LCAR performs nursing facility level of care assessments and determinations for adults

A nursing facility level of care (NF LOC) determination is required to qualify for Medicaid coverage of nursing facility services. It is also required for certain Home- and Community-Based (HCBS) waivers. Indiana offers the following HCBS waivers for adults with an NF LOC: 

  • Indiana PathWays for Aging (PathWays) Waiver - For adults who are 60 years of age or older
  • Health and Wellness Waiver - For adults under age 60
  • Traumatic Brain Injury (TBI) Waiver  - For individuals of any age with a TBI diagnosis. 

Note: The TBI Waiver, as well as two other waiver programs, are also available to individuals who have been determined to meet LOC criteria for an intermediate care facility for individuals with intellectual disabilities [ICF/IID]. If an individual does not meet NF LOC for the TBI Waiver.  LCAR will inform the TBI Waiver Case Manager as a referral to BDS to complete the ICF/IID LOC to ensure eligibility for TBI Waiver is determined. Inquiries about this process may be emailed to LCAR at INLCAR@maximus.com or BDS.Help@fssa.in.gov.

Frequently asked questions

LCAR stands for Level of Care Assessment Representative. The Indiana Family and Social Services Administration (FSSA), in partnership with various entities, conducts federally required Level of Care (LOC) assessment and determination services and intake counseling for PathWays individuals in need of a Nursing Facility Level of Care (NFLOC) for nursing facility (NF) admission or Home- and Community-Based Services (HCBS) Waiver programs.  

On July 1, 2024, the LCAR began Preadmission Screening and Resident Review (PASRR) and level of care determinations for individuals entering or residing in a skilled nursing facility.  

Beginning July 1, 2025, the LCAR will provide:  

  • PASRR 
  • Level of Care (LOC) assessments, and renewals 
  • LOC determination (outcome) recommendations and re-determinations 
  • Intake counseling for the PathWays 60+ population 
  • Medicaid application assistance 

These services apply to the PathWays for Aging, Health & Wellness, and Traumatic Brain Injury Waivers.  

A NF LOC is a measure of care needs that must be met for Medicaid recipients to access Medicaid funded nursing homes and certain HCBS Waivers. Medicaid will not pay for these services unless it is decided that a person meets that state’s NF LOC criteria. To decide if NF LOC criteria is met, an assessment must identify the person’s needs. This includes assessing their ability to complete day-to-day activities, medical conditions, medical treatments needed, cognitive abilities, and behavioral needs. 

Contact by phone: 833.597.2777

Contact by email: INLCAR@maximus.com

Additional resources: https://www.inlcar.com

Help Desk hours: Help Desk staff are available for phone inquiries from 8 am to 6 pm EST Monday-Friday.

Indiana’s Home- and Community-Based Services (HCBS) Waiver Services available for adults that require meeting NF LOC to qualify include:  

  • PathWays for Aging Waiver for adults who are 60 years of age or older 
  • Health and Wellness Waiver for adults under age 60 
  • Traumatic Brain Injury (TBI) Waiver for adults that have a TBI diagnosis.

Indiana has other HCBS Waiver programs available for adults that do not require meeting NF LOC to qualify.

The assessment used for nursing facility Level of Care (NF LOC) in Indiana for adults is the interRAI Home Care (HC).

You or someone who helps you with managing your care can contact Maximus at: 833.597.2777. A Maximus team member will gather some information about you so they can get your nursing facility Level of Care (NF LOC) assessment scheduled.

 

Once you have been referred to Maximus, they will have seven calendar days to gather the information for your assessment, and four additional calendar days for an outcome to be given, for a total of up to eleven calendar days to get the outcome.

Your nursing facility Level of Care (NF LOC) assessor will speak with you and others you would like to be included in the assessment and gather information about things like the type of help you need with daily activities, any medical care or treatments you need, and any conditions or diagnoses you may have.

 

An individual qualifies for nursing facility Level of Care (NF LOC) in IN if they have certain medical needs that must be performed by a nurse, or if they need help with completing at least three daily care tasks because of a medical condition.

 

Resources

FAQs guide

Frequently asked questions

Download our FAQs

Glossary of terms

Indiana LCAR glossary of common terms

Download glossary of common terms

Process overview

Level of care for adults process overview

Download process overview

Edlery woman speaking with her nurse