What to Do if You Disagree with a CARE Assessment​

1.     Start With the Case Manager

      If the CARE Assessment appears inaccurate, contact the assigned HCS/AAA case manager first. Provide:

    ~   A clear explanation of the issue

    ~   Specific sections you believe are incorrect (ADLs, cognition, behaviors, supervision needs, etc.)

    ~   Supporting documentation

2.     Request a CARE Reassessment (CARE Re-Open)

    ~   If the concern cannot be resolved through clarification, ask the case manager to re-open the CARE and conduct a reassessment.

Reasons include missed needs, communication barriers, or documented behaviors not captured.

3.     Ask for a Supervisory Review

    ~   If the disagreement affects payment grouping or level of care, request a supervisory review of the CARE results and payment rate determination.

4.     If DSHS Denies the Request → File an Administrative Fair Hearing

    ~   A Fair Hearing may be filed when DSHS denies a correction request. Appeals are generally due within 90 days.

5.     Documentation to Support a Dispute

    ~    Provide strong evidence such as daily care logs, behavior notes, medication logs, and physician orders.

6.     Keep Communication Professional and Written

    ~  Use clear language, reference specific CARE domains, email your requests, and keep copies.

Summary Flow:

    ~ Clarification with case manager

    ~  Request CARE reassessment

    ~  Supervisory review

    ~  Fair Hearing if denied

    ~  Support with strong documentation