9 Things the MLTC Assessment Looks For (So You Can Prepare With Confidence)

If your loved one may need home care through New York’s MLTC (Managed Long Term Care), the assessment can feel intimidating-especially if they’re the type to say, “I’m fine,” even when daily life is clearly getting harder. The good news: the assessment isn’t a “gotcha.” It’s designed to understand how safely someone can function day to day, what supports they already have, and what kind of assistance may be medically appropriate. In New York, this is commonly done using the state’s Uniform Assessment System (UAS-NY) community assessment process.

Below are nine key areas assessors typically look at, along with simple ways to prepare-without overthinking it.

1) Daily living tasks (ADLs): what they can actually do safely

One of the biggest areas is Activities of Daily Living (ADLs)-the basics like bathing, dressing, toileting, transferring (bed/chair), eating, and walking/mobility. The focus is not “Can you do it on your best day?” but “Can you do it consistently and safely-without risking falls, injury, or severe fatigue?” The UAS guidance emphasizes documenting actual performance in everyday tasks.

How to prepare:

• Make a short list of where help is needed (standby help vs hands-on help).
• Note any recent falls, near-falls, or fear of falling.

2) Instrumental tasks (IADLs): the “life management” stuff that breaks down first

These are the tasks that keep someone independent: meal prep, shopping, laundry, housekeeping, using transportation, managing finances, and phone use. People often “hide” these struggles by skipping tasks or relying quietly on family.

How to prepare:

• Write down what’s being avoided (expired food, unopened mail, missed appointments).
• Be honest about what family members are already doing behind the scenes.

3) Cognitive status and decision-making

Assessors look at memory, orientation, and everyday decision-making-things like remembering steps of a task, staying safe with the stove, following medication timing, or recognizing risky situations. The UAS-NY materials explicitly cover recording a person’s everyday decision-making ability.

How to prepare:

• Note repeated patterns (forgetting meds, confusion about dates, getting lost).
• Bring a simple timeline of changes over the last 3-6 months.

4) Mobility, transfers, and fall risk

Beyond “Can they walk?” the assessment often drills into:

• How they get up from bed/chair
• Balance, endurance, and gait
• Stairs, uneven surfaces, bathroom mobility
• Need for assistive devices (walker/cane/wheelchair)

How to prepare:

• List mobility aids used (even if “only sometimes”).
• Track any physical therapy recommendations and whether they’re being followed.

5) Medical conditions and symptom stability

MLTC is tied to long-term care needs, so assessors will consider diagnoses and how stable or complex symptoms are: pain, shortness of breath, dizziness, weakness, wound care needs, etc. The state’s MLTC-related policies describe how the assessment process is used to determine needs and route people through the appropriate level of assessment.

How to prepare:

• Have a current problem list (major diagnoses).
• Note “bad day” triggers (pain spikes, swelling, anxiety, fatigue).

6) Medication management and treatment routines

Even when someone is cognitively sharp, post-hospital medication schedules can be complicated. Assessors typically review:

• Number of medications and dosing complexity
• Ability to self-administer safely
• Use of pill organizers, reminders, or family support
• Any history of missed/doubled doses

How to prepare:

• Bring all medication bottles or a printed medication list.
• Note who actually sets up pills and how often mistakes happen.

7) Continence and toileting needs (including night-time realities)

This is a sensitive area, so families often minimize it. But toileting safety is a major driver of need-especially at night when falls are more common. Assessors may ask about urgency, accidents, nighttime frequency, and whether help is needed cleaning up or getting on/off the toilet.

How to prepare:

• Be factual (frequency, assistance needed, any skin irritation).
• Mention night-time supervision needs if relevant.

8) Behavioral health, mood, and social isolation

Depression, anxiety, withdrawal, and loneliness can significantly affect functioning: appetite, sleep, motivation, and willingness to bathe or leave the house. Assessments often capture psychosocial factors because they impact safety and consistency at home.

How to prepare:

• Note changes in routine (stopped hobbies, avoiding calls, staying in bed).
• Mention any grief, caregiver stress, or recent major life changes.

9) Informal supports, home environment, and safety setup

The assessment also looks at the ecosystem: who is helping, how often, and whether that support is sustainable. It may also consider home layout and risks (stairs, bathroom setup, clutter, poor lighting). The state’s conflict-free evaluation/enrollment information describes how independent assessments determine need and guide next steps for long-term care supports.

How to prepare:

• Write down what family/friends do each week (rides, meals, med setup).
• Be honest if help is inconsistent, long-distance, or causing burnout.

A confidence-boosting way to approach the assessment

The best mindset is: tell the story of an average week. Not the best day. Not the worst day. A realistic, typical week-what’s hard, what’s risky, and what supports already exist.

If you want a simple prep checklist, gather:

That clarity helps the assessor match the right level of managed long term care services to your loved one’s real needs-so you can move forward without guessing or waiting for a crisis.