acfi - are you ready for 2017? · pdf [email protected]...

ACFI - Are You Ready for 2017?

Michael Peachey

© W&L Aged Care Services 2016 wellnesslifestyles.com.au

[email protected] wellnesslifestyles.com.au ©W&L Aged Care Services 2016

“For ACFI 2 Mobility, ACFI 3 Personal Hygiene and ACFI 4 Toileting, this is a commitment of staff on a one‐to‐one basis” (ACFI User Guide, p5)


Budget Savings (Omnibus) Bill 2016

A Bill for an Act relating to budget savings, and for other purposes

Schedule 8 - Aged Care

Part 1 – Compliance

Part 2 – Adviser and administrator panels

Part 3 – Approved provider obligations



Items 1 and 2

Clarifies and validates that the Classification Principles may require the Secretary to take into account the manner in which care is provided and the qualifications of the person providing the care.

This is in keeping with the current Appraisal Pack, which specifies that in order to contribute to an ACFI score, certain complex health care procedures must be delivered by a registered nurse or allied health professional in a specified manner.



Item 4 and 8

Repeals paragraphs to remove the ‘second chance’, meaning that providers may be suspended from appraising their residents or required to reappraise residents if they provide false, misleading or inaccurate information in one appraisal that is subsequently reviewed and changed.

2013 – 5



Item 11

Empowers the Secretary to require a provider to reappraise a resident if the Secretary reasonably suspects that the resident’s care needs have significantly decreased.



Item 15

Removes the limit where, if the Secretary reviews and changes a resident’s classification, the changed classification can only be backdated for a maximum of six months.

This means that overpayments can be recovered from the provider for the whole period that the inaccurate or incorrect classification was in force.

3 - 4b – 56



Item 17

Introduces civil penalties for providers who make false, misleading or inaccurate ACFI claims.

Issued with a warning notice (entering a warning period for two years) relating to appraisals that have been reviewed and changed: • on one occasion if false or misleading information in the appraisal or • on two or more occasions if the appraisals were incorrect or

inaccurate and the changes made to the classifications are regarded as significant.

X @ 60 x 180



Items 19 and 20

Introduces an application fee specifically for providers seeking a reconsideration of a decision to change the classification of a resident.

The fee is to be specified in the Classification Principles.



Proposal for a new law or change to an existing one↓

House of Representatives↓

The Senate↓

Act

Commencement:1) At Royal Assent (i.e. signing by the Governor-General); or2) At a specified date; or3) On a date to be fixed by Proclamation



A Bill for an Act relating to budget savings, and for other purposes

Schedule 8 - Aged Care

Part 1 – Compliance

A day or days to be fixed by Proclamation.

However, if any of the provisions do not commence within the period of 6 months beginning on the day this Act receives the Royal Assent, they commence on the day after the end of that period


How can I find out when a Bill is going to receive the Royal Assent?

The Royal Assent is given by the Governor-General after he or she receives the necessary documentation from the Attorney-General and the Parliament. Therefore, we are not able to tell you exactly when a Bill will receive the Royal Assent.

How can I find out when the commencement of an Act is going to be proclaimed?

Proclamations fixing commencement dates for Acts, or sections of Acts, are drafted by OPC on instructions from the responsible department, and made by the Governor-General in Council.

For reasons of confidentiality, OPC is not able to advise you whether or not a particular Proclamation is being drafted.


1 January 2017 – Q11

56% → 98%

42%


1 January 2017 – Q12.1

1


1 January 2017 – Q12.4a

2


1 January 2017 – Q12.4b

4 & 120mins


1 January 2017 – Q12.12

The score will be reduced from 3 points to 1 where the treatment is for the management of arthritic joints and arthritic oedema involving the

application of tubular elasticised support bandages


1 January 2017 – Scoring Matrix


1 January 2017 – Combined Impact

Q11 C-Claim plus Q12 D-Claim (Q12.3, 4a, 5, 12)↓

Q11 B-Claim plus Q12 C-Claim (Q12.3, 4a, 5, 12)↓

Q11 B-Claim plus Q12 C-Claim (Q12.3, 4a, 5, 12)


Key Points

1. Claim correctly.

Validators are there to validate:

Downgrade to date of submission↓

Warning notice↓

Reappraise all residents… at a lower rate↓

Secondary validation – civil penalties


Key Points

2. Receive available funding now

The new matrix will apply to all new appraisals and reappraisals.

If there is an opportunity to receive funding you’re eligible for based on residents’ current care needs, then plan to complete reappraisals before 31st December 2016.


Key Points

3. Prioritise your work

Classification takes effect from the date the resident enters care

New classification takes effect from day 6 months after resident enters care from hospital

New classification takes effect from day 6 months after major change reappraisal took effect


Key Points

4. Understand the different ACFIs

Pre January 1st appraisals business rules: 4-days per week

Post January 1st appraisals business rules: 4-days per week and 120-mins


QUESTIONS

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