Texas Home Care Policies and Procedures

Texas home care policies and procedures: what HHSC actually requires

Every home care and home health provider in Texas is licensed as a Home and Community Support Services Agency (HCSSA) by the Texas Health and Human Services Commission (HHSC). The rules sit in 26 Texas Administrative Code Chapter 558, adopted under Chapter 142 of the Texas Health and Safety Code. A written policies and procedures manual is not optional paperwork. It is a core component of your license application and the document HHSC surveyors read closely during your initial licensure survey.

Whether you apply for Personal Assistance Services (PAS), Licensed Home Health Services, or a combined category, your manual has to show in writing exactly how your agency will deliver and oversee care. Thin, generic templates fail here, because a surveyor checks your policies against the specific standards in Chapter 558, not against a national average.

The policy and procedure categories Texas expects

The Chapter 558 minimum standards for all agencies drive most of what your manual must contain. At a minimum, expect to write and maintain policies covering:

• Client rights and responsibilities: the written notice of rights, the complaint and grievance process, and advance directive information given at admission.
• Individualized plan of care: how you assess each client, build the plan of care or service plan, obtain physician orders where required, and review it on schedule.
• Infection control: standard precautions, bloodborne pathogen controls, and safe handling of supplies in the home.
• Emergency preparedness: a written disaster plan that classifies clients by acuity and sets out response and continuity of care.
• Personnel qualifications and competency: administrator and supervising nurse requirements, background and registry screening, orientation, and ongoing in-service training.
• Quality assessment and performance improvement (QAPI): an ongoing program to monitor care, track complaints and outcomes, and record corrective action.
• Incident, abuse, neglect and exploitation reporting: how you self-report and investigate within the timeframes HHSC sets.
• Medication management: for agencies providing skilled nursing, safe administration, storage, and reconciliation under physician direction.
• Client records, confidentiality and HIPAA: clinical record content, retention, and protection of health information.

Why borrowed manuals get agencies into trouble

A manual built for another state, or copied from a competitor, will reference the wrong agency, the wrong regulator, and the wrong rule structure. Texas has its own administrator and supervising nurse qualifications, its own incident reporting expectations, and its own survey process. When a surveyor finds policies you cannot actually follow, or that contradict Chapter 558, the result is deficiencies, a plan of correction, and a delayed license. For the full Texas route, see our Texas home care licensing guide.

How Cura builds your Texas policies and procedures manual

We write a Texas-specific HCSSA policies and procedures manual mapped to 26 TAC Chapter 558 and matched to the license category you are applying for. Every policy is written so your team can actually operate it, and so it holds up when a surveyor asks to see it in practice. It is delivered as part of a fixed price agreed in writing before any work begins, alongside the rest of your application.

If you are starting from scratch, our Texas Licensed Home Health Services application support package includes the manual, the application build, and submission, so you are not assembling compliance documents alone. Book a free discovery call and we will map exactly what your Texas licensure will require.