Aged care means assessment - home care pre-entry 065-18082330
This document outlines the process for completing a home care means assessment before a care recipient enters care.
Process Direct
On this page:
RCA status and eligibility for verbal assessment
Processing Aged Care means assessment
Updating name, address and contact details
RCA status and eligibility for verbal assessment
Table 1
Step |
Action |
1 |
Preliminary check and dates for pre - entry assessment + Read more ... Complete the Aged care means assessment – preliminary checks including:
Determine the relevant dates for a home care pre-entry means assessment.
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2 |
Check the source of the RCA/HOM activity + Read more ... A care recipient not in receipt of a means tested income support payment will need to lodge an Aged Care Calculation of your cost of care including when they do not wish to disclose their means. What is the source of the RCA/HOM activity?
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3 |
Verbal assessments + Read more ... Verbal means assessments are only able to be completed for care recipients who receive a means tested income support payment (ISP). If a verbal assessment is requested by an authorised third party, see Accepting information from and disclosing information to a Power of Attorney to confirm authorisation. When undertaking a verbal means assessment, ask the care recipient or third party if they want to:
Can the home care means assessment be completed verbally?
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Outstanding information
Table 2
Step |
Action |
1 |
Check for an authorised person or organisation + Read more ... If the Authorising a person or organisation to enquire or act on your behalf section on the Aged Care Calculation of your cost of care has been completed, and all signatures/documentation are provided, see Adding or rejecting a nominee request to code a nominee. This nominee will be added to all aged care systems through the means assessment. See Person Permitted to Enquire (PPE) or Update (PPU) authority if a third party has been nominated as a:
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2 |
Check if additional information or documents are required + Read more ... To view paper claims and scanned supporting documents:
Check the date the document was scanned. There may also be older documents not related to the claim. Check details recorded by selecting .
Confirm the Aged Care Calculation of your cost of care form has been completed correctly and signed by the care recipient or authorised third party. See Aged care means assessment.
Is more information needed to finalise the means assessment?
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3 |
Collect outstanding information verbally + Read more ... Genuine attempts to contact by phone should be made to discuss the request if this has not already occurred. Send a pre-call notification SMS if the customer or nominee is subscribed to electronic messaging. See Calling a customer or returning a customer's call. Can the outstanding details be collected verbally?
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4 |
Issue a Request for Information (RFI) letter + Read more ...
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5 |
RFI has been issued + Read more ... Is it 21 days plus allow extra time for mail delivery since the RFI was issued to the care recipient? |
Processing Aged Care means assessment
Table 3
Step |
Action |
1 |
Starting a means assessment transaction + Read more ... If means assessment is being processed from a verbal assessment, a Social Online Application (SOA) shell is used to create a transaction in Process Direct. To create a new SOA shell:
To access an existing aged care means assessment from a scanned form, go to the Transaction Summary (TS) tile and search via the item ID. A pre-entry means assessment is cancelled if an aged care RFI was issued and the care recipient has not provided documentation within 21 days (plus allow extra time for mail delivery). A pre-entry means assessment is withdrawn if care recipient withdraws their means assessment request. Is this claim being cancelled or withdrawn?
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2 |
Partner details + Read more ... If there is a partner to be added, a Partner details (MOD P) form is required. See Update relationship status and link customer and partner records. See Change in relationship status from single to partnered or Change in relationship status from partnered to single for further information. Complete claim pre-checks, update relationship details and issue Requests for Information before selecting Process. See the relevant Operational Blueprint procedure for the update being processed. Relationship status is not able to be changed after Process has been selected as this will cause errors. If relationship status needs to be updated after Process has been selected, the assessments will need to regenerate. See Process Direct navigation, common screens and functions. Once any updates to MS are completed, select the Process button. The following task selectors will be displayed:
Select all task selectors and then select Next. |
3 |
Aged Care (RCA) Specific screens + Read more ... A list of Aged Care (RCA) specific screens will be displayed. Select required screens to complete a home care assessment:
Select Next. |
4 |
Update the RCA means test details (RMND) screen + Read more ... Aged care pre-entry assessments are valid for a maximum of 120 days from the date the assessment is completed. When the activity is completed, the DOE defaults to the current date. If this field has already been coded with an earlier date, select the bin icon to delete entry. To add the start date, in the Reform enquiry means test details table:
If the customer is choosing not to disclose their means, from the Means not disclosed table:
Note: if MND was previously coded as ‘Yes’, this may require updating to ‘No’ or blank Care recipients pay the full amount for the cost of their care if they do not disclose their income. A letter will not automatically issue until care starts. If a request for a pre-entry letter is received, advise the care recipient:
Once completed, select Next. |
5 |
Check RCA circumstance (RCIRC) screen + Read more ... Check the RCIRC tabs are populated as below:
Once completed, select Next. |
6 |
Dependent children – RDEP screen + Read more ... Dependent children mean that a care recipient will not have to pay an income tested care fee (ITCF). Income details must still be maintained on the record. See Aged Care fees and charges – care subsidy reduction to zero. If the customer has indicated that they have dependent children, under the Residential care assessment (RCA) dependants table:
See the References page for a link to the Aged Care Act 1997 definition of a dependent child. Once completed, select Next and see Table 4. |
7 |
Cancel or withdraw means assessment + Read more ... To cancel the means assessment, update to Not Required:
To withdraw the means assessment, update to Withdrawn:
Are there other updates that need to be made before finalising means assessment?
