Texas SB 240 · Primary source
HCSSA PL 2024-10: Chapter 331 for Home Health & Hospice
HHSC Provider Letter PL 2024-10 (April 18, 2024) applies Texas HSC Chapter 331 to home health and hospice agencies (HCSSAs) that employ two or more registered nurses. Agencies covered on that basis had to adopt a written workplace violence prevention program by September 1, 2024. SB 463 then struck the home-health limitation effective September 1, 2025 — every HCSSA service category now counts toward the two-RN test, and agencies newly covered by that change have until September 1, 2026 to comply.
On this page
Section 01
What PL 2024-10 is
A Provider Letter is the instrument HHSC uses to tell a class of licensed providers how a law applies to them. PL 2024-10 (issued April 18, 2024 by HHSC Long-Term Care Regulation) is the provider letter that applies HSC Chapter 331 to Home & Community Support Services Agencies (HCSSAs) — Texas-licensed home health and hospice providers under HSC Chapter 142.
A provider letter does not create coverage — the statute does. PL 2024-10 explains the obligation, clarifies the two-RN test, and confirmed the September 1, 2024 deadline for agencies covered at the time. Guidance can also lag the law, and here it does: the letter predates SB 463 and still describes coverage in home-health terms, so read it together with the amended statute rather than on its own.
Section 02
SB 463 changed the answer for many agencies
When PL 2024-10 issued, Chapter 331 reached only HCSSAs licensed to provide home health services. [SB 463 (89th Legislature)](/texas-sb-240-compliance/sb-463-2026-expansion) struck that limitation effective September 1, 2025 — coverage now turns solely on the license class and the two-RN test, whatever service categories the agency operates.
That creates two deadlines. An agency covered under the original home-health reading has been required to maintain its program since September 1, 2024. An agency that became covered only because SB 463 removed the limitation has until September 1, 2026 to comply. An agency that assumed it was out of scope in 2024 should re-run the coverage test now — the answer may have changed.
The deadline for newly covered agencies comes from SB 463’s transition section (uncodified §2), not from the codified chapter text.
Section 03
The two-RN coverage trigger
An HCSSA is covered by Chapter 331 only when it employs two or more registered nurses. PL 2024-10 clarifies the test precisely: an "employed RN" means a person with a current Texas RN license in a W-2 employment relationship with the agency — regardless of the nurse’s job duties. A director of nursing and an administrator who both hold active RN licenses can satisfy the two-RN trigger even if neither delivers hands-on patient care.
This is the most consequential clarification in the provider letter, because some agencies wrongly assume they are exempt. Confirming coverage is the first step of any survey-readiness audit for a home health or hospice agency.
Misreading the two-RN trigger — assuming exemption when the agency in fact employs two licensed RNs — is itself a route to a cited deficiency at survey.
Section 04
What covered HCSSAs must do
A covered HCSSA carries the same six Chapter 331 elements as any other covered facility, adapted to a home-based, mobile workforce:
- A WVP committee — including a registered nurse providing direct patient care; a physician providing direct care if any are employed; and a security-services employee if any are employed (many agencies employ none, which the documentation should state).
- A written, facility-specific WVP plan that reflects the realities of care delivered in patients’ homes and in the community — lone-worker exposure, travel, and unpredictable environments.
- Employee training at least annually, documented for all applicable field and office staff.
- A confidential reporting policy with anti-retaliation protection, including non-discouragement of contacting law enforcement.
- Post-incident response — acute medical treatment offered to staff directly involved and work-assignment adjustment.
- An annual plan evaluation reported to the governing body.
Section 05
Why home-based care changes the plan
A home health or hospice WVP plan cannot be a hospital plan with the name swapped. The risk profile is fundamentally a lone-worker, off-site profile: clinicians enter private homes alone, often after hours, in environments the agency does not control. A facility-specific plan for an HCSSA should address pre-visit risk screening, check-in/check-out procedures, communication and duress protocols, and visit-abort criteria — the elements a surveyor expects to see reflected for this workforce.
VIGILO writes the facility-specific plan and policies for the home-based context and delivers staff training suited to a mobile workforce.
