Special Care Facilities

As defined by Texas Health and Safety Code Section 248.002, a special care facility is an institution or establishment that provides a continuum of nursing or medical care or services primarily to persons with acquired immune deficiency syndrome or other terminal illnesses. Special residential care facilities are considered SCFs.

Texas Health and Safety Code Chapter 248 establishes the state licensing requirements for SCFs. Under state law, HHSC is responsible for the licensing and regulation of SCFs in Texas, and the Regulatory Services Division within HHSC carries out these duties.

HHSC adopts rules for SCFs including establishing standards for:

  • Licensing procedures and fees
  • License denial, probation, suspension, and revocation
  • Qualifications, duties, and supervision of professional and nonprofessional personnel and volunteers
  • Facility residents' rights
  • Medical and nursing care and services provided by a license holder
  • Facility organizational structure, lines of authority, delegation of responsibility, and facility operational requirements
  • Recordkeeping, including the disposal or destruction of those records
  • Any facility aspects necessary to protect the public or facility residents
  • Inspection, investigation, and enforcement procedures
  • Design, construction, fire prevention, sanitary, and safety requirements

SCFs are not certified to participate in the federal Medicare Program.

Laws and Rules

Texas Laws

Find or Verify a License


An applicant seeking an SCF license must submit a completed application, license fee, and other applicable documents to HHSC. The Health Facility Licensing Unit will not process an application until after HHSC Accounts Receivable receives and posts the license fee.

Refer to the application or instructions linked in this section for specific requirements.

HHSC must review and approve all required application materials received before issuing a license to an applicant.

Initial Licensure Application

Change of Ownership Application

Relocation Application

Architectural Review Information and Forms

Refer to the Architectural Review information.

Complaint and Incident Submission Information

Inspection Components

HHSC conducts health compliance on-site inspections to determine compliance with the provisions of the Health and Safety Code and associated rules listed in the Laws and Rules section of this page. During the inspection, HHSC staff generally perform the following activities:

  • Conduct an entrance and an exit conference with applicable facility personnel
  • Explain the inspection process and answer questions
  • Review clinical records
  • Review facility and personnel records
  • Review facility policies and procedures
  • Review quality assurance activities
  • Interview staff
  • Assess the facility’s compliance with applicable statutes and rules
  • Discuss final inspection findings with applicable facility personnel

Enforcement Actions

Human Trafficking Resources

Ethics or Medical Committee Reporting

Texas Health and Safety Code Chapter 166, Subchapter B, Section 166.054, as added by 88(R) HB 3162, requires health care facilities to report information regarding ethics or medical committee processes when an attending physician refuses to honor an advance directive or health care decision made by or on behalf of a patient who is determined to be incompetent or is otherwise mentally or physically incapable of communication. Facilities must submit a report no later than the 180th day after the facility notifies the person responsible for the patient's health care decision in writing regarding the review process as required by Section 166.046(b), as amended by 88(R) HB 3162.

The following form is required to be submitted by the facility to DAP:

For assistance completing the online forms, for technical support, or to provide feedback on the user experience, email Ethics or Medical Committee Reporting.

For questions regarding regulatory reporting requirements, email Health Care Regulation.

Contact Information

Health Care Regulation

Contact HCFR program staff for questions on health care regulation.

Health Care Facility Enforcement

Phone: 512-438-5439
Fax: 512-438-3697
Email: Health.Facilities.Enforcement@hhsc.state.tx.us

Mailing Address:
Texas Health and Human Services Commission
Regulatory Services Division
Health Care Facility Enforcement, MC 1866
P.O. Box 149347
Austin, TX 78714-9347

Open Records Requests

Texas Health and Human Services is committed to providing full access to public information. Read Open Records Policy and Procedures for information on how to submit an open records request.