[{"_1":2,"_100":-5,"_101":-5},"loaderData",{"_3":4,"_26":27},"root",{"_5":6,"_17":10,"_18":19,"_20":21,"_22":10,"_23":-5,"_24":-5,"_25":10},"user",{"_7":8,"_9":10,"_11":10,"_12":-5,"_13":-5,"_14":15,"_16":-5},"roles",[],"isAuthenticated",false,"isPremium","planName","subscriptionStatus","featureFlags",{},"insightsBudget","isDevelopmentHost","userPreferences",{},"recaptchaSiteKey","6LcvOJcUAAAAAHsB-gPGfGktcRlKpH7OTIU_dMTD","isImpersonating","impersonation","affiliateStatus","isFreedomPortal","routes/v2/article/layout",{"_28":29,"_30":31},"notFound",true,"relatedArticles",[32,76,88],{"_33":34,"_35":36,"_37":38,"_39":40,"_41":42,"_43":44,"_45":46,"_47":48,"_49":50,"_51":52,"_53":54,"_55":56,"_57":58,"_59":60,"_61":62,"_63":64,"_65":66,"_67":68,"_69":70,"_71":72,"_73":74,"_75":74},"mediaId",6493766,"mediaKeyId","5448241-39c6fbf63937b6d6e9e4499ba6d948be","parentId",5448241,"title","State explains how acuity points convert to hours and how HMA, PDN and CNA totals will be reconciled","audioSeconds",283,"startMs",2512000,"endMs",2795000,"viewUrl","/Search/View?dp=1&key=5448241-39c6fbf63937b6d6e9e4499ba6d948be&start=2512&end=2795","thumbnailUrl","https://assets.pipeline.soar.com/5448241-39c6fbf63937b6d6e9e4499ba6d948be/thumbnail_2512000.jpg","articleUrl","/articles/6493766/Colorado/State-explains-how-acuity-points-convert-to-hours-and-how-HMA-PDN-and-CNA-totals-will-be-reconciled","mediaUrl","https://secure.pipeline.soar.com/6493766-56552654ff3b1be4526deb4453aa7115/orig.mp4?Expires=1771156737&Signature=mzD2pbHE9QrhmxEHpm8eZ3f7VdH3lzlNACytTeM7A8OoxvyhPIBuyZ9tWzO-4tiJEUs5z9iztTHOdsYpqQtPbkcl-irptJ1mPDV4JNEUiITh1ptls~01uFcni9WpY6aaKsxb~y6RMWo03mw6PJ-rOT3BI0oGbuQLcYVkAn1BTwsH-eYAjExfw0W3ROZcwsftHXeyRo5ZR2FLpD44MsMf0n~a-8KuHvyoJ2khFLD8fSkI9B17PrAkyGYu76VdarBhIuEeLEdF0ffQ4zayHVk~fhNQHaHUC27MV-rlS5qyTSOnr4lbmNYQwCbBONnNp0zVXAzaapEoeGjPclBJ-ECa0g__&Key-Pair-Id=KUT5TJCACFTXG","author","Colorado Health Care Policy & Financing","date","2025-07-22T23:34:17.02Z","article","Colorado officials walked attendees through how the skilled-care acuity tool converts assessment points to recommended hours and addressed operational questions about overlap, additional considerations and how case managers can adjust recommendations.

Key conversions and logic

- Private duty nursing (PDN): OCL said each final PDN point in the tool equals 15 minutes of care.
- Long-term home health nursing visits: the tool produces visit-based outputs; OCL said an initial skilled nursing visit is assumed to be 2.5 hours and the tool calculates visits per day rather than a pure time-per-task figure.
- Certified nursing assistant (CNA) tasks and modifiers: the CNA tab includes three sections — CNA tasks (bathing, dressing, toileting, transfers, etc.), modifier A (communication/cooperation and neuromuscular issues) and modifier B (airway status, pain, seizures, skin, sensory impairments). Modifiers add time only when CNA tasks are present; combined totals are multiplied by seven to produce hours per week.
- Health Maintenance Activities (HMA) total: OCL staff confirmed that HMA recommendations will reflect the sum of relevant PDN hours, CNA hours and the time-equivalent of intermittent skilled nursing visits (the department summarized this as the totals from the three tabs being combined).

Reconciling atypical needs and additional time

Stakeholders asked how the system would capture atypical or extra time (for example, when a standard task takes longer than the default). OCL staff said the assessment tool contains an “additional considerations” box; the department clarified that those entries feed into the point/Hour total so they can appear on the recommendation letter. Cassie said the case manager retains authority to document deviations and request different hours in the prior authorization with supporting rationale; those requests are reviewed in medical necessity processing.

Duplication and care-plan translation

OCL acknowledged overlapping tasks can appear across PDN, intermittent nursing and CNA tabs. Officials said nurse assessors will discuss options with members (for example, whether PDN or HMA better meets needs), and case managers remain responsible for creating care plans and avoiding duplicative authorizations. A department staff member noted that if case managers or providers have supporting documentation that an assessed number of hours is insufficient, they may submit additional justification during the authorization process.