Section 06
Enforcement for HCSSAs
As with all of Chapter 331, there is no dedicated fine schedule. For HCSSAs, non-compliance surfaces as a deficiency at the HHSC HCSSA licensure survey, requiring a plan of correction, and as post-incident litigation exposure after a serious event involving a field clinician. The documentation is the defense.
Section 07
How VIGILO helps home health & hospice agencies
VIGILO confirms coverage against the two-RN trigger, builds the home-based facility-specific plan and committee, delivers annual training, and maintains the program through the annual evaluation and governing-body report. See the dedicated home health & hospice (HCSSA) page, and start with a survey-readiness audit.
Key dates
Dates that matter
- Apr. 18, 2024
PL 2024-10 issued
HHSC Long-Term Care Regulation issues Provider Letter PL 2024-10, applying Chapter 331 to home health and hospice HCSSAs with two or more employed RNs.
- Sept. 1, 2024
Deadline — originally covered agencies
HCSSAs covered under the original home-health reading (≥2 employed RNs) must have adopted and implemented a written WVP policy and plan.
- Sept. 1, 2025
SB 463 effective
The home-health limitation is struck: every HCSSA service category counts toward the two-RN test.
- Sept. 1, 2026
Deadline — newly covered agencies
HCSSAs covered only because of SB 463 must comply with the full Chapter 331 program by this date.
- Annually
Annual evaluation
The committee evaluates the plan and reports the results to the governing body each year.
Primary sources
- HHSC Provider Letter PL 2024-10 (Apr. 18, 2024) — application of HSC Chapter 331 to home health and hospice HCSSAs.
- Texas Health & Safety Code Chapter 331 (added by SB 240, 88th Legislature, 2023; amended by SB 463, 89th Legislature, 2025).
- SB 463 enrolled text, 89th Texas Legislature (2025) — strikes the home-health limitation; Sept. 1, 2026 transition deadline.
- Texas Health & Safety Code Chapter 142 — Home & Community Support Services Agencies (HCSSA licensure).
Part of the Texas SB 240 compliance hub.
Frequently asked
Frequently asked questions
What is HHSC Provider Letter PL 2024-10?
PL 2024-10, issued April 18, 2024 by HHSC Long-Term Care Regulation, is the provider letter that applies Texas HSC Chapter 331 to home health and hospice agencies (HCSSAs). It clarifies that an HCSSA is covered when it employs two or more registered nurses and confirmed the September 1, 2024 deadline for agencies covered at the time. It predates SB 463, which broadened HCSSA coverage effective September 1, 2025, so it should be read together with the amended statute.
My agency is not a home health provider. Are we covered now?
Possibly — re-run the test. Since September 1, 2025, SB 463 removed the home-health limitation: any HCSSA licensed under Chapter 142 that employs two or more registered nurses is covered, regardless of service category. Agencies newly covered by that change have until September 1, 2026 to adopt and implement the full Chapter 331 program.
When is a home health or hospice agency covered by Chapter 331?
An HCSSA is covered when it employs two or more registered nurses. PL 2024-10 defines an "employed RN" as a person with a current Texas RN license in a W-2 employment relationship with the agency, regardless of the nurse’s job duties — so two licensed RNs in administrative roles can trigger coverage.
What must a covered HCSSA do under PL 2024-10?
The same six Chapter 331 elements as any covered facility: a WVP committee with required members, a written facility-specific plan adapted to home-based care, training at least annually, a confidential anti-retaliation reporting policy, post-incident response, and an annual plan evaluation reported to the governing body.
How is a home health WVP plan different from a hospital’s?
A home health or hospice plan must address a lone-worker, off-site risk profile — clinicians entering private homes alone, often after hours. A defensible HCSSA plan covers pre-visit risk screening, check-in/check-out procedures, duress and communication protocols, and visit-abort criteria, rather than fixed-facility controls like a hospital emergency department.
What happens if an HCSSA does not comply?
Chapter 331 has no fine schedule. For HCSSAs, non-compliance surfaces as a deficiency at the HHSC home health/hospice licensure survey — requiring a plan of correction — and as post-incident litigation exposure after a serious event involving a field clinician. The urgency is survey-readiness and litigation exposure, not fines.
Find out where your program stands
A Survey-Readiness Audit scores your committee, plan, training, reporting policy, and governing-body evaluation against every applicable Chapter 331 instrument — in one document.