Pecan Hollow Home Care

Modeled data. No real people, clients, or companies.

As of Jul 15, 2026this quarter, Jun to Aug

Tyler delivers more of its planned care than any other branch, and two of its contracts are heading to fail.

El Paso is the reverse. Every contract it holds is heading to pass, and it delivers the least of its planned care.

The state grades 24 of our contracts. 21 are heading to pass and 3 are not.

How do we know?

The finding, in full: Tyler is 1st of 7 on hours delivered against its own plan and 7th of 7 on visits clocked in electronically, and 2 of its contracts will finish under the line. El Paso is 7th of 7 on hours delivered and 5th of 7 on clocking in, and every contract it holds will pass.
The count of contracts: The state grades 24 of our payer contracts. 21 will pass and 3 will finish under the line.
The rule behind the map's labels: The state grades a contract, not an office. It never blends a branch's contracts into one number, and there is no branch parameter on any report it publishes.

McAllenAll contracts heading to pass; the best at clocking inFort WorthAll contracts heading to pass; newest attendants slippingAustinAll contracts heading to pass; payers have asked for money backEl PasoAll contracts heading to pass; planned care unworkedHoustonAll contracts heading to pass; a payer's notice openSan AntonioOne contract will failTylerTwo contracts heading to fail

On the map

a contract heading to fail
every contract heading to pass
a payer's notice is open

Each label describes that branch's contracts. The state grades each contract, never the office.

These counties are derived by a published rule from published service areas and are attributed to no real agency. We found no per provider county list published in Texas.

County boundaries: U.S. Census Bureau, cartographic boundary file, counties, 2025 vintage, 1:500,000.

The money, across the agency

Care we gave and cannot bill yet

about $178,205

about $15,700 locks in the next 30 days

3,130 visits are waiting to be typed in or corrected. Until they are, they cannot be billed.

A visit locks 95 days after it happens, and a visit that locks unpaid can no longer be billed. About $15,700 of this locks in the next 30 days.

The most is at San Antonio.

Care we planned and nobody was sent to give

about $33,576

545 visits this quarter had no attendant assigned. The care was never given, so it can never be billed.

The state's grade counts only visits somebody worked, so none of this shows in any grade.

The most is at El Paso.

Every dollar here is our estimate. The state publishes the rate it pays for care it buys directly. We could not verify what each health plan pays, so that rate is our assumption.

How to read it

Each shaded area on the map is one branch and the counties it serves.
The mark on each branch shows how its contracts will finish this quarter. A contract needs 80 points out of 100 to pass.
Press a branch to see what is wrong there and the one thing to do about it.

Tyler

Tyler is doing the care, and two of its contracts are heading to fail.

The visits happen. Too many are typed in by hand instead of clocked in.

Where each contract is heading

Every contract has dropped every quarter. Two finish under the line.

The same block, another way

	Dec to Feb	Mar to May	so far	where it finishes
STAR+PLUS Plan A	94	86	78	74Will not pass
STAR+PLUS Plan B	92	87	77	74Will not pass
HHSC fee for service	92	91	85	82Passes

under the line

San Antonio

One San Antonio contract will fail this quarter, and most of the unpaid visits behind it can still be billed.

Some of its clients changed health plans, and the setup that sends their visits to the state still names the old plan.

Where each contract is heading

One contract finishes under the line. The rest are heading to pass.

The same block, another way

	Dec to Feb	Mar to May	so far	where it finishes
STAR+PLUS Plan B	90	82	71	66Will not pass
STAR+PLUS Plan A	95	95	95	93Passes
STAR+PLUS Plan D	95	96	96	94Passes
HHSC fee for service	95	96	96	95Passes

under the line

Houston

Every Houston contract is heading to pass, and one is still under a payer's notice from last winter.

The notice asks for training, and the training is due Jul 20.

Where each contract is heading

Its health plan contracts finished under the line last winter. All of them are above it now.

The same block, another way

	Dec to Feb	Mar to May	so far	where it finishes
STAR+PLUS Plan A	77	85	86	84Passes
STAR+PLUS Plan E	77	85	87	85Passes
STAR+PLUS Plan B	76	85	87	85Passes
HHSC fee for service	86	87	88	87Passes

under the line

El Paso

Every El Paso contract is heading to pass, while care it planned goes unworked.

The state's grade counts only the visits somebody worked, so it cannot see this.

Where each contract is heading

Every contract is heading to pass.

The same block, another way

	Dec to Feb	Mar to May	so far	where it finishes
STAR+PLUS Plan B	90	89	92	90Passes
STAR+PLUS Plan F	91	90	91	90Passes
HHSC fee for service	93	91	94	93Passes

Austin

Every Austin contract is heading to pass. Payers have sent notices to take back money paid for care it gave last winter.

