{"pack":"tx-pas","path":"/policies/texas/home-care/","name":"Texas PAS Policy and Procedure Manual (HCSSA)","state":"Texas","service":"Home care","license":"HCSSA license, Personal Assistance Services (PAS)","count":46,"forms":12,"categories":[{"name":"Client rights","count":3},{"name":"Service delivery","count":8},{"name":"Clinical tasks","count":7},{"name":"Safeguarding","count":1},{"name":"Infection control","count":3},{"name":"Emergency preparedness","count":1},{"name":"Records","count":2},{"name":"Privacy","count":3},{"name":"Human resources","count":6},{"name":"Governance","count":4},{"name":"Quality","count":3},{"name":"Business","count":3},{"name":"Ethics","count":2}],"policies":[{"ref":"TX-AD-01","path":"/policies/texas/home-care/advance-directives/","title":"Advance Directives","category":"Client rights","citation":"26 TAC §558.283","summary":"Sets out the written notice every client receives about the Agency’s advance directive policy, who receives it when the client is incapacitated, how a directive is recorded and honored, and the $500 penalty for failing to give the notice.","sample":false},{"ref":"TX-CR-01","path":"/policies/texas/home-care/client-rights-responsibilities-and-complaint-process/","title":"Client Rights, Responsibilities, and Complaint Process","category":"Client rights","citation":"26 TAC §558.282","summary":"Sets out every client right the Agency protects, the notices a client must receive before care begins, and a complaint process that is free of reprisal, with a separate route for allegations of abuse, neglect, or exploitation.","sample":true},{"ref":"TX-CR-02","path":"/policies/texas/home-care/agency-and-client-agreement-and-disclosure/","title":"Agency and Client Agreement and Disclosure","category":"Client rights","citation":"26 TAC §558.292","summary":"Requires a written agreement with every client or family before services begin that includes everything 26 TAC §558.292 lists (client rights, the advance directive notice, services, supervision, charges, and the complaint procedure) plus payment responsibility, contact details, and the conditions under which services change or end, and requires the client’s acknowledgment of receipt.","sample":false},{"ref":"TX-PAS-01","path":"/policies/texas/home-care/standards-specific-to-personal-assistance-services/","title":"Standards Specific to Personal Assistance Services","category":"Service delivery","citation":"26 TAC §558.404","summary":"Defines the personal assistance services the Agency may provide under its license, the tasks its attendants may and may not perform, how the individualized service plan is developed and reviewed, and how attendants are qualified and supervised.","sample":false},{"ref":"TX-SVC-01","path":"/policies/texas/home-care/coordination-of-services/","title":"Coordination of Services","category":"Service delivery","citation":"26 TAC §558.288","summary":"Requires that everyone who serves a client works from the same current service plan, that changes in the client’s condition or schedule are passed on the same day, and that services from other providers are coordinated and recorded.","sample":false},{"ref":"TX-SVC-02","path":"/policies/texas/home-care/independent-contractors-and-arranged-services/","title":"Independent Contractors and Arranged Services","category":"Service delivery","citation":"26 TAC §558.289","summary":"Requires a written contract before any independent contractor or other organization furnishes services to a client on the Agency’s behalf, sets what the contract must contain, and confirms that the Agency remains responsible for the care.","sample":false},{"ref":"TX-SVC-03","path":"/policies/texas/home-care/backup-services-and-after-hours-care/","title":"Backup Services and After-Hours Care","category":"Service delivery","citation":"26 TAC §558.290","summary":"Ensures a client is not left without a scheduled service when the assigned attendant is unavailable, and that the client can reach a responsible Agency employee outside office hours at a number that is answered at all times.","sample":false},{"ref":"TX-SVC-04","path":"/policies/texas/home-care/initiation-of-care-timeframes/","title":"Initiation of Care Timeframes","category":"Service delivery","citation":"26 TAC §558.294","summary":"Sets the Agency’s written timeframe for starting care after a referral is accepted, what happens when care cannot start in time, and how the client and referral source are told.","sample":false},{"ref":"TX-SVC-05","path":"/policies/texas/home-care/client-transfer-or-discharge/","title":"Client Transfer or Discharge","category":"Service delivery","citation":"26 TAC §558.295","summary":"Sets the grounds on which the