Industry Update, February 2023
Aged Care Funding Reform Committee Outcomes
We have not had another RACFRC meeting since last newsletter in December. So, no news is good news… sometimes.
If I am made aware of any new developments, I will keep you posted.
Handy emails for AN ACC Queries and Support
AMO assessors
This month’s feedback regarding AMO assessors:
Not reviewing progress notes as primary source of documentation. Remember the first principle of AN ACC is Resident assessment for funding to be separate from resident assessment for care planning purposes. This means clinical assessments that directly contribute to care plans are NOT to be considered for AN ACC scoring unless absolutely necessary. The AN ACC is in itself an assessment, so you cannot complete an assessment with another assessment.
Pressure to book in resident assessments including when the resident is a new admission under 7 days. Advice received encouraged persistence to reschedule to a more appropriate date if needed. Please advice the DoH via the ANACCassessment.health.gov.au if you continue to receive pressure that is unrelenting.
Assessments completed without interviewing or sighting resident receiving care leading to an incorrect Class allocation. Appeal Appeal Appeal.
legislation changes
Nil additional changes noted as yet.
Q&A
Our request for reassessment due to palliative care was not completed prior to the resident departing. How can we make sure this happens in a timely manner to receive appropriate funding?
Data analysis on urgent reassessments due to palliative care reasons shows less than 18% being incomplete prior to the resident passing. Overall, the reallocation of priorities for reassessments seems to be working and assessors are working on increasing their agility to get to RACs sooner.
Remember, if a resident’s decline is rapid, then the cost of care is not projected over an extended period of time so the financial impact will be minimal to the facility. Class 13 is not automatically allocated to palliative residents, as with other reassessments, the care time is what is being measured. You will receive the existing funding or the default rate for new residents; whichever is appropriate.
You are still encouraged to submit a palliative care status form for all new palliating residents. If you do not achieve the guidelines for Class 1 according to the form, submit anyway. The resident will be allocated Class 1 from the date of admission due to passing within the 3 month rule.
If you are rejected for Class 1, the program in My Aged Care will automatically allocate an AMO to complete an AN ACC assessment.
Current legislation is preventing any change to the process we have at the moment.
Sometimes we have more than one AMO visiting our facility for AN ACC assessments. Why is that?
The AMOs have been allocated a percentage of work to be undertaken. For example one AMO may have 50% of the allocations and the second AMO may have 20%. The program sitting behind the allocations on My Aged Care will automatically assign assessments ensuring the percentages of work is being maintained.
Will the Government consider changing the weighing behind the compounding factors as a result of information gathered by IHACPA?
It is not the intention of the Dept of Health to change the weighting or algorithm that sits behind the compounding factors.
My respite resident exited prior to having an assessment completed. How will I receive the appropriate payments?
When a respite resident exits a RAC to return home, the My Aged Care portal automatically assigns the AN ACC assessment to the ACAT team for completion in the community. You will be back paid to the respite admission date.
My new resident has been allocated a Class 2, will I have to repay the difference between the default payments?
Yes, this will automatically be deducted from your Medicare Payment Statement.
My resident has been admitted to hospital and we are unsure of date of return. What do we do about our request for reassessment?
On the My Aged Care Portal, remove the request for reassessment using the prompt the resident is unavailable. When the resident is readmitted, go back into My Aged Care and add the reassessment again. You will be back paid to the first original request date.
What are the compounding factors?
Classification Principles 2014
The actual requirements for each Class with compounding factors will never be shared by the Dept of Health.
Resources
You should be using both the Australian National Aged Care Classification Funding Guide as well as the AN ACC Reference Manual to guide your practice in managing AN ACC.
Photo by National Cancer Institute on Unsplash
