How to get a group home license in texas (2026 guide)

Last updated 2026-07-25

what is a group home, exactly

A group home is a residential setting, usually a house in an ordinary neighborhood, where a small number of unrelated people live together and receive some level of support: help with meals, medication reminders, supervision, personal care, or behavioral health services. The term covers a lot of ground. It gets used for homes serving people with intellectual and developmental disabilities (IDD), people in mental health or substance use recovery, and seniors who need help with daily activities but don't need a nursing home. Texas doesn't actually license anything called a "group home" as a single category. That's the confusing part for people just starting out. Depending on who lives there and what services you provide, your home falls under one of several different HHSC license or contract types: Assisted Living Facility (ALF), Adult Foster Care, Intermediate Care Facility for Individuals with an Intellectual Disability (ICF/IID), or a Home and Community-based Services (HCS) provider agreement for IDD group homes funded through Medicaid waivers ^[1]. Getting the category right before you file anything saves you months of rework. If you're building a small home for three to six seniors who need daily assistance, you're most likely looking at an ALF license. If you're setting up Medicaid waiver housing for adults with IDD, you're looking at an HCS or Texas Home Living (TxHmL) provider enrollment instead of an ALF license. These are different agencies within HHSC with different rulebooks, so don't assume one license covers both models.

what is assisted living

Assisted living is a residential care model for adults, usually seniors, who need help with daily activities like bathing, dressing, medication management, or meal prep but don't need the round-the-clock skilled nursing care a nursing home provides. Residents typically have their own room or apartment, share common spaces, and get support from staff who are on-site but not necessarily licensed nurses. In Texas, assisted living is a regulated license category under Texas Health and Safety Code Chapter 247 ^[2]. HHSC classifies facilities by "Type A," "Type B," and "Type C" designations based on the level of care and mobility needs of residents, with Type B and Type C homes serving residents who need more help evacuating in an emergency or who have greater cognitive impairment. The specific licensing standards live in Texas Administrative Code Title 26, Chapter 553 ^[3].

what is an assisted living facility

An assisted living facility (the formal, licensed version of the term) is any establishment furnishing food, shelter, and personal care services to four or more people unrelated to the proprietor, according to Texas Health and Safety Code Section 247.002 ^[2]. That four-person threshold matters a lot: if you're housing three or fewer unrelated residents in a home setting, you may fall under a different regulatory path or in some cases below the licensing threshold entirely, though local zoning and fire code rules can still apply. HHSC's Texas Administrative Code Chapter 553 spells out exactly what an ALF has to provide: at minimum, supervision, personal care assistance, meals, laundry, and some level of social and recreational activity ^[3]. The facility has to have a written statement of services for each resident, a plan for evacuation, and staff who are trained and, depending on the facility type, awake and on duty overnight. This is also the license category most people mean when they search "assisted living facility" as a business concept rather than a building type. If you're comparing licensing paths across states, our overview on assisted living facilities walks through how other states define the same care model differently.

what is the difference between assisted living and nursing home

Assisted living is for people who need help with daily activities but are largely able to direct their own care and don't require ongoing skilled nursing. A nursing home (called a skilled nursing facility, or SNF) is for people who need daily medical care, like wound care, IV therapy, or rehabilitation after surgery, supervised by licensed nurses around the clock. The licensing frameworks are entirely separate in Texas. Assisted living facilities are licensed under Health and Safety Code Chapter 247 and Texas Administrative Code Chapter 553 ^[2][3]. Nursing homes are licensed under a different chapter of the Health and Safety Code (Chapter 242) and a different set of administrative rules, with much stricter staffing ratios and mandatory RN coverage ^[4]. Staffing is the clearest practical difference. Nursing homes must have a registered nurse on duty for specific hours and licensed nurses covering all shifts. Assisted living facilities are staffed with direct care workers and "attendants," with training requirements set by HHSC, but they are not required to have RN-level coverage unless the facility's own service plans call for it. Cost is different too. Nursing home care is billed largely through Medicaid and Medicare Part A for short skilled stays, while assisted living is almost always paid privately or through state Medicaid waiver programs, not through the traditional Medicaid nursing facility benefit.