Agency may transfer or discharge a client, the written notice the client receives before it happens, the limited situations in which shorter notice is allowed, and how the client is helped to find other care.","sample":false},{"ref":"TX-SVC-06","path":"/policies/texas/home-care/client-care-policies-and-scope-of-services/","title":"Client Care Policies and Scope of Services","category":"Service delivery","citation":"26 TAC §558.281","summary":"Sets out which services the Agency provides and which it does not, how each client’s care is assessed, planned, started, paused, and ended, how staff handle emergencies and their own safety in the home, and how staff are supervised while they give care. It also sets out the workplace violence prevention committee, policy, plan, training and incident response that Texas Health and Safety Code Chapter 331 requires while the Agency employs at least two registered nurses.","sample":false},{"ref":"TX-SVC-07","path":"/policies/texas/home-care/laboratory-services/","title":"Laboratory Services","category":"Service delivery","citation":"26 TAC §558.284","summary":"States whether the Agency performs any laboratory test or handles any specimen, tells staff what to do when asked, and, for an agency that chooses to perform waived tests or carry specimens, sets out the CLIA certificate, safe testing and handling, and how results reach the client’s practitioner.","sample":false},{"ref":"TX-CL-01","path":"/policies/texas/home-care/physician-delegation-of-tasks/","title":"Physician Delegation of Tasks","category":"Clinical tasks","citation":"26 TAC §558.296","summary":"States whether the Agency accepts tasks that a client’s physician delegates to a staff member, tells staff exactly what to do if they are asked to perform such a task, and sets out the conditions and procedure that apply if the Agency ever decides to accept physician delegation.","sample":false},{"ref":"TX-CL-02","path":"/policies/texas/home-care/receipt-of-physician-orders/","title":"Receipt of Physician Orders","category":"Clinical tasks","citation":"26 TAC §558.297","summary":"Sets out whether the Agency acts on orders from a client’s physician or other practitioner, who in the Agency may receive them, the Agency’s time frame for getting a verbal order countersigned, and the safeguards for orders sent by fax, including what staff do when a fax goes to the wrong place.","sample":false},{"ref":"TX-CL-03","path":"/policies/texas/home-care/rn-delegation-to-unlicensed-staff/","title":"RN Delegation to Unlicensed Staff","category":"Clinical tasks","citation":"26 TAC §558.298","summary":"Sets out whether the Agency provides health-related tasks that need a registered nurse, what an attendant does if asked to perform a nursing task, and, where the Agency does provide such tasks, how the registered nurse assesses the client, decides whether the task may be delegated, teaches and checks the attendant, and supervises the task under the Texas Board of Nursing rules.","sample":false},{"ref":"TX-CL-04","path":"/policies/texas/home-care/nursing-education-licensure-and-practice/","title":"Nursing Education, Licensure, and Practice","category":"Clinical tasks","citation":"26 TAC §558.299","summary":"Makes sure any nurse who works for the Agency, in any role, holds a current license to practice in Texas that is verified before the nurse starts and kept under watch, and practices only within that license, the Texas Board of Nursing rules, and the limits of the Agency’s personal assistance services license.","sample":false},{"ref":"TX-CL-05","path":"/policies/texas/home-care/medication-administration/","title":"Medication Administration","category":"Clinical tasks","citation":"26 TAC §558.300","summary":"Says what staff may and may not do with a client’s medicines, who to call when something is wrong, and the medication list, administration record, and delegation safeguards that apply if Agency staff ever administer medications.","sample":false},{"ref":"TX-CL-06","path":"/policies/texas/home-care/pronouncement-of-death/","title":"Pronouncement of Death","category":"Clinical tasks","citation":"26 TAC §558.302","summary":"Says what staff do if a client dies during a visit: call 911 and the office, stay with the client, and leave the pronouncement of death to the people the law allows.","sample":false},{"ref":"TX-CL-07","path":"/policies/texas/home-care/sterile-water-saline-vaccines-and-drugs/","title":"Sterile Water, Saline, Vaccines, and Drugs","category":"Clinical tasks","citation":"26 TAC §558.303","summary":"Covers whether the Agency keeps or gives sterile water, saline, vaccines, or other drugs, and how they are stored and recorded if it