Other operational clarifications

- Daily caps: OCL said benefit caps (daily dollar or hour limits) are applied when relevant; as an example, staff noted a PDN assessment for 24 hours would be constrained by the applicable cap and presented as a smaller recommended number in the letter.
- Interim direct care calculator: OCL said the interim direct-care-services calculator was revised to include a place to log deviations from the nurse assessment (labelled as deviations for HMA) so case managers can document agreed changes.

Stakeholder reaction and remaining issues

Providers and case managers pressed for clarity on how additional considerations are reconciled in practice; several attendees reported inconsistent behavior when testing the tool. OCL offered follow-up walkthroughs and said additional training will be provided to ensure consistent calculation and documentation practices.","mediaType","Video","parentTitle","Nurse Assessor Stakeholder Meeting - July 8, 2025","oneSentenceSummary","OCL staff walked stakeholders through how the nurse-acuity tool converts task points into hours for private duty nursing, long-term home health and certified nursing assistant tasks, clarified that HMA totals combine those outputs, and described how case managers can request deviations.","taxTitle","Health Care Policy & Financing, Governor's Cabinet, Organizations, Executive, Colorado","taxId",27503,"location","Colorado","headline","","shortSummary",{"_33":77,"_35":36,"_37":38,"_39":78,"_41":79,"_43":80,"_45":81,"_47":82,"_49":83,"_51":84,"_53":85,"_55":56,"_57":58,"_59":86,"_61":62,"_63":64,"_65":87,"_67":68,"_69":70,"_71":72,"_73":74,"_75":74},6493772,"State previews Qualitrak referral form, recommendation letter; members and providers to receive assessment copies",325,524000,849000,"/Search/View?dp=1&key=5448241-39c6fbf63937b6d6e9e4499ba6d948be&start=524&end=849","https://assets.pipeline.soar.com/5448241-39c6fbf63937b6d6e9e4499ba6d948be/thumbnail_524000.jpg","/articles/6493772/Colorado/State-previews-Qualitrak-referral-form-recommendation-letter-members-and-providers-to-receive-assessment-copies","https://secure.pipeline.soar.com/6493772-403bc322f379cb06164386664e7ddd8c/orig.mp4?Expires=1771156737&Signature=GTZzHTwaY3xqiC0M-3kmkxcfwwVqRg3fWKUXiHkDUKium6gi0W6MPpVCoiBUd3deWXATAqmph-Oo8M-ov5aZrbbKS59zqSN5B75QkyhY7AbGfGBJHyTqfpRScGuVdY9-eOMqG8OdQSI8lMCZMQePJbc3F7XpntndcRzp1kvnKJT31PTtVRe7trxOhx2eO~wc5iMQer7rbP2ZZwc5pxT2Rm7HW-sdl7nH97hff2CwAWXBQJj4JzvPqv0afb4P9X~RQHQmR1WVDKSmPGoGcFiBGCaHqzXEqaVbVzzznEAkTM7a5JFxyIuY~ObzuM5hk1loQp0iyHoYPR8yevA~mpH8lA__&Key-Pair-Id=KUT5TJCACFTXG","State officials demonstrated the Qualitrak referral form and the format of the nurse-assessor recommendation letter, and said both members and providers will receive a copy of the completed assessment.

“The referral form is very simple, very straightforward,” OCL HCBS Division Director Candace Bailey said, describing a web form that allows providers, members or other reporters to submit referrals, select a preferred language and request an interpreter.

What the system will do

- Who can refer: OCL said a provider, a medical doctor, family members, neighbors or the member themselves can submit a referral in Qualitrak.
- Language and interpreter: the referral includes a member’s preferred language and an option to request an interpreter at intake.
- Sharing: the referral asks whether the member wants the assessment results shared and, if yes, prompts the referrer to name recipients such as a case manager or home health agency. State staff said this is not a HIPAA waiver; it only records who should receive the results.
- Duplicate detection: OCL said Qualitrak will flag duplicate referrals so multiple submissions for the same person do not create duplicate assessments.
- Recommendation letter and assessment copy: officials showed the recommendation-letter format and said the member will receive a copy of the full scored assessment (either printed or via the portal) along with the recommendation.

Access, disputes and appeals

OCL staff said the recommendation letter is an assessment-based recommendation and not a medical-necessity determination. Cassie, an OCL staff member who spoke during the session, said, “The nurse assessor recommendation is not a determination of medical necessity. It is not a determination of services. It is strictly a recommendation.”

If members or providers find errors in an assessment, OCL said they can contact Teligent directly (OCL provided a vendor email and phone number) or use the department’s home health inbox; staff said the inbox is monitored multiple times per day. If a subsequent prior authorization request that departs from the recommendation is denied, the denial can be appealed through the standard appeal process for authorizations.

