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.

Reviewed by Erika Crossley, Texas senior care startup specialist · Information last verified June 2026

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 →