14900, Four-Person Residence Approvals

Revision 22-1; Effective February 4, 2022

Home and Community-based Services (HCS) providers must request and obtain approval of all four-person residences from HHSC. LTCR is responsible for reviewing and approving all four-person residence requests in accordance with 40 TAC, Chapter 9, Subchapter D, §9.188.

 

14910 Four-Person Residence Approval Policy and Procedures

Revision 22-1; Effective February 4, 2022

To obtain approval of a four-person residence, the program provider must complete the following steps:

Complete Form 8491, Request for a Four-Person Residence Approval, and send it using any of the following methods:

Email: HCSFourPersonResidenceRequests@hhs.texas.gov 
Fax: 512-438-4148
Mailing address: 
Texas Health and Human Services Commission
WSC Residential Survey Coordinators, Mail Code E-348
P.O. Box 149030
Austin, TX 78714-9030

Include the following information:

  1. For a new home, enter information into the Client Assignment and Registration System (CARE) Screen C25 Provider Location Type Modification (two screens).
    • Header Screen (first screen) – Enter the Component Code, Location Code, "A" for Add and press enter.
    • Data Entry Screen (second screen) – Cursor will be blinking at Location Type; enter "4"; cursor will move to the next line; enter the effective date. The cursor then moves to "Ready to Add?" Enter "Y" and press enter.
  2. Establish location in CARE Screen C24 Provider Location (for new homes only). Refer to the User's Guide for data entry questions: https://hhsportal.hhs.state.tx.us/helpGuide/Content/16_CARE/WaiverPDF/MRA%20User%20Guide.pdf (Note: The CARE User's Guide is only available for those with access to the CARE system.)
  3. Send the following supporting documentation to HCSFourPersonResidenceRequests@hhs.texas.gov:
    • Current date;
    • Name of the agency;
    • Contact person and area code and phone number;
    • Component code and contract number;
    • Location code for the residence;
    • Address and county of the residence (including the ZIP code);
    • Certification from the program provider that the program provider intends to provide residential support to one or more individuals who will live in the residence; and
    • Written certification from the program provider that the residence to be approved is not the residence of any person except a person permitted to live in the residence, as described in 40 TAC, Chapter 9, Subchapter D, §9.153(39), relating to definitions.
  4. A current copy of the residence’s  certification as required by 40 TAC, Chapter 9, Subchapter D, §9.178(e)(1)(A), relating to certification principles and quality assurance:
    • the local fire safety authority having jurisdiction in the location of the residence as being in compliance with the applicable portions of the National Fire Protection Association (NFPA) 101: Life Safety Code, as determined by the local fire safety authority;
    • the local fire safety authority having jurisdiction in the location of the residence as being in compliance with the applicable portions of the International Fire Code (IFC), as determined by the local fire safety authority; or
    • the Texas State Fire Marshal’s Office as being in compliance with the applicable portions of the Life Safety Code, as determined by the Texas State Fire Marshal’s Office; or
    • the Texas Health and Human Services Commission (HHSC) as being in compliance with the portions of the Life Safety Code applicable to small residential board and care facilities and most recently adopted by the Texas Fire Marshal’s Office.

The program provider may ask the local fire authority to complete Form 5606, Life Safety Code Certification, to verify the inspection, if needed.

If the local fire authority refuses to inspect the residence, the program provider must ask the State Fire Marshal to inspect the residence. If both the local fire authority and the State Fire Marshal refuse to inspect the residence, a request may be made to HHSC to complete the inspection. Program providers must use Form 5604, HCS Program Provider Request for Life Safety Inspection, to request the inspection.

After initial full approval of a four-person residence, the program provider is required to maintain annual fire marshal certifications required by 40 TAC §9.178(e)(3)(A).

The HCS program provider can check the HHSC data system to see if the home has been approved.

For questions, contact HHSC Long-Term Care Regulation – HCS and TxHmL by email at HCSFourPersonResidenceRequests@hhs.texas.gov