The Client Assessment, Referral and Evaluation (CARE) program, more commonly referred to as nursing facility assessment, was created in 1994 by the Kansas Legislature as the Kansas response to the Federally mandated Pre-Admission Screening and Resident Review (PASRR) program. The goals of the assessment are to provide customers individualized information on long-term care options, determine appropriate placements in long-term care facilities, and collect data regarding individuals being assessed for possible nursing facility placement. For those individuals found to need further evaluation for specialized services related to Intellectual/Developmental Disability or Related Conditions and/or Mental Health an in-depth assessment is conducted, known as the PASRR Level II.
The Level I CARE assessments are conducted by assessors through the local Area Agencies on Aging (AAA) Level I must be completed prior to entering a nursing facility. The nursing facility is required to have a copy of the Certificate of CARE in the medical record at the nursing facility.
Admissions to a nursing facility when the Level I CARE assessment could not be completed prior to the person entering the nursing facility are known as special admissions. The facility accepts a special admission by completing Section A and B of the Level I CARE assessment (PASRR) and completing the Special Admission Fax Memo, then submitting the proper documentation making the admission valid for PASRR. The KDADS CARE Program offers webinar training once a month to all nursing facilities in the state to provide education on completing these admissions. The CARE Program sends out monthly e-mail correspondence to state nursing facilities to provide updates on the CARE process. The CARE Manual, found on the KDADS website, also provides instruction. The five special admissions are:
The Level I CARE assessment will provide a “level of care score” which is provided to the KanCare Clearinghouse for those persons wishing to utilize Medicaid as payment for nursing facility care. The Level I screens for “functional eligibility” only; KanCare clearinghouse determines fiscal eligibility for Medicaid.
Meeting the “functional eligibility” score does not guarantee that a person will be eligible for Medicaid for payment for nursing facility care. Should you feel the functional eligibility score on your CARE assessment is inaccurate, there are instructions on the back of the CARE Certificate with contact information to appeal this decision.
For those persons requiring a Level II PASRR evaluation it is important to note this must be completed PRIOR to admission to the nursing facility. CMS has tied nursing facility payment for care given to the completion of PASRR. No FFP is available for payment to the nursing facility until PASRR is completed.