Client Assessment, Referral and Evaluation (CARE)

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:

  1. Emergency Admission: When a person is unexpected to the nursing facility. Examples include: a caregiver becoming ill or passing away; a physician’s office recommending a person be admitted to a nursing facility and opposed to sending them home.; or a person’s home is destroyed by tornado or fire. These types of admissions happen suddenly and unexpectedly and there is not time to complete a Level I CARE assessment prior to admission. Nursing facilities are trained to follow
    the KDADS procedures to receive approval for an emergency admit, and the nursing facility is responsible for calling the local AAA to complete the Level I CARE assessment before day 7 of the admit.

  2. Less Than 30-Day, also known as Exempted Hospital Discharge. As stated in CFR 483.106: An individual admitted to any nursing facility directly from a hospital after receiving acute inpatient care at the hospital. An individual who requires nursing services for the condition for which he or she received care in the hospital. An individual whose attending physician has certified before admission to the facility that the individual is likely to require less than 30 days’ nursing facility services. If the person stays more than 30 days, it is the nursing facilities’ responsibility to call the AAA for the Level I CARE assessment before day 30 of the signed order.

  3. Respite Stay: If a caregiver needs a break and chooses a nursing facility to care for their loved one the stay cannot be longer than 30 days at one time. The nursing facility is responsible for calling the AAA and requesting a Level I CARE assessment if the individual decides they no longer wish to return home but instead prefers to reside in a nursing facility.

  4. Terminal Illness: This is when an individual is on hospice, palliative care or has a terminal illness and has a planned admission to a nursing facility. If the individual currently has a Level I CARE assessment it is not necessary to conduct the terminal illness admission. However, if there is no Level I CARE assessment, a terminal illness admission covers a person for six months. If the individual continues residing in the nursing facility after six months, the nursing facility is responsible for calling the AAA for the Level I CARE assessment before the six-month PASRR expires.

  5. Out-of-State PASRR: When a person is coming to a Kansas nursing facility from an out-of-state hospital or an out-of-state nursing facility. The person brings their initiating state’s PASRR documentation with them and gives it to the receiving nursing facility in Kansas. The state of Kansas accepts all other states’ PASRRs.

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.

If you have questions regarding the CARE program please contact the CARE office at 785-296-6446 or call KDADS at 785-296-4986 and request to be transferred to the CARE office.

Resources

FileTypeSizeUploaded onDownload
CARE ManualPDF1.07 MB30 Sep, 2019 Download
AAA Phone ListPDF631.83 KB09 Sep, 2019 Download
ID-DD Resident ReviewDOCX52.50 KB09 Sep, 2019 Download
ID-DD-PASRR Pre-Admission ScreenDOCX58.92 KB09 Sep, 2019 Download
MI Resident ReviewDOCX54.85 KB09 Sep, 2019 Download
MI-PASRR Pre-Admission ScreenDOCX67.89 KB09 Sep, 2019 Download
Complete Care Level 1PDF629.03 KB08 Jul, 2019 Download
Resident Review Check ListPDF168.08 KB08 Jul, 2019 Download
CARE Special Admission Fax MemoPDF817.20 KB30 Aug, 2018 Download
CARE BrochurePDF672.07 KB23 Sep, 2014 Download
Nursing Facility PASRR TrainingPDF775.36 KB19 Apr, 2018 Download
Helpful Hints When Signing up for an Account on Kansas TrainPDF21.42 KB09 Mar, 2018 Download
Course Registration Instructions on Kansas TrainPDF210.91 KB07 Mar, 2018 Download
CARE Quick Fax SheetPDF81.81 KB13 Feb, 2018 Download
Care Level 1 - Parts A and BPDF259.05 KB30 Jan, 2018 Download
How To Create an Account on Kansas TrainPDF203.51 KB16 Nov, 2016 Download
CARE Level II Manual - IDDPDF487.74 KB24 Sep, 2015 Download
CARE Brochure - SpanishPDF186.18 KB07 Jul, 2015 Download
MI RR Level 2 ManualPDF447.76 KB07 Jul, 2015 Download
Intro Care Level 2 ManualPDF851.49 KB07 Jul, 2015 Download
2010 CARE Annual Report v6PDF1.87 MB07 Jul, 2015 Download
FINAL - SFY 2011 Annual ReportPDF550.35 KB07 Jul, 2015 Download
CARE ANNUAL REPORT docxSFY 2014 docxlastPDF449.45 KB07 Jul, 2015 Download
CARE Brochure - EnglishPDF678.60 KB07 Jul, 2015 Download
CARE Annual ReportPDF449.46 KB05 Feb, 2015 Download
Cuidado Folleto EspanolPDF169.27 KB23 Sep, 2014 Download