does.","sample":false},{"ref":"TX-ANE-01","path":"/policies/texas/home-care/reporting-abuse-neglect-and-exploitation/","title":"Reporting Abuse, Neglect, and Exploitation","category":"Safeguarding","citation":"26 TAC §558.249","summary":"Every employee, contractor, and volunteer who has cause to believe a client has been abused, neglected, or exploited makes sure it is reported at once. Abuse, neglect, or exploitation by Agency staff is reported to HHSC immediately, and never later than 24 hours; abuse by anyone else, and self-neglect, is reported to DFPS; suspected abuse or neglect of a child is reported to DFPS. The Agency begins its own investigation immediately and sends HHSC Form 3613 no later than the 10th day after its report.","sample":true},{"ref":"TX-IC-01","path":"/policies/texas/home-care/infection-control/","title":"Infection Control","category":"Infection control","citation":"26 TAC §558.285","summary":"The Agency prevents the spread of infection through standard precautions, hand hygiene, personal protective equipment, staff health screening including tuberculosis screening, and an OSHA exposure control plan, and it tracks infections and exposures through the QAPI program.","sample":true},{"ref":"TX-IC-02","path":"/policies/texas/home-care/disposal-of-special-waste/","title":"Disposal of Special Waste","category":"Infection control","citation":"26 TAC §558.286","summary":"How the Agency identifies, contains, and disposes of special waste generated in a client’s home or at the Agency office, including sharps, in line with the Texas Department of State Health Services special waste rules and the OSHA bloodborne pathogens standard.","sample":false},{"ref":"TX-IC-03","path":"/policies/texas/home-care/bloodborne-pathogens-exposure-control-plan/","title":"Bloodborne Pathogens Exposure Control Plan","category":"Infection control","citation":"29 CFR §1910.1030","summary":"Protects staff from blood and other body fluids: gloves and other protective equipment, safe work practices including handling of sharps found in a client's home, hepatitis B vaccination, and what to do after a needlestick or a splash, under the Agency's written OSHA Exposure Control Plan.","sample":false},{"ref":"TX-EP-01","path":"/policies/texas/home-care/emergency-preparedness-and-response-plan/","title":"Emergency Preparedness and Response Plan","category":"Emergency preparedness","citation":"26 TAC §558.256","summary":"The Agency maintains a written emergency preparedness and response plan built on a documented risk assessment, names a disaster coordinator and alternate, keeps operations running through a continuity plan, assigns staff roles across mitigation, preparedness, response, and recovery, helps clients register with STEAR, and reviews and exercises the plan every year.","sample":false},{"ref":"TX-RM-01","path":"/policies/texas/home-care/client-records-and-retention/","title":"Client Records and Retention","category":"Records","citation":"26 TAC §558.301","summary":"Sets what every client record must contain, including the signed acknowledgments the rule requires, how records are kept confidential and secure, how they are released, and the five-year retention period after discharge.","sample":false},{"ref":"TX-RM-02","path":"/policies/texas/home-care/client-list-and-service-records/","title":"Client List and Service Records","category":"Records","citation":"26 TAC §558.293","summary":"Keeps a current list of every client for each licensed category of service, with the details the rule requires and every service delivered directly or under contract, and a dated record of each service given, so the office and an HHSC surveyor can see who is served, by whom, and when.","sample":false},{"ref":"TX-PRV-01","path":"/policies/texas/home-care/hipaa-privacy/","title":"HIPAA Privacy","category":"Privacy","citation":"45 CFR Part 164 Subpart E","summary":"Explains how staff protect clients’ health information: who may see it, when it may be shared, and what clients can ask for, applying the HIPAA Privacy Rule together with the stricter Texas rules on electronic disclosure and on the records of clients age 60 and over.","sample":false},{"ref":"TX-PRV-02","path":"/policies/texas/home-care/hipaa-security/","title":"HIPAA Security","category":"Privacy","citation":"45 CFR §§164.302-164.318","summary":"Explains how the Agency keeps electronic client records safe: passwords, locked phones and computers, who has access, backups, and what staff do when a device is lost or something looks wrong, applying the HIPAA Security Rule and the Texas duty to protect sensitive personal information.","sample":false},{"ref":"TX-PRV-03","path":"/policies/texas/home-care/hipaa-breach-notification/","title":"HIPAA