LTSS Frequently Asked Questions (FAQs)

STAIRS

Who do I contact if I need help completing my report?

Contact the PFD LTSS Customer Information and Training (CIT) team at (737) 867-7817 or PFD-LTSS@hhs.texas.gov.

Which is due this year -- my Accountability Report (AR) or my Cost Report (CR)?

Cost Reporting Cycle	Report Type	Reports Collected
Even-Year Cost Reports Beginning with 2022 cost reports, collected in 2023	CR CR CR CR CR	24RCC HCS/TxHmL ICF/IID NF RC
	AR AR AR	CPC DAHS DBMD
Odd-Year Cost Reports Beginning with 2021 cost reports, collected in 2022	CR CR CR	24RCC CPC DAHS
	AR AR AR AR AR	DBMD HCS/TxHmL ICF/IID NF RC

24RCC: 24-hour Residential Child Care

CPC: CLASS Case Management Agency/Primary Home Care/CLASS Direct Service Agency

DAHS: Day Activity and Health Services

DBMD: Deaf-blind with Multiple Disabilities

HCS/TxHmL: Home and Community-based Services/Texas Home Living

NF: Nursing Facility

RC: Residential Care

Please refer to the Cost Report Training Page for more information 

How do I change my official information (address, email, phone number)?

To change the official information that is on all of your cost and accountability reports, click “Edit My Info” on your STAIRS Dashboard. To edit the information used for each cost or accountability report, the Primary Entity Contact or Financial Contact can navigate to Step 1 in STAIRS (Combined Entity Identification). Please ensure the information on your STAIRS Dashboard is up-to-date. HHSC will use this information to contact you rather than the information on your cost reports.

How can I be excused from filing a cost report?

Examples of general reasons for cost report excusals are the following:

• If the provider performed no billable services during the provider's cost-reporting period.
• If the cost-reporting period would be less than or equal to 30 calendar days or one entire calendar month.
• If circumstances beyond the provider's control, such as the loss of records due to natural disasters or removal of records from the provider's custody by a regulatory agency, make cost report completion impossible.

For the 24RCC program specifically, examples of reasons for cost report excusals are the following:

• DFPS contract terminated or not renewed
• Basic-level services only
• State-placed days
• DFPS-placed days
• Occupancy rate less than 30% (Emergency Care Services only)
• Occupancy rate less than 50% (excludes CPAs and Emergency Care Services)

 you meet any of the above criteria, you may be eligible for a cost report excusal. To apply for an excusal, please email CostInformationPFD@hhs.texas.gov.

Do I need to complete a cost report for a contract that has not had any activity yet?

No, if there is no activity, then you may qualify for a cost report excusal. However, you will need to verify this excusal with PFD. Please contact us at (737) 867-7812 or CostInformationPFD@hhs.texas.gov if you believe you qualify for an excusal.

Why can’t I speak directly to my program’s rate analyst?

LTSS PFD has been reorganized, and there are no longer rate analysts assigned to specific programs. For questions regarding enrollment for Rate Enhancement, final cost or accountability reports, and Vendor Holds related to Cost and Accountability Reports, please contact the PFD Rate Enhancement team at (737) 867-7793 or PFD-RE@hhs.texas.gov.

For assistance with Cost or Accountability Report completion, instructions, informal reviews, and/or general guidance, please contact the PFD LTSS Customer Information and Training (CIT) team at (737) 867-7817 or PFD-LTSS@hhs.texas.gov.

How do I access STAIRS?

You will be sent an email with your login information from Fairbanks LLC. Please note that this email might be in your junk email folder. This email is sent automatically via STAIRS after the “Entity Contact” is determined via HHSC contract records. If you do not receive an email, please contact your contract manager to ensure that your paperwork is up-to-date.

How do I add a Preparer?

The Primary Entity Contact can add a Preparer in STAIRS Step 1, so long as the Preparer has completed the required training, and their name has been added to the Trained Preparers List. Please see the Managing Contacts Procedures PDF at the bottom of your STAIRS Dashboard for more detailed information.

