Last updated 2026-07-24
TL;DR
To start a group home in Texas, pick your license type through HHSC (assisted living, HCSSA, or an IDD/behavioral health license), meet zoning and fire code requirements, hire qualified staff, and pass a pre-licensing inspection. Most operators spend several months and several thousand dollars before their first resident moves in.
What is a group home, exactly?
A group home is a residential setting, usually a single house or small building, where a small number of unrelated people live together and get some level of personal care, supervision, or support staff. It's not a medical facility. It's a home with paid staff instead of, or in addition to, family caregivers. In Texas, the term "group home" isn't one specific license. It's an umbrella phrase that covers several different regulatory categories depending on who lives there and what care they need. A home for adults with intellectual or developmental disabilities (IDD) falls under different rules than a home for seniors who need help with bathing and medication, which falls under different rules than a recovery residence for people in addiction treatment. The Texas Health and Human Services Commission (HHSC) is the state agency that licenses most of these categories. Getting this classification right at the start matters more than almost anything else you'll do, because it determines your application form, your staffing ratios, your inspection checklist, and your fees. Pick the wrong category and you'll redo the whole application. If you're still deciding which population to serve, it helps to look at how licensing differs by group before you file anything. See assisted living facility requirements as one comparison point.
What is assisted living, and what is an assisted living facility?
Assisted living is a type of housing for older adults or adults with disabilities who need help with daily activities like bathing, dressing, or medication management, but who don't need the round-the-clock skilled nursing care of a nursing home. An assisted living facility (ALF) is the licensed building or home where that care is delivered. In Texas, HHSC licenses these under the Texas Health and Safety Code Chapter 247, and the facility is called an Assisted Living Facility or a Type A, Type B, or Type C facility, depending on the residents' mobility and cognitive needs. Type A residents can evacuate on their own in an emergency. Type B residents need staff help to evacuate or have moderate cognitive impairment. HHSC's own rule text describes assisted living facilities as places providing "personal care services... to four or more persons who are not related... to the owner" [1]. Small houses with three or fewer residents in Texas can sometimes operate without an ALF license, but the moment you add a fourth unrelated resident receiving personal care, you almost always cross into licensed territory. Confirm the exact resident count threshold and any recent statutory amendments with HHSC before you sign a lease, because this number gets cited wrong constantly online and the consequence of guessing wrong is an unlicensed-operation citation. For a side-by-side on how this differs from other senior housing options, see assisted living facilities.
What is assisted living vs nursing home, and what's the real difference?
Assisted living gives residents help with daily tasks in a home-like setting; a nursing home (called a skilled nursing facility, or SNF) provides 24-hour licensed nursing care for people with serious medical needs. The core difference is medical intensity, more than the building. A nursing home has to have a registered nurse on duty and provides things like wound care, IV therapy, and rehabilitation after surgery or a hospital stay. Assisted living is built around supervision and help with activities of daily living (ADLs) like eating, toileting, and mobility, not skilled medical treatment. CMS describes nursing homes as providing "skilled nursing care and rehabilitation services" while assisted living is generally classified as a residential, not medical, level of care [2]. Cost and staffing follow the same split. Nursing homes require licensed nurses around the clock; assisted living facilities in Texas require an on-site "attendant" awake and on duty, with specific staff-to-resident ratios that vary by facility type and time of day (day shift ratios differ from overnight ratios under HHSC rules). If your business plan involves any resident who needs IV medications, a feeding tube, or frequent skilled wound care, you're likely looking at a nursing facility license, not an assisted living or group home license, and that's a much bigger regulatory lift.
What does assisted living provide day to day?
Assisted living typically provides three meals a day, help with bathing and dressing, medication reminders or administration, housekeeping, laundry, social activities, and 24-hour supervision. It does not typically provide skilled nursing, physical therapy, or hospital-level medical monitoring. Under Texas rules, licensed facilities must have a written plan of care for each resident, staff trained in first aid and emergency procedures, and a system for medication management appropriate to the facility type (self-administration vs. staff administration of meds differs by Type A/B/C classification). HHSC requires facilities to maintain sufficient staff "to meet the 24-hour scheduled and unscheduled needs of each resident" [1]. For group homes serving people with IDD or mental health conditions instead of frail seniors, "what assisted living provides" translates into services like medication management, behavioral support plans, skills training, and transportation to day programs or work, licensed instead under HHSC's IDD or behavioral health/community services frameworks rather than Chapter 247.
