TX HHS Form 3230. Application for HHSC Approval to Operate a Hospital at Home Program

The TX HHS Form 3230, "Application for HHSC Approval to Operate a Hospital at Home Program", is designed to help hospitals seeking approval from the Texas Health and Human Services Commission (HHSC) to operate a hospital at home program in Texas. This form should be used by hospitals that have Centers for Medicare and Medicaid Services (CMS) approval to participate in the CMS Acute Hospital Care at Home Program.

The application requires providing specific information about the requesting hospital, including its name, contact details, license type, and CMS certification number. Additionally, hospitals must demonstrate CMS approval allowing them to participate in the CMS Acute Hospital Care at Home Program by submitting relevant documentation with their initial application or renewal request. The form also outlines fees associated with the application process, including a flat fee for initial applications and a per-bed fee for renewals.

This form is essential for hospitals seeking HHSC approval to operate a hospital at home program in Texas. By completing this application, hospitals can ensure they meet the necessary requirements and comply with relevant regulations. The TX HHS Form 3230, "Application for HHSC Approval to Operate a Hospital at Home Program", is a crucial step in obtaining approval from the Texas Health and Human Services Commission.