How to Fill Out the Louisiana LOCET Form for Nursing Facility Eligibility

The Louisiana LOCET form isn’t something you fill out on paper by yourself. The Level of Care Eligibility Tool is a structured phone interview conducted by trained screeners at Louisiana Options in Long Term Care, reached at 1-877-456-1146.¹ Your job is to gather the right information before the call so the screener can accurately capture the applicant’s medical conditions, daily functioning, and care needs. The interview then determines whether the applicant meets nursing facility level of care (NFLOC) criteria for a Medicaid-certified nursing home or a home and community-based waiver.

Who the LOCET Applies To

A LOCET screening is required for anyone seeking admission to a Medicaid-certified nursing facility in Louisiana, regardless of how the stay will be paid for. The Office of Aging and Adult Services (OAAS) determines level of care for every applicant before admission, and the LOCET is one of two mandatory documents; the other is the Level I Pre-Admission Screening and Resident Review (Level I PASRR).²

The screening also opens the door to community-based alternatives. Section FF of the LOCET asks the applicant to choose among Adult Day Health Care, Long-Term Personal Care Services, the Program of All-Inclusive Care for the Elderly, the Adult Residential Care Program, or direct nursing facility admission.³ Both the Community Choices Waiver and the ADHC Waiver require NFLOC as a condition of enrollment.⁴

Two boundaries are worth knowing. If the applicant is already receiving OAAS home and community-based services, a new LOCET isn’t required. And if someone is already in a nursing facility and needs to show they still qualify, the facility follows a separate continued stay request process rather than repeating the LOCET.²

How to Start the Screening

Call Louisiana Options in Long Term Care at 1-877-456-1146. The applicant, a family member, a hospital discharge planner, a nursing facility representative, or any other interested party can make the call.¹ The screener works through the LOCET structure section by section, entering answers into the OAAS Participant Tracking System (OPTS), which runs the eligibility logic and produces a presumptive NFLOC result. OAAS or its designees then verify that result under state and federal rules.⁵

What to Have Ready Before You Call

The call goes faster and more accurately when the information is at hand. Section AA of the LOCET collects basic identification: full name, date of birth, gender, marital status, primary address, Social Security number, and Medicaid number. If Medicaid is still pending or not yet assigned, the form has a code for that.³ Any Medicare, VA, or private insurance numbers should also be within reach.

Beyond identification, pull together:

The primary physician’s name, address, and phone number (Section DD).
Contact information for anyone holding power of attorney or legal guardianship (Section CC).
The applicant’s primary and secondary medical diagnoses, ideally with ICD codes from recent records (Section GG).
Specific details about how much help the applicant has needed with bathing, dressing, eating, transferring, toileting, locomotion, and personal hygiene over the past seven days.
Cognitive status: any short-term memory problems, difficulty making daily decisions, or trouble being understood.
Current treatments such as IV feedings, respiratory therapy, pressure sore care, or rehabilitation therapies, including minutes per week.
The number of physician visits and any new physician orders in the past 14 days.
The name, date of birth, and any disability status of the primary caregiver (Section B).

The screener will also ask where the applicant currently lives, whether safe and accessible housing exists in the community, and whether the applicant has lived in a nursing home at any point during the past five years.³

What the Screener Will Ask About

The interview is organized around seven eligibility pathways. The applicant only needs to qualify through one of them to meet NFLOC, and the OPTS system determines which pathway (if any) the answers satisfy.⁵

Activities of Daily Living

The screener rates each self-care task, typically over the past seven days, from independent to total dependence. To qualify on this pathway, the applicant must need at least limited assistance with toileting, transferring, or bed mobility, or extensive assistance with eating.⁶ Follow-up “degree of difficulty” questions explore how hard tasks were even when the applicant managed alone. Expect additional questions about meal preparation, shopping, and how often the applicant left the house during a typical week in the past 30 days.³

