LTSS RAD Frequently Asked Questions (FAQs)

STAIRS

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

Contact the RAD LTSS Customer Information Center (CIC) at (512) 424-6637, or at rad-ltss@hhsc.state.tx.us.

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 2018 cost reports, collected in 2019

 

CR

24RCC

HCS/TxHmL

ICF/IID

NF

RC

AR

CPC

DAHS

DBMD

Odd-Year Cost Reports

Beginning with 2019 cost reports, collected in 2020

CR

24RCC

CPC

DAHS

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

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

To change the official information that is on all of your cost and accountability reports, click on Edit My Info on your STAIRS Dashboard. To edit the information that is used for each individual cost or accountability report, the Primary Entity Contact or Financial Contact can navigate to Step 1 in STAIRS (Combined Entity Identification). Please ensure that the information on your STAIRS Dashboard is up-to-date, as this is the information that HHSC will use to contact you, not the information on your individual cost reports.

How can I be excused from filing a cost report?

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

  • The provider delivered no services.
  • The provider delivered less than a certain amount of service.
  • The contract was effective no more than 30 days before the end of the cost report period.

For the 24-hour Residential Child Care (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)

If you meet any of the above criteria, then you may be eligible for a cost report excusal. To apply for an excusal, please email radcostreportverification@hhsc.state.tx.us 

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 with RAD. Please contact us at (512) 438-2680 or radcostreportverification@hhsc.state.tx.us if you believe you qualify for an excusal.

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

LTSS RAD has reorganized and there are no longer rate analysts assigned to specific programs. Please direct your questions to the LTSS RAD Customer Information Center at (512) 424-6637.

How do I access STAIRS?

You will be sent an email with your login information from Fairbanks LLC; please note that this might be in your junk email folder. This email is sent 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 whose 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.

Which file formats can be uploaded to STAIRS?

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

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

How many units of service you were paid can be confirmed via your TMHP Remittance and Status (R&S) report; if you are an HCS/TxHmL provider, use the Client Assignment and Registration (CARE) System; if you are a DFPS provider, please contact your contract manager.

Please note that on your cost or accountability report, you must report the units of service that were delivered (or accrued) during your reporting period, which should match your R&S or other payment report. In order to ensure that you are paid correctly, please review your payment reports when you receive your payments to ensure that they are correct. This will allow you to correct any discrepancies in your billing before your cost report is completed.

If I have more than one contract for a single program, but only one of the contracts had activity in 2018, 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 CIC immediately at (512) 424-6637, or at rad-ltss@hhsc.state.tx.us; 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. HHSC Cost Reports and Accountability Reports, however, do not include any STAR Kids data.

If I have a client that lost their Medicaid 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 “Private 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., and/or 5.c.

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

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

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

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

Where can I get the 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). There is also an Appendix in the cost report instructions that 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 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.

And 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 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 on Step 11.

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, items uploaded can be viewed by clicking on the file name, and clicking on Download File.

Why is my accountability report (AR) or cost report (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, as 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, as long as your amendments are received within 60 days of your cost report submission. You can email your amendment(s) to RAD-LTSS@hhsc.state.tx.us. HHSC RAD will review the amendment(s) and make a determination based on the information provided.

Can the preparer also get notification of 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 on to the preparer yourself.

Training

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

For any computer issues during a webinar training, please contact the RAD LTSS Customer Information Center (CIC) at (512) 424-6637 or rad-ltss@hhsc.state.tx.us immediately.

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

No. In order to get credit for the training, each trainee must register separately and watch the training on their own individual device. To register for a training webinar, go the Registration section via the following link: https://rad.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 is able to 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 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 a training is required for another program, there will be separate times and dates to attend other upcoming trainings.

Is this training required if we were trained last year?

Per 1 TAC §355.102(d)(1) - Training schedules, it 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, and 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, which will cover you for 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 will I be able to 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. Please refer to the following link to view the list: https://rad.hhs.texas.gov/long-term-services-supports/cost-report-training

How do I get a training certificate for this webinar?

Training certificates are no longer issued. The Rate Analysis Department now keeps track of training completions without the need of certificates. Please refer to the following link for 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: https://rad.hhs.texas.gov/long-term-services-supports/cost-report-training. You can also find the Trained Preparers List in STAIRS: from your STAIRS Dashboard click “Manage” on the top right-hand side. When you click on “Add Preparer” you can 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 Rate Analysis, but I am not receiving payments. Whom do I contact?

A vendor hold is released after your required report is completed and HHSC determines that it is complete. Vendor hold funds may have to go through one nightly billing cycle before they are released. Once these funds are released, two payment periods may elapse before you receive a payment via direct deposit. Please anticipate waiting until the first business day two Saturdays after your vendor hold has been released to receive payment. 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 information in Step 12 of your STAIRS cost 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 find out 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 report.

If you believe your recoupment was caused by an adjustment to your cost 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 contained in Step 13. If HHSC did not make any adjustments to your cost report that impact your recoupment amount, you may still attempt to file an informal review but this 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 that is intended to incentivize increased compensation to attendants and, in nursing homes specifically, to incentivize increased direct care staffing and increased direct care wages and benefits. For the CPC, DAHS, DBMD, HCS/TxHmL, ICF/IID, and RC programs, this program is called attendant compensation rate enhancement; for 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 reports must be submitted to HHSC which document your spending on attendant compensation.
  • 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 and/or you do not meet the spending requirement, you will be subject to recoupment of revenues associated with unmet staffing goals and/or unexpended funds.
  • 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 in excess of those components of the Medicaid rates.
  • Cost reports and accountability reports must be submitted to HHSC which document your staffing levels and direct care staff spending levels.
  • 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. So if your attendant cost area is $10.97, then you must pay your attendants at least 90% of that per hour, or $9.88 per hour. The remaining 10%, or $1.09 per hour, is meant to be used for administrative costs.

If we just started Rate Enhancement on 9/1/18, is our reporting period still 1/1/18 - 12/31/18, or do we have to separate out the time before rate enhancement and the time after rate enhancement?

We will request separate reports from you that will indicate respective dates.

Where can I find information on rate enhancement for MCOs?

Please contact each Managed Care Organization to obtain their rate enhancement information.