Care receiver permanently enters or temporarily/permanently leaves an institution 009-06040070

Has the care receiver moved into the supported accommodation on a temporary or permanent basis? If the care receiver has been admitted on a:

• permanent basis, go to Step 3
• temporary basis and the carer is not providing care, see Temporary Cessation of Care (respite) provisions for Carer Payment (CP) and Carer Allowance (CA)
• temporary basis and the carer is providing care, go to Step 2

If a carer advises the care receiver will move permanently into an institution at a future date.

In Customer First, create a manual review on the Review Registration (RVR) screen and complete the fields as follows:

• Service Reason: CAR
• Review Reason: FCP (Carer Payment Future Rea)
• Due Date: expected date the care receiver is to enter the institution
• Source: INT
• Date of Receipt: today's date
• Notes: 'Care receiver expected to move permanently into an institution xx/xx/xxxx. Return to OB 009-06040070 to action.'
• Keywords: CARPMI
• Workgroup: leave blank
• Position: leave blank
• Transfer to Region: leave blank

The review will mature on the Due Date coded in the RVR activity. Workload Management will allocate the review for manual action.

Tell the carer if the entry date changes, they must contact again to have the date changed. Record details in a DOC.

At the supported accommodation, are there commercial care arrangements in place for the provision of personal care to the care receiver?

• Yes, see Temporary Cessation of Care (respite) provisions for Carer Payment (CP) and Carer Allowance (CA)
• No, as the supported accommodation meets the definition of a private home, entitlement to CP and/or CA is not affected if the carer continues to provide constant care (CP) or 20 hours of care per week (CA) and they provide care on a daily basis. Procedure ends here

For permanent care, at the supported accommodation, are there commercial care arrangements in place for the provision of personal care to the care receiver?

• Yes, see Step 7 in Table 2
• No, as the supported accommodation meets the definition of a private home, entitlement to CP and/or CA is not affected if the carer continues to provide constant care (CP) or 20 hours of care per week (CA) and they provide care on a daily basis. If the carer is getting CP (XWP), they can continue to qualify for payment level CA and their qualification for CP (XWP) is not affected. Procedure ends here

If the care receiver has:

• been admitted to the institution, go to Step 2
• been re-admitted to the institution, go to Step 6
• left an institution (temporarily or permanently), see Step 1 in Table 4

Note: delegation to use data contained in Aged Care Staff Portal for social security purposes, is limited to staff at the APS4 level or above. See Aged Care Staff Portal (ACSP) - Care Recipient in Context (CRiC). Staff must ensure they use information provided in line with Accepting information from and disclosing information to a care receiver or third party. Contact with the carer or care receiver may be required to confirm information.

Is the care receiver in care awaiting placement?

• Yes, and is in:
• an Aged Care or Multipurpose Service Facility, go to Step 3
• a hospital, go to Step 5
• No, go to Step 6

It is most likely that the absence from the carer is permanent. Are there any special circumstances, which indicate that the absence from the carer may be temporary?

• Yes, go to Step 4
• No, go to Step 6

Based on the special circumstances of the case, do the temporary cessation of care provisions apply?

• Yes, respite provisions for CP and CA are to be applied. Procedure ends here
• No, go to Step 6

Clarify with the carer whether the care receiver is likely to return home and if so, will the carer provide additional care and attention on regular and ongoing basis.

Is the care receiver likely to return home?

• Yes, and:
• additional care and attention is being provided on a regular and ongoing basis, hospitalisation provisions for CP and CA should be applied. If a CP (XWP) carer can access hospitalisation provisions for CA, qualification for CP (XWP) is not affected. Procedure ends here
• no additional care and attention is being provided, or is not being provided on a regular and ongoing basis, respite provisions for CP and CA should be applied. If a CP (XWP) carer can access respite provisions for CA, qualification for CP (XWP) is not affected. Procedure ends here
• No, go to Step 6

Is the carer in receipt of CP and/or CA for the care receiver entering an institution?

• Yes, go to Step 7
• No, and the carer or care receiver is partnered and either party is in receipt of another income support payment, see Assessment of circumstances for a couple separated due to illness. Procedure ends here

Is the care receiver partnered and one or both parties in receipt of an income support payment?