For security reasons, HHSC will no longer post the Trained Preparers list on the PFD website.

A list (in Excel) of those who have completed the training requirements and received credit to prepare cost or accountability reports for the year indicated is located on the Dashboard in STAIRS. Users will need to log into their STAIRS account to access the list.

Which file formats can be uploaded to STAIRS?

There are no restrictions on which file formats may be uploaded to STAIRS.

If I have more than one contract for a single program, but only one of the contracts had activity in 2022, should I answer “Yes” or “No” in Step 3.a. for “Active Entire Report Period”?

If the active contract is in rate enhancement, please contact the PFD LTSS Customer Information and Training (CIT) team at (737) 867-7817 or PFD-LTSS@hhs.texas.gov. Otherwise, just choose “No” in Step 3.a. for “Active Entire Report Period?”

Where do I enter information for STAR Kids?

You may add STAR Kids contract information in Step 3.b. and include it in your allocation summary. However, HHSC Cost Reports and Accountability Reports do not include any STAR Kids data.

If I have a client that lost their Medicaid benefits but we still provided services, how do I include that information in the cost report?

The units of service for these clients can be included in the “Non-Reimbursed and Other” section of Step 5 for the applicable service. Depending on which report you are completing, units of service will be reported on STAIRS Steps 5.a., 5.b., 5.c., or any combination of these steps.

Do I enter $0.00 if the owner did not pay herself or himself during the reporting period, but s/he worked all year?

Yes, but you must add a comment explaining why it is $0.00.

What is required if you answered with a "No" response to Child and Adult Care Food Program (CACFP) revenue?

You must provide documentation from CACFP that you do not qualify when you select “No” in STAIRS. If you do contract with CACFP but have no revenue, please contact the CACFP office.

Where can I get useful life data on used car depreciation? Is there an authoritative source?

The Texas Administrative Code lays out the specifications for allowable costs of depreciable transportation equipment in 1 TAC §355.103(b)(10)(C). Also, an Appendix in the cost report instructions has a list of useful lives for depreciation of common asset types.

Under what circumstances are daily time sheets required?

Per 1 TAC §355.102(j) - Cost allocation, the payroll costs of a direct care employee who works across cost areas within one contracted program would be directly charged to each cost area of that program. This is based upon that employee's continuous daily time sheets and the costs of a direct care employee who works across more than one service delivery area would also be directly charged to each service delivery area based upon that employee's continuous daily time sheets.

Also as per 1 TAC §355.105(b)(2)(B)(xii)(I) - Adequate documentation, the daily timesheet must document for each day, the staff member's start time, stop time, total hours worked, and the actual time worked (in increments of 30 minutes or less) providing direct services for the provider, the actual time worked performing other functions, and paid time off. The employee must sign each timesheet. The employee's supervisor must sign the timesheets each payroll period or at least monthly. Work schedules are unacceptable documentation for staff whose duties include multiple direct service types, both direct and indirect service component types, and both direct hands-on support and first-level supervision of direct care workers.

How can I make sure that all of my documents are uploaded and not blank?

Documents can be verified by reviewing all uploaded correspondence in the Upload Center in STAIRS. After clicking on the Upload Center tab, uploaded items can be viewed by clicking on the file name and clicking “Download File.”

Why is my AR or CR in “read-only” status?

You are likely logged in as a Preparer for an AR or CR that has the Methodology Certification (Step 10) completed. Or, you are not logged in as a “Preparer” for that AR or CR. You must be a Preparer to make entries and edits.

If there are multiple preparers, do they each have to complete the Preparer Certification, or just one preparer?

Only the primary preparer completes the Preparer Certification page.

Can cost reports be amended after submission if you later find out that some allowable costs were not included? If so, what is the timeframe to do this?

Yes, submitted cost reports can be amended as long as your amendments are received within 60 days of your cost report submission. You can email your amendment(s) to CostInformationPFD@hhs.texas.gov. HHSC PFD will review the amendment(s) and decide based on the information provided.

Can the preparer also get a notification of the auditor’s adjustments when the provider does?

