1

Nursing Facilities FAQ

Scroll or Select a Section

To Search: Press Ctrl F and type a keyword

General Questions     Base Wage Compliance Questions     Billing Questions     Change of Ownership Questions     

Compliance Questions     HBU Questions     New Facility Questions     NHIGB Questions

 

Page Updated: June 12, 2025

General Questions

Q. What if I am unable to obtain the required 5615 documentation from the county?​

  • A. If the 5615 for the review period is unavailable, you may submit a 5615 that is before the review period. The yearly cost of living adjustments (COLA) percentages will be used by the reviewer to calculate the missing 5615 amount. 5615 forms must have the county signature on it. ​

​

Q. Who do I contact if the county is non-responsive to my requests for the 5615s?​

​

Q. How do I submit an estimated 5615 form?​

  • A. Estimated 5615 forms can be emailed to HCPF_LTC_FinCompliance@state.co.us. In the comment section of the 5615 form or at the top of the 5615 form, write “Estimated 5615 from NF”. Reminder - always ensure HIPAA compliance by sending via encrypted email. ​

​

Q. Where should I submit my updated surety bond information?​

< Back to Top

< Back to Nursing Facilities Operations

Base Wage Compliance Questions

Q. Who do I contact with questions about the base wage attestation form?​

  • A. Email: HCPF_BaseWage@state.co.us  The Direct Care Workforce (DC Workforce) team will be able to answer your questions. ​

​

Q. There is a payment hold on my billing account, who do I contact to get it removed?​

​

Q. How often do I have to submit an attestation form?​

  • A. Submission occurs annually. Watch for communications from HCPF related to attestation requirements. Most submissions are due in June or July. ​

 

Q. Who is considered a direct care worker (DCW)?​

  • A. DCW are either employed by or contracted with the Provider Agency. DCW are non-administrative employees or independent contractors who provide hands-on care, services, and support to older adults and individuals with disabilities across the Long-Term Services and Supports continuum within Home and Community-Based settings. Defined in 10 CCR 2505-10, Section 8.7418.​

​

Q. Where can I find more information about the base wage compliance requirements?​

​

Q. What is the difference between the attestation form and the wage compliance review?​

  • A. The attestation form is the initial submission of direct care worker information to HCPF. This is received and reviewed by the Direct Care Workforce team. The wage compliance review utilizes the submitted attestation form to initiate a wage compliance review to verify the information on the attestation form and compliance with the regulations. The Financial Compliance Unit team performs these reviews.

 

Q. I have a wage compliance review question who do I contact?​

​

Q. I received a wage compliance review notification letter, what does this mean?​

  • A. HCPF has selected you for review to ensure your compliance with direct care worker compensation regulations. Submit the requested information by the deadline specified, in the format requested, and by the required secure method.​

​

Q. Who do I contact about the wage compliance review notification letter I received?​

​

Q. What happens if I don’t comply with the direct care workers compensation regulations? ​

  • A. Noncompliance may result in recoupment of Medicaid funds for rendered services applicable to the regulations and/or a monetary penalty based on the amount of Medicaid funds paid during the review period. Refer to 10 CCR 2505-10, Section 8.7418 for more information.​

​

Q. Who do I contact about the Medicaid review notification letter I received?​

  • A. Email the assigned compliance reviewer listed on the notification letter. ​

​

Q. How do I request an extension on submitting the requested documentation?​

  • A. Email the assigned compliance reviewer listed on the notification letter. Include the reason and how much time you need. Extensions may or may not be approved. ​

​

Q. How do I submit the requested documentation?​

  • A. Send documents via encrypted email to the assigned compliance reviewer or contact the reviewer and request a link to a secure Google site folder.

 

Q. How much time do I have to submit the requested documents?​

  • A. Initial document submission – 45 days from the date of the notification letter or by the date specified on the letter.​
    • Corrective action plan – 30 days from the date sent or by the date specified on the preliminary questions list.​
    • Adverse action letter – 30 days from the date of the letter per CRS 25.5-4-401​
    • Informal reconsideration response letter – 30 days from the date of the letter per CRS 25.5-4-301​

​

Q. What happens if I miss a deadline?​

  • A. Depending on the stage of the review, the reviewer will complete the next step of the review. If the adverse action date is missed, the reviewer will recoup any amount due from future payments to your facility. 

​

 ​< Back to Top

< Back to HCBS Wage Compliance Oversight

Billing Account Questions

Q. Who should I contact to update my facility contact information?​

​

Q. I don’t remember my provider portal password, what do I do?​

  • A. The reset password option on the portal login screen can be used if you know the established User ID for your facility. Otherwise contact Provider Services. ​

​

Q. Who do I contact if I have billing questions?​

< Back to Top

< Back to Nursing Facilities Billing and Change of Ownership

Change of Ownership Questions

Q. Who do I contact to report a change of ownership, tax id change, or withdrawal from Medicaid?​

  • A. Email HCPF_LTC_Facilities@state.co.us - This notice must be sent at least 45 days before you anticipate the change to occur. The required CHOW or closing review will be initiated before the anticipated effective date. ​

​

Q. Who can answer questions regarding my change of ownership?​

​

Q. Why was money deducted from my facility claims?​

  • A. If the deduction is related to an account receivable amount and you are undergoing a CHOW, the amount could represent escrow withholding until the required compliance review is completed by the Financial Compliance Unit (FCU) team. ​

