Full Definition

A Home and Community Support Services Agency (HCSSA) is the Texas-specific term for an agency licensed by HHSC to provide home-based health and support services. Texas licenses three categories of HCSSAs: home health (skilled nursing and therapy), personal assistance services (non-medical aide services), and hospice.

HCSSAs must meet Texas licensing requirements, including minimum staffing standards, patient rights protections, quality assurance programs, and compliance with HHSC survey standards. Like nursing facilities and assisted living communities, HCSSA inspection reports are public records.

For families selecting home health or home care agencies in Texas, verifying that the agency holds a current HCSSA license is a basic but important due diligence step. License status can be confirmed through the HHSC website. Unlicensed home care providers — sometimes called “gray market” or “registry” workers — are not subject to the same oversight, background check requirements, or consumer protections.

HCSSAs that are Medicare-certified must also meet federal Conditions of Participation and are subject to CMS oversight and public quality reporting through Medicare’s Care Compare. Families should use both the Medicare quality data and the Texas HHSC licensure record when evaluating home health agencies.