• Yes, illness separated rate may apply. Go to Step 8
• No, see Step 1 in Table 3

If an absence is more than 14 days and due to illness, the couple may be entitled to the illness separated rate. For detailed information, see Assessment of circumstances for a couple separated due to illness.

If entitled to the illness separated rate, coding the Marital Status (MS) page will allow the illness separated rate to be paid automatically.

If the carer is the partner of the care receiver, go to the Marital Status page/ MS screen in the carer’s record, otherwise use the care receiver’s record. Update the following fields:

• Event Date
• Marital Status, update this field only if changed
• Qualifier Code
• Source
• Receipt date in Customer First, or the DOR in Customer Record
• In Customer First select Continue or in Customer Record, press [Enter]

For coding assistance, see Assessment of circumstances for a couple separated due to illness.

CP

Carers in receipt of CP continue to receive payment for 14 weeks from the date of event (DOV). This provision does not apply to CP (XWP).

In most cases, this will be the day after the person enters the institution. If there is uncertainty about when the care receiver entered the institution, check the RCA Institution Summary (RIS) screen in Customer First on the care receiver's record to confirm the date. The carer may have provided care to the care receiver in the morning before they entered the institution.

If the date of cancellation is the following day, code a review to record via the RVR screen for the expected date the care receiver is to enter the institution. The Date of Receipt will need to be changed to the cancellation date, however a DOC is required to clearly state the correct Date of Receipt.

Text to include in the DOC: “the Date of Receipt has been coded as the Date of Effect due to a system limitation which prevents an earlier date of receipt. In this case the carer was eligible for payment on the date of receipt, and the date of effect was the following day”.

Staff must ensure they use information provided in line with Accepting information from and disclosing information to a care receiver or third party. Contact with the carer or care receiver may be required to confirm information.

Note: delegation to use data contained in Aged Care Staff Portal for social security purposes, is limited to staff at the APS4 level or above. See Aged Care Staff Portal (ACSP) - Care Recipient in Context (CRiC).

Respite care before entering institution:

Check the Absences Enquiry (ABCE) screen for a summary of the absences taken in the current calendar year.

• code 'Y' in the Go to Absences Details Screen (Y/N) field
• Press [Enter]. The ABSN screen will display
• if the day the care receiver enters the institution (such as a nursing home) is a respite day, the date of event is:
• the date the care receiver entered the institution permanently, as the carer was not providing care to the care receiver on that day, or
• the date the carer became aware the care receiver was not returning to their care

Hospitalisation before entering institution:

Check the Absences Enquiry Screen (ABCE) screen for a summary of the absences taken in the current calendar year.

• Code 'Y' in the Go to Absences Details Screen (Y/N): field
• Press [Enter]. The ABSN screen will display
• if the day the care receiver enters the institution is a hospitalisation day (hospitalisation absence) and then transferred to a nursing home or institution, the carer is still considered to be providing daily care and attention on that day. As such, the date of event will be:
• the day after the care receiver enters the institution, or
• the date the carer became aware the care receiver was not returning to their care

The carer can start work in excess of 25 hours per week during the 14 week period from the date the carer stopped providing constant care and the care receiver entered an institution, as the usual CP constant care criterion does not have to be met. All of the normal income and assets rules still apply, so the carer's rate of payment may be affected by the income earned.

If the care receiver has been re-admitted to an institution, the 14 week extension may not be applicable. Contact the Level 2 Policy Help Desk for advice.

CA

Cancel CA from the first day the carer did not provide care and attention. There is no provision to continue payment for 14 weeks, this only applies to CP.

In most cases, payment is cancelled the day after the person permanently enters the institution. If there is uncertainty about when the care receiver entered the institution, check the RCA Institution Summary RIS page in Customer First on the care receiver's record to confirm the date. The carer may have provided care to the care receiver in the morning before they entered the institution. If no details are shown on the RIS screen, use the day after the person permanently entered the institution as advised by the carer.

If the date of cancellation is the following day, code a review to record via the RVR screen for the expected date the care receiver is to enter the institution. The Date of Receipt will need to be changed to the cancellation date, however a DOC is required to clearly state the correct Date of Receipt.

Text to include in the DOC: “the Date of Receipt has been coded as the Date of Effect due to a system limitation which prevents an earlier date of receipt. In this case the carer was eligible for payment on the date of receipt, and the date of effect was the following day”.

