Level of Care Assessments

Indiana Nursing Facility Level of Care (LOC) Assessments

The Indiana Level of Care Assessment Representative (LCAR), administered by Maximus, helps Hoosiers seeking or receiving long-term care navigate the eligibility process and ensure they receive the appropriate supports.

An NF LOC assessment determines whether an individual qualifies for:

• • Admission to a Medicaid-certified nursing facility, or

  • Access to certain Home and Community-Based Services (HCBS) waivers
    
    

Administered by: Maximus – Indiana LCAR

• • Phone: 1-833-597-2777 (Mon–Fri, 8:30 a.m.–6:00 p.m. ET)

  • Email: INLCAR@maximus.com

  • Website: inlcar.com

  • State Info: FSSA LOC Page
    
    

Who Needs an LOC Assessment

• • Adults or children applying for nursing facility admission or specific HCBS waivers

  • Any individual seeking waiver services for the first time

  • Required for:

    1. Health & Wellness (H&W) Waiver

    2. Traumatic Brain Injury (TBI) Waiver – For children with TBI diagnosis; may require ICF/IID LOC if NF LOC is not met

    3. Medicaid-certified nursing facility admission

Understand the Process

• • Adults 

  • Children 

  • PASRR

  • FAQ

Level of Care Tools for NFLOC

• • Adults (18+): Full interRAI HC

  • Ages 4–17: interRAI PEDS

  • Under 4: interRAI EY

For more details:

• • Under 60: H&W / TBI Fact Sheet 

  • 60+: Pathways Fact Sheet
    
    

Assessment Process

1. 1. Request an Assessment: Online, by phone, or through:

      • • Area Agency on Aging (AAA)

        • Aging & Disability Resource Center (ADRC)

        • Hospital or nursing facility (for NF admissions)

   2. Assessment Method: Conducted by trained evaluators virtually or in-person

   3. Timeline:

      • Completed within 7 calendar days

      • LOC recommendation issued within 11 calendar days of request

   4. Results:

      • Mailed to the individual

      • AAA notified via Maximus AssessmentPro if eligible, then proceeds with service planning

Qualifications:

• • Must require a level of care comparable to a nursing facility.

  • Medical conditions must need ongoing monitoring/treatment by skilled professionals.

  • Must have significant functional limitations due to:

    1. Cognitive impairments (e.g., severe memory deficits, poor judgment, limited executive function).

    2. Physical impairments (e.g., difficulty with mobility, self-care, ADLs)

    3. Behavioral health issues (e.g., aggression, elopement, impulse control problems) requiring support/supervision.
       
       

Appeals

If you disagree with your LOC determination, follow the appeal instructions provided in your official LOC outcome letter.

Nursing Facility Preadmission Screening and Resident Review (PASRR)

If seeking nursing facility admission, Maximus also conducts the Preadmission Screening and Resident Review (PASRR) to ensure services meet the individual’s needs in the most appropriate setting.

• • Stay informed: https://www.in.gov/fssa/da/projects/pre-admission-screening-resident-review/

  • Listserv: Sign up to receive updates on PASRR trainings, webinars, and changes.

  • Presentations: Facilities can request a one-hour on-site PASRR presentation by emailing PASRR@fssa.in.gov 

Need help at any stage? Reach out—we’re happy to guide you through the process and connect you with resources while you wait.