does medicare cover assisted living facilities

No. Medicare does not pay for assisted living room and board, personal care, or custodial supervision. Medicare.gov is direct about this: "Medicare & Medicaid usually don't cover room and board costs for long-term care or assisted living" ^[5]. Medicare Part A can cover a short skilled nursing facility stay after a qualifying hospital stay, and Medicare can pay for doctor visits, physical therapy, or medical equipment a resident receives while living in assisted living, but it will not pay the facility's monthly rent or care fee. Medicaid is a different story, and this is where it gets state-specific. Texas Medicaid does not pay for room and board in assisted living either, but it can help cover the personal care and habilitation services delivered there through home and community-based services (HCBS) waiver programs, most notably STAR+PLUS for seniors and adults with disabilities ^[6]. This is a common point of confusion for new operators: your resident's Medicaid waiver might pay you for the care you provide, but the resident (or their family) is still responsible for the room and board portion out of pocket or through their own income and Social Security benefit.

how do i start a group home in texas: the licensing steps

Starting a licensed group home or assisted living facility in Texas runs through several sequential stages with HHSC's Long Term Care Regulation division. Skipping ahead (buying property before confirming zoning, or hiring staff before you know your facility type) is the single most common way operators burn cash before they ever get a license. 1. Decide your license category. Confirm with your state licensing agency which HHSC pathway fits your population: ALF (Chapter 553), HCS/TxHmL provider enrollment for IDD group homes, or another program type ^[1][3]. 2. Choose and vet your property. Confirm local zoning allows a residential care use in that location, and check the property against Chapter 553's physical plant standards (room size, exits, fire separation) before you sign a lease or close on a purchase. Our guide to assisted living at home covers how single-family home conversions typically need to handle this. 3. Form your business entity and get your tax IDs. You'll need this before HHSC will process an application. 4. Complete required training. Texas requires an ALF administrator to hold a valid license or, in smaller facilities, meet alternate qualification standards set by HHSC; confirm current administrator licensing requirements directly with HHSC before you build your staffing plan ^[3]. 5. Submit the license application to HHSC Long Term Care Regulation, along with the required application fee. Confirm the current fee schedule with HHSC, since fees are set in the Texas Administrative Code and are revised periodically ^[3]. 6. Pass your life safety and health inspections. The State Fire Marshal's Office or local fire authority typically inspects for life safety code compliance, and HHSC surveyors conduct the licensing survey of the physical plant and your policies. 7. Get your license issued and start operating within the terms of your license (the specific facility type, resident capacity, and level of care you were approved for). Each of these steps has its own document trail: entity paperwork, floor plans, staff files, policy manuals, training certificates. Building that paperwork stack from scratch is the part that eats the most time. That's the exact gap our $299 State Group Home Licensing Kit is built to close: state-specific application checklists and policy manual templates so you're not reinventing every form from a blank page.

what does the hhsc application actually require

HHSC's licensing application for an assisted living facility asks for a lot more than a form and a check. Expect to submit: proof of business entity formation, a floor plan showing resident rooms, exits, and common areas, a fire safety inspection report, your policy and procedure manual, resident rights and grievance procedures, an emergency preparedness and evacuation plan, staffing plan with job descriptions, and documentation of the administrator's qualifications ^[3]. HHSC also requires background checks for anyone with direct client contact, run through the Texas Department of Public Safety's criminal history system and the HHSC Employee Misconduct Registry ^[3]. Plan for this early. A background check that comes back with an unresolved finding can delay your opening date by weeks while you sort it out with HHSC's Consumer Rights and Services or Nurse Aide Registry teams. One thing new operators underestimate: HHSC reviews your written policies just as closely as your physical building. A thin policy manual (a few pages of generic language pulled from a template that doesn't match Texas rule citations) is a common reason applications get sent back for more information. Your medication management policy, your incident reporting policy, and your resident rights policy all need to map to specific Chapter 553 provisions, more than sound reasonable.

what staffing does a texas assisted living facility need

Staffing rules scale with facility type and resident population. Texas Administrative Code Chapter 553 requires ALFs to maintain sufficient staff to meet residents' documented needs at all times, with specific rules getting stricter for Type B and Type C facilities, which serve residents needing more help evacuating or with greater cognitive or physical impairment ^[3]. At minimum, expect these staffing components in your plan: - A licensed or HHSC-qualified administrator responsible for day-to-day operations

• Direct care staff ("attendants") trained in first aid, CPR, resident rights, abuse/neglect reporting, and infection control before or shortly after hire
• Awake overnight staff, required for Type B and Type C facilities
• A designated staff member responsible for medication administration or assistance, trained per HHSC's medication aide or delegation rules Your staff-to-resident ratio isn't fixed at a single number in statute the way some states do it. Texas instead requires staffing "sufficient to meet the needs" of the specific residents in the home, which HHSC surveyors evaluate against each resident's individual service plan during inspection ^[3]. That means a home with six residents who all need heavy physical assistance may need more staff on shift than a home with six independent residents who just need medication reminders. Build your staffing plan around actual resident acuity, not a guess.