Most of those notices say the records of the visits could not be produced.

Where each contract is heading

Every contract is heading to pass.

The same block, another way

	Dec to Feb	Mar to May	so far	where it finishes
STAR+PLUS Plan A	88	91	93	91Passes
HHSC fee for service	89	92	93	92Passes
STAR+PLUS Plan C	91	94	94	93Passes

Fort Worth

Every Fort Worth contract is heading to pass. Its newest attendants are getting worse at clocking in.

Across the whole agency, new attendants are getting better.

Where each contract is heading

Every contract is heading to pass.

The same block, another way

	Dec to Feb	Mar to May	so far	where it finishes
HHSC fee for service	93	94	92	91Passes
STAR+PLUS Plan B	93	93	93	92Passes
STAR+PLUS Plan A	93	93	94	94Passes

McAllen

Every McAllen contract is heading to pass, and no branch clocks in better.

It still has visits waiting to be typed in before they lock.

Where each contract is heading

Every contract is heading to pass.

The same block, another way

	Dec to Feb	Mar to May	so far	where it finishes
STAR+PLUS Plan C	96	96	96	95Passes
HHSC fee for service	96	96	97	96Passes
STAR+PLUS Plan A	93	96	97	96Passes
STAR+PLUS Plan B	96	96	97	96Passes

The one thing to do

Order an alternative device for each of the 20 homes that qualify, and set up their attendants on it.

Who: Alicia Blackwell, EVV coordinator
By when: Jul 27, our model's last safe day to order

What it buys

In our model, both failing contracts then finish above the line.

STAR+PLUS Plan A

STAR+PLUS Plan B

Why it is happening

Clocking in fell when the landlines were taken out.

In April and May, 20 clients lost the home phone their attendants clocked in on.
No replacement device was ordered, so 19 attendants have no way to clock in.
The office types those visits in by hand, and the state marks a contract down for every visit typed in by hand.

Against the other six branches

Best of the seven at delivering care. Last at clocking it in.

Clocking in

the other sixthe middle branchTyler 62 in 100this quarter so far

100

7th of 7

Accepted the first time they are sent

the other sixTyler 97 in 100

100

5th of 7

Planned hours delivered

the other sixthe middle branchTyler 95 in 100

100

1st of 7

How do we know?

The stored sentences, word for word

The insight: Tyler delivered 95 in 100 of the hours its office planned this quarter, and every one of its visits had an attendant assigned. The state's grade marks its contracts down because 29 in 100 of its visits were typed in by hand, and 279 more are still waiting to be typed in.
The cause: 20 client landlines were removed after the landline review and no alternative device has been ordered, so the 19 attendants still working those homes have no way to clock in.
What ordering the devices today is worth, in our model: Ordered today, the devices arrive Jul 22. STAR+PLUS Plan A then finishes at 83 instead of 74, and STAR+PLUS Plan B at 82 instead of 74.

Every figure, contract by contract

Contract	Dec to Feb	Mar to May	so far		Heading to range	Status	Last day the fix can be in place, in our model
STAR+PLUS Plan A	94	86	78	↓	74 73 to 74	Will not pass	Aug 4
STAR+PLUS Plan B	92	87	77	↓	74 73 to 76	Will not pass	Aug 3
HHSC fee for service	92	91	85	↓	82 81 to 83	Passes	not needed

Where the figures come from

The grades: EVV Usage Report (the EVV Portal)
The landlines: EVV Landline Phone Verification Report (EVV system)
The visits still waiting to be typed in: EVV Visit Log (EVV Portal)

The one thing to do

Change the plan on the 26 clients' EVV setup from STAR+PLUS Plan B to STAR+PLUS Plan A.

Who: Noemi Hinojosa, biller
By when: Today. More of their visits lock every day.

What it buys

In our model the grade stays under the line even if this is fixed today. Most of the money does not have to be lost.

STAR+PLUS Plan B

about $69,692

of care on 1,161 visits these clients were given, unpaid until the visits are corrected

Every dollar here is our estimate. The state publishes the rate it pays for care it buys directly. We could not verify what each health plan pays, so that rate is our assumption.

Then: Correct those clients' 1,161 open visits, oldest first, once their EVV setup is changed.Claudia Simmons, EVV coordinator

Why it is happening

The state started turning back visits when clients changed health plans.