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Updating name, address and contact details
Table 4
Step |
Action |
1 |
Personal Details task selector + Read more ... Select required screens to update from the list presented:
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2 |
Marital Status (MS) screen + Read more ... Partner Details cannot be updated after processing the assessment has begun. Updates must be actioned prior to claim commencement. Is the current marital status and partner information correct?
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3 |
Update address and contact details + Read more ... Update a postal address when requested by:
A postal address is not updated when requested by:
For additional information on updating addresses (including postal), see:
To add new address details:
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4 |
Updating personal contact information + Read more ... If the care recipient provides new information, update as required:
Once personal details completed, see Table 5 |
Income and assets details
Table 5
Step |
Action |
1 |
Income and assets information + Read more ... An Aged Care Calculation of your cost of care requests income information as at the date of event (DOV) of the aged care means assessment. Supporting documents may include a history of income. For multiple updates to income support payment (ISP) changes:
If the partner has recently died, do not contact the care recipient or nominee. See Bereavement reviews for further information on reviews following the death of a member of a couple. Has the care recipient advised of any changes to their income and assets details?
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2 |
Select screens for updating income and assets + Read more ... Care recipients receiving an ISP can advise income and asset changes that occurred before the means assessment date of event (DOV). Code these changes as part of the means assessment. See Verifying income and assets for details or documents required. See Verifying income and assets to determine if further verification and documents are required. Select the screens to update from Income and Assets task selector.
The coding of income and assets for aged care purposes aligns with the Social Security Act 1991. See the below links for further information including Process Direct coding:
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3 |
Find out if there is employment income + Read more ... Does the care recipient (or their partner) get any income from employment?
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4 |
Code employment income – ISP care recipients + Read more ... Employment income reporting requirements for a care recipient (or partner) in receipt of an ISP:
If this is the first time that the care recipient (or partner) is declaring income, see Recording and correcting employment income details. |
5 |
Code employment income – self funded retirees + Read more ... Care recipients not in receipt of an ISP:
See Determining the Date of Event for employment income for help coding income. |
6 |
DVA income + Read more ... If no DVA income has been declared for aged care means assessment purposes, go to Step 7 If the care recipient has declared a DVA payment is received check the Department of Veterans' Affairs Summary (DVAS) screen for DVA coding. Is the DVA payment/benefit coded correctly on DVAS screen:
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7 |
Real estate and business income + Read more ... Update the Real Estate and Business (REBS) screen if the care recipient indicates:
Does the care recipient have income from any of the above?
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8 |
Real estate income + Read more ... Does the care recipient (or partner) receive rental income from real estate, including their principal home?
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9 |
Code rental income + Read more ... When rental income is received from a property for a home care means assessment, that is not already coded on REBS, handover to Customer First is required. See the Handover function table in Process Direct navigation, common screens and functions to complete. Refer to Customer First tab to complete means assessment. For help with coding rental income, see Assessing and coding the Real estate details Mod R and Income from boarders and lodgers.
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10 |
Code business income + Read more ... When a care recipient (or partner) receives income from a business, any income from the business will be included in the home care means assessment. If previously recorded business income has changed, see Changes to income and assets from a business structure. Does the care recipient (or partner) receive income from a sole trader business or a partnership?
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11 |
Interest in a private trust or company + Read more ... Does the care recipient have an interest in a private trust or private company?
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12 |
CAO referral required for private trust or private company + Read more ... the care recipient (or partner) has an interest in a private trust or private company:
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Finalise the means assessment
Table 6
Step |
Action |
1 |
Resolve edits or errors + Read more ... After coding all required updates, select Assess and the Errors (SWE) screen will display any warnings or errors that require action in the Message Log. These messages inform of the items that need to be resolved to prepare to finalise the claim. On the SWE screen:
The RCAA Assessment Determination (RCAD) screen will display once all errors have been resolved. |
2 |
Review and finalise assessment + Read more ... RCAA Assessment Determination (RCAD) screen is displayed but not required for a home care means assessment. The Entitlements (ELD) screen displays the outcome of the assessment and payment dates. Ensure the details are correct:
If required, check the following screens and make any necessary updates such as manual rate adjustments on the Daily Rate Component (RAC) and Daily Rates Summary (RATS) screens.
