Group home license Texas: the full 2026 setup guide

Last updated 2026-07-26

What is a group home in Texas licensing terms?

In everyday language, a "group home" means a residential house where a small number of unrelated adults with disabilities, mental illness, addiction recovery needs, or age-related frailty live together and get supervision or personal care. Texas licensing law doesn't actually use that phrase for adult homes. Instead, the Health and Human Services Commission (HHSC) regulates these houses under a handful of specific license categories, and which one applies depends on who lives there and how much hands-on care they need. For seniors and adults needing help with daily activities, the relevant license is usually an Assisted Living Facility (ALF) license under Texas Health and Safety Code Chapter 247 ^[1]. For smaller, home-based settings serving three to four residents with a live-in caregiver model, Texas also licenses Adult Foster Care (AFC) providers, which contract mostly through Medicaid managed care ^[2]. If your home will serve people with intellectual or developmental disabilities (IDD), you're more likely looking at an HCS (Home and Community-based Services) or ICF/IID license through HHSC's long-term care division rather than an ALF license ^[3]. So the honest first move isn't Googling "group home license Texas" and expecting one form. It's figuring out which population you're serving and matching that to the correct HHSC program area. Get this wrong and you'll fill out the wrong application, which costs you months. For background on how assisted living licensing works generally before you narrow into Texas specifics, see assisted living facility.

What is assisted living, and how is it different from a group home?

Assisted living is a licensed care setting where residents get help with activities of daily living (bathing, dressing, medication reminders, mobility) plus meals, housekeeping, and supervision, but they don't need the round-the-clock skilled nursing care a nursing home provides. In Texas, an assisted living facility is any establishment furnishing food, shelter, and personal care to four or more people unrelated to the proprietor, per Health and Safety Code Section 247.002 ^[1]. "Group home" is really just a physical and operational style: a smaller residential-scale house rather than a large campus. Many Texas group homes ARE licensed as assisted living facilities, specifically Type A or Type B ALFs, because that's the license that legally matches a small residential care setting. Others operate as Adult Foster Care homes, which by rule serve no more than four residents in an actual family-style home setting ^[2]. The practical difference for an operator: ALF licensing has more building code, staffing ratio, and administrator requirements written into state rule. AFC is lighter-touch but ties you closely to Medicaid managed care contracts and a smaller resident cap. Neither is "easier," they're just different tracks for different business models. For a broader comparison of assisted living terminology across states, see assisted living facilities.

What is an assisted living facility under Texas law?

Type A	Residents who can evacuate the building without physical help in an emergency	No overnight nursing requirement
Type B	Residents who need help evacuating, or have some nursing/behavioral needs	Awake staff required at night
Type C (Adult Foster Care variant)	Small home settings, typically 3-4 residents	Family-home model	HHSC's own ALF minimum standards are published in Texas Administrative Code Title 26, Chapter 553 [4]. That chapter spells out staffing ratios, physical plant rules (room size, exits, fire safety), medication management procedures, and resident rights. If you're building a group home business plan around a small house rather than a large facility, Type A or Type B is almost always the license you'll apply for, not a hypothetical "Type C group home license" (Texas doesn't have a formal Type C ALF category; that naming gets confused with AFC homes online). One thing operators miss: HHSC requires an ALF license before you can advertise, market, or accept residents. Operating unlicensed is a violation subject to injunctive action and penalties under Chapter 247 [1].

Under Texas Health and Safety Code Chapter 247, an assisted living facility is a licensed establishment that provides personal care services, lodging, and meals to four or more unrelated residents who need help with at least some daily living activities but don't require the level of nursing care a skilled nursing facility provides ^[1]. HHSC issues three types: | ALF Type | Who it serves | Key feature |

What is assisted living vs nursing home, in practical terms?

