Of course, AN-ACC is a different tool than ACFI and components that were more heavily funded under ACFI are no longer as impactful under AN-ACC. AN-ACC is also a case mix funding under which it is normal to see some Residents funded more highly and others funded lower. Having said all of that – there are some trends that we’ve seen that may be influencing your Residents to be worse or better off. The good news is most of those things we’re noticing are actionable and will work to improve your AN-ACC in the future.
Let’s take a look.
Residents that are funded higher under AN-ACC
Your shadow assessment results have come back significantly higher than your ACFI.
Remarkable! But before you celebrate, check the following:
Comparing Apples with Apples
Ensure you’re removing any impact from the Basic Daily Fee Subsidy and your Viability or Homeless Supplement you were receiving under the ACFI funding scheme. As we know, these items are being rolled into an AN-ACC and therefore your AN-ACC should be higher than ACFI.
The other thing we know is the Government is introducing an additional $3.9 billion to allow Facilities to transition and fund some of the items under the age care reform including the mandated care minutes.
So, in an ideal AN-ACC world, your AN-ACC would indeed be higher than your ACFI because you need to do more with it.
To get a true picture of how much better off you are truly under AN-ACC you must first:
- Analyse what you will no longer be getting
- Analyse the implementation and ongoing costs associated with your strategy to meet the additional Aged Care Reform requirements
Unfunded Care / Missed Funding under ACFI
Once you’ve taken out the impact of those items listed in Point 1, we’re still noticing that some Facilities have many Residents that are significantly better funded under AN-ACC than they were under ACFI. To us, this may indicate unfunded care being provided now under ACFI. MyVitals confirms this in many instances.
Let me explain! Your AN-ACC Assessor is not there to optimise your funding. They’re there to pull together an existing clinical picture using documentation, interview and observation to complete their AN-ACC tools that generate your AN-ACC Classification. If your AN-ACC Assessor has been able to identify care to fund under AN-ACC that wasn’t funded under ACFI using evidence of the care already being provided and needed, then this represents missed opportunity to us and may also indicate a potential Accreditation / Quality risk. Chances are, that if you’re missing funding under ACFI, you are possibly also missing out on funding under AN-ACC, even if your funding is higher under AN-ACC that it was under ACFI. There’s still some time left before AN-ACC comes in to rectify this missed ACFI funding and possibly even essentially self-fund your AN-ACC Reassessment program.
Residents that are funded lower under AN-ACC
Viability & Base Tariff Mismatches
While we are seeing many MMM 5 region Facilities receiving some viability type funding for the first time, we’re also seeing some Facilities that previously were eligible for viability that have now been classified as MMM 4 and therefore are funded at the standard base tariff. This is happening in Facilities that are located in regional or remote areas but maybe town centres, and so, due to their population size are classified as MMM 4. These Facilities are seeing a significant drop in their funding purely because they are no longer eligible for any viability or Facility-specific related additional funding. We believe that these Facilities may be able to get assistance under the transition fund, but we’re still waiting on information about that.
Underclaiming AN-ACC
So why are so many Residents losing funding under AN-ACC compared to ACFI? To answer this question, you need to take a look at the AN-ACC process. Remember, the AN-ACC Assessor’s job is to use documentation, interview and observation to compile the information they require for their AN-ACC tools in order to assign an AN-ACC classification. And they have an hour per Resident in which to do all of this!
So there are three areas in your Clinical journey that could be impacting your AN-ACC and causing missed funding.
- Comprehensive Assessment & Care Planning that is not rooted in proactive, holistic & comprehensive assessment that articulates a clear clinical picture. When articulating the clinical picture, ensure you understand what areas are important under AN-ACC and make it easy for the Assessor to identify these. In particular, in the area of cognition, the AN-ACC assessments don’t include a validated tool for cognition to measure cognitive ability. Instead it looks at presentations that may indicate cognitive issues. So, they are considering different things than ACFI did. Have you adapted your care planning processes for this?
- Care delivery that is not congruent with your care, assessment or clinical picture: The entire clinical journey and clinical picture needs to be congruent. Ensure your Care team are training in AN-ACC and compliance and understand the need behind the care being delivered.
- Resident Care Understanding and Acceptance: If your assessment and care plan, for example, identifies that George is a falls risk and needs assistance in the shower, but when you discussed care with George and George’s preferences were to only shower in the evening. But there’s just not the resourcing available to assist George in the shower at night. Then when the Assessor is interviewing George, he is going to tell them about showering and how he’s perfectly fine doing it by himself. Even though he knows that he’s likely to have a fall, break his hip and therefore not be able to achieve his being able to go to church on Sundays.
How do you ensure you’re claiming your entitled AN-ACC?
So, in summary, what can you do to ensure you’re receiving all your entitled AN-ACC?
- Ensure Clinical Assessment by an expert Aged Care Clinician able to pull together the holistic picture using comprehensive assessment.
- Ensure Care delivery is congruent with the clinical picture, care plan and documentation. Ensure detailed handover is undertaken and regular education for the team on the AN-ACC process and compliance. Ensure the care team understand the care needing to be delivered, and why it needs to be delivered, particularly in the areas of proactive care. Without clarity, proactive care can seem disempowering. For example – when somebody moves into Aged Care and based on our clinical assessment, we’re recommending that they get assistance in the shower. Although this is generally not anybody’s desire, it is incredibly empowering. How? Because if a Resident is a high risk of falls, and they do have a fall then all those activities that a Resident may want to do that feel empowering, are no longer achievable.
- Ensure Resident Care Understanding and Acceptance (where appropriate). Using the same example as the point above, Residents understanding and accepting that their care is aligned to their goals.
Victoria Kelly
Managing Director & Co-owner