Once the claim outcome is correct, select Finish. |
3 |
Finalise Note + Read more ... Claim finalisation note template will display and be available to update where required. Most information will be pre-populated from coding:
Note: when date of receipt is more than 120 days in past, the RCA status will show as cancelled due to expiry (RCA/CAN-EXP). Complete a new RCA/HOM using same information but using the current date as the date of receipt. This will start the 120 days valid assessment period from the correct date. Once note is complete, select Finalise. Message will display status of means assessment. |
4 |
Follow up action + Read more ... Determine if action is needed:
When a care recipient has failed to provide information to complete the assessment, and they are in receipt of a means tested ISP, request required forms/documents under relevant payment type. See Verifying income and assets and Requesting information (CLK) |
Customer First
This page contains the process for completing a home care means assessment for care recipients who have not started to receive a home care package.
On this page:
RCA status and eligibility for verbal assessment
Partner, children, contact and address details
RCA status and eligibility for verbal assessment
Table 1
Step |
Action |
1 |
Preliminary check and dates for pre - entry assessment + Read more ... Complete the Aged care means assessment – preliminary checks including:
Determine the relevant dates for a home care pre-entry means assessment.
|
2 |
Check the source of the RCA/HOM activity + Read more ... A care recipient not in receipt of a means tested income support payment will need to lodge an Aged Care Calculation of your cost of care including when they do not wish to disclose their means. If no activity on Activity List (AL) screen, index an RCA/HOM activity. See Indexing, re-indexing and cancelling claim activities What is the source of the RCA/HOM activity?
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3 |
Verbal assessments + Read more ... Verbal means assessments are only able to be completed for care recipients who receive a means tested income support payment (ISP). If a verbal assessment is requested by an authorised third party, see Accepting information from and disclosing information to a Power of Attorney to confirm authorisation. When undertaking a verbal means assessment, ask the care recipient or third party if they want to:
Can the home care means assessment be completed verbally?
|
Outstanding information
Table 2
Step |
Action |
1 |
Check for an authorised person or organisation + Read more ... If the Authorising a person or organisation to enquire or act on your behalf section on the Aged Care Calculation of your cost of care has been completed, and all signatures/documentation are provided, see Adding or rejecting a nominee request to code a nominee. This nominee will be added to all aged care systems through the means assessment. See Person Permitted to Enquire (PPE) or Update (PPU) authority if a third party has been nominated as a:
|
2 |
Check if additional information or documents are required + Read more ... Confirm the Aged Care Calculation of your cost of care form has been completed correctly and signed by the care recipient or authorised third party. See Aged care means assessment.
Is more information needed to finalise the RCA/HOM activity?
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3 |
Collect outstanding information + Read more ... Genuine attempts to contact by phone must be made to discuss the request if this has not already occurred. Send a pre-call notification SMS if the customer or nominee is subscribed to electronic messaging. See Calling a customer or returning a customer's call. Note: although there is no obligation to provide information verbally, advise the benefits and potential consequences of failing to provide requested information within the required timeframe. Can the outstanding details be collected verbally?
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4 |
Issue a Request for Information (RFI) letter + Read more ...
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5 |
RFI has been issued + Read more ... Is it 21 days plus allow extra time for mail delivery since the RFI was issued to the care recipient?
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Partner, children, contact and address details
Table 3
Step |
Action |
1 |
Partner and dependent children + Read more ... If there is a partner to be added, a Partner details (MOD P) form is required. See Update relationship status and link customer and partner records. Dependent children mean that a care recipient will not have to pay an income tested care fee (ITCF). Income details must still be maintained on the record. See Aged Care fees and charges – care subsidy reduction to zero. If a care recipient has a dependent child in their care, on the RCA dependants (RDEP) screen record:
See the References page for a link to the Aged Care Act 1997 definition of a dependent child. |
2 |
Update care recipient name, address and contact details + Read more ... If the care recipient provides a new home address, telephone details or alternate names:
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3 |
Update care recipient postal address + Read more ... Update a postal address in Customer First when requested by:
A postal address is not updated in Customer First when requested by:
For additional information on updating addresses (including postal) see: |
Income and assets details
Table 4
Step |
Action |
1 |
Income and assets information + Read more ... An Aged Care Calculation of your cost of care requests income information as at the date of event (DOV) of the aged care means assessment. Supporting documents may include a history of income. For multiple updates to income support payment (ISP) changes:
If the partner has recently died, do not contact the care recipient or nominee. See Bereavement reviews for further information on reviews following the death of a member of a couple. Has the care recipient advised of any changes to their income and assets details?