Assisted living and nursing homes both provide residential long-term care, but they sit at different acuity levels and answer to different licensing chapters. Assisted living (Chapter 247) is for people who need help with daily activities but not ongoing skilled nursing. Nursing facilities (licensed under Texas Health and Safety Code Chapter 242) are for people who need daily skilled nursing care, rehabilitation, or medically complex management ^[5]. The blunt version: if a resident needs a nurse checking on wound care, IV medications, or complex chronic disease management every day, that's nursing facility territory, and a group home ALF license doesn't cover it. If a resident needs reminders to take pills, help getting dressed, supervision to prevent wandering, and someone to cook meals, that's assisted living. Staffing rules reflect this split. ALFs under 26 TAC Chapter 553 require an awake attendant on duty but not a licensed nurse around the clock ^[4]. Nursing facilities must have a licensed nurse on-site 24 hours a day under federal nursing home requirements referenced in 42 CFR Part 483 ^[6]. That single staffing difference drives most of the cost and complexity gap between the two license types, and it's why you can't casually convert a group home license into a nursing home license by just hiring more people. For readers building out a facility-scale operation instead of a residential-scale house, facility assisted living covers how larger buildings differ operationally.

Does Medicare cover assisted living facilities or group homes in Texas?

No. Medicare does not pay for room and board at assisted living facilities, group homes, or nursing homes for custodial (non-skilled) long-term care. CMS is explicit about this: Medicare covers short-term skilled nursing facility stays after a qualifying hospital stay, and it covers home health and hospice under specific conditions, but it does not cover the ongoing personal care and housing costs of assisted living ^[7]. What DOES pay for group home care in Texas, at least for some residents, is Medicaid, specifically through Texas's STAR+PLUS managed care program and HCBS waiver programs that can cover personal care services, and in some cases room-and-board offsets, for eligible low-income seniors and people with disabilities ^[8]. Adult Foster Care providers often contract directly with STAR+PLUS managed care organizations for this reason. Straight ALF room-and-board, though, is usually private-pay unless a resident qualifies for a specific Medicaid diversion or waiver slot, and slots are limited with waitlists in many Texas HCBS waiver programs ^[8]. If your business plan assumes steady Medicare reimbursement for a group home, that assumption is wrong and will sink your pro forma. Build your financial model around private pay, long-term care insurance, VA Aid and Attendance where applicable, and Medicaid waiver contracts, not Medicare.

How do I start a group home in Texas, step by step?

Starting a licensed group home in Texas runs through several sequential steps, and skipping ahead (like signing a lease before confirming zoning) is the most common expensive mistake. 1. Pick your population and license type. Seniors and adults needing ADL help usually means an ALF license (Type A or B) under Chapter 247 ^[1]. IDD populations usually route through HHSC's HCS or ICF/IID licensure instead ^[3]. Mental health and recovery group homes may fall under different HHSC behavioral health contracts, and some smaller sober-living homes operate outside formal licensure entirely if they don't provide personal care services, though this varies and you should confirm with your state licensing agency before assuming you're exempt. 2. Confirm zoning and property fit. Cities and counties regulate group homes through zoning ordinances, and Texas group homes for people with disabilities also get federal Fair Housing Act protection against discriminatory zoning under 42 U.S.C. Section 3604 ^[9]. That protection doesn't mean zero local process, though; confirm with your city or county planning department before signing a lease. 3. Line up your building. HHSC's ALF minimum standards under 26 TAC Chapter 553 set requirements for bedroom square footage, number of residents per room, bathroom ratios, fire exits, and sprinkler or alarm systems depending on facility type ^[4]. An existing single-family house often needs modification to meet these standards; budget for that before you commit to a property. 4. Submit your HHSC license application. This includes the facility application, background checks (fingerprint-based criminal history checks for owners, administrators, and staff), proof of financial solvency, your policies and procedures manual, staffing plan, and fire marshal or life safety inspection approval. Application and licensing fees are set by HHSC and vary by facility size and type; confirm current fee schedules directly with HHSC's Long Term Care Regulation division rather than relying on a third-party estimate. 5. Pass your pre-licensure inspection. HHSC surveyors will inspect the physical building and review your written policies before issuing the license. 6. Hire and train staff to meet ratio and qualification requirements before you accept your first resident. For a structured way to organize all of this paperwork (policy manual templates, staffing plan formats, application checklists) so you're not building it from a blank page, GroupHomePath's $299 State Group Home Licensing Kit walks through the document set state by state; see the licensing kit builder for the Texas version.

