(a) An applicant for a license must not admit a client or initiate services until the applicant completes the application process and receives an initial license.
(b) A first-time application for a license is an application for an initial license.
(c) An application for a license when there is a change of ownership is an application for an initial license.
(d) A separate license is required for each place of business as defined in §558.2 of this chapter (relating to Definitions).
(e) An agency's place of business must be located in and have an address in Texas. An agency located in another state must receive a license as a parent agency in Texas to operate as an agency in Texas.
(f) An applicant must be at least 18 years of age.
(g) Before issuing a license, HHSC considers the background of:
  (1) the applicant;
  (2) a controlling person of the applicant;
  (3) a person with a disclosable interest;
  (4) an affiliate of the applicant; and
  (5) the chief financial officer.
(h) Before issuing a license, HHSC considers the background and qualifications of the administrator and alternate administrator in accordance with §558.244 of this chapter (relating Administrator Qualifications and Conditions and Supervising Nurse Qualifications).
(i) HHSC may deny an application for an initial license or for renewal of a license if a person described in subsection (g) or (h) of this section:
  (1) on the date of the application:
    (A) is subject to denial or refusal as described in Chapter 560 of this title (relating to Denial or Refusal of License) during the time frames described in that chapter;
    (B) has an unsatisfied final judgment in any state or other jurisdiction; or
    (C) is delinquent on child support obligations (Texas Family Code Chapter 232);
  (2) for two years preceding the date of the application, has a history in any state or other jurisdiction of any of the following:
    (A) an unresolved federal or state tax lien;
    (B) an eviction involving any property or space used as an inpatient hospice agency; or
    (C) an unresolved final Medicare or Medicaid audit exception; or
  (3) for 12 months preceding the date of the application, has a history in any state or other jurisdiction of any of the following:
    (A) denial, suspension, or revocation of an agency license or a license for a health care facility;
    (B) surrendering a license before expiration or allowing a license to expire instead of the licensing authority proceeding with enforcement action;
    (C) a Medicaid or Medicare sanction or penalty relating to the operation of an agency or a health care facility;
    (D) operating an agency that has been decertified in any state under Medicare or Medicaid; or
    (E) debarment, exclusion, or involuntary contract cancellation in any state from Medicare or Medicaid.

Source Note: The provisions of this §558.11 adopted to be effective June 1, 2006, 31 TexReg 1455; amended to be effective December 1, 2006, 31 TexReg 9620; amended to be effective September 1, 2009, 34 TexReg 5139; amended to be effective January 18, 2012, 37 TexReg 127; transferred effective May 1, 2019, as published in the April 12, 2019, issue of the Texas Register, 44 TexReg 1893; amended to be effective April 25, 2021, 46 TexReg 2427