How do I start a group home in Texas? (step by step)
Starting a group home in Texas means choosing your license category, forming your business entity, securing a compliant property, hiring qualified staff, submitting your HHSC application, passing a pre-licensing inspection, and getting your license issued before you accept a single resident. Here's the realistic order of operations. Step 1: Pick your population and license type. Are you serving seniors needing personal care (ALF, Chapter 247), adults with IDD (HCS/ICF program licensure through HHSC), people needing home and community support services (HCSSA license), or a mental health/recovery residence? Each has a separate application, separate fee, and separate rule chapter. Call HHSC's Long-term Care Regulatory division before you write a business plan, not after. Step 2: Form your business entity and get an EIN. Most operators form an LLC through the Texas Secretary of State. You'll need this entity name on your license application, your lease, and your bank account. Step 3: Find and secure a property. The site has to meet zoning requirements (many cities treat small group homes as a protected residential use under the Fair Housing Act, but larger facilities may trigger separate zoning review), plus fire and life-safety code. Don't sign a lease or close on a purchase until you've confirmed zoning with the local planning department, in writing. Step 4: Pass fire marshal and building inspections. Your local fire marshal (or the State Fire Marshal's Office, depending on jurisdiction) has to inspect for things like smoke detectors, fire extinguishers, exit signage, and sprinkler requirements, which scale up sharply once you exceed certain resident counts. Step 5: Write your policy and procedure manual. HHSC application reviewers expect written policies covering admission and discharge criteria, medication management, emergency preparedness, resident rights, abuse/neglect reporting, and staff training. This is the single most time-consuming paperwork item for first-time applicants. Step 6: Hire and train staff. You'll need a qualified administrator (Texas requires ALF administrators to be licensed separately through HHSC's Assisted Living Facility Administrator licensing program) plus direct care staff who complete required orientation and ongoing training hours. Step 7: Submit your license application and fee to HHSC. Fees vary by facility type and bed count; confirm the current fee schedule directly with HHSC's Long-term Care Regulatory fee page before budgeting, since these numbers get updated periodically. Step 8: Pass your pre-licensing survey (inspection). An HHSC surveyor visits before you're licensed to confirm the physical plant, staffing, and policies match what you submitted. Expect this to take a half day to a full day depending on facility size. Step 9: Get your license and start intake. Once issued, licenses in Texas typically need renewal on a set cycle; mark your renewal date the day you get the license, not six months before it expires. Building every one of these documents from scratch, the policy manual especially, is where most first-time applicants lose weeks. If you want a starting template built around HHSC's actual application requirements instead of a blank page, that's exactly what our $299 State Group Home Licensing Kit is built to shortcut, though the state agency is always the final word on what they'll accept.
What does it cost and how long does it take to open?
There's no single statewide number here because it depends heavily on your license type, facility size, and whether you're leasing or buying property, and nobody publishes a reliable statewide average because so much of the cost is local (property, renovation, insurance). Budget in three buckets: state fees, physical plant costs, and staffing/operating capital before your first resident moves in. State licensing fees themselves are usually the smallest bucket, often in the low thousands of dollars depending on facility type and bed count; confirm the exact current fee with HHSC's Long-term Care Regulatory division, since Texas updates fee schedules periodically and this article won't guess a number that changes. The larger costs are usually the physical plant (fire suppression systems, ADA-compliant bathrooms, ramps, generator backup power in some facility types) and working capital to cover payroll and rent before your census fills up. Timeline realistically runs three to nine months from "decision to open" to "first resident admitted," with the biggest variables being how fast your local jurisdiction processes zoning and fire marshal sign-off, and how complete your HHSC application package is on first submission. Applications that come in missing policy manual sections or staffing documentation get sent back for correction, which is the single most common cause of delay.
