Overview of PPECC Licensing Standards in Texas
Licensing Application and Fees

Welcome!

Thank you for taking the Overview of Prescribed Pediatric Extended Care Center (PPECC) Licensing Standards in Texas Licensing Application and Fees computer-based training.

This course is designed to provide general information on the PPECC licensing application requirements. It remains the full responsibility of each applicant to complete the application in its entirety with accurate  information.

This pre-licensing program training is designed to meet the requirements listed in the TAC, Title 26, Part 1, Chapter 550 at §550.105 for PPECC administrators, nursing directors and their alternates.

Successful completion of this CBT satisfies the specific licensure requirement at Texas Administrative Code (TAC), Title  26, Part 1, Chapter 550, §550.305(b)

 

computer

For policy/course content questions contact a

PPECC policy specialist at (512) 438-3161 or by email at policyrulestraining@hhsc.state.tx.us

 

For licensing/application questions contact a PPECC licensing specialist at (512) 438-2630.

 

 

Organization of Training

This training is organized into four topics. It offers an introduction to the PPECC laws and regulations regarding the application process.

Texas Unified Licensure Information Portal (TULIP)

Texas Health and Human Services Commission has introduced TULIP, an online system for submitting long-term care licensure applications. TULIP has replaced paper licensure applications for all provider types, including PPECC and applies to initial licenses, renewals and changes of ownership.

Required Documentation of Successful Participation

How will the completion of this CBT be documented and verified? 

PPECC administrators, nursing directors and their alternates, must upload a signed certificate of completion to TULIP along with the application.

HHSC will not approve a PPECC license application without this signed certificate for each of the required participants, and centers must keep copies of these signed certificates on file and available.

 

Required Laws and Regulations

What reference materials are required to complete the CBT?

files

To successfully complete this training, you must have access to the required laws and regulations; which are listed below. PPECCs must maintain compliance with these laws and regulations.

 

They include:

 

  • Health and Safety Code Chapter §248A;
  • Texas Administrative Code (TAC) Title 26 Part 1 Chapter 550;
  • National  Fire Protection Association (NFPA) 101, 2000 edition; and
  • TAC Title 1 Part 15, Chapter 363

 

Learning Objectives

target

In this course, the participant will:

 

  • Review the criteria and eligibility requirements regarding a license for PPECCs;

 

  • Distinguish between application types to assist in the completion of an application; and

 

  • Identify the requirements for notifying HHSC when there is a change in licensure status.

 

General Licensure Requirements

The next slides will review  basic requirements for obtaining a PPECC license.

TIP: As you proceed through the course, it may helpful to  make notes.

Eligibility for Reimbursement

woman and cash

PPECC providers who wish to be eligible for reimbursement for Title XIX (Medicaid) benefits must:

 

  • Meet program requirements found in the Texas Administrative Code (TAC), Title 1, Part 15, Chapter 363;

 

  • Complete the required Medicaid provider enrollment application forms after obtaining a PPECC license or temporary license from HHSC; and

 

  • Enter into a written provider agreement.

 

For information on how to become a Medicaid provider, please email  HHSC @ HHSC_PPECC@hhsc.state.tx.us

 

Criteria and Eligibility for a License

When reviewing the criteria to obtain a license, it's important to understand the application requirements for a PPECC license.

Some of these requirements include:

Applicant Qualifications

checklist

Before issuing a license, HHSC considers the background and qualifications of:

 

  • The applicant;
  • A controlling person of the applicant;
  • A person with a disclosable interest;
  • An affiliate of the applicant;
  • The administrator;
  • The alternate administrator; and
  • The chief financial officer, (if applicable).

 

Are You Qualified?

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An applicant must have met:

 

  • Approval of building plans through a plan review by the HHSC Architectural Unit at (512) 438-2371 or fax (512) 438-4623;
  • Documented compliance with local building ordinances;
  • Local fire authority codes;
  • Life Safety Code (LSC) standards and the requirements in TAC Title 26 Part 1, Chapter 550, Subchapter E ; and
  • Requirements based on an on-site health inspection by HHSC.

 

Basic Application Requirements

Let's review some of the general requirements of the application.

Building Approval

blueprints

Let's review some of the requirements for building approval.

Prior to applying for a license, an applicant must submit applicable plans for any of these scenarios:

  • New buildings;
  • Additions;
  • Conversions of  buildings not licensed by HHSC; and 
  • The remodeling of existing licensed  centers.

