Clarification of HH/CC & RSS/SL On-Site Inspections In Ch 565 of HCS TAC

by | Jan 30, 2026

January 30th, 2026

As of January 29th, 2026, I received clarification from HCS/TxHmL policy that the HCS provider no longer has to specifically provide the SC with a copy of the on-site inspection results within 5 days of inspection, according to Ch 565 TAC.  This does apply to both RSS/SL (Group Homes) and HH/CC homes on-site inspections.  Basically, my understanding is that there is no timeline, other than upon request. So you must maintain the inspection report or completed form in the individual’s records and provide if requested by HHSC, LIDDA, CMS or other appropriate authority. 

Below is the response I received:

“Thank you for attending the HCS/TxHmL IDD/PI Webinar on Jan. 27th, 2026, and for your inquiry. The slide and discussion you are referring to were related to an inquiry submitted directly to HHSC and pertained specifically to HH/CC; we were providing the response from HHSC to that particular inquiry. Per 26 TAC 565.25, before any program services are provided in the residence, the program provider must conduct on-site inspections, including a residence in which supervised living and residential support is provided as described in 26 TAC 565.25(a)(1), which states the following:

(a) Before providing services to an individual in a residence in which supervised living or residential support is provided, and annually thereafter, the program provider must:

(1) conduct an on-site inspection to ensure that, based on the individual’s needs, the environment is safe, accessible, and suited for the individual’s abilities, and complies with applicable federal, state, and local regulations for the community in which the individual lives;

All rules you mentioned in your email pertain to all HCS and CFC services, including maintaining records and documentation that may be requested by an agency described in 26 TAC 565.25(d).”

 

Note From Twogether Consulting:  Just to clarify, a provider does have to make available the documentation upon request per 26 TAC 565.25(d):

(d) The program provider must make available all records, reports, and other information related to the delivery of HCS Program and CFC services as requested by the Texas Health and Human Services Commission (HHSC), other authorized agencies, or the Centers for Medicare and Medicaid and deliver such items, as requested, to a specified location or delivered electronically if available.

The rule does not provide specific deadlines to provide on-site inspection documentation; however, the program provider must maintain all documentation and have them readily available.

January 27th, 2026

During the HCS, TxHmL & PI Provider Webinar with LTCR on January 27th, 2026, there was a clarification concerning the on-site inspection that is required for all HH/CC homes initially, and quarterly thereafter, completed by the HCS provider.  There was no clarification for RSS and SL home on-site inspections.

We were told during the session that the provider did not need to send a copy or evidence of completing a host home inspection to the service coordinator within 5 days of inspection for HH/CC on-site inspections.  There was no mention of RSS or SL on-site inspections.

It was stated that the HCS provider does not need to send SC’s the results of the on-site inspection according to the Ch 565 of the TAC, concerning HH/CC inspections, but must be maintained in the individual’s record and made available upon request by HHSC, CMS, the LIDDA, and other authorized agencies.  They mentioned TAC Ch 565.25 b and d, but not 565.25 (a) which refers to RSS and SL on-site inspections.

Below is the TAC:  I do not see any wording that would indicate otherwise for RSS or SL on-site inspections, but please check the HCS policy to confirm whether this applies to all on-site inspections or just those for HH/CC homes.

565.25

(a) Before providing services to an individual in a residence in which supervised living or residential support is provided, and annually thereafter, the program provider must:

(1) conduct an on-site inspection to ensure that, based on the individual’s needs, the environment is safe, accessible and suited for the individual’s abilities, and complies with applicable federal, state, and local regulations for the community in which the individual lives;

(2) complete any action identified in the on-site inspection for a residence in which supervised living or residential support will be provided:

(A) before an individual moves in; or
(B) within 30 days if an individual is already in the residence; and
(C) document justification for any actions that cannot be completed before the individual moving in or within 30 days with a plan for completion.

(b) Before providing services to an individual in a residence in which host home/companion care is provided and quarterly thereafter, the program provider must:

(1) conduct an on-site inspection to ensure that, based on the individual’s needs, the environment is safe, accessible, and suited for the individual’s abilities and needs, and complies with applicable federal, state, and local regulations for the community in which the individual lives; and

(2) require proof of completion of any action identified in the on-site inspection for a residence in which host home/companion care will be provided to ensure that the residence meets the needs of the individual:

(A) before an individual moves in; or
(B) within 30 days if an individual is already in the residence; and
(C) document justification for any actions that cannot be completed before the individual moving in or within 30 days and include a plan for completion.
(d) The program provider must make available all records, reports, and other information related to the delivery of HCS Program and CFC services as requested by the Texas Health and Human Services Commission (HHSC), other authorized agencies, or the Centers for Medicare and Medicaid and deliver such items, as requested, to a specified location or delivered electronically if available.