1January: 2 clients changed health plans
2May: 12 clients changed health plans
3June: 8 clients changed health plans
4July: 4 clients changed health plans

26 clients are on one health plan in the state's file and on another in our setup.
Every visit sent for them since the change has been turned back.
Care worth about $69,692 on 1,161 visits cannot be billed until the setup is changed.

Against the other six branches

Last of the seven at getting visits accepted the first time they are sent.

Clocking in

the other sixthe middle branchSan Antonio 93 in 100

100

2nd of 7

Accepted the first time they are sent

the other sixthe middle branchSan Antonio 89 in 100this quarter so far

100

7th of 7

Planned hours delivered

the other sixthe middle branchSan Antonio 91 in 100

100

6th of 7

How do we know?

The stored sentences, word for word

The cause: 26 clients have STAR+PLUS Plan A on the state's file and STAR+PLUS Plan B on our EVV setup, and every one of their 5,693 sends since their plan changed has been rejected.
The insight: The state grades each payer contract on its own. Care worth about $69,692 on 1,161 of those clients' visits cannot be billed until their EVV setup is changed.
What changing the plan today is worth, in our model: Changed today, STAR+PLUS Plan B finishes at 75 instead of 66, still under the line.
What correcting the visits is worth: about $69,692 on 1,161 visits

Every figure, contract by contract

Contract	Dec to Feb	Mar to May	so far		Heading to range	Status	Last day the fix can be in place, in our model
STAR+PLUS Plan B	90	82	71	↓	66 60 to 69	Will not pass	too late
STAR+PLUS Plan A	95	95	95	↓	93 90 to 95	Passes	not needed
STAR+PLUS Plan D	95	96	96	↓	94 92 to 96	Passes	not needed
HHSC fee for service	95	96	96	↓	95 91 to 96	Passes	not needed

Where the figures come from

The grades: EVV Usage Report (the EVV Portal)
The plan change and the visits turned back: Visit History search (EVV Portal)

The one thing to do

Run the EVV policy, system, portal and clock in and clock out training that STAR+PLUS Plan A's notice requires.

Who: Alma Foster, branch manager
By when: Jul 20, when the notice's training is due

What it buys

It meets the first step of the notice. If it is missed, the payer may hold back payments until it is done.

Houston's notice is here, due Jul 20
First notice
Asks for the EVV policy, system, portal and clock in and clock out training
20 business days to meet it
Second notice, or later
Asks for a corrective action plan
10 business days to meet it
Third notice, or later
Termination may be proposed, and only after the progressive steps and three failed quarters inside 24 months.

Why it is happening

Half of the visits not clocked in electronically come from one group of its attendants.

322 attendants who worked

54 attendants

half of these visits

the other half

2,513 visits not clocked in electronically

54 of Houston's 322 attendants carry half of its visits not clocked in electronically.
Coaching that group reaches half of the problem.

Against the other six branches

6th of 7 at clocking in, its lowest place.

Clocking in

the other sixthe middle branchHouston 78 in 100

100

6th of 7

Accepted the first time they are sent

the other sixHouston 97 in 100

100

3rd of 7

Planned hours delivered

the other sixthe middle branchHouston 94 in 100

100

2nd of 7

How do we know?

The stored sentences, word for word

The cause: 1,938 visits at Houston this quarter were typed in by hand for a missed clock in or clock out, and 54 of its 322 attendants carry half of its visits not clocked electronically.
What the training is worth: It meets the first step of STAR+PLUS Plan A's notice ladder. If it is missed, the payer may temporarily withhold Medicaid claims payments until requirements are met.

Every figure, contract by contract

Contract	Dec to Feb	Mar to May	so far		Heading to range	Status	Last day the fix can be in place, in our model	On this row
STAR+PLUS Plan A	77	85	86	↓	84 83 to 85	Passes	not needed	payer's notice open
STAR+PLUS Plan E	77	85	87	↓	85 84 to 86	Passes	not needed	failed with no notice
STAR+PLUS Plan B	76	85	87	↓	85 85 to 86	Passes	not needed	failed with no notice
HHSC fee for service	86	87	88	↓	87 86 to 88	Passes	not needed

Where the figures come from

The grades: EVV Usage Report (the EVV Portal)
The attendants behind half: EVV Service Provider Clock In and Clock Out Report (EVV system)
The notice: A notice of noncompliance is a letter from a payer and is not a report in the portal. The ladder is handbook 11010, and the appeal clocks are 11030 and 11040.

The one thing to do

Assign an attendant to each of the 13 clients who had a visit with nobody assigned since Jul 1 and have had no visit worked since then.

Who: Gloria Salinas, scheduler
By when: Today

What it buys

An hour nobody worked cannot be made up. Assigning attendants to these clients keeps more hours from being lost.

