Aged Care – fees and charges 065-19103017

Item

Questions and answers

1

What are the allowable income amounts for means assessment purposes?

There are different allowable income amounts depending on the care recipient's marital status at the date of effect of the assessment. The aged care allowable income amount is made up of:

• maximum basic pension rate, plus
• maximum pension supplement rate, plus
• pension allowable income amount, minus
• minimum pension supplement rate

The pension rates for a single person (as at 20 September 2019) are:

• maximum basic pension = $850.40 per fortnight
• maximum basic pension supplement = $68.90 per fortnight
• minimum pension supplement = $37.00 per fortnight
• pension allowable income amount = $174.00 per fortnight

The allowable income amount is $850.40 + $68.90 + $174.00 - $37.00 = $1,056.30 per fortnight.

The pension rates for a partnered person (as at 20 September 2019) are:

• maximum basic pension = $641.00 per fortnight (each)
• maximum pension supplement = $51.90 per fortnight (each)
• minimum pension supplement = $27.90 per fortnight (each)
• pension allowable income amount = $308.00 per fortnight (each)

The allowable income amount is $641.00 + $51.90 + $308.00 - $27.90 = $973.00 per fortnight.

The pension rates for a member of an illness separated couple (as at 20 September 2019) are:

• maximum basic pension = $850.40 per fortnight (each)
• maximum pension supplement = $68.90 per fortnight (each)
• minimum pension supplement = $37.00 per fortnight (each)
• pension allowable income amount = $308.00 per fortnight (each)

The allowable income amount is $850.40 + $68.90 + $308.00 - $37.00 = $1,190.30 per fortnight.

2

How do I calculate the daily means tested care fee (MTCF)?

The daily MTCF is determined by comparing the MTCF daily amount in excess of the maximum accommodation supplement ($54.39 as at 20 September 2016) up to the cost of care subsidy per day.

For example, if the MTCF daily amount is $80.00 and the maximum accommodation supplement is $54.39 and the care subsidy is $30.00, the fee calculation is:

$80.00 - $54.39 = $25.61

As $25.61 is less than the subsidised cost of care ($30.00), the daily MTCF the care recipient pays is $25.61.

Note: the MTCF amount can vary after entering residential care if the care recipient's circumstances or the value of their income or assets changes.

3

What is the date of event (DOV) for means test assessments?

The date of event (DOV) is the date used to calculate aged care fees and charges for care recipients and can vary depending on the situation.

4

What determines whether a care recipient will pay an accommodation payment or an accommodation contribution (low means or not low means)?

The means assessment determines the care recipient's 'daily means tested amount'.

If a care recipient's daily means tested amount at entry is less than the maximum accommodation supplement rate ($57.49 as of 20 September 2019), they are low means and will not pay an accommodation payment. Instead, they pay an accommodation contribution of up to $57.49 per day (equal to their daily means tested amount).

If the daily means tested amount at entry is over the maximum accommodation supplement rate of $57.49 per day, the care recipient is not low means and pays an accommodation payment (Refundable Accommodation Deposit (RAD), or a combination of a smaller RAD and a Daily Accommodation Payment (DAP)).

5

What is an ACFI?

The Aged Care Funding Instrument (ACFI) is a tool used by aged care providers to determine a care recipient’s level of care needs. The assessed level of care determines the government subsidy paid to the aged care service for providing care to the resident.

An ACFI:

• Cannot be completed in the first 7 days after a care recipient enters care
• Cannot be submitted to Services Australia until after the care recipient has been in care for 28 days
• Should be completed within two months of the care recipient entering care

There are 3 funding categories aligned to the assessment of care required:

• Activities of Daily Living (ADL)
• Behaviour (BEH)
• Complex Health Care (CHC)

Each of these categories has 4 funding levels:

• Nil
• Low
• Medium
• High

For example, a care recipient’s may have been assessed using the ACFI as:

• ADL – High
• BEH – Medium
• CHC - Low

Based on ACFI subsidy rates from 1 July 2019, the assessed cost of care is:

• $113.67 (ADL High) + $17.85 (BEH Medium) + $16.71 (CHC Low) = $148.23 per day

6

How does an ACFI affect the MTCF?

