Have you formed a Texas business entity for your PPECC operation?
Yes — entity formed and registered with the Texas Secretary of State
In progress — formation underway
Not yet
I'm not sure if I need a separate entity
HHSC PPECC Licensing Standards CBT
26 Texas Administrative Code Chapter 550
Have you completed the mandatory HHSC PPECC Administrator CBT?
Yes — CBT certificate obtained and ready to upload to TULIP
Not yet — but I know it is required
I didn't know a CBT was required before applying
I have started but not completed it
HHSC PPECC Licensing Standards CBT
26 Texas Administrative Code Chapter 550
Are you aware of the HHSC financial-responsibility requirement for PPECC applicants, including the letter of credit requirement?
Yes — reviewed and understand the requirement
Partially — I know there's a financial requirement but haven't looked into it
No — I haven't seen this requirement
Not sure what this refers to
HHSC PPECC Licensing Standards CBT
26 Texas Administrative Code Chapter 550
Have you identified the individual(s) who will serve as the licensed operator or administrator of record with HHSC?
Yes — identified and confirmed
In progress — working on this
Not yet
Not sure what this role requires
HHSC PPECC Licensing Standards CBT
26 Texas Administrative Code Chapter 550
Have you identified a facility location for your PPECC?
Yes — facility identified and under contract or lease
Actively looking — have specific targets under evaluation
Exploring options — no specific sites yet
Not yet started this process
HHSC PPECC Licensing Standards CBT
26 Texas Administrative Code Chapter 550
Have you engaged a licensed architect familiar with HHSC PPECC facility and physical-plant requirements to review your facility?
Yes — architect has reviewed against HHSC requirements
Not yet — but I know I need this
No — I wasn't aware architect review is typically required
N/A — facility not yet identified
HHSC PPECC Licensing Standards CBT
26 Texas Administrative Code Chapter 550
Have you reviewed the HHSC PPECC equipment requirements (nursing station equipment, therapy equipment, emergency equipment)?
Yes — reviewed and have begun mapping equipment needs
Not yet — but I know there are equipment requirements
No — I haven't looked at equipment requirements
N/A — facility not yet identified
HHSC PPECC Licensing Standards CBT
26 Texas Administrative Code Chapter 550
Have you reviewed the HHSC PPECC license application (Form 3720-P)?
Yes — reviewed and understand what's required
Partially — I've seen it but haven't gone through it carefully
Not yet
I don't know where to find it
HHSC PPECC Licensing Standards CBT
26 Texas Administrative Code Chapter 550
Have you established a TULIP portal account with HHSC for your PPECC application?
Yes — TULIP account established
Not yet — but I know TULIP is the submission channel
No — I didn't know TULIP is required
In progress
HHSC PPECC Licensing Standards CBT
26 Texas Administrative Code Chapter 550
Do you understand the difference between a provisional PPECC license and a standard PPECC license in Texas?
Yes — familiar with both and the timeline between them
Partially — I know there's a provisional stage but not the details
No — I wasn't aware there were two license types
Not sure how this applies to my situation
HHSC PPECC Licensing Standards CBT
26 Texas Administrative Code Chapter 550
Have you reviewed whether any prior adverse licensing actions, investigations, or ownership history could affect your PPECC license application?
Yes — reviewed and no issues identified
In progress — working through this with counsel
No — I haven't looked into this
Not applicable
HHSC PPECC Licensing Standards CBT
26 Texas Administrative Code Chapter 550
Have you identified a medical director for your PPECC?
Yes — identified; holds Texas license to practice medicine, ABMS/AOA pediatric board certification, and 2+ years supervisory pediatric management experience
In conversations — potential candidate identified but not committed
Not yet — have not started this search
I didn't know the full qualification requirements for a PPECC medical director
26 Texas Administrative Code Chapter 550
Have you identified a Director of Nursing (DON) for your PPECC?
Yes — identified; holds Texas RN license and 2+ years supervisory pediatric nursing experience
In conversations — potential candidate identified but not committed
Not yet
I didn't know the DON must be a full-time PPECC employee
26 Texas Administrative Code Chapter 550
Have you designed the governance documentation for your clinical leadership structure (medical director agreement, nursing director employment, supervision structure)?
