Texas Home Care Agencies: License and Registry Checks

In Texas, home health, hospice and personal assistance agencies must hold a Home and Community Support Services Agency (HCSSA) license from the Texas Health and Human Services Commission. You can look up an agency in the HHSC Long-term Care Provider Search on the TULIP portal. Agencies must check unlicensed staff against state registries before hire. Suspected abuse of an older adult at home goes to the Texas Abuse Hotline at 1-800-252-5400.

Who licenses in-home care providers in Texas

Texas Health and Human Services Commission (HHSC), HCSSA Licensing and Certification. HCSSAs must be licensed to operate in Texas. License categories include Personal Assistance Services, Licensed Home Health Services, Licensed and Certified Home Health Services (Medicare certified), versions of both home health categories with a home dialysis designation, Hospice, and Hospice with an Inpatient Unit. To verify an agency, open the TULIP Long-term Care Provider Search, choose the program and service type, and search by name, license number, city, ZIP code or county.

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Key facts for Texas

HHSC licenses, certifies and surveys home and community support services agencies, which provide home health, hospice and personal assistance services.
Personal Assistance Services is the HCSSA category for routine ongoing help with activities of daily living in a home, and it includes respite.
Texas law exempts from HCSSA licensing an individual hired and paid directly by the client or the client's family or legal guardian to provide home health or personal assistance services.
HCSSAs must search the Nurse Aide Registry and Employee Misconduct Registry before hiring an unlicensed worker with client contact, and at least every 12 months after.
HHSC says a person listed on the Employee Misconduct Registry is permanently unemployable in any HHSC-regulated agency or facility in Texas.
Starting August 3, 2026, HCSSAs must use the Search Engine for Multi-Agency Reportable Conduct (SEMARC), plus the Nurse Aide Registry, to decide whether a person is employable.
Texas law requires anyone with reasonable cause to believe a person 65 or older, or an adult with disabilities, is being abused, neglected or exploited to report it to DFPS.
STAR+PLUS is a Texas Medicaid managed care program for adults age 65 or older and adults with disabilities, and its long-term services include help at home with daily activities.

Which home care providers need a Texas license?

Texas calls licensed home care providers Home and Community Support Services Agencies, or HCSSAs. HHSC says HCSSAs must be licensed to operate in Texas. HHSC licenses, certifies and surveys them to protect people receiving home health, hospice and personal assistance services.

Per the HCSSA FAQs, the license categories are:

Personal Assistance Services (PAS): routine, ongoing help with activities of daily living at home, including respite. This is the non-medical category.
Licensed Home Health Services: medical, nursing and related care at home. It can carry a home dialysis designation.
Licensed and Certified Home Health Services: home health that is also Medicare certified and must meet federal rules at 42 CFR Part 484.
Hospice and Hospice with an Inpatient Unit.

One agency can hold several categories. Make sure the category on the license matches the care you want. An agency licensed only for personal assistance services is not licensed to provide home health care.

A caregiver you hire and pay directly does not need an HCSSA license. Texas Health and Safety Code 142.003 exempts an individual hired and paid directly by the client or the client's family or legal guardian. In that case there is no agency license to check, and your own screening matters more.

How do I look up a Texas home care agency's license?

Use the Long-term Care Provider Search on HHSC's TULIP portal. HHSC says it covers home health, hospice and personal assistance services.

Pick the program type and the service type you need.
Search by provider name, license number, city, ZIP code or county.
Open the agency's record and compare its name, address and service categories to what the agency told you.

The search page notes that home health and hospice agencies may serve counties other than the one they are registered in. A search by county shows agencies serving that area even if they are registered elsewhere.

Which worker registries apply in Texas?

Under 26 TAC 558.247, an HCSSA must search the Nurse Aide Registry (NAR) and the Employee Misconduct Registry (EMR) before hiring an unlicensed worker who will have face-to-face contact with clients. It may not employ anyone listed as unemployable in either registry, and it must search again at least every 12 months.

The EMR lists unlicensed staff with confirmed findings of abuse, neglect or exploitation. HHSC says a person on the EMR is permanently unemployable in any HHSC-regulated agency or facility. HHSC also says its Employability Status Check Search is open to the public and searchable by name or Social Security number.

The system is changing. HHSC's HCSSA FAQs say HCSSAs must use the Search Engine for Multi-Agency Reportable Conduct (SEMARC), plus the NAR, to determine employability starting August 3, 2026. SEMARC draws on the EMR and records from other state agencies. It is open only to authorized users, not the public.