No. Once the certification has been uploaded, HHSC will not communicate directly with the preparer unless the provider (Entity Contact) has given us the authority to do so in writing. Alternatively, you may forward the information to the preparer yourself.

Training

Can multiple people get credit for this training if we all watch it on one device?

No. To get credit for the training, each trainee must register separately and watch the training on their own device. To register for a training webinar, go to the Registration section via the following link: https://pfd.hhs.texas.gov/long-term-services-supports/cost-report-training.

Will I still get credit if I view the webinar training on my tablet?

Yes. However, we monitor the attentiveness of our trainees, so make sure that the tablet can log in to the presentation and that the webinar is front-and-center (not running in the background). If you are viewing the webinar on a computer with a dual-monitor setup, for instance, please be sure that the GoToWebinar session is active in the foreground. You will not receive credit for attending a training session if you are deemed inactive.

Is this training for all programs, or do I have to do the training for other programs?

Each training will be for one specific program. If training is required for another program, there will be separate times and dates to attend other upcoming training sessions.

Is this training required if we were trained last year?

Per 1 TAC §355.102(d)(1) - Training schedules, the answer depends on which program the training is for. Beginning with the 2018 cost reports, certain programs will require a cost report during even years only and others during odd years only, with accountability reports during the off-years. DBMD will still require an accountability report every year, and 24RCC will still require a cost report every year. For DBMD and 24RCC, you must complete a training every odd year. If you complete an even-year training for DBMD or 24RCC, you will be covered for the even-year only.
For all other programs, if your program requires a cost report for 2018, for instance, then you must complete the 2018 training for your program. That training will cover both 2018 cost reports and 2019 accountability reports for your program. In other words, you must complete the applicable training during your cost reporting years, and this training will cover you for both that cost report and the upcoming accountability report. If you are trained during an accountability report year, you will still need to take the cost report training the following year.

How soon after the training can I work on my cost report/accountability report?

After your training is completed, it may take three to five business days for HHSC to add the names of individuals who have completed the training to the Trained Preparers List. The list is located on the Dashboard in STAIRS. Users will need to log into their STAIRS account to access the list.

How do I get a training certificate for this webinar?

Training certificates are no longer issued. PFD now keeps track of training completions without certificates. Please refer to the Trained Preparers List, a list of persons who have completed the training requirements for preparing cost or accountability reports for the year(s) indicated. The Trained Preparers List is located in STAIRS. From your STAIRS Dashboard, click “Manage” on the top right-hand side. Click “Add Preparer” to access the list. You can search this list by cost report year, program type, and the Preparer’s name.

Payments/Billing

I am no longer on vendor hold for PFD, but I am not receiving payments. Whom do I contact?

Please refer to the Vendor Hold webpage here for information on PFD-related vendor hold information and resources.

If you still have questions, whom to contact is based on whom you bill with:

1. Providers who bill through Managed Care Organizations (MCOs): HHSC releases the vendor hold and the release information is shared with the MCOs through a nightly data file; contact the individual MCO for which the release was expected.
2. Providers who bill through CARE (HCS/TxHmL): Contact the HCS Billing and Payment Review Unit (B&P) at 512-438-5359.
3. Providers who bill through TMHP: Contact Provider Recoupments and Holds (PRH) at 512-438-2200, option 3.

How do I know whether I owe money?

To determine whether you have a recoupment for Rate Enhancement (RE), please refer to the information in Step 12 of your STAIRS cost or accountability report, also known as the Provider Adjustment Report. Recoupment information is also sent to the provider via email as a result of the Notification of Adjustments. To inquire about any other type of recoupment, please contact your contract manager.

If I have a recoupment for rate enhancement and I disagree with the recoupment, what are my options?

HHSC has an informal review process for disagreements with any adjustments that HHSC has made to your cost or accountability report.

If you believe your recoupment was caused by an adjustment to your report, you may file an informal review by selecting “Disagree” in Step 12 no later than your review period expiration date and by following the instructions in Step 13. If HHSC did not make any adjustments to your report that impacted your recoupment amount, you could still request an informal review, but this review will not change your recoupment amount.