One copy of contract documents must be submitted to HHSC before construction begins. These contract documents must include building approval from  the local fire authority or, if the jurisdiction does  not have a local fire authority, the state fire  marshal.

 

However, you  may submit a license application to HHSC before receiving fire authority approval.

 

You may then submit a copy of a signed  and dated written  approval for occupancy by the local fire authority or state fire marshal that describes the center by name and address.

 

 

 

Review

recall

Key points to remember:

 

  • Program requirements can be found in the TAC, Title 26, Part 1 Chapter 550.
  • Before issuing a license, HHSC considers the background and  qualifications of the applicants.
  • Applicants must complete the application as per the instructions in TULIP.
  • HHSC does not refund the license fee, except as provided in §550.114.
  • You must submit plans for new or unlicensed buildings; additions; and the remodeling of existing licensed centers prior  to the submission of the application.

 

 

Types of Applications

The next few slides will review the distinguishing  requirements for each licensure type. Also, this section  reviews the required updates a PPECC must submit when licensure status changes.

These updates and requirements include:

Initial License Application Process

ppt file

Initial Licensure Documentation Review

The following items are required for the initial licensure process in addition to the TULIP application:

Temporary License 

Option §550.123

The temporary license is an option for all applicants for a PPECC license but is not required.  An applicant may choose to apply for an initial PPECC license only. Applicants who would like to request a temporary license must do so in writing upon submission of  the initial license application to HHSC. 

§550.123(b) To request a temporary license, the applicant must submit to HHSC  Provider Licensure and Certification Unit, a written request for a temporary license and a  copy of the applicant's policies, procedures and staffing plans that demonstrate compliance  with the licensing standards of this chapter.

Temporary License Documentation Review

The following are documents required for the temporary licensure process:

In addition to the items required for an initial license:

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Renewal Application Process

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The process for a renewal license is as follows: 

  • Renewal applications are submitted before the expiration date. HHSC sends a reminder at least 120 days before the expiration.
  • In accordance with Texas Government Code, §2001.054, HHSC  considers that a license holder meets the deadline if the  submission is no later than 60 days before the expiration date.
  • The application must be complete or include a letter explaining  what the circumstances were that prevented the inclusion of  the  missing information.
  • The license fee established in §550.112 is $2,625.00. There  will be a $50.00 fee per day for each day after the 60 day  deadline the application is submitted. The maximum late fee is $500.00
  • The license expires on the third anniversary of the effective date.

 

 

Renewal Licensure Documentation Review

The following are items required for the renewal licensure process in addition to the TULIP renewal application:

Renewal Application Denial Process

The process for denying a renewal license is as follows:

To learn more about the denial process read the rules at §550.115

 

Change of Ownership (CHOW) Application Process

The process for a CHOW license is as follows:

CHOW Licensure Documentation Review

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The following items are required  in addition to the TULIP CHOW application for the CHOW licensure process:

  • A letter of credit for $250,000.00 from a bank that is insured by the FDIC in the  name of the applicant.
  • Management company agreement (if applicable)
  • Copy of written notification to the local health authority that the applicant is  submitting a license application to HHSC
  • A copy of an approved inspection of the center by the local fire marshal
  • A written notice to HHSC that the center is ready for a LSC inspection
  • Property documents (lease, sublease, or deed)
  • A copy of the results for the PPECC pre-licensure computer-based training for  the administrator
  • Required legal entity documents for applicant (and management company, if  applicable)
  • CHOW Affidavit
  • Licensing fee

 

Increase in Capacity Application Process

The process for an increase in capacity license requires:

 

Then HHSC will conduct both an onsite :

Note: The capacity may (not) be increased without approval from HHSC.

Decrease in Capacity Application Process

The process for an decrease in capacity license is as  follows:

Increase/Decrease Licensure Documentation Review

The following are documents required for the  increase in capacity licensure process:

The following document is required for the  decrease in capacity licensure process:

Relocation Application Process

man moving

The relocation process is as follows:

 

  • The existing center must continue to  maintain operations meeting all  requirements, until HHSC has approved  the relocation.
  • Relocation or providing services at a new  location without prior approval from HHSC is  not allowed, therefore the applicant must use  the form 3720-P in TULIP and apply for a new center.  The application requirements are the same as an initial Licensure.
  • Submit an initial licensure application for the  new location.
  • Submit the licensure fee of $2,625.00.
  • Once the new center has met the initial
  • licensure requirements the former center  must close and move its business operations  to new location.

