Introduction
The Aged Care Funding and Fees landscape is complex and ever-changing, and we understand that Payment Statements can be a little challenging to read at times. A sound understanding of the Supplements, Subsidies and Fees that your Facility is entitled to ensures that you and your Residents do not miss out. Your Payment Statement Reconciliation team need to know not only what is listed on a Payment Statement, but also what you might be missing out on and how to get it.
So, to make your reconciliation easier, we have put together a glossary covering the current supplements, subsidies, fees and reductions that exist for your Residents. Remember that the legislation surrounding aged care payments changes regularly, so please ensure that you and your team stay up to date.
These are the current supplements, subsidies, fees and reductions. To learn more about these and any grandparented supplements and subsidies, rates and fees and how to interpret your Payment Statement, reach out to us via email at team@providerassist.com.au or call us on 1300 419 119.
Care-Related Supplements/Subsidies:
Care-Related Supplements and Subsidies provide funding to cover care costs.
AN-ACC Variable Subsidy – Respite Care
The AN-ACC Variable Subsidy for Respite Care is paid on behalf of eligible Residential Respite Residents to help cover their care costs.
It is paid for each day an eligible Resident receives care with the payment rate determined by their Respite AN-ACC Class on the day.
Eligible Residents must:
- Be in Residential Respite Aged Care, and
- Have an ACAT approval for Residential Respite Care (including a relevant Respite AN-ACC Class), and
- Have not exceeded their 63-day limit (unless an extension has been approved)
AN-ACC Variable Subsidy – Permanent Care
The AN-ACC Variable Subsidy for Permanent Care is paid on behalf of eligible Permanent Residents to help cover their care costs.
It is paid for each day an eligible Resident receives care with the payment rate determined by their Permanent AN-ACC Class on the day.
Eligible Residents must:
- Be in Permanent Residential Aged Care, and
- Have an ACAT approval for Permanent Residential Care (including a relevant Permanent AN-ACC Class), and
- Have not exceeded their various leave entitlements (such as the 52-day Social Leave or 28-day Hospital Leave entitlements)
AN-ACC Fixed Subsidy
The AN-ACC Fixed Subsidy is paid on behalf of eligible Permanent and Respite Residents to help cover care costs that do not change significantly with changes in individual Residents’ needs or with small changes in occupancy.
Facilities will receive the same rate of funding for all Residents at their Facility based on their Base Care Tariff (BCT). There are 6 BCT categories based on:
- Location (2019 Modified Monash Model – MMM Score)
- Specialisation (Homeless or Remote/Very Remote Aboriginal and/or Torres Strait Islander)
Eligible Residents must:
- Be in Permanent or Respite Residential Care, and
- Have an ACAT approval for Permanent or Respite Residential or Care, and
- Have not exceeded their:
- 52-Days of Social Leave for Permanent Residents, or
- 63-Day Limit for Respite Residents (unless an extension has been approved)
AN-ACC Initial Entry Adjustment
The AN-ACC Initial Entry Adjustment is paid on behalf of eligible Permanent Residents to help cover the one-off costs of moving a Resident into a new care environment or between services.
It is paid at the same rate for every eligible Resident irrespective of their AN-ACC Class or their Facility’s Base Care Tariff.
Eligible Residents must:
- Be entering Permanent Residential Care, and
- Have an ACAT approval for Permanent Residential Care (their Permanent AN-ACC Class will not affect the amount paid)
Oxygen Supplement
The Oxygen Supplement is paid on behalf of Residents who have a medical need for continual oxygen therapy. The supplement is not payable for an emergency or for a short-term illness such as bronchitis.
Providers can apply for the supplement through Services Australia by completing the AC011 (Application for the Oxygen and/or Enteral Feeding Supplement). The supplement does not transfer between Providers even if the Resident received it at their previous Home or Residential Aged Care Provider.
Eligible Residents must:
- Be in Permanent or Respite Residential Care (it is also payable for Home Care Residents), and
- Have a medical certificate from a doctor which states the Resident’s oxygen requirements and their continual need for the administration of oxygen, and
- Be a Resident of a Residential or Home Care Provider who has hired, borrowed, or own the equipment used to provide oxygen
Enteral Feeding Supplement
The Enteral Feeding Supplement is paid on behalf of Residents who have a medical need for enteral feeding. The supplement is not payable for dietary formulas that are taken orally, used as food supplements, or administered in addition to food by mouth.