What staffing and training does Texas require?
Texas requires a licensed administrator for assisted living facilities, adequate direct-care staff coverage 24 hours a day, and documented initial and ongoing training for all direct care workers. Staffing ratios and training hour minimums differ by facility type (A, B, or C) and by whether you're licensed as an ALF versus an IDD or behavioral health group home. ALF administrators must hold a Texas Assisted Living Facility Administrator's license, which requires completing an HHSC-approved training program and passing an exam; this is separate from a nursing home administrator license and separate from any IDD program qualifications. Direct care staff generally need documented training in first aid, CPR, resident rights, abuse/neglect recognition and reporting, infection control, and, for facilities serving residents with dementia or significant cognitive impairment, dementia-specific care training. Criminal background checks are non-negotiable. HHSC requires fingerprint-based criminal history checks for owners, administrators, and employees with direct resident contact before they start work, run through the Texas Department of Public Safety and FBI databases via HHSC's centralized background check system. Skipping this step, or letting someone start work before clearance comes back, is one of the fastest ways to get a licensing action against you.
What do zoning and property requirements look like?
Zoning is often the part first-time operators underestimate most. Small group homes (typically six or fewer unrelated residents with disabilities) are generally protected as a residential use under the federal Fair Housing Act, meaning cities usually can't zone them out of single-family residential districts just because it's a group home. HUD's guidance confirms that reasonable accommodation requirements under the Fair Housing Act apply to local zoning decisions affecting group homes for people with disabilities [3]. That protection gets thinner as facility size grows. A home with 10, 15, or 20 beds starts looking, to a zoning board, more like a commercial or institutional use, and many municipalities require a special use permit, conditional use permit, or separate commercial zoning classification once you exceed a certain resident count. That threshold is set locally, not by the state, so you have to confirm it with your specific city or county planning department. Beyond zoning classification, the property itself has to pass local building and fire code review, which usually means: fire-rated doors and walls if you're licensed for six or more residents, adequate exit width and a second means of egress from sleeping areas, working smoke and carbon monoxide detectors in every bedroom and common area, and in many jurisdictions an automatic fire sprinkler system once you cross a certain occupant threshold. Get your local fire marshal to walk the property before you finalize a lease. It's a free conversation and it can save you from signing on a building that would need $40,000 in sprinkler retrofits to pass. For operators weighing whether to serve seniors from a private home setting versus a purpose-built facility, assisted living at home covers how that choice affects licensing scope.
Does Medicare cover assisted living facilities?
No. Medicare does not cover the cost of room and board or personal care in assisted living facilities. Medicare.gov states plainly that Medicare "doesn't cover: Long-term care... Room and board when the medical care you get is provided in an assisted living facility, group home, or other residential setting" [4]. Medicare will cover specific medical services delivered to someone who happens to live in assisted living, things like doctor visits, physical therapy ordered by a doctor, or short-term skilled nursing after a qualifying hospital stay, but it won't pay the facility's monthly rate for housing, meals, or personal care assistance. Medicaid is a different story and matters a lot for group home operators. Texas Medicaid, through HHSC's STAR+PLUS Home and Community Based Services (HCBS) waiver and other 1915(c) waiver programs, can cover personal care services and some residential supports for eligible low-income seniors and people with disabilities, though it typically does not cover room and board costs either. CMS's overview of Medicaid HCBS waivers confirms these programs are designed to let states cover "a broad array of home and community-based services" as an alternative to institutional care [5]. If Medicaid reimbursement is part of your business model, you'll need a separate provider enrollment process through HHSC in addition to your facility license, and that process has its own timeline and paperwork stack.
