How much does it cost to start a care home in Texas?

The exact government fees (these never change)

• —Texas LLC (Secretary of State, Form 205): $300, one time.
• —Background check (IdentoGO + DPS + FBI): $39.75 per person.
• —Adult Foster Care (1–3 residents): $0 — no license, just HHSC enrollment.
• —Boarding Home: $0 state license; some cities charge a local permit (Houston ~$307 first year).
• —Type A or Type B ALF license: $300 base + $15 per bed, capped at $2,250 for a 3-year license. A 16-bed home is $540.
• —ICF/IID: $225 + $7.50 per bed, plus federal Medicaid certification.
• —HCS group home: provider contract, plus a federal Medicaid application fee (~$750, 2026).

The variable costs (where the real money goes)

Government fees are the smallest part. What actually moves your budget is the property and getting it care-ready. Turning a normal Texas house into a licensable small care home typically runs about $15,000–$50,000+ (ramps, an accessible bathroom, grab bars, fire-rated doors, and a sprinkler retrofit if one is needed). Liability insurance, initial staffing, and a few months of operating runway round it out.

A larger ground-up assisted living building is a different category entirely — a multi-million-dollar construction project. Most first-time operators start small, prove the model, then scale.