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Effective Date: 




Updated: 5/2017



The Texas Health and Human Services (HHS) Preadmission Screening and Resident Review Program (PASRR) requires Local Intellectual and Development Disabilities Authorities (LIDDA)’s to report a nursing facility (NF) that refuses or fails to comply with requirements to initiate specialized services. In accordance with the Texas Department of Aging and Disability Services’ Fiscal Years 2016 and 2017 Contract Amendment Three, Attachment G, Page G-4, all LIDDA’s must report NF non-compliance for the initiation or the provision of specialized services to HHS Consumer Rights and Services (CRS). The LIDDA must also report non-compliance to initiate specialized services to the PASRR unit using the PASRR Reporting of Non-Compliance form. The LIDDA must submit a form even if there are no complaints to report that month.  


When to Prepare

The LIDDA will complete the form when it has filed a complaint with CRS against an NF for failure to initiate or deliver specialized services. Each complaint must be on a separate form thus one complaint per form. The following is a list of the specialized services provided by NFs:

  • occupational therapy (OT);
  • physical therapy (PT);
  • speech therapy (ST);
  • customized manual wheelchair (CMWC); and
  • durable or adaptive medical equipment (Other DME).



Reporting a Complaint:

  • After confirming three documented attempts to get the NF to initiate services for an individual and determining which specialized services were not initiated or delivered, the LIDDA will contact the CRS hotline at 1-800-458-9858 to report a complaint.During the call, it is important for LIDDA staff to state the individual is not receiving needed specialized services.
  • Include accurate and complete information on the individual requiring specialized services.
  • Provide the CRS representative with the specific complaint issue (Failure to Initiate Services/Failure to Provide Ongoing Services) for the following services: OT, PT, Speech, CMWC and Other DME.
  • Make sure CRS provides the CRS Tracking Number before you end the call.
  • LIDDA staff must cooperate with any complaint investigation initiated as a result of calling the CRS hotline.The expectation includes sharing the service coordinator’s progress notes with the HHS Regulatory Services investigators (documentation of attempts to work with the NF to deliver specialized services as agreed to by the Interdisciplinary team).

Complaint Form:

  • Complete all required fields in each section of the form and make sure the information is legible. Incomplete forms will be considered insufficient and not processed. Ensure the following information is provided:
    • date the form was completed;
    • name of the LIDDA;
    • contact name, phone and fax number;
    • month the report reflects;
    • name and Medicaid number of the individual requiring specialized services; and
    • date report was made to CRS.
  • Include the CRS Intake Tracking Number on the reporting form and make sure the proper box is checked under “Complaint Issue” section.Multiple boxes may be checked for the complaint type.
  • Do not use abbreviations for any fields on the form.
  • Submit a report by the 15th of every month for the previous month’s data, even if there were no complaints to report. Mark “N/A” on the form if no complaints were reported.
  • Fax this form to the PASRR Unit at 512-438-2180.

The PASRR Unit Form Review Process includes:

  • confirming all sections of the form are completed properly;
  • contacting the LIDDA if more information is needed; and
  • reporting the LIDDA to Contract Accountability & Oversight and Performance Contracts when a monthly form has not was submitted as required.

The PASRR Unit will use the reports submitted to track an NF for non-compliance regarding delivery of specialized services. Additionally, the PASRR Unit will also track and monitor LIDDAs compliance of submitting the monthly report. For questions related to the form, please contact the PASRR Unit at 1-855-435-7180.