Executive Brief — Platform Overview — 2026
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“What the EMR did for the hospital, Cura OS does for care in the community.”
For decades, EHRs have given hospitals real-time intelligence at the point of clinical care — and that capability continues to accelerate. The established solutions offered to HCBS programs adapted that clinical architecture for community settings, importing medical workflow assumptions into a space defined by non-licensed direct support professionals, non-clinical settings, and person-centered care plans. Cura was built from the HCBS reality outward. The authorized care plan is the operational document. Plain-language guidance is the delivery mechanism. The DSP is the primary user. Cura OS is the infrastructure the community-based system has been waiting for — built for the other 23 hours.
EVV confirms a caregiver arrived. Plan-Driven Service Validation confirms the authorized care was delivered — against the individual's Plan of Care, at the moment of service, before payment.
Federal Policy Alignment
CMS CRUSH Initiative
CMS-6098-NC (Feb 25, 2026): CMS has shifted strategy from retrospective claims recovery to real-time point-of-care validation. Cura is that infrastructure.
CMS Access Rule
2028/2030 compliance deadlines require states to document that HCBS services are delivered as authorized. EVV cannot satisfy this requirement. PDSV can.
Rebalancing Mandates
Every state's Olmstead compliance depends on a commitment states cannot currently make with confidence: that community placement is as reliable as institutional care.
Two Markets, One Platform
Aging & Adult HCBS / Long-Term Services
$100B+ in annual spend and the fastest-growing HCBS segment. States cannot fulfill the Olmstead rebalancing commitment without real-time confirmation that community placement is as reliable as institutional care. Access Rule 2028/2030 deadlines make quality documentation mandatory — not aspirational.
IDD & Developmental Disabilities
Where Cura was built and validated. Rate accountability, PERM compliance, and CRUSH alignment are the active policy drivers. The IDD waiver population — highest acuity, most federally scrutinized — is the proof-of-concept market that demonstrates platform capability for the full HCBS population.
Infrastructure & Execution at Scale
Cloud-Native. Secure. Government-Grade.
Institutional deployments available as FedRAMP aligned dedicated private cloud instances — no shared tenancy, customer-controlled data residency, isolated security perimeter. End-to-end encryption, zero-trust access control, role-based permissions, and 7-year audit log retention. The architecture security reviews expect, delivered the way government data governance requires.
Open Interoperability.
FHIR R4, HL7, and Direct Protocol integration available for existing MMIS, MCO authorization systems, and EHRs. Bi-directional data exchange bridges HCBS service records and clinical systems — care coordination across settings through a single unified view, not parallel silos. No rip-and-replace. Cura operates alongside existing EVV infrastructure.
Enterprise Deployment Competency.
The Cura leadership team carries direct experience leading large-scale health system deployments — multi-year programs, enterprise governance structures, clinical and technical peer review, and formal benefits realization frameworks that produced documented, auditable outcomes at the level of shareholder and public reporting. Organizational change management at state program scale is not a planning assumption here. It is prior experience.
Deployment-Efficient by Design.
No EVV replacement. No new legislation. No full procurement cycle required to begin. The state's existing support coordination infrastructure is the adoption lever. A scoped pilot can be operational within 90–120 days of a planning agreement — with real-time state oversight dashboards active from day one.