Yes — governance documentation drafted
In progress
Not yet
Not sure what governance documentation is required
26 Texas Administrative Code Chapter 550
Are you familiar with the HHSC minimum nursing staffing ratio for PPECC operations?
Yes — familiar with the minimum 1:3 staff-to-minor ratio and the census-tier requirements
I know there's a staffing ratio requirement but not the details
No — I haven't looked at staffing ratio requirements
I thought staffing ratios were the same as other pediatric settings
26 Texas Administrative Code Chapter 550
Have you designed the nursing documentation model for your PPECC — including daily nursing notes, shift documentation, and plan-of-care compliance documentation?
Yes — nursing documentation standard designed and mapped to HHSC and TMHP requirements
In progress — working on the nursing documentation model
Not yet — planning to address after licensing
I'm using a documentation model from a different care setting
26 Texas Administrative Code Chapter 550
Are you aware of the December 2024 TMHP requirement that daily attendance log data elements must be documented for each service day?
Yes — aware of the December 2024 changes and have incorporated them into the documentation model
Partially — I know there were changes but have not mapped them fully
No — I wasn't aware of December 2024 TMHP documentation changes
I'm not sure this applies to my situation
26 Texas Administrative Code Chapter 550
Have you mapped the nursing assessment timing requirement for newly admitted children?
Yes — nursing assessment within 3 business days of admission is designed into the admissions workflow
I know there's a nursing assessment requirement but not the specific timing
No — I haven't looked at the nursing assessment requirement
I thought the nursing assessment was part of the plan of care, not a separate step
26 Texas Administrative Code Chapter 550
What is your plan for providing therapy services at your PPECC?
Providing therapy services on-site with employed therapists
Providing therapy services on-site with contracted therapists
Not planning to offer therapy services at launch
Haven't decided yet
26 Texas Administrative Code Chapter 550
Which therapy disciplines have you confirmed provider licensure for? (Select all that apply.)
Physical therapy (PT)
Occupational therapy (OT)
Speech-language pathology (SLP)
Developmental therapy (DT)
None confirmed yet
26 Texas Administrative Code Chapter 550
Have you designed a session-documentation standard for therapy services that integrates with the interdisciplinary plan of care?
Yes — session documentation standard designed and linked to the POC
In progress
Not yet
I'm planning to use the therapy documentation standard from my current practice
26 Texas Administrative Code Chapter 550
Have you designed your PPECC admissions process, including eligibility criteria, physician orders, and enrollment documentation?
Yes — admissions process designed and documented
In progress
Not yet
Not sure what a PPECC admissions process requires
TMHP PPECC PA forms (F00124, F00142)
TMHP CSHCN Services Handbook Chapter 33
Do you have a process for verifying TMHP eligibility for prospective PPECC enrollees?
Yes — TMHP eligibility verification process designed
In progress
Not yet
Not sure how TMHP eligibility verification works for PPECCs
TMHP PPECC PA forms (F00124, F00142)
TMHP CSHCN Services Handbook Chapter 33
Have you designed the admission packet your PPECC will use (physician orders, parent consent, enrollment documentation)?
Yes — admission packet template designed
In progress
Not yet
I'm planning to use an admission packet from a different care setting
TMHP PPECC PA forms (F00124, F00142)
TMHP CSHCN Services Handbook Chapter 33
Have you designed the interdisciplinary plan-of-care template for your PPECC, aligned with HHSC and TMHP requirements?
Yes — POC template designed, includes physician signature, nursing assessment, and therapy goals
In progress
Not yet
I'm planning to use a plan-of-care template from a different care setting
TMHP PPECC PA forms (F00124, F00142)
TMHP CSHCN Services Handbook Chapter 33
Are you aware of the physician-signature timeline for the PPECC plan of care under HHSC licensing standards?
