CARES Assessment in Florida: 701B Level-of-Care Evaluation Explained

The CARES assessment is the clinical gatekeeping step between your parent and Florida Medicaid-funded long-term care. Without a Nursing Facility Level of Care (NHLOC) determination from this assessment, your parent cannot access the SMMC LTC waiver — regardless of how bad their financial situation is or how long they've been on the waitlist.

The Two-Step Process Most Families Don't Expect

Florida's Comprehensive Assessment and Review for Long-Term Care Services (CARES) program operates in two stages, and confusing them causes delays.

Step 1: The 701S Screening (Telephone)

This is the initial triage. You initiate it by calling the Elder Helpline at 1-800-963-5337 or contacting your local Aging and Disability Resource Center (ADRC). The ADRC must reach back within three business days to schedule the screening.

The 701S is a 30-to-60-minute telephone interview evaluating:

• Activities of Daily Living (bathing, dressing, eating, transferring, toileting)
• Instrumental Activities of Daily Living (managing finances, medications, cooking, housekeeping)
• Cognitive status and behavioral concerns
• Home environment safety
• Current caregiver availability and capacity

The screening generates two numbers that determine everything:

• Priority score (1 to 5): Measures overall frailty level
• Waitlist rank (1 to 8): Determines how quickly the elder can access SMMC LTC benefits

Before the screening can proceed, a DOEA CARES Informed Consent form must be signed by the elder or their legal representative and submitted via email or fax.

Step 2: The 701B Comprehensive Assessment (In-Person)

This only happens after DCF verifies financial eligibility and an SMMC LTC slot opens for your parent's priority rank. A CARES registered nurse or social worker visits the elder — at home, in a hospital, or in a nursing facility — to conduct a thorough face-to-face evaluation.

The 701B assesses:

• Detailed ADL dependency levels (not just "needs help" but how much help and how often)
• Cognitive impairment severity
• Medical complexity (diagnoses, medications, treatment requirements)
• Risk factors for institutional placement
• Whether the elder truly requires a Nursing Facility Level of Care

The assessor issues the formal NHLOC determination. Without this certification, SMMC LTC enrollment cannot proceed.

How the 8-Rank Waitlist Works

The 701S screening places your parent into one of eight priority ranks:

• Ranks 1-2: Low frailty — not placed on the active waitlist
• Rank 3 (score 30-39): Moderate frailty — active waitlist, wait times range from months to years depending on regional funding
• Rank 4 (score 40-45): High frailty — active waitlist, faster slot release than Rank 3
• Rank 5 (score 46+): Highest standard frailty — prioritized for immediate slot release
• Rank 6: Individuals transitioning from other programs (e.g., iBudget)
• Rank 7: Imminent risk — no capable caregiver, high risk of nursing home placement within one to three months
• Rank 8: Adult Protective Services high-risk referral — immediate slot release

How to Prepare for the Assessment

The quality of information you provide directly affects your parent's priority score. Families who downplay deficits (out of pride, denial, or misunderstanding the process) get lower scores and longer waits.

Document specific incidents. Instead of "Mom sometimes forgets things," record "On June 3, Mom left the stove on for four hours. On June 10, she was found wandering the parking lot at 2 AM unable to identify her apartment." Specifics drive scores up.

Compile the medication list. Include every prescription, dosage, and frequency. Missed medications and complex regimens indicate higher medical complexity.

Note all falls. Dates, circumstances, injuries, and whether emergency services were called. Falls are a major ADL dependency indicator.

Be honest about caregiver burnout. If the primary caregiver is overwhelmed, working full-time, or dealing with their own health issues, say so. Lack of caregiver capacity pushes the priority score higher and can trigger Rank 7 (Imminent Risk) classification.

What Happens If Your Parent's Condition Changes

If your parent is on the waitlist and experiences a hospitalization, a significant cognitive decline, a fall, or the loss of their primary caregiver, contact the ADRC immediately to request a clinical re-screening. An updated 701S screening is the primary mechanism for adjusting the priority score and moving from Rank 3 to Rank 7.

There's also an expedited pathway: if the elder enters a licensed nursing facility as a private-pay resident and remains for 60 consecutive days, they can bypass the community waitlist entirely under SMMC "Reserve Capacity" rules.

The Florida Care Decision Guide includes a pre-assessment preparation checklist, a clinical activity log for documenting ADL deficits, and the complete ADRC contact workflow — so you walk into the screening with objective, organized evidence that reflects your parent's true care needs.

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