If I pay more than the spending requirement, will I receive a refund?

No, HHSC does not issue refunds for spending more than the Rate Enhancement Spending Requirement.

Which bill codes are used for priority and non-priority units?

Please refer to the following link to view the current long-term care bill code crosswalk: https://hhs.texas.gov/doing-business-hhs/provider-portals/long-term-care-providers/resources/long-term-care-bill-code-crosswalks.

If you have further questions about bill codes, please contact your contract manager.

Rate Enhancement

What is the rate enhancement program?

Rate enhancement is a voluntary program for LTSS providers intended to incentivize increased compensation to attendants. The rate enhancement program incentivizes increased direct care staffing, direct care wages, and benefits, specifically in nursing homes. For the CPC, DAHS, DBMD, HCS/TxHmL, ICF/IID, and RC programs, this program is called attendant compensation rate enhancement. For nursing facilities (NFs), this program is called nursing facility direct care staff enhancement.

After enrolling in rate enhancement, providers are given an add-on rate to their attendant compensation rate or direct care staff compensation rate.

Basic overview of attendant compensation rate enhancement participation:

• At least 90% of the attendant cost area of your rate (including the add-on), must be spent directly on attendant compensation.
• Attendant compensation includes salaries, payroll taxes, benefits, and mileage reimbursement.
• Cost and Accountability reports documenting your spending on attendant compensation must be submitted to HHSC.
• If you do not meet your spending requirement, you will face recoupment for the funds associated with your unmet spending requirement. After recoupment, the attendant care rate for rate enhancement participants will not be less than the rate paid to providers not participating in rate enhancement.

Basic overview of direct care staff enhancement participation:

• Minimum staffing requirements must be met, which are based on the statewide average direct care staff hours associated with the direct care staff rate component for NFs, adjusted for each facility’s case mix.
• At least 85% of the direct care staff area of the rate must be spent directly on direct care staff compensation.
• If you do not meet your staffing requirement, you do not meet the spending requirement, or both, you will be subject to recoupment of revenues associated with unmet staffing goals, unexpended funds, or both.
• Recoupments based on direct care staff spending below 85% of the direct care staff compensation component may be offset by allowable dietary and fixed capital asset costs above those components of the Medicaid rates.
• Cost reports and accountability reports documenting your staffing levels and direct care staff spending levels must be submitted to HHSC.
• Participants may staff at one of several optional levels above the minimum requirement and may receive additional payments depending on available funds.

What is my spending requirement?

To meet your spending requirement for attendant compensation rate enhancement, you must spend at least 90% of the attendant cost area of your rate on compensation for attendants, including wages, taxes, and benefits.

If we just started Rate Enhancement on 9/1/22, is our reporting period still 1/1/22 - 12/31/22, or do we have to separate the time before rate enhancement and the time after rate enhancement?

We request that you submit separate reports for the dates before and after rate enhancement.

Where can I find information on rate enhancement for MCOs?

Please contact each MCO to obtain their rate enhancement information.

What do I do if I have computer issues during a webinar training?

For any computer issues during a webinar training, please contact the PFD LTSS Customer Information and Training (CIT) team at (737) 867-7817 or PFD-LTSS@hhs.texas.gov. The Preparer may need to retake another webinar training if computer issues are not resolved.

How do I upload an Entity Certification Page?

The Entity Certification Page must be completed and uploaded by the Primary Entity Contact whose name is identified in Step 1. The Entity Certification will be uploaded in Step 11. The provider also has the option to digitally sign the certification. More information regarding digital signatures can be found here.

Can you please give me the number of units I had for each period of my cost report?

Fee for Service (FFS) paid units of service can be confirmed via your TMHP Remittance and Status (R&S) report, claims reports, and service logs. For all DFPS providers, please contact your contract manager for a detailed or summary report of all paid units of service. Managed care STAR+PLUS units can be obtained from the contracted MCO that should include all paid units of service for each reporting period. Please note that on cost and accountability reports, you must report the units of service that were delivered and paid during the reporting period that matches your R&S and/ or other payment reports.