Yes — aware that the physician must sign the POC within 30 days of plan initiation (26 TAC §550.607)
I know a physician signature is required but not the timeline
No — I wasn't aware of a physician-signature timeline
I thought the POC timeline was 14 days (note: the 14-day window is the TMHP CSHCN billing standard for verbal PA only — the HHSC licensing standard under §550.607 is 30 days)
TMHP PPECC PA forms (F00124, F00142)
TMHP CSHCN Services Handbook Chapter 33
Does your plan-of-care template include transportation stability documentation, as required by the December 2024 TMHP compliance baseline?
Yes — transportation stability is included in the POC template
Not yet — I am aware of the December 2024 changes
No — I wasn't aware transportation stability must be in the POC
N/A — not planning to provide transportation
TMHP PPECC PA forms (F00124, F00142)
TMHP CSHCN Services Handbook Chapter 33
Have you reviewed the HHSC PPECC medical-record content requirements under 26 TAC §550.803?
Yes — reviewed; medical-record content requirements are mapped into the record design
Not yet — but I know there are specific requirements
No — I haven't looked at medical-record requirements for PPECCs
I assumed medical-record requirements would be similar to home health or outpatient therapy
26 Texas Administrative Code Chapter 550
What is your current plan for the PPECC medical-record system?
Purpose-built clinical record system designed for PPECC (e.g., Harbor)
Planning to use a generic EHR adapted for PPECC
Planning to use paper records
Haven't decided yet
26 Texas Administrative Code Chapter 550
Have you designed a medical-record retention policy for your PPECC?
Yes — retention policy designed per HHSC requirements
Not yet — but I know there are retention requirements
No — I haven't looked at retention requirements
I'm planning to use the retention policy from my current practice
26 Texas Administrative Code Chapter 550
Have you designed a QAPI (Quality Assurance and Performance Improvement) program for your PPECC?
Yes — QAPI plan drafted with data-collection indicators and review cycle
In progress
Not yet — planning to address after opening
I didn't know a QAPI program is required for PPECCs
26 Texas Administrative Code Chapter 550
Have you defined the quality indicators your QAPI program will track (nursing documentation, therapy outcomes, attendance, incident reports)?
Yes — quality indicators defined and linked to data sources
In progress — some indicators defined
Not yet
Not sure what quality indicators are appropriate for a PPECC
26 Texas Administrative Code Chapter 550
Have you reviewed the HHSC PPECC Inspection/Survey CBT to understand what surveyors will look for?
Yes — reviewed; survey scope understood
Not yet — but I know CBT materials are available
No — I wasn't aware of a survey-preparation CBT
I'm relying on my clinical experience to prepare for surveys
26 Texas Administrative Code Chapter 550
What is your plan for transportation to and from your PPECC?
Operating our own transportation vehicles and staff
Contracting with a transportation provider
Expecting families to arrange their own transportation
Haven't decided on the transportation model yet
26 Texas Administrative Code Chapter 550
Does your plan-of-care template include transportation stability documentation, as required by the December 2024 TMHP compliance baseline?
Yes — included
Not yet
I wasn't aware this was required in the POC
N/A
26 Texas Administrative Code Chapter 550
Have you mapped the T2002 (transportation) billing-evidence documentation requirements?
Yes — T2002 documentation standard designed
Not yet — but I know T2002 is a PPECC billing code
No — I'm not familiar with T2002 billing-evidence requirements
I didn't know PPECC transportation was separately billable
26 Texas Administrative Code Chapter 550
Have you initiated or completed TMHP PPECC provider enrollment?
Yes — enrolled or enrollment in final stages
In progress — application submitted
Not yet started
Not sure what TMHP provider enrollment requires for PPECCs
TMHP PPECC PA forms (F00124, F00142)
TMHP CSHCN Services Handbook Chapter 33
Do you understand the difference between the CSHCN FFS (TMHP fee-for-service) channel and the STAR Kids (managed care MCO) channel for Texas PPECC billing?
Yes — understand both channels and how to route each child
Partially — I know there are two channels but not the operational differences
No — I wasn't aware of the two-channel structure
I thought all Texas Medicaid was processed through TMHP directly
TMHP PPECC PA forms (F00124, F00142)
TMHP CSHCN Services Handbook Chapter 33
Have you designed a prior authorization (PA) workflow for PPECC services, including initial PA, renewal PA, and changes during the authorization period?