What's the difference between assisted living and a group home license, specifically in Texas?
| Assisted Living Facility (Type A/B/C) | Seniors, adults needing personal care | HHSC Long-term Care Regulatory | Health and Safety Code Ch. 247 [1] | |
|---|---|---|---|---|
| HCSSA (home and community support) | Home-based personal/health care clients | HHSC Long-term Care Regulatory | Health and Safety Code Ch. 142 | |
| IDD group home (HCS/ICF programs) | Adults with intellectual/developmental disabilities | HHSC IDD Program Services | 40 TAC Ch. 9, various subchapters | |
| Recovery residence | Adults in substance use recovery | Often voluntary certification, not state license | Varies; confirm with HHSC and local recovery residence councils | The practical takeaway: don't assume one license covers everything. A home serving both seniors with dementia and adults with IDD, for instance, may need to pick one primary population and license type, or maintain two separate certifications, depending on how HHSC classifies the mixed population. This is exactly the kind of question worth a phone call to HHSC before you draft floor plans. |
"Assisted living facility" is a specific licensed category under Texas Health and Safety Code Chapter 247, while "group home" is a general term that can mean an ALF, an IDD group home, a recovery residence, or a mental health residential setting, each governed by different rules. If you tell HHSC you want to open a "group home," the first question they'll ask is which population and which program, because the application forms diverge from there. Here's a comparison of how the major Texas categories differ: | Category | Typical population | Texas licensing authority | Core regulation |
What paperwork and policies does HHSC expect to see?
HHSC expects a full policy and procedure manual covering admission criteria, resident rights, medication management, emergency and disaster preparedness, staff training records, incident and grievance reporting, and infection control, submitted alongside your license application, not written after the fact. This manual is typically the largest single document in your application packet. At minimum, expect to produce: a resident admission agreement template, an emergency evacuation and disaster plan specific to your building, a medication management policy that matches your facility type's rules on self-administration versus staff administration, an abuse/neglect/exploitation reporting policy that matches Texas mandatory reporting law, a staff training and orientation curriculum with sign-off logs, and financial documentation showing you can operate for a reasonable startup period without immediate full occupancy. HHSC surveyors will cross-check your written policies against what they observe on the pre-licensing inspection. If your manual says medications are stored in a locked cabinet and the inspector finds an unlocked med cart, that's a citation on day one. Write policies that describe what you'll actually do, not what sounds good on paper, because inspectors check both. If you want to see how policy manual requirements compare across different facility types before drafting yours, assisted living breaks down the core categories operators confuse most often.
What happens during the pre-licensing inspection?
The pre-licensing inspection (often called a survey) is an on-site visit by an HHSC surveyor to confirm your building, staffing, and written policies actually meet the standards in your application before your license is issued. Expect the surveyor to walk every resident bedroom, bathroom, kitchen, and common area, check fire and life-safety equipment, review staff files and training documentation, and interview your administrator about emergency procedures. Common first-time citation areas include: missing or expired staff background check documentation, medication storage that doesn't match the facility's approved policy, missing or non-functional smoke detectors in individual bedrooms, incomplete resident admission paperwork, and fire drill logs that don't exist yet because no one has lived there to drill with. If the surveyor finds deficiencies, you'll typically get a written statement of deficiencies and a chance to submit a plan of correction before licensure is finalized; this is normal and most first-time applicants get at least a few minor findings. The goal isn't a perfect inspection, it's a facility that fixes findings fast and documents that it did. For a deeper walkthrough of what inspectors specifically look for room by room, see how facility assisted living requirements map onto inspection checklists.
Frequently asked questions
What is assisted living?
Assisted living is housing for adults, usually seniors, who need help with daily activities like bathing, dressing, or medication but don't need full-time skilled nursing care. It combines a private or semi-private living space with staff support, meals, and supervision, and in Texas it's licensed under Health and Safety Code Chapter 247 as an ALF.
What is a group home?
A group home is a residential setting where a small number of unrelated people live together with staff support or supervision. It's a general term, not one license; in Texas, depending on the population served, a group home might be licensed as an assisted living facility, an HCSSA, an IDD group home, or operate under separate recovery residence standards.
What is an assisted living facility?