You can check a certified nurse aide's status yourself in the TULIP public registry. HHSC no longer issues written verification of nurse aides and points the public to that search. For an agency caregiver, ask the agency to confirm in writing that it ran the required registry and criminal history checks.

How do I report abuse or a problem with a caregiver in Texas?

In an emergency or a life-threatening situation, call 911 or local police first.

Report suspected abuse, neglect or exploitation of a person 65 or older, or an adult with a disability, to the Texas Abuse Hotline at 1-800-252-5400 or TxAbuseHotline.org. It runs 24 hours a day. Adult Protective Services, part of the Department of Family and Protective Services, investigates for adults living in the community and can arrange short-term help.

For complaints about unlicensed staff at an HHSC-regulated agency, HHSC lists its Complaint and Incident Intake line at 1-800-458-9858.

What is STAR+PLUS, and where do I apply?

STAR+PLUS is a Texas Medicaid managed care program for adults who have disabilities or are 65 or older. Its long-term services and supports include help at home with basic daily activities, home changes for safe movement, and short-term care that gives caregivers a break.

A person must first be approved for Medicaid and meet program criteria. People with Medicare can often enroll too, and STAR+PLUS does not change how they get Medicare services. Members choose a health plan in their area and get a service coordinator. To apply, use the state's online Medicaid application or call 2-1-1. HHSC decides eligibility, so check its page for the full rules.

How to choose a provider in Texas

Look up the agency in the HHSC TULIP Long-term Care Provider Search before you sign anything.
Match the license category to the care: Personal Assistance Services for non-medical help, a home health category for nursing or therapy.
If you need Medicare-covered home health, confirm the agency holds Licensed and Certified Home Health Services.
Ask the agency to confirm in writing that each caregiver passed the required registry checks and a criminal history check.
Check a certified nurse aide's status yourself in the TULIP public registry.
If you hire a caregiver directly, know that no HCSSA license applies and run your own references and background checks.
Ask how the agency handles a missed shift and how fast it sends a replacement.
Keep the Texas Abuse Hotline number, 1-800-252-5400, where family members can find it.
If cost is a barrier, ask HHSC or 2-1-1 whether the person may qualify for STAR+PLUS.

In-home care in Texas cities

Houston

Questions people ask

Does a home care agency need a license in Texas?

Yes. Agencies that provide home health, hospice or personal assistance services must be licensed by HHSC as Home and Community Support Services Agencies. The license lists which categories of service the agency may provide.

How do I check a Texas home care license?

Use the Long-term Care Provider Search on HHSC's TULIP portal. Choose the program and service type, then search by agency name, license number, city, ZIP code or county. Compare the categories listed to the care you need.

Does a private caregiver I hire need a Texas license?

No HCSSA license is needed for an individual hired and paid directly by the client or the client's family or legal guardian, under Texas Health and Safety Code 142.003. You become responsible for screening the caregiver yourself.

What is the Employee Misconduct Registry?

It is an HHSC registry of unlicensed workers with confirmed findings of abuse, neglect or exploitation. HHSC says a listed person is permanently unemployable in HHSC-regulated agencies and facilities. Agencies must check it, along with the Nurse Aide Registry, before hiring unlicensed staff.

What changed with SEMARC in 2026?

HHSC says that starting August 3, 2026, HCSSAs must use the Search Engine for Multi-Agency Reportable Conduct, plus the Nurse Aide Registry, to determine whether a person is employable. SEMARC combines the EMR with records from other state agencies and is limited to authorized users.

Where do I report abuse of an older adult at home in Texas?

Call the Texas Abuse Hotline at 1-800-252-5400 or report at TxAbuseHotline.org. Call 911 first in an emergency. For complaints about staff at an HHSC-regulated agency, HHSC lists its Complaint and Incident Intake line at 1-800-458-9858.

Does STAR+PLUS pay for help at home?

STAR+PLUS is a Texas Medicaid managed care program for adults 65 and older and adults with disabilities. Its long-term services include help at home with daily activities and short-term respite. Eligibility is set by HHSC, and you apply through the state's Medicaid application or by calling 2-1-1.

Sources

This guide was written by our editorial team from the public sources listed above. It is general information, not legal or medical advice; confirm licensing and terms directly with any provider.

How to check a home care agency in Texas