Yes — PA workflow designed for both CSHCN FFS and STAR Kids
In progress
Not yet
I'm not familiar with what the PPECC prior authorization process requires
TMHP PPECC PA forms (F00124, F00142)
TMHP CSHCN Services Handbook Chapter 33
Are you aware of the three required documents for STAR Kids PPECC prior authorization requests?
Yes — aware of all three: (1) CCP Prior Authorization Request Form, (2) PPECC Plan of Care (F00122), and (3) Nursing Addendum to Plan of Care
Partially — I know there are specific PA documents but not all three
No — I didn't know STAR Kids has specific required PA documents
I'm only planning to serve CSHCN FFS (not STAR Kids) clients
TMHP PPECC PA forms (F00124, F00142)
TMHP CSHCN Services Handbook Chapter 33
Are you familiar with the Texas PPECC billing code structure — T1025 (per diem, for service days exceeding 4 hours) and T1026 (hourly, for service days of 4 hours or less)?
Yes — familiar with both codes and the daily billing logic (T1025 and T1026 may not both be billed on the same day)
I know T1025 and T1026 exist but not the specific coding logic
No — I wasn't aware of the specific billing codes for PPECCs
I thought T1025 and T1026 could both be billed on the same day
TMHP PPECC PA forms (F00124, F00142)
TMHP CSHCN Services Handbook Chapter 33
Have you designed a daily documentation model that produces billing evidence for T1025 or T1026 claims without requiring manual assembly after the service day?
Yes — daily documentation standard designed to produce billing evidence in real time
In progress
Not yet — planning to address after opening
I'm planning to generate billing evidence separately from clinical documentation
TMHP PPECC PA forms (F00124, F00142)
TMHP CSHCN Services Handbook Chapter 33
Have you designed an attendance-to-authorization reconciliation process that confirms billing aligns with active authorization periods?
Yes — reconciliation process designed
In progress
Not yet
I didn't know billing must be reconciled against authorization periods
TMHP PPECC PA forms (F00124, F00142)
TMHP CSHCN Services Handbook Chapter 33
Have you reviewed the HHSC PPECC initial survey requirements and what documentation surveyors will review?
Yes — initial survey scope reviewed; documentation model aligned
Partially — I know a survey is required but not what it covers
No — I haven't looked at survey requirements
Planning to address survey preparation after licensing
HHSC PPECC Licensing Standards CBT
26 Texas Administrative Code Chapter 550
Have you reviewed the HHSC PPECC Inspection/Survey CBT?
Yes — reviewed the inspection CBT
Not yet — but I know it is available
No — I didn't know there was a survey-preparation CBT
HHSC PPECC Licensing Standards CBT
26 Texas Administrative Code Chapter 550
Have you designed a corrective action plan (CAP) process for your PPECC?
Yes — CAP process template and escalation model designed
Not yet — but I know CAPs are part of the survey process
No — I haven't looked at CAP requirements
Planning to design the CAP process if/when we receive findings
HHSC PPECC Licensing Standards CBT
26 Texas Administrative Code Chapter 550
What is your current plan for clinical record management at your PPECC?
Planning to use Harbor — a PPECC-native clinical operations record
Planning to use a generic EHR and adapt it for PPECC
Planning to use paper records
Still evaluating options — haven't decided
Using a system from my current practice setting
Aegis source-informed guidance library
Have you mapped how nursing documentation, therapy documentation, authorization status, attendance, and billing evidence will connect in your operating model?
Yes — integration model designed; all areas linked
Partially — some connections mapped but not all
Not yet — planning to address after opening
I wasn't aware these areas needed to be explicitly connected
Aegis source-informed guidance library
Have you evaluated Harbor as a PPECC-native clinical operations record?
Yes — evaluated; decision made
Heard of it — haven't looked closely
No — this is the first time I'm seeing Harbor mentioned
I'm looking at it now as a result of this assessment
Aegis source-informed guidance library
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