Breach Notification","category":"Privacy","citation":"45 CFR §§164.400-164.414","summary":"Explains what to do if client information is lost, stolen, or sent to the wrong person: tell the office at once, so the Agency can assess the incident and notify every person, agency, and outlet the law requires, within the deadlines federal and Texas law set.","sample":false},{"ref":"TX-HR-01","path":"/policies/texas/home-care/staffing/","title":"Staffing","category":"Human resources","citation":"26 TAC §558.245","summary":"Sets the Agency’s written staffing policies under 26 TAC §558.245: orientation, job-specific training and competency, continuing training, job descriptions, background checks, annual evaluations, discipline, volunteers, care of pediatric clients, and the signed policy compliance statement, and the Agency’s own staffing standards.","sample":false},{"ref":"TX-HR-02","path":"/policies/texas/home-care/personnel-records/","title":"Personnel Records","category":"Human resources","citation":"26 TAC §558.246","summary":"Lists what every personnel record must contain for employees, contractors, and volunteers, how long the Agency keeps it, who may see it, and how it is produced for a surveyor.","sample":false},{"ref":"TX-HR-03","path":"/policies/texas/home-care/verification-of-employability-and-background-checks/","title":"Verification of Employability and Background Checks","category":"Human resources","citation":"26 TAC §558.247","summary":"Requires a criminal history check and Nurse Aide Registry and Employee Misconduct Registry searches (the Employee Misconduct Registry through SEMARC from August 3, 2026) before an unlicensed person has face-to-face contact with a client, repeats the registry searches at least every 12 months, and requires immediate discharge of anyone listed as unemployable or with a barring conviction.","sample":false},{"ref":"TX-HR-04","path":"/policies/texas/home-care/volunteers/","title":"Volunteers","category":"Human resources","citation":"26 TAC §558.248","summary":"Sets the conditions under which the Agency may use volunteers: the same background checks as employees, written role descriptions, orientation, supervision, and a volunteer record for each person.","sample":false},{"ref":"TX-HR-05","path":"/policies/texas/home-care/drug-testing-policy/","title":"Drug Testing Policy","category":"Human resources","citation":"26 TAC §558.253","summary":"States the Agency’s written drug testing policy for personnel who have direct contact with clients, including the testing method, and requires that a copy be given to everyone who applies for services and to anyone who asks, and to every employee.","sample":false},{"ref":"TX-HR-06","path":"/policies/texas/home-care/home-health-aide-training-and-supervision/","title":"Home Health Aide Training and Supervision","category":"Human resources","citation":"26 TAC §558.701","summary":"Sets who may be used as a home health aide (26 TAC §558.701), the training and competency evaluation the rule requires, and the in-service training and nurse supervision the Agency applies, if it uses home health aides. Personal assistance services attendants are covered by Policy TX-PAS-01.","sample":false},{"ref":"TX-GOV-01","path":"/policies/texas/home-care/organizational-structure-and-lines-of-authority/","title":"Organizational Structure and Lines of Authority","category":"Governance","citation":"26 TAC §558.242","summary":"Requires the Agency to keep a current written organizational chart that shows who reports to whom, from the governing body down to every direct care position, and to make it available to surveyors on request.","sample":false},{"ref":"TX-GOV-02","path":"/policies/texas/home-care/administrative-and-supervisory-responsibilities/","title":"Administrative and Supervisory Responsibilities","category":"Governance","citation":"26 TAC §558.243","summary":"Sets out what the governing body, the Administrator, the Alternate Administrator, and supervisors are each accountable for, and guarantees that a qualified leader is reachable during every hour the Agency operates.","sample":false},{"ref":"TX-GOV-03","path":"/policies/texas/home-care/administrator-qualifications-and-training/","title":"Administrator Qualifications and Training","category":"Governance","citation":"26 TAC §558.244","summary":"Describes who may serve as Administrator or Alternate Administrator of a personal assistance services agency, the 24 clock hours of initial training (eight of them before designation) and the 12 clock hours of continuing education each must complete, and how the Agency proves it.","sample":false},{"ref":"TX-GOV-04","path":"/policies/texas/home-care/agency-dissolution/","title":"Agency