136

visits since Jul 1 had nobody assigned.

Why it is happening

13 of every 100 hours El Paso planned had nobody sent to work them.

El Paso

81 worked

13 nobody sent

6 missed or cut short

The other six branches, together

93 worked

7 missed or cut short

nobody sent, fewer than one in 200

this quarter so far

Each grid is all the hours planned, as a hundred squares.

Every dollar here is our estimate. The state publishes the rate it pays for care it buys directly. We could not verify what each health plan pays, so that rate is our assumption.

That care, about $30,989, was never given, so it can never be billed.
13 clients have had no visit worked since they were left without an attendant.
El Paso loses attendants faster than any other branch.

Against the other six branches

Last of the seven at delivering its planned care.

Clocking in

the other sixthe middle branchEl Paso 87 in 100

100

5th of 7

Accepted the first time they are sent

the other sixEl Paso 97 in 100, the middle branch

100

4th of 7

Planned hours delivered

the other sixthe middle branchEl Paso 81 in 100

100

7th of 7

How do we know?

The stored sentences, word for word

The cause: 499 visits at El Paso this quarter had nobody assigned to work them, and its attendant turnover runs 69 in 100 a year, the highest of the seven.
What staffing these clients is worth: 136 visits since Jul 1 had nobody assigned, and those hours cannot be made up.

Every figure, contract by contract

Contract	Dec to Feb	Mar to May	so far		Heading to range	Status	Last day the fix can be in place, in our model
STAR+PLUS Plan B	90	89	92	↓	90 88 to 91	Passes	not needed
STAR+PLUS Plan F	91	90	91	↓	90 90 to 91	Passes	not needed
HHSC fee for service	93	91	94	↓	93 91 to 94	Passes	not needed

Where the figures come from

The grades: EVV Usage Report (the EVV Portal)
The hours nobody was assigned: EVV Service Delivery Exception Report (the EVV system)
Hours authorized against hours worked: EVV Units of Service Summary (the EVV system, and the EVV Portal)

The one thing to do

Type in or correct the 15 open visits that lock in 14 days or less, oldest first.

Who: Loretta Rangel, EVV coordinator
By when: Today, the last day before the first of them locks

What it buys

about $867

of care on 15 open visits that lock in 14 days or less. A visit that locks unpaid can no longer be billed.

Every dollar here is our estimate. The state publishes the rate it pays for care it buys directly. We could not verify what each health plan pays, so that rate is our assumption.

Why it is happening

Most of the agency's take-back notices for missing records on last winter's claims are Austin's.

132 notices for missing records on last winter's claims, across the agency

Austin 111

the other six branches

Payers have sent 116 notices on last winter's claims, to take back about $7,082.
43 of Austin's 116 notices from last winter are under appeal.
111 of the agency's 132 notices for missing records on last winter's claims are Austin's.

Against the other six branches

Neither first nor last of the seven on any track.

Clocking in

the other sixAustin 89 in 100, the middle branch

100

4th of 7

Accepted the first time they are sent

the other sixthe middle branchAustin 97 in 100

100

2nd of 7

Planned hours delivered

the other sixthe middle branchAustin 93 in 100

100

5th of 7

How do we know?

The stored sentences, word for word

What typing in these visits is worth: about $867 on 15 visits

Every figure, contract by contract

Contract	Dec to Feb	Mar to May	so far		Heading to range	Status	Last day the fix can be in place, in our model
STAR+PLUS Plan A	88	91	93	↓	91 91 to 92	Passes	not needed
HHSC fee for service	89	92	93	↓	92 92 to 93	Passes	not needed
STAR+PLUS Plan C	91	94	94	↓	93 93 to 94	Passes	not needed

Where the figures come from

The grades: EVV Usage Report (the EVV Portal)
The visits that lock soonest: EVV Visit Log (EVV Portal)

The one thing to do

Pull yesterday's visits with no clock out every morning and call each attendant before their next shift.

Who: Bernadette Vela, EVV coordinator
By when: Every morning

What it buys

Each visit missing its clock out already counts against the grade. Calling the attendant before their next shift is how to keep it from happening again.

2,440

visits since Dec 1 were missing only the clock out.

Why it is happening

Every quarter, more of the visits by Fort Worth's attendants with under 6 months on the job are typed in by hand. Across the agency, fewer are.

Since Dec 1, 71 in 100 of Fort Worth's typed-in visits were missing only the clock out.
At the middle branch of the seven it is 33 in 100.

Against the other six branches

Not last of the seven on any track.