Providers can apply for the supplement through Services Australia by completing the AC011 (Application for the Oxygen and/or Enteral Feeding Supplement) form. The supplement does not transfer between Providers even if the Resident received it at their previous Home or Residential Aged Care Provider.
Eligible Residents must:
- Be in Permanent or Respite Residential Care (it is also payable for Home Care Residents), and
- Have a doctor’s (not a dietician’s) written certification that the care recipient has a medical need for enteral feeding, and
- Have a doctor’s or dietician’s written certification that the dietary formula prescribed is nutritionally complete, and
- Have details of their particular enteral feeding requirements, which can be in their written certification, care plan or hospital discharge papers, or dietician’s enteral feeding instructions
Veterans’ Supplement
The Veterans’ Supplement is paid on behalf of Residents who have service-related mental health conditions. The supplement is intended to ensure a veteran’s mental health condition does not act as a barrier to accessing appropriate care and is paid directly to a Residential Aged Care Facility for the period the Resident receives care.
Eligible Residents must:
- Be in Permanent or Respite Residential Care (it is also payable for Home Care Residents), and
- Have a (DVA accepted) service-related mental health condition, and
- Have consented to their information being disclosed to Services Australia, and
- There is no requirement for eligible veterans to apply or undergo an assessment for the supplement to be paid.
*War widow(er)s and dependants are not eligible for the supplement
Non-Care Related Supplements/Subsidies:
These Supplements and Subsidies are paid to cover a range of financial costs, primarily for accommodation and hotel related services, or for the Facility itself meeting certain criteria.
Accommodation Supplement
The Accommodation Supplement is paid on behalf of Residents who have been assessed as unable to pay their full accommodation costs.
Eligible Residents must:
- Be in Permanent Residential Aged Care, and
- Have an entry date into Residential Aged Care between 20 March 2008 and 30 June 2014, and
- Have been classified as a Supported or Partially Supported Resident by Services Australia based on their asset amount
Means-Tested Accommodation Supplement
The Means-Tested Accommodation Supplement is paid on behalf of Residents who have been assessed as unable to pay their full accommodation costs.
Eligible Residents must:
- Be in Permanent Residential Aged Care, and
- Have an entry date into Residential Aged Care on or after 1 July 2014 or have chosen to “Opt-In” to the post-1 July 2014 rules, and
- Have been classified as a Low Means Resident by Services Australia based on their Means Assessment, and
- Have a Means-Tested Amount greater than the industry maximum Accommodation Supplement rate
Respite Accommodation Supplement
The Respite Accommodation Supplement is paid on behalf eligible Residential Respite Residents and helps cover accommodation costs associated with Respite Care.
Eligible Residents must:
- Be in Residential Respite Care, and
- Have an ACAT approval for Residential Respite Care, and
- Have not exceeded their 63-day limit (unless an extension has been approved)
*Residents do not need to complete a Means Assessment to be eligible for this funding.
Supported Ratio Incentive
The Supported Ratio Incentive was implemented to encourage Aged Care Homes to provide care to financially disadvantaged Residents.
Under this scheme, a higher amount of Accommodation-related funding is paid on behalf of all eligible Concessional, Assisted, Supported, Partially Supported and Low Means Residents at a Facility where 40% or more* of their Permanent, non-Extra Service, Residents have been classified as eligible for accommodation-related funding.
*Prior to 01/10/2022, the additional funding was only paid where over 40% of Residents were classified as eligible for accommodation-related funding.
Eligible Residents must:
- Be in Permanent Residential Aged Care, and
- Be a Resident at a Facility where 40% or more* of their Permanent, non-Extra Service, Residents have been classified as eligible for accommodation-related funding, and
- Have been classified as a Concessional, Assisted, Supported, Partially Supported or Low Means Resident, and
- Be eligible to receive the relevant Accommodation-related funding based on their classification
Higher Accommodation Supplement (Significant Refurbishment)
The Higher Accommodation Supplement was implemented to encourage refurbishment of Aged Care Homes.
Under this scheme, Facilities that meet the criteria for Significant Refurbishment or were Newly Built from 20 April 2012 are paid a higher rate of the relevant Accommodation-related Supplements.
Eligible Residents must:
- Reside at a Significantly Refurbished Facility or one that has been Newly Built on or after 20 April 2012, and
- Be in Residential Respite Care, or
- Be in Permanent Residential Care, and
- Have been classified as a Concessional, Assisted, Supported, Partially Supported or Low Means Resident, and
- Be eligible to receive the relevant Accommodation-related funding based on their classification
Hardship Supplement
The Hardship Supplement is paid on behalf of eligible Residents to help cover all kinds of costs associated with Residential Aged Care for Residents who are undergoing Financial Hardship or are impacted financially by circumstances outside their control.
