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✴️ Nurse Assessor and Skilled Care Acuity Assessment

✴️ This is a Priority Project for the Office of Community Living
 

Nurse Assessor     Skilled Care Acuity Assessment     Stakeholder Engagement     Contact Us

Announcement of Skilled Nurse Assessor Vendor

March 13, 2025

A vendor has been selected for Solicitation UHAA 2025-00126 Skilled Nurse Assessor. This selection was made after a HCPF-appointed multidisciplinary evaluation committee reviewed proposals in a competitive Request For Proposal process. 

The selected vendor, Telligen, has accepted the award, and the program will be implemented beginning July 1, 2025.

Telligen Signed Contract - April 2025

Nurse Assessor

What is the Nurse Assessor?

  • The nurse assessor is a new process that streamlines the way members are assessed and receive recommendations for skilled care services, including Registered Nurse (RN), Certified Nursing Assistant (CNA), and Health Maintenance Activities (HMA).
     
  • The Department of Health Care Policy and Financing (HCPF) will holistically assess members, using a 3rd party skilled nurse assessor, for the appropriate level of skilled care services across selected service modalities. 
     
  • The skilled nurse assessor will also help educate members about skilled care services and all service delivery options, including self-direction, and ensure members understand the service that will best meet their needs based on their assessment.
     

Why Implement a Nurse Assessor?

  • HCPF requested funds to implement this initiative through a budget request (R-10) in 2023. 
       
  • The nurse assessor will eliminate any conflict of interests that currently exist in the process of accessing skilled care services.
     
  • The Nurse Assessor will provide a holistic assessment of the member’s need for skilled care services.
     
  • One assessment completed by the Nurse Assessor will decrease the number of assessments for members. For example, when a member is assessed and finds that they do not need Private Duty Nursing (PDN), an additional assessment is not necessary to assess their need for Long-Term Home Health (LTHH). 
     
  • The Nurse Assessor will be responsible for educating members about all the available services to meet their skilled care needs, which enables the member to choose the service delivery option(s) that best meet their needs.
     

When Will the Nurse Assessor Start?

  • HCPF anticipates implementing the Nurse Assessor on July 1, 2025.  
     
  • HCPF anticipates aligning the implementation of the skilled nurse assessor with the resumption of Long-Term Home Health (LTHH) PAR requirements.
     
  • HCPF anticipates the Nurse Assessor will use the newly developed Skilled Care Acuity Assessment, a valid and reliable tool for assessing members’ skilled care needs. 

 

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Skilled Care Acuity Assessment

What is the Skilled Care Acuity Assessment?

  • A clinically reliable and validated tool(s) to determine the appropriate level of care and associated hours for members seeking skilled care services.
     
  • The Skilled Care Acuity Assessment will be completed by a 3rd party Nurse Assessor. 
    • The Request for Proposal (RFP) for the Nurse Assessor includes a requirement for the new vendor to digitize this tool for use.  
       

Why Develop the Skilled Care Acuity Assessment?

  • HCPF and its stakeholders have identified the need for a consistent and reliable tool for assessing members for skilled care services.
     
  • HCPF received funding to implement a LTHH acuity tool in FY 2019-20 through R-9, “Long-Term Home Health/Private Duty Nursing Acuity Tool.” 
    • HCPF used this funding to conduct an environmental scan in FY 2020-21 of other state approaches but was unable to identify an appropriate tool, concluding that HCPF must build one from the ground up. There was not adequate funding to build and implement a tool with the funding from that request.
       
  • The American Rescue Plan Act (ARPA) and associated funding gave HCPF an opportunity to continue to pursue the development of this needed tool.
     
  • ARPA Initiative 6.01 launched in October 2021 and concluded in September 2024.  
     

When will the Skilled Care Acuity Assessment Start Being Used?  

  • HCPF anticipates use of the Skilled Care Acuity Assessment will start with the implementation of the 3rd party Nurse Assessor and resumption of Long-Term Home Health (LTHH) Prior Authorization Requests (PARs) all of which are being phased in starting July 1, 2025. 

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Stakeholder Engagement

Nurse Assessor Listening Log - Updated May 2025 

Nurse Assessor Stakeholder Meeting

Next Meeting:

June 10, 2025 from 10:30 a.m. to 12 p.m.
Join via Google Meet
Join via Phone: 319-346-6054‬ PIN: ‪773 830 666‬#

Meeting Materials

May 13, 2025

April 29, 2025 - Health Maintenance Activities and Nurse Assessor Stakeholder Meeting

April 8, 2025

March 11, 2025

February 11, 2025 

    

Contact Us

Email: HomeHealth@state.co.us  

Phone: 303-866-5638

Reasonable accommodations will be provided upon request for persons with disabilities. Auxiliary aids and services for individuals with disabilities and language services for individuals whose primary language is not English may be provided upon request.

Please notify John Barry at 303-866-3173 or John.R.Barry@state.co.us or the Civil Rights Officer at hcpf504ada@state.co.us at least one week prior to the meeting to make arrangements.

 

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