what does the inspection process look like

Before HHSC issues your initial license, expect at least two separate inspections: a life safety/fire inspection and a licensing survey of the physical plant, policies, and (once you have residents) actual care delivery. The fire inspection checks things like smoke detectors, fire extinguishers, exit signage, sprinkler systems (required in most ALFs depending on size and type), and evacuation route clearance. This is often handled by the State Fire Marshal's Office or a local fire marshal with delegated authority, and it has to be current before HHSC will finalize licensure ^[3]. The HHSC licensing survey looks at your building against Chapter 553's physical plant standards (minimum room square footage, bathroom ratios, kitchen sanitation) and reviews your policy manual, staff files, and (post-licensure) resident records. After you're licensed, HHSC conducts unannounced inspections on a recurring basis, and any complaint HHSC receives can trigger an additional unannounced visit. Keeping your policy manual, training logs, and incident reports current and easy to pull is the difference between a routine inspection and a stressful one.

what about zoning and neighborhood pushback

Zoning is where a lot of otherwise well-prepared operators get stuck, because it's a local government issue, not an HHSC issue. A city or county can restrict where a residential care facility operates through its zoning code, and Texas cities vary widely in how they classify group homes. Federal fair housing law gives some protection here. The Fair Housing Act, as amended, prohibits municipalities from using zoning to exclude group homes for people with disabilities in ways that treat them differently from other residential uses, and HUD has published guidance on how reasonable accommodation requests work under the Act ^[7]. That said, this protection isn't automatic or unlimited, and it doesn't override legitimate, non-discriminatory zoning, occupancy, or building code requirements that apply to all residential structures equally. Before you sign a lease or make an offer on a property, call the city or county planning department and ask directly: is a licensed assisted living facility or a group home for [your population] a permitted use at this address, and does it require a conditional use permit, special exception, or public hearing? Get the answer in writing if you can. Rezoning fights and neighbor objections at a public hearing can delay a project by six months to over a year, and no HHSC license fixes a zoning problem.

how much does texas group home licensing cost and how long does it take

There's no single flat number here because it depends heavily on your license type, facility size, whether you're leasing or buying property, and how much renovation the building needs to meet Chapter 553's physical plant standards. Confirm exact, current application and licensing fees directly with HHSC before budgeting, since these are set in administrative rule and change periodically ^[3]. What you can budget for in terms of time: expect the full path from initial planning to an issued license to run several months at minimum, often longer if the property needs renovation to meet fire and physical plant code, if zoning approval requires a public hearing, or if your application is returned for missing documentation. Operators who build their staffing plan, policy manual, and floor plan before submitting (rather than during HHSC's review) consistently move faster through this process, because most delays come from documents being incomplete rather than from the substance being denied.

how to start a group home for iDD or mental health populations specifically

If your group home is for adults with intellectual or developmental disabilities funded through Medicaid, you're not applying for an ALF license at all. You're enrolling as a provider under HHSC's Home and Community-based Services (HCS) waiver program or Texas Home Living (TxHmL) program, which have their own provider enrollment application, staff qualification standards, and person-centered service planning requirements set out in Texas Administrative Code Title 26, Chapter 263 . Homes serving adults in mental health or substance use recovery may fall under yet another framework, sometimes licensed as a personal care facility, sometimes operating outside formal HHSC licensure if the home doesn't meet the four-or-more-unrelated-residents threshold and doesn't hold itself out as providing personal care services. This is genuinely one of the trickiest areas to self-diagnose. Call HHSC Long Term Care Regulation directly and describe your exact population and services before you assume which rulebook applies; guessing wrong here can mean operating unlicensed and facing enforcement action later. Our broader guides on assisted living and facility assisted living models compare how different populations get served under different license structures across states, which is useful context if you're deciding which population to serve before you've locked in Texas specifically.

Frequently asked questions

What is assisted living in simple terms?

Assisted living is housing for adults, usually seniors, who need help with daily tasks like bathing, dressing, or medication but don't need full-time nursing care. Residents live in a shared or private space with staff nearby to help, plus meals and social activities included. In Texas it's a licensed category under Health and Safety Code Chapter 247 ^[2].

What is a group home?

A group home is a residential house where a small number of unrelated people live together with some level of staff support, ranging from IDD and mental health group homes to senior assisted living. Texas doesn't license a single category called 'group home'; it's regulated as an assisted living facility, an HCS/TxHmL provider, or another HHSC category depending on who lives there ^[1].