How do I start a group home if I want to serve people with disabilities specifically (IDD)?

If your group home will serve adults with intellectual or developmental disabilities, you're generally not applying for an ALF license at all. Texas routes IDD residential services through HHSC's Home and Community-based Services (HCS) waiver program or through Intermediate Care Facilities for Individuals with an Intellectual Disability (ICF/IID), both licensed and regulated separately from Chapter 247 assisted living rules ^[3]. HCS group homes typically serve small numbers of residents (commonly three or four per home) and require a Medicaid waiver contract, individual service plans, and specific direct support professional staffing and training requirements set by HHSC. Getting an HCS provider contract involves a separate enrollment process through HHSC's Provider Enrollment portal, on top of the physical site license. This is a genuinely different regulatory track from senior assisted living, with different inspection standards, different staff training curricula (much of it built around person-centered planning and behavior support), and different funding mechanics. Don't assume your ALF license research applies here; confirm the correct program area with HHSC before building your business plan.

What staffing does a Texas group home need to have on-site?

Staffing requirements depend on your license type, but every Texas ALF must have a designated administrator who meets HHSC qualification and training requirements under 26 TAC Chapter 553, plus enough direct care staff to meet resident needs around the clock ^[4]. Type A facilities need staff awake or on-call depending on resident evacuation ability; Type B facilities, which serve residents needing help evacuating or with greater care needs, require awake staff overnight, more than on-call staff ^[4]. Medication aides who administer medications must complete HHSC-approved medication aide training and certification. Administrators of larger ALFs must complete an HHSC-approved administrator training program and pass a competency exam. Staff-to-resident ratios aren't fixed at a single number in Texas rule the way some states do it; instead, the standard requires "sufficient staff" to meet each resident's assessed needs, which HHSC surveyors evaluate during inspection based on your resident population's acuity. That's less predictable than a hard ratio, but it also means a home with lower-acuity residents can sometimes run leaner than a home with residents needing more hands-on help. Build your staffing plan around actual resident needs assessments, not a guess, and expect surveyors to ask you to justify your numbers during inspection.

What does the Texas inspection and survey process look like?

HHSC conducts a pre-licensure inspection before your first license is issued, then unannounced surveys periodically after that, generally on an annual cycle, plus complaint-driven inspections if HHSC receives a report about your facility ^[1][4]. Surveyors check the physical building against Chapter 553 minimum standards, review resident records and care plans, check medication administration logs, interview residents and staff, and confirm staff training and background check documentation is current. Common citation areas nationally in residential care inspections include medication management errors, incomplete staff training documentation, inadequate care plan updates, and fire/life safety deficiencies (blocked exits, missing smoke detector coverage, expired fire extinguisher inspections). Texas surveyors follow the same general pattern. Keep your policy and procedures manual current, keep training certificates on file and organized, and do a mock walkthrough of your building against the Chapter 553 physical plant checklist before every survey window. For a deeper look at how inspections work and how to prepare for them across states, the assisted living overview covers general survey prep strategy that applies in Texas too.

What does assisted living actually provide day to day?

Assisted living provides a bundle of services centered on helping residents live as independently as possible while getting support with things they can no longer safely do alone. That typically means help with bathing, dressing, grooming, and toileting; medication reminders or administration by a trained medication aide; three meals a day plus snacks; housekeeping and laundry; transportation to medical appointments; and social or recreational activities. What assisted living does NOT typically provide is ongoing skilled nursing care, IV therapy, ventilator management, or ongoing wound care beyond basic first aid, which is why residents whose needs escalate past what the ALF license allows often have to transfer to a nursing facility. Texas Chapter 247 rules define the outer edge of what an ALF can legally do, and HHSC surveyors will cite a facility that's providing care beyond its license type's scope ^[1][4]. For family members comparing options, this is the practical dividing line: assisted living is for daily living support, nursing homes are for medical care needs. Group homes marketed for seniors in Texas are almost always operating at the assisted living end of that spectrum, not the nursing home end.