Although based on income and assets, the means tested care fee (MTCF) is also limited by the 'cost of care' based on a care recipient's Aged Care Funding Instrument (ACFI) assessment.

A care recipient cannot pay more than the applicable funding for their assessed level of care. For example:

• MTCF is $80.00 per day
• ACFI assessment is $72.74 per day
• The care recipient can only be levied $72.74 per day for their MTCF

As at 1 July 2019, a subsidy of $57.819 per day is paid to aged care providers for new care recipients with an Aged Care Assessment Team (ACAT) approval, until an ACFI is submitted. Services Australia adjusts and backdates payments to providers when they receive the ACFI.

7

What is a standard resident?

A Standard resident is a resident who is neither a Protected resident, Phased resident nor a Non-Standard resident.

8

What is a protected resident?

A Protected resident must have been in permanent care or on pre-entry leave at any time in the 28 days prior to 20 September 2009 and not subsequently discharged from care for more than 28 days and not be:

• A Non-Standard resident, and
• Means Not Disclosed (MND), and
• A self-funded retiree on 19 September 2009, or
• In receipt of an income support payment on 20 September 2009 with an assessed annual non-pension income equal to or more than the threshold amount of $9,360 if single or $8,892 for each member of a couple if partnered

9

What is a phased resident?

Certain residents who entered permanent care for the first time between 20 September 2009 and 19 March 2013 inclusive were Phased residents for daily fee purposes. From 20 March 2013, all existing Phased residents are Standard residents for daily fee purposes.

Residents who entered care on or after 20 March 2013 are Standard residents only.

10

What is a non-standard resident?

A Non-Standard resident must be a pre-2008 reform resident, meaning they entered permanent care before 20 March 2008 and have not subsequently been discharged from care for more than 28 continuous days and not have a dependent child, and:

• be a self-funded retiree, or
• be Means Not Disclosed (MND), or
• agreed to pay an accommodation bond more than 10 times the single annual Age Pension rate at the time they entered care

Scheme

Resident Status

Fees and Charges

Subsidies and Supplements (subject to eligibility criteria)

1997-2005 Residential Care

Concessional (determined by service provider)

BDF – Basic Daily Fee / Basic Daily Care Fee

ITF – Income Tested Fee

ITSR – Income Tested Subsidy Reduction

Accommodation Bond

N/A

Accommodation Charge

Concessional Supplement

1.7.2005

Residential Care

• Concessional
• Assisted
• Neither

BDF – Basic Daily Fee / Basic Daily Care Fee

ITF – Income Tested Fee

ITSR – Income Tested Subsidy Reduction

Accommodation Bond

N/A

Accommodation Charge

Concessional Supplement

20.3.2008

Residential Care

• Fully Supported
• Partially Supported
• Not Supported

BDF – Basic Daily Fee / Basic Daily Care Fee

BDF Supplement

ITF – Income Tested Fee

ITSR – Income Tested Subsidy Reduction

Accommodation Bond

N/A

Accommodation Charge

Accommodation Supplement

1.7.2014

Home Care

N/A

BDF – Basic Daily Fee / Basic Daily Care Fee

ITF – Income Tested Fee

ITCF – Income Tested Care Fee

MTF – Means Tested Fee (ACMPS displays)

ITSR – Income Tested Subsidy Reduction

1.7.2014 Residential Care

Low Means

BDF – Basic Daily Fee / Basic Daily Care Fee

BDF Supplement (commenced 2012)

DAC – Daily Accommodation Contribution

MTC – Means Testing Contribution

ACC CONT – Accommodation Contribution (SPARC display)

MTAS – Means Tested Accommodation Supplement

RAC – Refundable Accommodation Contribution (lump sum)

Accommodation Payment

MTAS – Means Tested Accommodation Supplement

MTCF – Means Tested Care Fee (with change in circumstances)

MTF – Means Tested Fee (with change in circumstance

MTSR – Means Tested Subsidy Reduction

Not Low Means

BDF – Basic Daily Fee / Basic Daily Care Fee

BDF Supplement

MTCF – Means Tested Care Fee

MTF – Means Tested Fee

MTSR – Means Tested Subsidy Reduction

RAD – Refundable Accommodation Deposit

(lump sum)

Accommodation Payment

N/A

DAP – Daily Accommodation Payment

N/A