Kepro Assessment (Maine-Specific)
A KEPRO Assessment is a necessary part of applying for MaineCare (Medicaid) assistance to pay for long term care. The process is performed by a Registered Nurse under KEPRO Health Systems, an independent corporation contracted with the state of Maine to medically evaluate if care is needed and at what level.
These assessments were formerly conducted by a company called GOOLD Health Systems, so you may still hear people referring to them as “GOOLD Assessments.”
The evaluation is performed in the patient’s home, senior care community, or hospital room. The nurse asks questions regarding the senior’s ability to take care of himself, what kinds of medications he is taking, what kind of help he requires, and his income. Input from family caregivers is also considered. This is important because if your loved one has dementia, he may not be conveying an accurate account of his needs.
A KEPRO Assessment is ordered if there is a new MaineCare application, or if there is a change in the care level of a MaineCare-approved individual. An Assessment referral can be made by the care community where the senior resides, or by the family caregivers if the senior has not yet moved into a care community, but has a reserved an available spot. It is important to note, KEPRO will not complete an assessment unless there is an open space for the senior in a care community.
This can sometimes present a challenge for the family, as MaineCare facilities are often hesitant to hold a space for a senior unless MaineCare is already approved and MaineCare cannot be approved until the KEPRO Assessment is complete, which can take up to five business days. If you are working with a Senior Care Advisor, they can help you navigate this challenge. If you are working as your own advocate, the best approach, if you cannot hold a spot, is to confirm with the community that there is currently a space open should your loved one be qualified by KEPRO for that level of care. That will satisfy KEPRO; however, know that you should not let yourself get too attached to a particular option in a particular community because by the time KEPRO is complete, the space may be gone..
KEPRO Assessments are only valid for thirty days. If you do not find a new space for your loved one in that time period, you will have to order a new Assessment. There is no fee for ordering a KEPRO Assessment.
If your loved one will be using VA benefits, Long Term Care Insurance, or private assets to pay for long-term care, you will likely not need a KEPRO Assessment. However, some communities that accept both private pay and MaineCare require a KEPRO assessment, anyway, in order to assure that the individual in question will be eligible for MaineCare when and if their assets run out.
If you have questions about getting a KEPRO assessment or would like some input on how to prepare, contact us.