An assisted living facility (ALF) is the specific licensed building or home where personal care services are provided to unrelated residents, typically four or more, under Texas Health and Safety Code Chapter 247. HHSC classifies ALFs as Type A, B, or C based on residents' mobility and cognitive needs, which determines staffing and evacuation requirements.
What is assisted living vs nursing home?
Assisted living provides help with daily tasks like bathing and medication in a residential setting, while a nursing home provides 24-hour skilled nursing care for people with significant medical needs, such as wound care or IV therapy. Nursing homes require licensed nurses on duty around the clock; assisted living does not.
How do I start a group home in Texas?
Pick your license category based on the population you'll serve, form a business entity, secure a property that meets zoning and fire code, hire qualified staff (including a licensed administrator for an ALF), write your policy manual, submit your application and fee to HHSC, and pass a pre-licensing inspection before accepting residents.
What is the difference between assisted living and a nursing home license in Texas?
Assisted living facilities are licensed under Health and Safety Code Chapter 247 and provide personal care, not skilled nursing. Nursing homes are licensed as skilled nursing facilities and must have licensed nursing staff on duty 24 hours a day, along with the ability to provide medical treatments assisted living facilities are not equipped or licensed to provide.
Does Medicare cover assisted living facilities?
No. Medicare does not cover room and board or personal care costs in assisted living facilities, group homes, or other residential settings, according to Medicare.gov. Medicare may cover specific medical services a resident receives, like doctor visits or short-term skilled nursing after a hospital stay, but not the facility's housing or care costs.
How much does it cost to open a group home in Texas?
There's no single statewide figure; costs depend on license type, building size, and whether you lease or buy. State licensing fees are typically the smallest cost bucket. The bigger costs are usually property renovation for fire and life-safety compliance and working capital for staff payroll before the home reaches full occupancy. Confirm current fees directly with HHSC.
How long does it take to get a group home license in Texas?
Most operators need three to nine months from initial decision to first resident admission, depending on how quickly local zoning and fire marshal approvals come through and whether the HHSC application package is complete on first submission. Missing policy manual sections or staffing documentation is the most common cause of delay.
Do I need a special zoning permit for a group home in Texas?
Small group homes serving people with disabilities are generally protected under the federal Fair Housing Act as a residential use, but this protection weakens as resident count grows. Many cities require a special use or conditional use permit once a facility exceeds a locally set resident threshold, so confirm zoning rules with your city or county planning department before signing a lease.
What license do I need to serve adults with IDD in a Texas group home?
Group homes serving adults with intellectual or developmental disabilities are typically licensed through HHSC's IDD program services, often tied to Home and Community-based Services (HCS) or Intermediate Care Facility (ICF) program enrollment, rather than the Chapter 247 assisted living license used for senior care homes. Confirm the exact program pathway with HHSC before applying.
Do group home staff need background checks in Texas?
Yes. Texas requires fingerprint-based criminal history checks through HHSC's centralized background check system for owners, administrators, and any employee with direct resident contact, run against Texas DPS and FBI records. Staff generally cannot begin unsupervised work with residents until clearance results come back.
What does assisted living provide that a plain group home doesn't?
Licensed assisted living typically provides structured meals, staff-supervised medication management, 24-hour trained staff coverage, and a formal plan of care for each resident, all documented under state rule. A less formal group home arrangement may lack these documented staffing ratios and medication protocols unless it's also separately licensed.
Sources
- Texas Health and Human Services, Assisted Living Facilities Requirements: Definition of assisted living facility, staffing sufficiency requirement, and Type A/B/C classification
- Medicare.gov, Nursing Home Care: Nursing homes provide skilled nursing and rehabilitation services distinct from assisted living
- CMS, Home & Community-Based Services 1915(c): Medicaid HCBS waivers allow states to cover home and community-based services as an alternative to institutional care
- Texas Health and Safety Code, Chapter 247: Statutory basis for assisted living facility licensing in Texas
- Texas Health and Safety Code, Chapter 142: Statutory basis for home and community support services agency (HCSSA) licensing
- Texas Secretary of State, Business Formation: Process for forming an LLC or other business entity in Texas