Dissolution","category":"Governance","citation":"26 TAC §558.291","summary":"Sets out the written plan the Agency follows if it closes or gives up its license, so that every client is transferred safely, every record is preserved, and HHSC, staff, and payers are told in time.","sample":false},{"ref":"TX-QA-01","path":"/policies/texas/home-care/quality-assessment-and-performance-improvement/","title":"Quality Assessment and Performance Improvement","category":"Quality","citation":"26 TAC §558.287","summary":"The Agency runs a written quality assessment and performance improvement program led by a committee that meets at least twice a year, measures negative client outcomes, staff misconduct complaints, infection control, medication errors, and the appropriateness of complaint responses, and corrects any threat to safety immediately.","sample":false},{"ref":"TX-QA-02","path":"/policies/texas/home-care/agency-investigations/","title":"Agency Investigations","category":"Quality","citation":"26 TAC §558.250","summary":"How the Agency investigates complaints, incidents, and allegations. Every matter is documented and its investigation started within 10 days of receipt, completed within 30 days unless the reason for delay is recorded, and allegations of abuse, neglect, or exploitation are investigated immediately.","sample":false},{"ref":"TX-QA-03","path":"/policies/texas/home-care/peer-review/","title":"Peer Review","category":"Quality","citation":"26 TAC §558.251","summary":"How the Agency reviews the professional practice of any licensed health care professional it employs or contracts, including nursing peer review under Texas Occupations Code Chapter 303 whenever the Agency regularly employs, hires, or contracts for eight or more nurses, and the protections a nurse has when requesting safe harbor.","sample":false},{"ref":"TX-FIN-01","path":"/policies/texas/home-care/financial-solvency-and-business-records/","title":"Financial Solvency and Business Records","category":"Business","citation":"26 TAC §558.252","summary":"The Agency keeps itself financially able to meet its obligations to clients, staff, and creditors, maintains the business and financial records that show this, and makes them available to HHSC on request.","sample":false},{"ref":"TX-FIN-02","path":"/policies/texas/home-care/billing-and-insurance-claims/","title":"Billing and Insurance Claims","category":"Business","citation":"26 TAC §558.254","summary":"The Agency bills only for services that were actually provided, documented, and authorized, at the rates disclosed to the client or agreed with the payer, and it corrects and refunds any overpayment it discovers.","sample":false},{"ref":"TX-FIN-03","path":"/policies/texas/home-care/electronic-visit-verification/","title":"Electronic Visit Verification","category":"Business","citation":"42 U.S.C. §1396b(l)","summary":"Requires every attendant to record the type, date, location, and start and end time of each Medicaid personal care visit through an approved electronic visit verification system, and sets out what the Agency does when a visit cannot be recorded electronically.","sample":false},{"ref":"TX-ETH-01","path":"/policies/texas/home-care/prohibition-of-solicitation-of-patients/","title":"Prohibition of Solicitation of Patients","category":"Ethics","citation":"26 TAC §558.255","summary":"No one acting for the Agency may pay, offer, or accept anything of value for referring or securing a client, and no one may pressure, deceive, or induce a person into choosing the Agency. Marketing is truthful, respects a client’s freedom of choice, and never involves gifts to referral sources or clients beyond nominal value.","sample":false},{"ref":"TX-ETH-02","path":"/policies/texas/home-care/compliance-program/","title":"Compliance Program","category":"Ethics","citation":"1 TAC §371.1655","summary":"Sets out how the Agency prevents, finds, and fixes billing and conduct problems through a written compliance program with a compliance lead, training, routine monitoring, and a way for anyone to raise a concern without fear of retaliation.","sample":false}],"copy":{"reviewed":"2026-11-08","intro":"For Texas agencies licensed by HHSC as a Home and Community Support Services Agency (HCSSA) in the Personal Assistance Services (PAS) category. The manual has 46 policies and 12 forms, with the client forms in English and Spanish. It is written to 26 TAC Chapter 558, the HCSSA licensing rules. Each policy opens with a plain-English summary and names the rule section it follows, and every one is filled in with your agency's name and details. You get Word and PDF files to keep, and your