Eligible Residents can apply for the Hardship Supplement for a range of Fees and Charges such as:
- The Basic Daily Fee (both Permanent and Respite Residents)
- Accommodation Fees for Permanent Residents
- Means-Tested Care Fees for Permanent Residents
Eligible Residents must:
- Have less than $41,496 in assets (excluding Unrealisable Assets)
- Have gifted less than $10,000 in the past year or $30,000 in the past 5 years
- Have their Essential Expenses (daily living costs) assessed to determine their remaining income, where they will be eligible if:
- They have less than 15% of the Basic Age Pension remaining
*All of this is captured in SA462: Aged Care Claim for Financial Hardship Assistance form
Fees & Reductions:
These Fees and Reductions are either levied directly from the Resident or by Services Australia on behalf of the Resident to help cover the cost of accommodation or care.
Basic Daily Fee
The Basic Daily Fee is paid by all Residents in Residential Aged Care. It is intended to cover the costs of day-to-day services a Resident receives such as meals, laundry, heating and cooling.
Residents pay this fee directly to their Aged Care Home, generally on a fortnightly or monthly basis.
All Residents in Permanent or Respite Residential Care are eligible to pay the Basic Daily Fee.
Daily Accommodation Contribution (DAC) and Refundable Accommodation Contribution (RAC)
The Daily Accommodation Contribution (DAC) and Refundable Accommodation Contribution (RAC) are paid by eligible Residents as a contribution towards their accommodation costs.
Services Australia determines the amount an eligible Resident can contribute through a Means Assessment. This amount is advised to the Resident and their Provider as a daily rate (DAC) and is generally reviewed every quarter.
Once a Resident is advised of their DAC amount, they can choose to pay this as a daily rate or through a combination of a lump-sum (RAC) and daily amount.
Eligible Residents must:
- Be in Permanent Residential Care, and
- Have an ACAT approval for Permanent Residential Care, and
- Have an entry date into Residential Aged Care on or after 1 July 2014 or have chosen to “Opt-In” to the post-1 July 2014 rules, and
- Be classified by Services Australia as a Low Means Resident, and
- Have a Means-Tested Amount greater than $0 but less than the industry maximum Accommodation Supplement rate
Daily Accommodation Payment (DAP) and Refundable Accommodation Deposit (RAD)
The Daily Accommodation Payment (DAP) and Refundable Accommodation Deposit (RAD) are paid by eligible Residents to cover their accommodation costs.
The amount an eligible Resident will pay is negotiated between the Resident/their representative and the Provider. The negotiated amount will usually be in the form of a Refundable Accommodation Deposit (RAD).
Once a RAD amount has been agreed to, the Resident can choose to pay this as a daily rate, as a lump-sum (RAD) or through a combination of a lump-sum (RAD) and daily amount.
Eligible Residents must:
- Be in Permanent Residential Care, and
- Have an ACAT approval for Permanent Residential Care, and
- Have an entry date into Residential Aged Care on or after 1 July 2014 or have chosen to “Opt-In” to the post-1 July 2014 rules, and
- Be classified by Services Australia as a “Means Not Disclosed” (MND) Resident, or
- Be classified by Services Australia as a Not Low Means (High Means) Resident, and
- Have a Means-Tested Amount greater than the industry maximum Accommodation Supplement rate
Means-Tested Care Fee (Means-Tested Subsidy Reduction)
The Means-Tested Care Fee (MTCF) is paid by eligible Residents as a contribution towards their care costs.
Services Australia determines the amount an eligible Resident can contribute through a Means Assessment. This amount is advised to the Resident and their Provider as a daily rate and is generally reviewed every quarter.
The relevant amount is reduced from your total funding for each eligible Resident on your monthly Payment Statement.
Eligible Residents must:
- Be in Permanent Residential Care, and
- Have an ACAT approval for Permanent Residential Care, and
- Have an entry date into Residential Aged Care on or after 1 July 2014 or have chosen to “Opt-In” to the post-1 July 2014 rules, and
- Be classified by Services Australia as a “Means Not Disclosed” (MND) Resident, or
- Be classified by Services Australia as a Not Low Means (High Means) Resident, and
- Have a Means-Tested Amount greater than the industry maximum Accommodation Supplement rate
