A functional long-term-care assessment is a comprehensive psychosocial evaluation often used to determine medical eligibility for state Medicaid programs, including home and community based services (HCBS) and long-term services and supports (LTSS). Assessment items include activities of daily living (ADLs), instrumental activities of daily living (IADLs), cognition, and physical health. The assessment process usually takes place in-home. Functional assessments help providers determine the client’s functional abilities, functional status, impairments, and health care needs, thus determining Medicaid eligibility and the proper level of care. The client may then be placed in a nursing home, skilled nursing facility, or other care facility like assisted living, or they may be able to remain in-home and receive home care from home health agencies and caregivers.
Some assessors use functional assessment tools such as the Lawton-Brody IADL Scale or the Klein-Bell Activities of Daily Living Scale (K-B Scale), while others use state-specific questionnaires and assessments. These assessments are important for those seeking Medicaid services, as they help monitor the patient’s health status, provide person centered care, create care plans, and help with care coordination. Many Medicaid waiver programs require an assessment from new applicants, as well as annual assessments for those already receiving long-term care services.