What's the realistic cost and timeline to get licensed?

Texas doesn't publish a single flat licensing fee that applies to every group home; ALF licensing fees are tied to facility capacity and license type and change periodically, so confirm current fee amounts directly with HHSC's Long Term Care Regulation licensing division before budgeting ^[1]. Beyond the state fee itself, plan for costs around fire marshal inspection, building modifications to meet Chapter 553 physical plant standards, background check processing for every owner and staff member, and liability insurance, all of which vary significantly by property condition and location. Timeline-wise, expect the application-to-license process to run several months at minimum once your building is ready, longer if your property needs construction work to meet fire and life safety standards or if your application has gaps that trigger requests for more information. HHSC doesn't guarantee a fixed processing window, and rushing a submission with missing documentation is the single most common cause of delay. A realistic operator plan budgets six months to a year from "decide to open a group home" to "first resident moves in," accounting for zoning confirmation, property preparation, license application, staff hiring and training, and pre-licensure inspection. Anyone promising a faster guaranteed timeline isn't being straight with you; state review timelines aren't something a vendor or consultant controls.

What happens after you get licensed? Ongoing compliance basics

A Texas ALF license isn't a one-time achievement, it's a standing obligation. You'll need to renew your license periodically per HHSC's schedule, maintain current staff training and background check records, report significant incidents (falls with injury, elopement, abuse or neglect allegations) to HHSC as required under Chapter 247 and its administrative rules, and keep your resident census and care documentation audit-ready at all times ^[1][4]. HHSC also investigates complaints from residents, families, or the public at any time, separate from the routine survey cycle. A pattern of complaints or a serious deficiency finding can trigger enforcement action ranging from a plan of correction requirement up to license suspension or revocation in serious cases. Operators who treat licensing as a paperwork event they complete once, then forget, are the ones who get blindsided by a bad survey. Build your policy manual, staff training calendar, and incident reporting process as living systems from day one, not documents you write once for the application and never touch again.

Frequently asked questions

What is assisted living?

Assisted living is a licensed residential care setting that helps adults, usually seniors, with daily activities like bathing, dressing, and medication management, while also providing meals, housekeeping, and supervision. It's for people who need support but not the round-the-clock skilled nursing care a nursing home provides. In Texas, it's licensed under Health and Safety Code Chapter 247 ^[1].

What is a group home?

A group home is a residential house where a small number of unrelated adults live together and receive supervision or care, often for aging, disability, mental health, or recovery needs. It's a descriptive term, not a specific Texas license category; most adult group homes in Texas are licensed as assisted living facilities or Adult Foster Care providers depending on resident needs ^[1][2].

What is an assisted living facility?

An assisted living facility is a state-licensed establishment providing food, shelter, and personal care services to residents who need help with daily activities but don't require ongoing skilled nursing care. Texas defines this under Health and Safety Code Section 247.002 as serving four or more unrelated residents, with HHSC issuing Type A or Type B licenses depending on resident evacuation ability and care needs ^[1].

What is the difference between assisted living and a nursing home?

Assisted living helps residents with daily activities like dressing and medication reminders; nursing homes provide daily skilled nursing care, rehabilitation, and medical management for more complex conditions. Texas licenses these separately: assisted living under Chapter 247, nursing facilities under Chapter 242 ^[1][5]. Nursing homes require 24-hour licensed nurse staffing; assisted living does not ^[6].

Does Medicare cover assisted living facilities?

No. Medicare does not pay for room, board, or custodial care at assisted living facilities or group homes. CMS confirms Medicare covers only short-term skilled nursing stays after a qualifying hospital stay, plus limited home health and hospice services, not ongoing assisted living costs ^[7]. Medicaid waiver programs, not Medicare, are the public funding source some residents use instead.

How do I start a group home in Texas?

