McAllen Senior AdvisorWhat license does a home care agency need in Texas?
Any agency that sends staff into a home to provide health or personal care needs a Home and Community Support Services Agency (HCSSA) license from HHSC under 26 TAC Chapter 558, issued with one or more service categories.
| HCSSA service category | What it allows |
|---|---|
| Licensed home health services | Skilled nursing, therapy and home health aide visits ordered by a physician |
| Licensed and certified home health services | The same, plus Medicare and/or Medicaid certification so the agency can bill those programs |
| Hospice services | Comfort-focused care for a person with a terminal illness, usually paid by the Medicare hospice benefit |
| Personal assistance services (PAS) | Hands-on help with bathing, dressing, grooming, meals and housekeeping by attendants; no skilled nursing |
The categories matter more than the agency's name. An agency licensed only for personal assistance cannot send a nurse to change a wound dressing, and an agency licensed for home health but not certified cannot bill Medicare for those visits.
How many licensed home care agencies are in Hidalgo County?
HHSC's directory lists 257 agencies in Hidalgo County licensed only for personal assistance services, plus 126 home health agencies that also hold a personal assistance license and 52 hospices, for 486 licensed home care offices in the county.
That density is unusual even for Texas, and it reflects how much in-home attendant care Medicaid pays for in the Valley. It also means families have choices, and that agencies vary. Our home health and hospice roster and personal care agency roster list them all with license numbers and first-license dates.
What is the difference between a branch and a parent agency?
A parent agency holds the license, and a branch office or alternate delivery site operates under it; HHSC's directory marks each office, which is why one company can appear more than once in a city.
When comparing agencies, look at the parent: that is where the license, the administrator and the supervising nurse sit. Ask how many clients the McAllen or Edinburg office serves, who supervises the attendants in your parent's town, and how backup coverage works when an attendant calls in sick at 6 a.m.
What should families ask a Valley home care agency?
Ask which license categories the agency holds, whether it is Medicare-certified if Medicare is paying, which STAR+PLUS plans it contracts with if Medicaid is paying, and how it screens and trains the attendant who will be in your parent's home.
- Is the attendant an employee of the agency, and is the agency bonded and insured?
- Who is the supervising nurse, and how often will they visit?
- How are schedules recorded? Texas Medicaid attendant visits use electronic visit verification.
- Can the same attendant come each day, and does the attendant speak the language your parent prefers?
- How do you report a problem, and to whom?
Complaints about a licensed agency go to HHSC Complaint and Incident Intake at 1-800-458-9858.
Side by side
| An HCSSA license shows | An HCSSA license does not show | |
|---|---|---|
| Legality | The agency may provide the listed services in Texas | That it is Medicare-certified unless the category says so |
| Scope | Which categories: home health, hospice, personal assistance | Which towns it actually covers |
| Quality | That it met licensing standards | A rating; Texas does not rate agencies |
| Payment | Nothing about which health plans it contracts with | Whether STAR+PLUS will pay this agency |
Sources: Texas Health and Safety Code ch. 247 and 242; 26 TAC chapters 553, 554, 558 and 559; HHSC directories, TULIP and handbooks; CMS; CareScout; VA rate tables, as cited above. See our editorial standards.
