INFO Memo 04-26-02

Memorandum for Home and Community-Based Services Staff and Stakeholders

DATE: April 7, 2026

FROM: Veronica Jameson, Bureau Chief, Bureau of Policy and Quality Enhancements

SUBJECT: Communicating Reassessment Results and LOC Determination to Participants

This memorandum provides an immediate update to the Department of Health and Senior Services (DHSS) guidelines on how provider reassessors should communicate Level of Care (LOC) assessment results with participants.

To prevent confusion, provider reassessors should not inform participants that their LOC determination is final at the time of the assessment. While assessment results may suggest that LOC is met or not met, the outcome is not final until the Provider Reassessment Review (PRR) team completes a thorough review and confirms coding accuracy. This is also applicable to service reductions.

The PRR team will review the assessment the following month after the assessment was completed, at which point the final determination will be made. Therefore, no immediate action, such as case closure, will occur solely based on the assessment appointment.

To help participants understand the PRR process and next steps, provider reassessors shall:

  • Review assessment and care plan results with the participant
    • Whether the Level of Care (LOC) was met or not met
    • Any changes made to the care plan
  • Answer any questions the participant may have about these results or updates
  • Explain these results are preliminary and the review team will confirm the results in approximately one month
    • Let them know the team will only contact them if additional information is needed.
  • If no additional information is needed and LOC is met, explain the results will be submitted and the provider will be notified of the updated care plan
  • If LOC is not met or services are being reduced, explain an Adverse Action notice will be sent
    • This notice begins the 10‑day closure period for HCBS services when LOC is not met.
    • For service reductions, changes will take effect on the first day of the following month.

DHSS appreciates the ongoing efforts of provider reassessors to minimize confusion and help participants clearly understand the reassessment and review process.

Questions regarding this memorandum should be directed to the Bureau of Policy and Quality Enhancements via e‑mail at LTSS@health.mo.gov.