Pick your population and matching HHSC license type (ALF under Chapter 247 for seniors/adults, HCS or ICF/IID for IDD populations), confirm local zoning, prepare a building that meets 26 TAC Chapter 553 physical plant standards, submit your HHSC application with background checks and policies, pass your pre-licensure inspection, then hire and train staff before accepting residents ^[1][3][4].

How do I start a group home for people with disabilities in Texas?

If you mean adults with intellectual or developmental disabilities, you'll likely apply through HHSC's HCS waiver program or ICF/IID licensure rather than a standard assisted living license. This requires a separate Medicaid provider enrollment process, specific direct support staff training, and different inspection standards than senior assisted living homes ^[3].

What license do I need for a Texas group home serving seniors?

Most Texas group homes serving seniors need an Assisted Living Facility license, Type A or Type B, issued by HHSC under Health and Safety Code Chapter 247. Type A serves residents who can evacuate independently; Type B serves residents needing evacuation help and requires awake overnight staff ^[1][4]. Smaller family-style homes may instead qualify as Adult Foster Care.

How much does it cost to get a group home license in Texas?

Texas ties ALF licensing fees to facility capacity and type, and fees change periodically, so there's no single flat number; confirm current fees with HHSC's Long Term Care Regulation division directly. Beyond the state fee, budget for building modifications to meet fire and life safety standards, background checks, and insurance, all of which vary by property ^[1].

How long does it take to get a Texas group home license?

There's no fixed statutory timeline HHSC guarantees. Realistically, expect several months from a complete application submission to license issuance, and plan for six months to a year total from decision to opening once you account for zoning confirmation, building prep, staff hiring, and the pre-licensure inspection.

What's the difference between Adult Foster Care and an ALF license in Texas?

Adult Foster Care serves a small number of residents (commonly up to four) in a family-home setting and often ties to Medicaid managed care contracts through programs like STAR+PLUS. Assisted Living Facility licensing under Chapter 247 covers a broader size range with more detailed physical plant and staffing rules written into 26 TAC Chapter 553 ^[1][2][4].

Do Texas group homes need to meet special zoning rules?

Group homes for people with disabilities get federal protection against discriminatory zoning under the Fair Housing Act (42 U.S.C. Section 3604), but local zoning and permitting processes still apply and vary by city and county. Confirm requirements with your local planning department before signing a lease or purchase agreement ^[9].

What staff qualifications does Texas require for group homes?

Every licensed ALF needs a qualified administrator who completes HHSC-approved training, and staff who administer medications must complete HHSC-approved medication aide certification. Beyond that, Texas requires "sufficient staff" to meet residents' assessed needs rather than one fixed ratio, with surveyors evaluating adequacy during inspection based on actual resident acuity ^[4].

Sources

1. Texas Health and Safety Code, Chapter 247 (Assisted Living Facilities): Definition and licensing requirements for assisted living facilities in Texas, including the four-or-more-resident threshold
2. Texas HHSC, Adult Foster Care program page: Adult Foster Care serves small numbers of residents in family-home settings and connects to Medicaid managed care
3. Texas HHSC, Home and Community-based Services (HCS) Program: IDD residential services in Texas are licensed through HCS or ICF/IID rather than standard ALF licensure
4. Texas Administrative Code, Title 26, Chapter 553 (Licensing Standards for Assisted Living Facilities): Minimum standards for ALF staffing, physical plant, medication management, and administrator qualifications
5. Texas Health and Safety Code, Chapter 242 (Nursing Facility Licensing Act): Nursing facilities are licensed separately from assisted living under Texas law
6. Code of Federal Regulations, 42 CFR Part 483, Subpart B: Federal requirement that nursing facilities have a licensed nurse on site 24 hours a day
7. Medicare.gov, long-term care coverage information: Medicare does not cover custodial long-term care or assisted living room and board costs
8. Texas HHSC, STAR+PLUS Medicaid managed care program: STAR+PLUS is a Texas Medicaid managed care program that can fund personal care services for eligible residents
9. U.S. Code, Title 42, Section 3604 (Fair Housing Act): Federal Fair Housing Act protections apply to group homes for people with disabilities against discriminatory zoning