staff read and sign each policy on their phone.","rulesTitle":"What 26 TAC Chapter 558 asks your policies to cover","rules":[{"head":"Client rights and complaints.","text":"A written statement of client rights and a complaint process free of reprisal, with a separate route for abuse, neglect or exploitation.","cite":"26 TAC §558.282"},{"head":"Client agreement.","text":"A written agreement before services begin, covering what the rule lists: client rights, the advance directive notice, services, supervision, charges and the complaint procedure.","cite":"26 TAC §558.292"},{"head":"Abuse, neglect and exploitation.","text":"Staff report at once. Abuse by agency staff goes to HHSC immediately, never later than 24 hours, and HHSC Form 3613 follows no later than the 10th day after the report.","cite":"26 TAC §558.249"},{"head":"Backup and after-hours care.","text":"A client is not left without a scheduled service when an attendant is unavailable, and can reach a responsible employee at any hour.","cite":"26 TAC §558.290"},{"head":"Infection control.","text":"How the agency prevents the spread of infection: standard precautions, hand hygiene, protective equipment and staff health screening.","cite":"26 TAC §558.285"},{"head":"Emergency preparedness.","text":"A written emergency preparedness and response plan, with a disaster coordinator and an alternate.","cite":"26 TAC §558.256"}],"asks":[{"ref":"TX-CR-02","title":"Agency and Client Agreement and Disclosure","category":"Client rights","q":"Show me a signed client agreement and tell me what date services actually started.","path":"/policies/texas/home-care/agency-and-client-agreement-and-disclosure/"},{"ref":"TX-SVC-03","title":"Backup Services and After-Hours Care","category":"Service delivery","q":"What happens when an attendant calls in sick at 6 a.m.?","path":"/policies/texas/home-care/backup-services-and-after-hours-care/"},{"ref":"TX-ANE-01","title":"Reporting Abuse, Neglect, and Exploitation","category":"Safeguarding","q":"Show me your last self-report to HHSC and the Form 3613 that followed it. How many days apart are they?","path":"/policies/texas/home-care/reporting-abuse-neglect-and-exploitation/"},{"ref":"TX-IC-01","title":"Infection Control","category":"Infection control","q":"Show me your written exposure control plan and the date it was last reviewed.","path":"/policies/texas/home-care/infection-control/"},{"ref":"TX-EP-01","title":"Emergency Preparedness and Response Plan","category":"Emergency preparedness","q":"Who is your disaster coordinator, who is the alternate, and how do staff reach them after hours?","path":"/policies/texas/home-care/emergency-preparedness-and-response-plan/"}],"faq":[{"q":"Is this the right manual for my license?","a":"It is for HCSSAs licensed in the Personal Assistance Services category. Agencies licensed for home health (LHHS or LCHHS) or hospice need the Texas home health or Texas hospice manual."},{"q":"Does it cover workplace violence prevention?","a":"Yes. Since S.B. 463 (effective September 1, 2025), Health and Safety Code Chapter 331 applies to a PAS agency that employs two or more registered nurses, with compliance due September 1, 2026. Policy TX-SVC-06 sets out the committee, the written policy and plan, how incidents are handled and the yearly review."},{"q":"What about HHSC's proposed rewrite of Chapter 558?","a":"HHSC proposed a rewrite of most of Chapter 558 in the Texas Register on September 18, 2026. It was not in force when this manual was last reviewed, so the policies follow the rules in force today."},{"q":"Are the client forms in Spanish?","a":"Yes. The client forms come in English and Spanish, filled in with your agency's details."},{"q":"What do the 46 policies cover?","a":"Client rights (3), service delivery (8), clinical tasks (7), safeguarding (1), infection control (3), emergency preparedness (1), records (2), privacy (3), human resources (6), governance (4), quality (3), business (3) and ethics (2)."}]},"guides":[{"path":"/guides/home-care-agency-policies/","h1":"What policies does a home care agency need?"},{"path":"/guides/abuse-neglect-exploitation-reporting/","h1":"Abuse, neglect and exploitation policies: what each state requires"},{"path":"/guides/infection-control-policy/","h1":"What should a home care infection control policy include?"},{"path":"/guides/staff-policy-acknowledgment/","h1":"Staff policy acknowledgment: how read-and-sign works in home care"},{"path":"/guides/how-to-write-policies-and-procedures/","h1":"How to write policies and procedures for a home care agency"},{"path":"/guides/how-often-review-policies/","h1":"How often should policies and procedures be reviewed and updated?"}]}