Letters to Providers advising of a change to ACFI Classification of some residents

In this section:

Questions and Answers

Why is the Department writing to approved providers?

Under the Aged Care Act 1997 (the Act), the Department must change a classification if the classification was for any reason incorrect. The Act also requires that the Department must give written notice of this change.

Why have these changes to classification been made?

The Department has identified that the classification of some residents was incorrect due to an administrative issue that has now been corrected. This affects some residents who between 1 July and 30 November 2012:

Entered care, were appraised and were classified;
Had classifications expire, were re-appraised and had classifications renewed; or
Had classifications changed by the Department.

Specifically, it relates to residents whose classification in the Activities of Daily Living and/or Complex Health Care domain was affected by the 1 July 2012 changes to the Aged Care Funding Instrument (ACFI).

In practical terms what does this change mean?

Providers will continue to receive funding in line with the ACFI changes announced in June and no adjustment will need to be made to past or future payments for these residents. The new classification will match the intended classification.

What is the impact on providers and residents?

There will be no change to the payments that have already been made as a result of this change in classification.

The new classification will match the intended classification.
No adjustments need to be made to past or future payments.
Providers will continue to receive funding in line with the ACFI changes announced in June 2012.

There is no impact on residents as a result of this change in classification.

Each resident’s ACFI classification will align with the ACFI changes announced in June 2012.
No residents will need to be re-appraised as a result of this change.

When will the changed classification take effect?

The changed classification will take effect from the date of the original classification.

When will providers receive these letters?

The majority of these letters will be sent in December 2012. Some providers may receive letters in early 2013 in relation to classifications of residents that the Department did not have records for at the time the letters were prepared.

Providers will be able to easily differentiate these letters from the usual change of classification letters the Department sends following a review because they make specific reference to the 1 July 2012 ACFI Changes. As noted above, the change of classification letters that refer to 1 July 2012 changes will not result in any adjustments to payments.

What will happen when I complete another appraisal in the future on these residents?

Each ACFI appraisal is a stand-alone assessment of a resident’s care needs at that time.
Any re-appraisals need to be based on a current assessment of the resident’s care needs and is not linked to previous classifications.

What caused the classifications to be incorrect?

The classifications were incorrect due to an administrative oversight by the Department.

Does this affect the price changes which were implemented on 1 July 2012?

No.

Why doesn’t the new classification match the current classification for some of my residents?

This occurs where there has been a subsequent classification for a resident. In these cases, the letter relates only to the classification identified by the date in the letter. Subsequent classifications will not require a change in classification, unless they have been identified separately. However, as indicated above, there will be no change to payments as a result of this administrative issue.

An example is provided below.

A provider receives the letter with the following table in the attachment.

Name	Classification	Date of Classification
Example Name	MHL	3 July 2012

On reviewing this resident’s classification the provider notes that this resident is currently funded at a HHM level. Further investigation shows that the resident was classified at MHL on 3 July 2012 with a classification of HHM applying from 15 September 2012 following a major change appraisal.

In this case, the changed classification only applies to the classification of MHL that applied from 3 July 2012 to 14 September 2012. The HHM classification that came into effect on 15 September 2012 will be unaffected unless it is identified separately.

As the new classification for this period matches the intended classification, there will no adjustment to payments.

What if there has been a change in classification after the date of classification in this letter?

The Department has written to providers in relation to the majority of affected classifications. However, in some cases data may not have been available at the time the letter was prepared. The Department will write separately about the classifications in coming months.

In a minority of cases, approved providers may receive a second letter in relation to the same resident’s reclassification. This will only occur where the resident was both classified and reclassified between 1 July and 30 November 2012 and their reclassification was also affected by the same administrative issue. However, as indicated above, the change in classification confirms the intended classification for the resident and there will be no change to the payments you have received.

An example is provided under the question “Why doesn’t the new classification match the current classification for some of my residents?”
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