How to Become a Licensed HCSSA Provider

The Texas Department of Aging and Disability Services (DADS) licenses, certifies and surveys home and community support services agencies (HCSSAs) for compliance with state and federal laws and regulations. Through these regulatory activities, DADS protects Texas citizens receiving home health, hospice and personal assistance services.

HCSSAs must be licensed to operate in Texas. To become licensed, an agency must:

Required Documents for an Initial License

Applications and required fees must be sent to:

Regular mail
Regulatory Services
Accounts Receivable
Mail Code E-411
Texas Department of Aging and Disability Services
P.O. Box 149030
Austin, Texas 78714

Overnight delivery
Regulatory Services
Accounts Receivable
Mail Code E—411
Texas Department of Aging and Disability Services
701 West 51st St.
Austin, Texas 78751

Please see the Licensing Standards for Home and Community Support Services Agencies Handbook for more information.

Initial Branch, Alternate Delivery Site and Medicare Branch Applications

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Required Legal Entity Documents

Medicare Certification

Participation in the state and federal Medicaid program and the federal Medicare program is voluntary. However, each agency must be certified for the appropriate Medicare program before serving clients who are eligible for this program.

Attention: Applicants seeking an initial parent or alternate delivery site license to provide licensed and certified home health services (authorization to provide services to Medicare beneficiaries) should read Provider Letter #15-10, Direction from the Centers for Medicare & Medicaid Services (CMS) on Prioritization of Initial Medicare Certification Surveys.

Accreditation Agencies

Required Documents for Medicare Certification

These documents are required if the agency is seeking certification or is currently certified through the Medicare program.

Attention: Home health and Hospices agencies that are (1) initially enrolling in Medicare, (2) adding a branch or multiple location, or (3) revalidating their enrollment information, must submit with their CMS 855 application:

  • Verification of the application fee in an amount prescribed by CMS, and/or
  • A letter for a request for a hardship exception to the application fee.

The provider must pay the application fee electronically through, either via credit card or debit card. The application fee applies to CMS 855 applications that the agency's Regional Home Health Intermediary/Medicare Administrative contractor (MAC) receives on or after March 25, 2011.

The following links provides additional information and the current application fee process:

Time frames

An application from an agency for an initial parent, branch office or alternate delivery site license is processed in accordance with three general time frames:

  • Upon receipt of a thoroughly complete application in the DADS HCSSA Licensing Branch (this will be after it has gone through the mail room and accounting; about 10 days from mailing), DADS will issue or deny the license within 45 days.
  • If DADS receives an incomplete application, the DADS HCSSA Licensing Branch will notify the HCSSA applicant in writing of any deficient items in the application. The applicant must respond with complete and correct information within 30 days from the date of the letter or the application will be denied.
  • Upon receipt of the application deficiency response in the DADS HCSSA Licensing Branch, DADS will issue or deny the license within 45 days.

After an initial license is issued, the agency must notify the DADS regional office upon enrolling its first client and request an initial health survey using DADS Form 2020, Notification of Readiness for Initial Survey. After an initial license is issued for an alternate delivery site with or without an inpatient unit, the hospice agency must notify the DADS regional office upon enrolling its first client and request an initial health survey using DADS Form 2020-A, Notification of Readiness for a Health Survey of a Hospice Inpatient Unit (currently under development). This survey request must be completed within six months of the issuance of the initial license. Licensing surveys will continue to be done at regular intervals and must be passed in order for the agency's license to be renewed. For an agency to retain its license, any inspection, survey, follow-up visit or complaint/incident investigation must show that the agency is in compliance with the current state licensure or federal certification laws and rules, or both.

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State and Federal Regulations and Requirements

Click here for a list of all applicable state and federal regulations and requirements. HCSSA providers are responsible for reading and understanding these regulations prior to becoming a licensed provider.

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Related Links

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Regular Surveys and Investigations of Complaints and Incidents

DADS conducts on-site surveys of HCSSAs after issuance of the initial license, 18 months after the initial survey and every 36 months thereafter to ensure that they are in compliance with state licensure and federal certification regulations. Initial surveys for some changes of ownership may be conducted by desk review.

DADS conducts on-site investigations or desk reviews for all self-reported incidents received from agencies and complaints from clients, family members, friends and others. Surveyors initiate investigation of complaints and incidents in agencies within 24 hours, 2 days, 10 days, 45 days, 90 days or at the time of the next on-site survey, depending on the priority assigned by the intake program specialist who receives the complaint or incident report. The priority is based on the immediacy and seriousness of the allegation. Complaint and complainant information is confidential and is not shared with the agency.

If surveyors find a state licensure violation or federal deficiency during a visit, survey staff may make a follow-up visit to ensure that the agency has corrected the violation or deficiency and is in compliance with the regulations. All surveys and investigations are unannounced. DADS does not notify agencies prior to conducting surveys, follow-up visits or investigations. For information on how to report a complaint, please visit the DADS Consumer Rights and Services Complaint Intake section website.

Survey Reports

When the surveyor completes the survey, investigation, follow-up or other visit, he or she writes a report of the findings detailing the agency’s noncompliance with state or federal regulations, which are called violations and deficiencies, respectively. Interested parties may request survey results by contacting the Consumer Rights and Services Complaint Intake section at 1-800-458-9858.

Enforcement Actions

Once the surveyor completes the report, the HCSSA program manager reviews the findings to provide guidance to the surveyor and to determine if an enforcement action is necessary due to noncompliance with a federal condition of participation or a state licensure violation. An array of enforcement actions are available under state licensing laws, including actions against an agency’s license and monetary sanctions called administrative penalties. For HCSSAs with a Medicare provider agreement, recommended sanctions may include revocation of the Medicare provider number.

State and federal regulations give agencies the right to request an informal review of deficiencies to refute the cited violations/deficiencies and to appeal enforcement actions.

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Updated: October 1, 2015