Cognitive Performance

Short-term memory is tested with a recall exercise. The screener also asks about daily decision-making and how well the applicant can make themselves understood. Qualifying generally requires a combination of memory and decision-making problems, or significant communication limits paired with cognitive decline. Severe impairment in daily decision-making qualifies on its own; minimal decision-making difficulty needs to be paired with significant trouble being understood.⁶

Physician Involvement

This pathway looks at the past 14 days. It takes either one doctor visit plus at least four new order changes, or at least two doctor visits in that period.⁵

Treatments, Rehabilitation, Service Dependency, and Behavior

The last four pathways cover more specialized clinical situations:

Treatments and conditions: active care like IV feedings, respiratory therapy, or pressure sore care, and diagnoses such as Alzheimer’s disease, multiple sclerosis, or head trauma that affect daily functioning.³
Skilled rehabilitation therapies: current or scheduled speech, occupational, or physical therapy measured in minutes per week.
Service dependency: reliance on ongoing care that can only be safely delivered in a structured setting.
Behavior: behavioral issues requiring supervision or intervention beyond what a typical home caregiver can provide.

The NFLOC eligibility manual lists the qualifying criteria for each pathway in detail.⁵

After the Call

Completing the LOCET alone does not clear the applicant for admission. OAAS begins its formal review only after receiving both the LOCET and a completed Level I PASRR, which a qualified health care professional fills out to screen for signs of mental illness or intellectual disabilities.² The Level I PASRR must be signed and dated on the day it’s completed and cannot be dated more than 30 days before admission.⁷

Once OAAS has both documents, Louisiana law allows two working days for a response.² If the Level I PASRR shows no indication of mental illness or intellectual disability and the applicant meets NFLOC, OAAS may approve admission, which must then occur within 30 days of the approval notice.⁷ If the Level I flags possible mental illness or intellectual disability, the applicant is referred for a Level II PASRR by the Office of Behavioral Health or the Office for Citizens with Developmental Disabilities, and the nursing facility cannot admit the individual until that Level II process is complete.

A completed LOCET is valid for 30 calendar days before admission. If the applicant does not enter a facility within that window, or if there is a break in institutional care, a new LOCET is required. The same 30-day rule applies to the Level I PASRR.²

For applicants choosing a community-based program, the LOCET establishes the medical eligibility needed for waiver enrollment. From there, a support coordinator or the program itself handles financial eligibility and enrollment.

If the Applicant Is Denied

If OAAS determines that the applicant does not meet NFLOC, the denial notice will state the deadline to appeal.⁸ You have several ways to file:

Online through the Division of Administrative Law’s website.
By mail to the Division of Administrative Law, Health and Hospitals Section, P.O. Box 4189, Baton Rouge, LA 70821-4189.
By fax at 225-219-9823.
By phone at 225-342-5800 or 225-342-0443, though a written request is recommended.

If the appeal is filed within 10 days of the denial, any services the applicant is currently receiving continue while the appeal is pending. A final decision should come within 30 days of filing, unless both sides agree to more time.⁸ Federal rules at 42 CFR Subpart E require written notice explaining the reasons for the decision, the regulations behind it, and the right to request a hearing.⁹

Before filing a formal appeal, the provider who requested services can ask OAAS for a reconsideration with additional supporting documentation within 30 days of the denial. If services are denied again after reconsideration, the formal appeal option remains open.⁸

1
Maximus Clinical Services. Louisiana PASRR Frequently Asked Questions
2
Louisiana Department of Health. Guide to Nursing Facility Admission and Continued Stay Requests
3
Louisiana Department of Health. Louisiana DHH Nursing Facility Level of Care Eligibility Tool
4
Louisiana Medicaid Program. Community Choices Waiver
5
Louisiana Department of Health. OAAS Nursing Facility Level of Care Eligibility Manual
6
Louisiana Department of Health. LAC Title 50 Part II – Level of Care Pathways
7
Louisiana Department of Health. LAC Title 50 Part II – Medical Certification
8
Louisiana Department of Health. How to Appeal Medicaid
9
eCFR. Fair Hearings for Applicants and Beneficiaries