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Comprehensive Assessment and Review
for Long-Term Care Services (CARES)

Comprehensive Assessment and Review for Long-Term Care Services (CARES) is Florida’s federally mandated pre-admission screening program for nursing home applicants. A registered nurse and/or assessor performs client assessments. A physician or registered nurse reviews each application to determine the level of care that is most appropriate for the applicant. The assessment identifies long-term care needs, establishes the appropriate level of care (medical eligibility for nursing facility care) and recommends the least restrictive, most appropriate placement. The program emphasizes approaches that make it possible for individuals to remain in their homes through home-based services, or in alternative community placements such as assisted living facilities.

Federal law mandates that the CARES program perform an assessment or review of each individual who requests Medicaid reimbursement for nursing facility placement or who seeks one of several waivers, including but not limited to the Project AIDS Care (PAC), the Aged and Disabled Adult (ADA) or the Assisted Living for the Frail Elderly (ALE) waivers. A CARES assessment is also mandatory if a private-pay applicant is suspected of having mental retardation or mental illness. Any person or family member can initiate a CARES assessment by applying for the Medicaid Institutional Care Program (ICP). A private-pay assessment may be requested if a family wants to know whether their loved one meets the level of care for a nursing facility or other placement. These assessments are completed as a free service.

Services or Activities

    • Medical eligibility for the Medicaid Institutional Care Program (ICP)
    • Medical eligibility for several Medicaid waivers that provide community services
    • Medical assessment for all mentally ill clients for ICP
    • Medical assessment for all developmentally disabled clients for ICP
    • Medical assessment for residents in nursing facilities entering court-ordered receivership
    • Medical utilization review of Medicaid nursing home residents for continuing eligibility

Administration

The Department of Elder Affairs is responsible for the federal program through an interagency agreement with the Agency for Health Care Administration. Nineteen CARES field offices are located throughout the state. CARES personnel include registered nurses and assessors, administrative support staff, office supervisors, and regional program supervisors. Physicians are used as consultants as part of the staffing process. CARES management structure also includes central office staff responsible for program and policy development.
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