Many caregivers and entrepreneurs in North Texas dream of opening a small residential care home — a house in a regular neighborhood where a handful of older adults receive personal, attentive care. It’s rewarding work, and it requires careful planning. This overview walks through the main steps so you know what to expect. Requirements change, so always confirm current rules with Texas Health and Human Services (HHSC).
1. Understand what a residential care home is in Texas
In Texas, a residential care home that provides personal care to older adults is typically licensed as an assisted living facility (ALF) by HHSC. Even a small home serving only a few residents generally needs a license when it provides personal care services. Many people call these homes “residential care homes,” “care homes” or “small assisted living homes.”
2. Decide between Type A and Type B
Texas assisted living facilities are licensed by type, based on the residents they serve:
- Type A — residents who don’t need routine staff attendance while sleeping and can follow directions in an emergency.
- Type B — residents who may need help evacuating, may not be able to follow emergency directions, and may need attendance at night.
Your choice affects building requirements, staffing and the residents you can admit, so it’s one of the first decisions to make.
3. Plan your home, budget and staffing
Before applying, think through the property (location, layout, accessibility and safety features), your startup budget, how you’ll staff the home day and night, and the services you’ll offer — such as help with bathing, dressing, medication assistance, meals and memory care support.
4. Complete the HHSC licensing process
According to HHSC, the licensing process for an assisted living facility generally includes:
- Completing the required pre-survey, computer-based training
- Submitting an application through HHSC’s online licensing portal, along with required documents and fees
- Providing an approved fire marshal inspection
- Passing a Life Safety Code inspection and a health inspection
Fees, forms and timelines change, so check the HHSC website for the latest requirements before you begin.
5. Prepare policies, forms and training
Written policies and procedures, admission packets, medication records, incident reports and caregiver training materials are part of running a well-organized home. Care Home Association offers policies, forms and manuals and training resources, with reduced pricing for members.
6. Build your network
Relationships matter. Connecting with other care home owners, home health and hospice agencies, pharmacies and referral sources helps you learn and grow. That’s exactly what Care Home Association membership is for.
Get help with your startup
Care Home Association offers paid residential care home startup consulting for people planning to open a care home in North Texas. Consulting supports your preparation but is not a guarantee of licensing approval — that decision rests with HHSC. Call 972-693-1646 to talk about your plans.
