CARE Assessment Kansas: Level of Care Score and What to Expect

Before Kansas will approve your parent for the Frail Elderly waiver or the Senior Care Act, they need to establish that your parent requires a nursing-home level of care. The instrument that makes that determination is the CARE Level I assessment, and the score that matters is 26.

Fall below 26, and the state considers your parent functionally ineligible for subsidized home care. Hit 26 or above, and the next gate is financial. Understanding how the assessment works — and what the assessor is actually measuring — is the difference between qualifying on the first attempt and losing weeks to a reapplication.

Who Conducts the Assessment

Maximus is the state-contracted assessing organization for Kansas HCBS programs. When the ADRC refers your parent's case, Maximus schedules an in-person evaluator to visit your parent's home. The assessment should be scheduled within 10 to 15 business days of the ADRC referral.

As of July 2025, KDADS separated the ADRC (intake and options counseling) from the Assessing Entity (clinical evaluation) to prevent conflicts of interest. This means the person who took your first call is not the same person who conducts the assessment. You'll need to coordinate separately with Maximus on scheduling.

What the CARE Level I Tool Measures

The CARE assessment evaluates three domains:

Activities of Daily Living (ADLs) — bathing, dressing, grooming, toileting, transferring (bed to chair), eating, and mobility. The assessor rates how much hands-on help your parent needs for each task: independent, needs supervision, needs physical assistance, or fully dependent.

Instrumental Activities of Daily Living (IADLs) — managing medications, preparing meals, handling finances, using the telephone, shopping, housekeeping, and laundry. These tasks measure whether your parent can function independently in a home setting.

Cognitive and behavioral factors — memory loss, disorientation, wandering, agitation, depression, resistance to care, and judgment impairment. Cognitive decline often contributes as many points as physical limitations.

Each domain adds to a composite score. The threshold is 26 points — roughly the level where a person needs consistent daily assistance to remain safe at home. It's the same threshold used for nursing home admission screening.

Why Families Score Below 26 on the First Try

The most common reason is underreporting. Families — especially the parent being evaluated — minimize the severity of daily difficulties. A parent who says "I manage fine" when they've fallen twice in the last month and regularly forget medications will score lower than their actual needs warrant.

The score reflects what the assessor observes during the visit and what the family reports. If your parent has a lucid, energetic day during the assessment and downplays their struggles, the score reflects that snapshot.

Before the assessment, document everything:

• Every fall, near-fall, or balance incident in the last 90 days
• Medication errors — missed doses, double doses, wrong pills
• Episodes of confusion, disorientation, or getting lost
• Times your parent left the stove on, the door unlocked, or wandered
• How much hands-on help bathing, dressing, and transferring actually requires
• Any incidents that prompted the current care search (hospital stay, ER visit, APS referral)

Bring this documentation to the assessment. The assessor should incorporate reported history, not just the in-person observation. A written log is harder to dismiss than verbal claims.

What Happens at Each Score Level

Score 26 or above, Medicaid-eligible: Your parent enters the Frail Elderly waiver pipeline. Since July 2026, that means the waitlist — unless a crisis exception, institutional transition, or PACE enrollment applies.

Score 26 or above, over Medicaid limits: Your parent is referred to the Senior Care Act, which provides home care services on a sliding fee scale without Medicaid's strict $2,000 asset limit.

Score below 26: The state considers your parent functionally ineligible for subsidized home care programs. Your options at that point are private-pay home care and other non-subsidized supports. You can request a reassessment if the situation changes.

Reassessment Is Annual

The CARE assessment isn't permanent. The state mandates a reassessment every 365 days. If your parent's health improves and their score drops below 26, waiver services are terminated. If their needs increase, the care plan can be adjusted upward within the MCO's authorized service limits.

The annual reassessment is also where families lose services they didn't expect to lose. A parent who's been stable on waiver services for a year may present well to the reassessor precisely because the services are working. Document ongoing needs just as carefully for reassessments as for the initial evaluation.

For a complete guide to the CARE assessment preparation, financial application, and everything that follows the score — the Kansas Home Care, Waivers & Support Guide walks through the full pathway with checklists and decision trees.

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