Other operational notes

- Qualitrak is not a provider-selection tool; members will use other channels to select agencies.
- Referrers receive email or portal notifications at key events such as scheduling and letter issuance.
- The department will post a listening log with chat questions and written answers after the meeting.

OCL asked stakeholders to review screenshots and to send follow-up questions; staff said the slides and recording will be posted for agencies to reference.","Colorado showed screenshots of the Qualitrak referral form and the assessment recommendation letter, saying members will receive a copy of scored assessments and that the system de-duplicates referrals and supports language preference and sharing options.",{"_33":89,"_35":36,"_37":38,"_39":90,"_41":91,"_43":92,"_45":93,"_47":94,"_49":95,"_51":96,"_53":97,"_55":56,"_57":58,"_59":98,"_61":62,"_63":64,"_65":99,"_67":68,"_69":70,"_71":72,"_73":74,"_75":74},6493777,"Colorado delays nurse-assessor launch to Aug. 1; ramp-up of assessments begins July 21 to prevent authorization gaps",3818,351000,4169000,"/Search/View?dp=1&key=5448241-39c6fbf63937b6d6e9e4499ba6d948be&start=351&end=4169","https://assets.pipeline.soar.com/5448241-39c6fbf63937b6d6e9e4499ba6d948be/thumbnail_351000.jpg","/articles/6493777/Colorado/Colorado-delays-nurse-assessor-launch-to-Aug-1-ramp-up-of-assessments-begins-July-21-to-prevent-authorization-gaps","https://secure.pipeline.soar.com/6493777-4bfbbeef4580feffb9afe6469f45352a/orig.mp4?Expires=1771156737&Signature=InBdxWvESTQ7dYBfqjmIanRmAZvyRc-dXS15roaRtS0iInVecckToOPkC6B3j1uvMJ9evL3rzkaWQPZtIZaYoGnJb~9W5fmcnzEl3jygxAQu4OdKRU5pabf2ItFtJjzGVmmNpuMs08Bi12-EfEAoQllXNHYpD1Dg9Jh3xvDV6t0qDGOgQJQfn4S6iKqnNogC1LVtXVAoZn4UVlHdWI~LLBytXQvAQ77MVxjXxim~ervn6BBAxlzDQYDAgdce38dYAdF2-TJ5KA3LhTVSZUlfEdWP28brusMMm3C6WuFkuzt2btnpQ45vSzxmirqVRMqSXumDBlawmZDl4AsO15r6ew__&Key-Pair-Id=KUT5TJCACFTXG","The Office of Community Living (OCL) at the Colorado Department of Health Care Policy & Financing delayed full implementation of its nurse-assessor program to Aug. 1, 2025, and will begin a small ramp-up of assessments on July 21 to avoid lapses in active prior authorizations (PARs).

OCL HCBS Division Director Candace Bailey said the program’s vendor systems “weren’t quite ready” and the delay was chosen to ensure a reliable launch. “We really committed to only operationalizing and launching this program once we were fully confident that everything was ready to go,” Bailey said.

Why it matters: the nurse-assessor process will drive recommendations for skilled-care delivery options, including Health Maintenance Activities (HMA), private duty nursing (PDN) and long-term home health. Agencies and families were concerned that an immediate launch could create service interruptions for members with PARs that expire around the start date.

Key details

- Ramp-up start: July 21, 2025. A limited cohort of cases will be assessed by the vendor (Teligent) during the ramp-up.
- Full launch: Aug. 1, 2025. The state said assessments and the skilled-care acuity tool will be live statewide on that date.
- Covered PARs for ramp-up: OCL identified adult long-term home health and PDN members whose PARs expire in the Aug. 1–10 window; those cases were selected for the July 21 ramp-up so prior authorizations can be processed without a lapse.
- Pediatric rollover requirement: beginning Aug. 1, pediatric long-term home health PAR submissions must total 15% of a home health agency’s caseload per month. Agencies determine which cases are submitted monthly; the department will track compliance.
- Assessment validity and timing: completed assessments are valid for 60 days for purposes of authorizations; the state also said members must receive a new assessment each certification year (an annual reassessment).

OCL said agencies that are part of the ramp-up received direct emails with training and lists of members included in the cohort. Bailey said the ramp-up is intended both to protect members whose authorizations would otherwise expire in early August and to give vendors and agencies a “slow start” with a small set of live cases.

What to watch next: OCL said it will monitor early implementation, post public data where permitted, and follow up with agencies that need technical or process support. The agency cautioned that some metrics can’t be published until counts exceed privacy safe-harbor thresholds.","The Office of Community Living said the statewide nurse-assessor program will launch Aug. 1 after a one-month delay; a small ramp-up cohort will begin July 21 to process prior authorizations that expire in early August and reduce risk of service gaps.","actionData","errors"]

Article not found

State explains how acuity points convert to hours and how HMA, PDN and CNA totals will be reconciled

State previews Qualitrak referral form, recommendation letter; members and providers to receive assessment copies

Colorado delays nurse-assessor launch to Aug. 1; ramp-up of assessments begins July 21 to prevent authorization gaps