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Transition Care Extension Form

Transition Care Extension Form for Aged Care Assessment Teams (ACATs)

PDF version of the Transition Care Extension Form (PDF 63 KB)
If you are unable to download the PDF file please send an email to: acc@health.gov.au for a copy to be sent to you.

Text Version

Below is the text from the Transition Care Extension form.

Transition Care Extension Form

Under the Flexible Care Subsidy Principles 1997 , a Transition Care Recipient can have their episode extended by a maximum of 42 days to ensure that their further transition care needs are met. In such cases, an assessment for an extension, specifying the duration of the extension, may be made by an ACAT based on information provided by the transition care service provider, and other sources as appropriate. The application for the extension must be completed within the initial 12 week episode of transition care.

The maximum duration for an extension is 42 days, and only one extension is available per transition care episode. The transition care service provider, in consultation with the hospital geriatric rehabilitation service where necessary, must complete Part 1 of this form and forward it to the ACAT for assessment. Based on the information provided by the service provider, and other sources such as the care recipient and relevant health professionals as appropriate, the ACAT will assess whether or not an extension is required and complete Part 2 of this form.

Part 1 to be completed by the Transition Care Service Provider:

Service provider details
Name of Transition Care Service

Service provider's ID
Phone:

Care Recipient details
Care Recipient name
Date of birth
Male
Female

Date of original entry to Transition Care

Specify which Transition Care goals were not achieved in 12 weeks

Specify therapeutic & social goals for the Care Recipient during the extension

Specify team action required to achieve Care Recipient goals during extension

Specify outside services action required to achieve Care Recipient goals during extension

Part 2 to be completed by the ACAT:

Extension required
Yes
Number of days of extension (up to 42 days)

No

Name of Aged Care Assessment Team
ACAT Delegate ID
Signature
Date

Distribution by the ACAT

• If an assessment has been made that the care recipient has further transition care needs and an extension to the transition care episode is required:
  • Send the Original Copy to the State Manager, Medicare Australia, in their State/region – see addresses below;
  • Provide a Copy to the care recipient or their carer;
  • Provide a Copy to the transition care service provider; and
  • Retain a Copy for ACAT records.
• If an extension is not required, the ACAT must contact the transition care service provider.

Medicare Australia – State office telephone numbers and addresses

New South Wales and Australian Capital Territory
Switchboard - (02) 9895 3640
Aged Care
Medicare Australia
GPO Box 9923
Sydney NSW 2001

South Australia and Northern Territory
Switchboard - (08) 8274 9333
Aged Care
Medicare Australia
GPO Box 9923
Adelaide SA 5001

Victoria
Switchboard - (03) 9605 7333
Aged Care
Medicare Australia
GPO Box 9923
Melbourne VIC 3001

Western Australia
Switchboard - (08) 9214 8333
Aged Care
Medicare Australia
GPO Box 9923
Perth WA 6001

Queensland
Switchboard - (07) 3004 5888
Aged Care
Medicare Australia
GPO Box 9923
BrisbaneE QLD 4001

Tasmania
Switchboard - (03) 6215 5333
Aged Care
Medicare Australia
GPO Box 9923
Hobart TAS 7001?