 

 

Relocation Licensure Documentation Review

The following are documents required for the relocation licensure process in addition to the TULIP application:

Review

Review

The requirements for Initial Licensure; Renewal of License; Change of Ownership  (CHOW); Capacity Increase/Decrease; and Center Relocation have been reviewed.

 

Each of these licensure types have:

 

  • Distinct requirements and circumstances that require the applicant to use the  application form 3720-P in TULIP to notify HHSC of your intentions;

 

  • Conditions which were explained and require certain fees; and

 

  • A specific document checklist the applicant is required to review.

 

The applicant should pay attention to the process required or sequence of steps for each  type of licensure. The applicant should review each of the required timeframes to avoid  noncompliance.

 

Updates for a Change in Administration

Notification procedures a center must complete:

No fee is associated with this change.

Updates for a Change in Ownership Interest/Ownership Hierarchy

Notification procedures a center must complete:

No fee is associated with this change.

Updates for a Change in Management Company or Management Company Information

Notification procedures a center must complete:

No fee is associated with this change.

Updates for a change of Center Contact Information

Notification procedures a center must complete:

No fee is associated with this change.

Updates for a Change of Center Operating Hours

Notification procedures a center must complete:

No fee is associated with this change.

Updates for a Name Change

Notification procedures a center must complete:

No fee is associated with this change.

Review

review

We have reviewed the requirements for Change in Administration and  Management; Transfer of Ownership Interest; Change in Management Company  Information; Change of Center Contact Information; Change in Center Operating  Hours; and  Legal Name or Center Name Change.

 

Each of these update types:

 

  • Have distinct requirements and circumstances that require the applicant to use  the application form 3720-P in TULIP.

 

  • Have specific conditions and timeframes for notification to HHSC;

 

  • Do not require fees to be submitted to HHSC; and

 

  • Require additional documents the applicant must send in with the application .

 

Licensing Fees

In the next few slides the required fee for each licensure type and some of the conditions which apply to these fees are reviewed.

Some of these conditions include:

 

NOTE: Updates will not require a fee, however a center is required to comply with the rule to avoid noncompliance.

Licensing Fees Overview

The schedule of fees for licensure of a center is as follows:

Licensing Fees Overview

Certain licensing fees are subject to the following:

Additional Documentation

The next few slides review additional required documentation to  accompany the application form 3720-P in TULIP. This information should  accompany the application. This serves as a checklist to assist the applicant in the submission process.

Provide Copies of Sole Proprietorship Documents

Ownership Disclosure Documents

Business Entity Documents

 

Provide Copies of For-Profit Documents

Ownership Disclosure Documents

Business Entity Documents

Provide Copies of Non-Profit Documents

Ownership Disclosure Documents

Business Entity Documents

Include non-profit corporations, non-profit limited liability companies and non-profit unincorporated associations.

 

Provide Copies of Limited Liability Documents

Ownership Disclosure Documents

Business Entity Documents

Provide Copies of General Partnership Documents

Ownership Disclosure Documents

Business Entity Documents

Provide Copies of General Partnership Limited Liability Documents

Ownership Disclosure Documents

Business Entity Documents

 

Provide Copies of Limited Partnership Documents

Ownership Disclosure Documents

Business Entity Documents

Provide Copies of Limited Partnership Limited Liability Documents

Ownership Disclosure Documents

Business Entity Documents

Provide Copies of Other Documents 

(Example: investment company)

Ownership Disclosure Documents

Business Entity Documents

Provide Copies of Federal, State, County or City, Hospital Authority Documents

Ownership Disclosure Documents

Business Entity Documents

Review

Board

The application process requires additional documentation to accompany  form 3720-P in TULIP.

 

The business models reviewed are Sole Proprietorship; For-Profit; Non-Profit; Limited Liability; General Partnership; General Partnership Limited Liability; Limited Partnership; Other, Specify such as Investment Company; and Federal, State, County or City, Hospital Authority.

 

The two types of required documentation are ownership disclosure documents and business entity documents.

 

Certificate of Completion: PPECC Licensing Application

Congratulations!  You have completed  the course.

Please print and sign this certificate.

When signing, please include your position and center name.

Mail or fax a copy of the certificate with your license application to verify your successful  completion.