Clocking in

the other sixthe middle branchFort Worth 89 in 100

100

3rd of 7

Accepted the first time they are sent

the other sixthe middle branchFort Worth 97 in 100

100

1st of 7

Planned hours delivered

the other sixFort Worth 93 in 100, the middle branch

100

4th of 7

How do we know?

The stored sentences, word for word

The insight: Its attendants in their first six months had 14, 17 and 22 in 100 of their visits typed in by hand over the last three quarters, against 17, 15 and 14 across the agency.
The cause: 71 in 100 of Fort Worth's visits typed in by hand since Dec 1 were missing only the clock out, against 33 at the middle branch of the seven.
What the morning calls are worth: Since Dec 1, 2,440 visits were missing only the clock out, and the state's grade already counts each of them as typed in by hand.

Every figure, contract by contract

Contract	Dec to Feb	Mar to May	so far		Heading to range	Status	Last day the fix can be in place, in our model
HHSC fee for service	93	94	92	↓	91 91 to 92	Passes	not needed
STAR+PLUS Plan B	93	93	93	↓	92 91 to 93	Passes	not needed
STAR+PLUS Plan A	93	93	94	→	94 93 to 94	Passes	not needed

Where the figures come from

The grades: EVV Usage Report (the EVV Portal)
The missing clock outs: EVV Service Provider Clock In and Clock Out Report (EVV system)
The newest attendants: EVV Service Provider Clock In and Clock Out Report (EVV system)

The one thing to do

Type in the 43 visits still waiting, oldest first.

Who: Hannah Zamora, EVV coordinator
By when: Jul 31, the last day before the first of them locks

What it buys

Typed in before they lock, these visits can still be billed.

about $2,543

of care on 43 visits still waiting to be typed in. A visit cannot be billed until someone types it in.

Every dollar here is our estimate. The state publishes the rate it pays for care it buys directly. We could not verify what each health plan pays, so that rate is our assumption.

Why it is happening

72 of the 88 visits that locked unpaid belong to one client.

Already locked, unpaid

about $4,182

on 88 visits

Four clients changed health plan on Jan 1. Three were moved over in time.

January

February

March

April

May

Jan 1

Jan 2

Moved over in time

sent under the new plan

Not moved over until Feb 6

sent under the old plan and turned back

moved over

95 days later

72 visits locked unpaid, Apr 6 to May 11

The fourth was not moved over until Feb 6.
Until then the client's visits went out under the old plan. Last winter they were turned back 290 times.
The 72 visits before the fix were never sent under the new plan. They locked 95 days after they happened.
A change of health plan made through the state's enrollment broker takes effect on the first of a month, so that is the day to check who pays for each client.

Against the other six branches

Best of the seven at clocking in.

Clocking in

the other sixthe middle branchMcAllen 96 in 100

100

1st of 7

Accepted the first time they are sent

the other sixMcAllen 97 in 100

100

6th of 7

Planned hours delivered

the other sixthe middle branchMcAllen 94 in 100

100

3rd of 7

How do we know?

The stored sentences, word for word

The insight: McAllen can no longer bill about $4,182 of care on 88 visits that locked unpaid, and 75 of them are STAR+PLUS Plan A visits from Dec to Feb.

Every figure, contract by contract

Contract	Dec to Feb	Mar to May	so far		Heading to range	Status	Last day the fix can be in place, in our model
STAR+PLUS Plan C	96	96	96	↓	95 94 to 97	Passes	not needed
HHSC fee for service	96	96	97	↓	96 95 to 97	Passes	not needed
STAR+PLUS Plan A	93	96	97	↓	96 95 to 97	Passes	not needed
STAR+PLUS Plan B	96	96	97	↓	96 95 to 97	Passes	not needed

Where the figures come from

The grades: EVV Usage Report (the EVV Portal)
The visits turned back: Visit History search (EVV Portal)
The visits locked and waiting: EVV Visit Log (EVV Portal)

The rules behind it

The rule	Source
A change of health plan made through the state's enrollment broker takes effect on the first of a month	STAR+PLUS Handbook 3300, Administrative Procedures and STAR+PLUS Program Support Unit Operational Procedures Handbook, Appendix XVII, State Cutoff Dates
The state's guide to rejections says to confirm who pays against the client's eligibility record for the day of the visit	EVV Visit Transaction Rejection Guide, dated Jun 5, 2026
A visit locks 95 days after it happens	Handbook 9050, Rev 25-1, effective Mar 12, 2025

Jan 1, 2026 was also the day the state's new plans for people with both Medicare and Medicaid began in Hidalgo County. The modeled world holds no reason for any client's change.

Source: The state's page, Options for Medicare and Medicaid Dual Coverage