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2 |
Select screens for updating income and assets + Read more ... Care recipients receiving an ISP can advise income and asset changes that occurred before the means assessment date of event (DOV). Code these changes as part of the means assessment. See Verifying income and assets for details or documents required. See Verifying income and assets to determine if further verification and documents are required. In Customer First:
Note: if data already exists on a screen, a Y will appear on the RCTS screen. Check the data for accuracy. The coding of income and assets for aged care purposes aligns with the Social Security Act 1991. See the below links for further information:
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3 |
Find out if there is employment income + Read more ... Does the care recipient (or their partner) get any income from employment?
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4 |
Code employment income – ISP care recipients + Read more ... Employment income reporting requirements for a care recipient (or partner) in receipt of an ISP:
If this is the first time that the care recipient (or partner) is declaring income, see Recording and correcting employment income details. |
5 |
Code employment income – self funded retirees + Read more ... Care recipients not in receipt of an ISP:
See Determining the Date of Event for employment income for help coding income. |
6 |
DVA income + Read more ... If no DVA income has been declared for aged care means assessment purposes, go to Step 7 If the care recipient has declared a DVA payment is received check the Department of Veterans' Affairs Summary (DVAS) screen for DVA coding. Is the DVA payment/benefit coded correctly on DVAS screen:
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7 |
Real estate and business income + Read more ... Update the Real Estate and Business (REBS) screen if the care recipient indicates:
Does the care recipient have income from any of the above?
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8 |
Real estate income + Read more ... Does the care recipient (or partner) receive rental income from real estate, including their principal home?
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9 |
Code rental income + Read more ... For help with coding rental income, see Assessing and coding the Real estate details Mod R and Income from boarders and lodgers.
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10 |
Code business income + Read more ... When a care recipient (or partner) receives income from a business, any income from the business will be included in the home care means assessment. If previously recorded business income has changed, see Changes to income and assets from a business structure. Does the care recipient (or partner) receive income from a sole trader business or a partnership?
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11 |
Interest in a private trust or company + Read more ... Does the care recipient have an interest in a private trust or private company?
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12 |
CAO referral required for private trust or private company + Read more ... If the care recipient (or partner) has an interest in a private trust or private company check if a CAO assessment has been completed within the last 12 months, a new referral may not be required. Check the Document List (DL) for a Completed CAO Assessment DOC and review the CAO Assessment DOC to make sure the information is applied to previous CAO assessment. Has the most recent CAO referral been completed within the last 12 months?
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13 |
CAO assessment referral + Read more ...
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Finalise the RCA/HOM activity
Table 5
Step |
Action |
1 |
Cancel or withdraw claim + Read more ... A pre-entry means assessment is cancelled if an aged care RFI was issued and the care recipient has not provided documentation within 21 days (plus allow extra time for mail delivery). A pre-entry means assessment is withdrawn if care recipient withdraws their means assessment request. Is this claim being cancelled or withdrawn?
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2 |
Check RCA circumstance (RCIRC) screen + Read more ... Check the RCIRC screen fields are populated as below:
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3 |
Update the RCA means test details (RMND) screen + Read more ... Aged care pre-entry assessments are valid for a maximum of 120 days from the date the assessment is completed. When the activity is completed, the DOE defaults to the date of receipt of the activity. If assessment is being completed at a later date, a new entry needs to be added. To add the start date, go to the RMND screen:
Existing Reform Enquiry Means Test data prevents the above coding. In these cases:
Is this assessment being finalised as means not disclosed (MND)?
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4 |
Finalise the RCA/HOM as means not disclosed (MND) + Read more ... Care recipients pay the full amount for the cost of their care if they do not disclose their income. A letter will not automatically issue until care starts. If a request for a pre-entry letter is received, advise the care recipient:
Ensure the RCIRC screen fields DSS Require Income Details and Date of Effect (DOE) are populated as below:
Navigate to the RCA Means Test Details (RMND) screen within the RCA/HOM activity. Key the following:
Existing Reform Enquiry Means Test data prevents the above coding. To display a blank Reform Enquiry Means Test entry to update:
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5 |
Cancel or withdraw a pre-entry means assessment + Read more ... To cancel or withdraw a pre-entry means assessment:
Save documents to the Customer Information folder located on the Service Officer's team shared drive. Customer Information must not be saved to a desktop or personal H drive. Procedure ends here. |
6 |
Attach Auto-text Fast Note to RCA/HOM activity + Read more ... When the RCA/HOM activity coding is complete, exit and attach a Fast Note to record the assessment outcome.
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7 |
Assessment result (AR) + Read more ... When the Fast Note is complete:
For care recipients currently in care who require a manual pre-entry letter (HC1), see Aged care letters - creating manual letters. Note: when date of receipt is more than 120 days in past, the RCA status will show as cancelled due to expiry (RCA/CAN-EXP). Complete a new RCA/NCL using same information but using the current date as the date of receipt. This will start the 120 days valid assessment period from the correct date. |
8 |
Follow up action + Read more ... Determine if action is needed:
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