How to start a group home in Texas

How you start a group home in Texas depends on who you serve. For seniors, a 1–3 resident home needs no license (Adult Foster Care); 4+ needs an assisted living license. For adults with intellectual or developmental disabilities, you become an HCS provider (up to 4 residents per home) or open a licensed ICF/IID.

Written by Erika Crossley, senior living operator — not an attorney · Information last verified June 2026

This is general information, not legal advice. Erika Crossley is not an attorney. Texas law here turns on your specific property, your recorded deed restrictions, your city, and your individual residents — and municipal ordinances change without notice. Every document she prepares is a first draft for review and signature by your own licensed Texas attorney before it is used with a resident. No outcome, including license approval or permit approval, is guaranteed. Do not buy a property in reliance on this page. Take it to a Texas attorney first.

Pick your path

—Seniors, 1–3 residents: Adult Foster Care — no license, HHSC enrollment, you live in the home.
—Seniors, 4+ residents: Type A or Type B assisted living license.
—Adults with IDD: HCS provider (Home and Community-based Services) — up to 4 residents per home, contracted through HHSC.
—Higher-support IDD: a licensed ICF/IID facility with federal Medicaid certification.

What the IDD path actually requires

Becoming an HCS provider is not just an LLC and a house. Texas requires roughly three years of paid experience providing services to people with IDD (or a qualifying microboard), completion of the HHSC Pre-Application Orientation, and that you apply during an open-enrollment window. There is also a federal Medicaid application fee (about $750 in 2026). It is the highest-revenue group-home path, and we walk you through every requirement.

Match me to the right group-home path →

Common questions

Can I open a group home in Texas without a medical background?

For a senior Adult Foster Care or assisted living home, yes — you do not need a medical background to own it. The HCS (IDD) path is different: it requires about three years of paid IDD-services experience to become a provider.

How many people can live in a Texas group home?

It depends on the path: Adult Foster Care is 1–3, an HCS group home is up to 4, and a licensed ALF or ICF/IID can serve more.

Is a group home profitable in Texas?

It can be. IDD homes bill Medicaid by the resident’s assessed level of need, and senior homes earn private-pay or Medicaid rates. Profitability depends on your costs, occupancy, and payer mix.

Related license types

HCS Group Home (IDD) →ICF/IID →Adult Foster Care →