OPPAGA text logo with graphic of FL historic capitol
OPPAGA text logo with graphic of FL historic capitol

Department of Elder Affairs

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

What is the purpose of the program?

The Comprehensive Assessment and Review for Long-Term Care Services (CARES) program is Florida's federally mandated nursing home pre-admission screening program. A registered nurse or assessor performs face-to-face client assessments and a physician or registered nurse reviews each application to determine the medical level of care for the applicant. Through the assessments, CARES staff
  • identifies a client's long-term care needs;
  • determines the level of care required to meet those needs; and
  • makes it possible for individuals to remain safely in their homes using home and community-based services or in alternative community settings such as assisted living facilities.

Who is served by the program?

Federal law requires a CARES assessment for all individuals who request Medicaid reimbursement for nursing facility placement or home and community services. A nursing home applicant assessment provides an evaluation of the medical necessity for nursing facility care, the level of care required by the individual, and a pre-admission screening to determine serious mental illness or intellectual disabilities. Florida residents seeking Medicaid assistance for nursing facilities or community-based long-term care services must meet both medical and financial eligibility requirements. Financial eligibility is determined by the Florida Department of Children and Families or the Social Security Administration (SSA).

How does the program make a medical eligibility determination?

To conduct a medical eligibility determination, a registered nurse and/or assessor identifies the physical and mental capacity,  healthcare needs, and social support systems using a comprehensive assessment instrument. 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, and establishes the appropriate level of care (medical eligibility for nursing facility care), and recommends the least restrictive, most appropriate placement. For more information on this program, please see the Department of Elder Affairs Summary of Programs and Services.

How many clients are assessed by CARES?

During Fiscal Year 2018-19, CARES program staff and local agencies conducted 103,734 assessments. This exceeds the department's performance standard of 85,000 assessments.

How long does it take for CARES staff to determine medical eligibility?

During Fiscal Year 2018-19, CARES program staff took an average of 9.9 days to determine medical eligibility. There was no established standard for this measure for Fiscal Year 2018-19. The department has requested a Fiscal Year 2020-2021 standard of 12 days.

How are these activities funded?

Fiscal Year: 2020-21
Fund Salary Rate/ Position General Revenue Trust Funds
SALARY RATE
POSITIONS
SALARIES AND BENEFITS
FROM GENERAL REVENUE FUND
FROM OPERATIONS AND MAINTENANCE TRUST FUND
OTHER PERSONAL SERVICES
FROM GENERAL REVENUE FUND
FROM OPERATIONS AND MAINTENANCE TRUST FUND
EXPENSES
FROM GENERAL REVENUE FUND
FROM OPERATIONS AND MAINTENANCE TRUST FUND
OPERATING CAPITAL OUTLAY
FROM GENERAL REVENUE FUND
FROM OPERATIONS AND MAINTENANCE TRUST FUND
SPECIAL CATEGORIES
CONTRACTED SERVICES
FROM GENERAL REVENUE FUND
FROM OPERATIONS AND MAINTENANCE TRUST FUND
SPECIAL CATEGORIES
RISK MANAGEMENT INSURANCE
FROM GENERAL REVENUE FUND
FROM OPERATIONS AND MAINTENANCE TRUST FUND
SPECIAL CATEGORIES
LEASE OR LEASE-PURCHASE OF EQUIPMENT
FROM GENERAL REVENUE FUND
FROM OPERATIONS AND MAINTENANCE TRUST FUND
SPECIAL CATEGORIES
TRANSFER TO DEPARTMENT OF MANAGEMENT SERVICES - HUMAN RESOURCES SERVICES PURCHASED PER STATEWIDE CONTRACT
FROM GENERAL REVENUE FUND
FROM OPERATIONS AND MAINTENANCE TRUST FUND
TOTAL
8,845,758
8,879,986

Where can I find related OPPAGA reports?

A complete list of related OPPAGA reports is available on our website.

Where can I get more information?

What are the applicable statutes?

Section 409.912(15), Florida Statutes.

Whom do I contact for help?

Department of Elder Affairs, Bureau of Comprehensive Assessment and Review for Long-Term Care Services, 850-414-2000
Elder Helpline, 1-800-963-5337 or 1-800-955-8771 for TDD or 1-800-955-8770 for voice or contact a local CARES office

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