Check Before the Checkers Show Up: Getting Ready for a Texas Home Care Survey

One of the most common questions new home care agencies in Texas ask is, "Are we doing it right?” With so many rules, forms, and documents to manage, it’s easy to feel unsure—especially while waiting for that first state survey.

Here’s what agencies need to know to stay prepared.

**The Rules Matter**

Surveys are based on the standards in Chapter 558 of the Texas Administrative Code. They’re not light reading, but that’s the rulebook—and surveyors will follow it closely. Agencies are also held to their own policies, so those should be reviewed at least annually to ensure they reflect current practices. If policies say one thing and operations show another, that’s a red flag.

**Form 2020: Start the Clock**

Within six months of receiving a license, agencies must submit Form 2020 (the survey readiness form). It signals that the agency has:

* A policies and procedures manual

* Employee files for both the administrator and alternate

* At least one client file

*Find the Regional Manager email address to send it to HERE

• Keep that email indefinitely, and call them if you don't get a read-receipt

After submission, agencies are added to a long waitlist. Since PAS-only agencies are lower priority, surveys may be delayed—sometimes even beyond the first license renewal. Until then, agencies should operate as if a survey could happen any day.

**Surveys Are Unannounced**

Surveyors can show up Monday–Friday, 8 AM to 5 PM. If the office is closed, there must be a sign on the door with a contact number. From the moment surveyors call, the administrator or alternate has two hours to arrive for the entrance interview.

**What Surveyors Want to See**

The list is long, so being organized is essential. Surveyors will ask for:

* The full policies and procedures manual

* QAPI and emergency preparedness documentation

* Logs of incidents, complaints, infections, and satisfaction surveys

* A list of current and recently discharged clients and Employee List

* Sample admission packet, new hire packet, and marketing materials

* Selected client files, including time sheets, notes, and supervisory visits

* Selected caregiver files—often tied to specific client cases

* And yes, they will request to visit up to 3 clients in their homes

Missing items can usually be provided during the survey, but scrambling to locate documentation doesn’t leave a good impression. Staying survey-ready is far better than playing catch-up.

**Don’t Confuse Licensing with Contract Visits**

Site visits from TMHP or managed care organizations are separate and focused on contract compliance. Licensing surveys are strictly about the agency’s adherence to state regulations—not billing or payer-specific details.

Something that helps a lot on survey day is remembering that surveyors are watching for everyday consistency, not perfection. The habits you build during regular operations show up clearly when someone else walks through your door. If your team documents things as they go and keeps information easy to find, that steadiness becomes obvious. It is the same reason discussions around reporting and documentation matter so much. Good habits behind the scenes make you look organized without even trying.

Survey interactions also become easier when you treat them the same way you treat challenging conversations with clients or families. Staying calm, asking questions, and getting clarity will always serve you well. Many agencies use the exact same communication strategies they rely on in tough client conversations because the skills overlap. If a surveyor mentions a concern, you can simply say, “Would you mind pointing me to that regulation” It keeps the conversation grounded and respectful.

Some agencies like to give their staff short, casual refreshers leading up to survey season so everyone feels confident about their role. These do not need to be formal. A five minute team reminder about where documents are stored or who handles certain tasks can go a long way. If you prefer more structured support, the ideas often used in team communication and development training can help you build a smoother workflow that holds up well when surveyors are in the office.

When the team feels steady and informed, the whole survey experience feels less stressful. Surveyors pick up on that energy too.

The bottom line: agencies that serve clients well, often meet the standards—they just need to ensure it's all properly documented. For those unsure where they stand, a mock survey or consultation can make a big difference.

Don't forget to watch the YouTube video on this topic!

Check Before the Checkers Show Up

HUGE ANNOUNCEMENT! Slusher Consulting is now offering the 16 Hour Administrator Training required before an agency's 1 year license anniversary.

For more tips on being ready for your survey, check out our earlier post and video: Show Me the Reg

Take credit for your work and if you need help and assurance, or thinking about starting your own agency, reach out, we'd love to help you. Book a Free 20 minute call.

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