider identifier; copies of all legal entity documentation; and the agency's IRS tax identification number. Attach a plan for providing training and personnel education and a plan for the orderly transfer of client care in the event of an interruption in business.

Submit all forms and documentation of the above information along with a check for the licensing fee of $1,750, as of September 2010, to:

Regulatory Services Accounts Receivable Mail Code E-411 Texas Department of Aging and Disability Services P O Box 149030 Austin, TX 78714


The Texas Association for Home Care & Hospice is a nonprofit association formed for licensed providers (see Resources).


Numerous state and federal statutes and rules apply to licensing a home health agency in Texas. Seek qualified legal advice for detailed information.