Unspent home care amounts

If a person changes home care provider, you must transfer the person’s unspent amounts to their new provider. If they leave home care or pass away, you must return the amounts to them (or their estate) and the Australian Government. Deduct any exit amount before you transfer or return amounts.

What are unspent home care amounts?

You must calculate the unspent home care amount when a person exits your home care service.

A person’s unspent home care amount is the total amount of unspent funds left in their package on the day you stopped providing care (the cessation day).

You calculate the amount for the period between:

  • 1 July 2015 or the date they started receiving home care from you (whichever is later)
  • the cessation day

You do not get a home care subsidy for the cessation day.

Step 1. Calculate the unspent home care amount

Before calculating, make sure you have:

  • finalised all subsidy and supplement claims
  • received all home care fees
  • identified all expenses such as outstanding invoices for services

Do not include:

  • home care fees paid in advance — you must separately refund these fees to the care recipient
  • a home care subsidy for the cessation day — we will not pay you a subsidy for that day

To calculate a person’s unspent home care amount for the required period:

  1. work out the total amount of subsidy, fees, and transfer portions paid
  2. work out the total amount you have spent or will spend on providing services
  3. subtract the step 2 amount from the step 1 amount — if the result is negative, take it to be nil
  4. deduct any exit amount from the step 3 amount — the exit amount cannot be more than the step 3 amount

The unspent home care amount is the step 3 amount (if no exit amount applies) or the step 4 amount.

For more detail, view the Examples of Calculating Unspent Home Care Amounts.

Step 2. Provide written notice

Within 56 days after the cessation day, you must give the care recipient (or their authorised representative) written notice.

The written notice must include:

  • the cessation day
  • the unspent home care amount
  • any exit amount that has been deducted
  • any unpaid home care fees that have been deducted
  • how you will pay the unspent home care amounts, including timeframes

You must identify the following amounts (even if they are zero):

  • care recipient portion — the unspent amount from home care fees paid (less any unpaid fees owed)
  • Commonwealth portion — the unspent amount from subsidies paid
  • transfer portion (if changing providers) — the unspent amount to be paid to the new provider

If a care recipient has unpaid fees, you:

  • must manage this under the terms of their home care agreement
  • cannot use subsidies to account for them

Step 3. Pay the unspent home care amount

When a person changes to a new provider

When a person changes providers, the unspent home care amount (less any exit amount) moves with them.

Within 56 days after the cessation day, the person must let you know who their new provider is.

Within 70 days after the cessation day, you must:

  • pay the transfer portion to the new provider
  • give a copy of the written notice to the new provider at the time you pay them

The new provider must separately list the transfer portion in the person’s monthly statement.

If a person does not give you their new provider’s details within the 56 days, you must treat any unspent home care amount as if they have left home care.

When a person leaves home care or passes away

Within 70 days after the cessation day, you must tell Services Australia about the Commonwealth portion, even if it is zero. You do this through aged care online claiming.

Services Australia will recover the Commonwealth portion by either:

  • deducting amounts from future home care subsidy payments for the person
  • issuing a debt notice

You must also pay the care recipient portion to the person or their authorised representative:

  • if the person is leaving home care — within 70 days after the cessation day
  • if the person has passed away — within 14 days after seeing the probate will or letters of administration

Step 4. Keep records

You must keep a record of:

  • the written notice of unspent home care amounts
  • payment of unspent home care amounts to other providers or care recipients (or their estate)

Non-compliance and sanctions

We may take regulatory action if you do not pay unspent home care amounts by the required date. If we impose a sanction, you must pay the unspent amounts by the date stated in the sanctions notice.

We publish non-compliance and sanction notices on the following My Aged Care tools:

Legislation

For full details, see Division 3A — Responsibilities of approved providers of home care — unspent home care amounts and exit amounts in the User Rights Principles 2014.

Last updated: 
22 January 2020
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