Transparency & Methodology
How We Rate Houston Home Health Agencies
Every agency in our directory gets a trust score and compliance badge based on public Texas HHSC data. Here's exactly how the score is calculated and what each badge means.
The Regulator
What Is HHSC and Why Does It Matter?
The Texas Health and Human Services Commission (HHSC) licenses every home health agency operating in Texas as a Home and Community Support Services Agency (HCSSA). To legally provide skilled nursing, therapy, or personal care in a patient's home, an agency must hold an active HHSC license.
HHSC conducts unannounced surveys of licensed agencies, investigates complaints, and publishes enforcement actions against agencies that violate state standards. All of this data is public — most directories just don't surface it. We do.
Understanding the Data
What Is an Enforcement Action?
An enforcement action is a formal regulatory step HHSC takes when an agency violates state standards. Common types include:
- Administrative Penalty
- A fine levied against the agency. Amounts typically range from $100 to $10,000 per violation, depending on severity and history.
- License Suspension
- The agency's license is temporarily suspended. The agency cannot accept new patients during suspension.
- Consent Order
- A negotiated agreement between HHSC and the agency outlining required corrective actions and timelines.
- License Revocation
- The most severe action — the agency loses its license to operate. Rare, but we surface it when it occurs.
Important context: A single past enforcement action does not necessarily mean an agency is unsafe today. Many agencies have resolved issues and improved significantly. That's why we show agency responses alongside the record, and why we look at the last 3 years — not a lifetime record.
Survey Results
How to Read Deficiency Levels
When HHSC surveys an agency, any care standard violations found are called deficiencies. HHSC assigns each deficiency a level based on the potential or actual harm to patients:
| Level | Description |
|---|---|
| Level 1 | Minimal risk — no actual harm, low potential for harm |
| Level 2 | Moderate risk — potential for minimal harm or limited actual harm |
| Level 3 | Serious risk — actual harm occurred, or high risk of serious harm |
| Level 4 | Immediate jeopardy — conditions posing immediate serious threat to patient health or safety |
Our trust score places higher weight on Level 3 and Level 4 deficiencies, which represent real or imminent patient harm.
The Algorithm
How the Trust Score Is Calculated
Every agency starts at 100. Points are deducted for risk factors we find in HHSC public data:
- Inactive or suspended license: −50 points
- License expiring within 30 days: −10 points
- Each enforcement action (last 3 years): −15 points (max −60)
- Each Level 4 deficiency (last 2 years): −15 points
- Each Level 3 deficiency (last 2 years): −8 points
- Each Level 2 deficiency (last 2 years): −3 points
- 5+ years licensed with zero enforcement actions: +5 bonus
Scores are refreshed every Saturday after HHSC publishes updated licensing data.
What Each Badge Means
Trust Badges Explained
No enforcement actions in the last 3 years. License active and current.
Low-level deficiencies found during routine surveys. No enforcement actions. Common and not necessarily a concern.
More serious deficiencies or a small number of enforcement actions. Worth asking the agency directly for current status.
Multiple enforcement actions or serious deficiencies in the last 3 years. Review the agency's compliance record carefully before selecting.
Independent Verification
Verify Any Agency on TULIP Yourself
We source all data from HHSC public records, but we encourage families to verify directly. HHSC's TULIP portal gives you the most current licensing and survey information:
- Go to tulip.hhs.texas.gov
- Select Program Type: Home and Community Support Services Agencies
- Enter the agency name or license number
- Click the agency name to view surveys, deficiencies, and enforcement history
Data currency: Our enforcement data is refreshed weekly from HHSC public sources. There may be a lag of up to one week between an HHSC action and its appearance here. For the most current information, always verify directly with HHSC TULIP. If you believe our data for a specific agency is incorrect, contact us.