​

Q. What happens if I don’t notify HCPF of a CHOW?​

  • A. Non-reporting will result in a delay in the initiation of the required CHOW reviews.​

​

Q. I want to sell my facility to a new owner. What do I do?​

 

< Back to Top

< Back to Nursing Facilities Billing and Change of Ownership

Compliance Questions

Q. Why was money deducted from my facility claims?​

  • A. If the deduction is related to an account receivable amount, the amount could represent a recoupment for a completed review. If undergoing a change of ownership, the amount could represent escrow withholding until the review is completed. ​

​

Q. What if I am unable to obtain the required 5615 documentation from the county?​

  • A. If the 5615 for the review period is unavailable, you may submit a 5615 that is before the review period. The yearly cost of living adjustments (COLA) percentages will be used by the reviewer to calculate the missing 5615 amount. 5615 forms must have the county signature on it. ​

​

Q. Who do I contact if the county is non-responsive to my requests for the 5615s?​

​

Q. How do I submit an estimated 5615 form?​

  • A. Estimated 5615 forms can be sent to HCPF_LTC_FinCompliance@state.co.us. In the comment section of the 5615 form or at the top of the 5615 form, write “Estimated 5615 from NF”. Reminder - always ensure HIPAA compliance by sending via encrypted email. ​​

​

Q. Where should I submit my updated surety bond information?​

 

Q. Who do I contact about the Medicaid review notification letter I received?​

  • A. Email the assigned compliance reviewer listed on the notification letter ​

​

Q. How do I request an extension on submitting the requested documentation?​

  • A. Email the assigned compliance reviewer listed on the notification letter. Include the reason and how much time you need. Extensions may or may not be approved. ​

​

Q. How often will my facility undergo a compliance review?​

  • A. The FCU team performs a variety of reviews, and the rotation period can range from a year to five years.​

​

Q. How do I submit the requested documentation?​

  • A. Send documents via encrypted email to the assigned compliance reviewer or contact the reviewer and request a link to a secure Google site folder. ​

​

Q. I received the adverse action letter, how do I submit an informal reconsideration request?​

  • A. Gather the supporting documentation for the item(s) to be reconsidered and submit your written request to the reviewer within 30 calendar days from the date of the adverse action letter. Refer to the adverse action letter for more information.​

​

Q. What are my options for reimbursing HCPF when my review has been completed?​

  • A. Request recoupment from future payments by contacting the reviewer or submit a check to HCPF. ​
    • Lockbox: Department of Health Care Policy & Financing, Attn: OCL Finance Recoveries, PO Box 17274, Denver, CO 80217 ​
    • Overnight: Department of Health Care Policy & Financing, Attn: OCL Recoveries, 303 E. 17th Ave., Suite 1100, Denver, CO 80203​

​

Q. How much time do I have to submit the requested documents?​

  • A. Initial document submission – 45 days from the date of the notification letter or by the date specified on the letter.​
    • Preliminary questions – 30 days from the date sent or by the date specified on the preliminary questions list.​
    • Adverse action letter – 30 days from the date of the letter per CRS 25.5-4-401​
    • Informal reconsideration response letter – 30 days from the date of the letter per CRS 25.5-4-301​

​

Q. What happens if I miss a deadline?​

  • A. Depending on the stage of the review, the reviewer will complete the next step of the review. If the adverse action date is missed, the reviewer will recoup the amount due from future payments to your facility. ​

 

< Back to Top

< Back to Nursing Facilities Compliance

Hospital Back Up (HBU) Questions

Q. Can HBU and Home and Community Based Services (HCBS) benefits be used together?

  • A. No, the member must qualify for Health First Colorado (Colorado's Medicaid Program) long-term care benefits and HBU is separate funding. HBU is a program for people in the hospital.
     

< Back to Top

< Back to HBU Program

New Facility Questions

Q. I want to open a new facility, what do I do?​

  • A. Each January and July, a new or non-Medicaid nursing facility can apply to become a Medicaid facility if the county (service area) can be reasonably served by that nursing facility. Review 10 CCR 2505-10, Section 8.430 - Medicaid Certification of New Nursing Facilities or Additional Beds regulations.

Visit Nursing Facility Application and Enrollment page

< Back to Top

Nursing Home Innovations Grant Board (NHIGB) Questions

Q. What are the project categories? ​

  • A. The project categories are:
    • Consumer information​
    • Resident of family council​
    • Direct improvements to quality of care​
    • Cultural change/direct improvements to quality of life​
    • Training​
       

Q. What is the maximum allowable amount per project?​

  • A. The Centers for Medicare and Medicaid Services (CMS) has set the cap at $5,000 per facility per project. ​
     

Q. What are some non-allowable projects?​

  • A. Civil Money Penalties (CMPs) cannot be used to duplicate Medicaid/Medicare funding or capital improvements for the nursing home. For additional information on allowable and non-allowable projects please refer to the CMS website, under Downloads. ​
     

Q. When is the application deadline?​

  • A. We accept applications from January 1 through September 30, 2025. ​
     

Q. How many years can a project transpire?​

  • A. Projects must be at least one year and cannot exceed three years. ​
     

Q. If I need help with my application or have additional questions, who can I contact?​

< Back to Top

< Back to Nursing Facilities Stakeholder Meetings and Communication