What is an assisted living facility, legally, in Texas?

Under Texas Health and Safety Code Section 247.002, it's any establishment providing food, shelter, and personal care to four or more unrelated people, licensed and regulated by HHSC under Texas Administrative Code Chapter 553 ^[2][3]. Homes with three or fewer unrelated residents may fall outside this specific license category, though zoning and fire rules still apply.

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

Assisted living serves people who need help with daily activities but not ongoing skilled nursing; nursing homes serve people who need daily medical care under round-the-clock licensed nursing staff. They're licensed under entirely different Texas Health and Safety Code chapters (247 for ALF, 242 for nursing facilities) with very different staffing requirements ^[2][4].

Does Medicare cover assisted living facilities?

No. Medicare.gov states Medicare 'usually doesn't cover room and board costs for long-term care or assisted living' ^[5]. Medicare can pay for medical services a resident receives while living there, like doctor visits or short-term therapy, but not the facility's monthly room and care charges.

Does Texas Medicaid pay for assisted living?

Texas Medicaid doesn't cover room and board in assisted living, but HCBS waiver programs like STAR+PLUS can pay for the personal care and habilitation services delivered there ^[6]. Families typically still cover room and board separately through income, Social Security, or private funds.

How do I start a group home in Texas?

Identify your correct HHSC license category (ALF, HCS/TxHmL, or another program), confirm local zoning allows the use at your chosen property, form your business entity, build your staffing and policy manual, submit your HHSC application with required fees, pass fire and licensing inspections, then operate within your approved license terms ^[1][3].

What license does an assisted living facility need in Texas?

An Assisted Living Facility license issued by HHSC Long Term Care Regulation under Texas Administrative Code Title 26, Chapter 553, classified as Type A, Type B, or Type C depending on resident mobility and care needs ^[3].

How long does it take to get an assisted living license in Texas?

There's no fixed statutory timeline, and it varies with property readiness, zoning approval, and application completeness. Operators who prepare their floor plan, staffing plan, and policy manual before applying typically move through HHSC review faster than those submitting incomplete applications; confirm current processing expectations with HHSC directly.

Can I run a small group home with only 3 residents without a license?

Texas's ALF licensing threshold under Section 247.002 applies to establishments serving four or more unrelated residents ^[2]. Homes below that threshold may not need an ALF license, but local zoning, fire code, and other regulatory requirements can still apply, so confirm with your state licensing agency and local building department before assuming you're exempt.

Does zoning affect where I can open a group home in Texas?

Yes. Local zoning codes determine whether a residential care use is permitted at a given address, and this is separate from HHSC licensing. The federal Fair Housing Act limits how municipalities can exclude group homes for people with disabilities through zoning ^[7], but you still need to confirm local zoning classification before signing a lease.

What background checks does Texas require for group home staff?

HHSC requires criminal history checks through the Texas Department of Public Safety and a check of the HHSC Employee Misconduct Registry for anyone with direct client contact in a licensed facility ^[3]. Build in extra time for this step since unresolved findings can delay your opening.

Is an IDD group home licensed the same way as senior assisted living in Texas?

No. Senior assisted living is licensed under Texas Administrative Code Chapter 553 as an ALF. IDD group homes funded through Medicaid waivers are enrolled as HCS or TxHmL providers under a separate set of rules in Chapter 263, with different application and staffing requirements ^[3][8].

Sources

1. Texas Health and Human Services, Long Term Care Regulation: HHSC regulates multiple distinct license and contract categories for residential care, including ALF, ICF/IID, and HCS/TxHmL provider enrollment
2. Texas Health and Safety Code, Chapter 247: Definition of assisted living facility as serving four or more unrelated residents and the statutory basis for ALF licensing
3. Texas Administrative Code, Title 26, Chapter 553: Licensing standards for assisted living facilities including facility types, staffing, training, background checks, and physical plant requirements
4. Texas Health and Safety Code, Chapter 242: Nursing facility licensing is governed by a separate statutory chapter with distinct staffing requirements
5. Medicare.gov, Long-Term Care: Medicare usually doesn't cover room and board costs for long-term care or assisted living
6. Texas Health and Human Services, STAR+PLUS: STAR+PLUS is the Texas Medicaid managed care program covering long-term services and supports including personal care in community settings
7. Texas Administrative Code, Title 26, Chapter 263: HCS provider enrollment and standards for IDD group homes are governed by a separate chapter from ALF licensing