Staff must ensure they use information provided in line with Accepting information from and disclosing information to a care receiver or third party. Contact with the carer or care receiver may be required to confirm information.

Respite care before entering institution - if the day the care receiver enters the institution (such as a nursing home) is a respite day, the date of cancellation is:

• the date the care receiver entered the institution permanently, as the carer was not providing care to the care receiver on that day, or
• the date the carer became aware the care receiver was not returning to their care

Hospitalisation before entering institution - if the day the care receiver enters the institution is a hospitalisation day (hospitalisation absence) and is then transferred to a nursing home or institution, the carer is still considered to be providing daily care and attention on that day. As such, the cancellation date will be:

• the day after the care receiver enters the institution, or
• the date the carer became aware the care receiver was not returning to their care

These rules apply to CP (XWP) as normal.

• Yes, and they are:
• receiving CP (XWP), go to Step 4
• not receiving CP (XWP), go to Step 3
• No, go to Step 4

Note: this screen will update details for CP details.

Update the Care Receiver Care and Institution Details (CRCI) page with the care receiver's details:

• Go to the care receiver's record. If the CRN is unknown, it is recorded on the carer's Care Receiver Summary (CRS) page
• While in the care receiver's record:
• go to CRS and select the 'self' line, and
• click Continue. The Care Receiver Task Selector (CETS) page is shown
• To view the CRCI page, on the CETS page:
• select Care & Institution Details
• select Continue
• Under 'Carer Receiver in Institution Details', complete the Date of Event field using the first date the carer did not provide constant care. In most cases, this will be the day after the person permanently enters the institution. Because circumstances may change, it is possible to record and view multiple events of a care receiver moving permanently into or out of an institution
• If the care receiver:
• entered respite while awaiting permanent entry into another institution (such as a nursing home), the date of event is the date the care receiver entered the nursing home or institution permanently, as the carer was not providing care to the care receiver on the day. A respite absence should have already been coded on the Temporary Cessation of Care Update page
• was in hospital (hospitalisation absence) and then transferred to a nursing home or institution, the carer is still considered to be providing daily care and attention. As such, the event date will be the day after the person enters the institution
• Select 'Yes' option in the Permanently in Institution field. This action can be reversed. For example, if the care receiver comes back home after a few weeks the indicator can be changed back to 'N', and the absence details should be considered as it may be necessary to code the details on the Temporary Cessation of Care Update page as respite if the absence was temporary and not permanent. CP continues for 14 weeks from the date of effect (DOE)
• Before adding the new provisional line, complete the Source and Receipt Date fields
• Source (if referring to an RCA Assessment, this would be INT)
• Date of Receipt (if referring to an RCA assessment, see finalisation DOC on care receiver’s record)
• When updates are completed, click on the 'Add' button to add the new provisional line then click on the Continue button
• Finalise activity on Assessment Results (AR) screen
• This will ripple to the carer's record and create a future activity cancelling CP automatically when the carers 14 week continuation period has stopped

Is the carer also receiving CA?

• Yes, go to Step 4
• No, go to Step 5

Cancel CA by using the Carer cancellation and suspension workflow in the carer's record.

CP will continue to be paid for 14 weeks from the first date the carer did not provide constant care.

In most cases, the date of cessation of care will be the day after the person enters the institution and this is the date that should be used for the workflow date of event (DOV).

In the workflow:

• 'S'elect the care receiver. If wanting to cancel CA for a chosen care receiver(s) only, select the care receiver(s)
• At the CA 'Select a reason at the care receiver level':
• for adult care receivers - choose the reason 'PMI - Permanently moved to an institution' from the dropdown list
• for a dependent child who moved permanently to an institution - select 'Care requirement not met (CRM)
• In the date of effect (DOE) field, enter the date of event (DOV). Select continue

If the workflow is not available or not working, manually code the absence. For manual coding, see Step 1 in Table 5.

Update the care receiver's address (if needed). For assistance, see Updating address details and Change of address to an aged care home.

Record the details on a DOC in the carer's record.

Finalise the activity on the Assessment Results (AR) page.

If the carer is receiving Family Tax Benefit (FTB) for a child care receiver, follow up to see if FTB is still payable. See Child leaves customer's care/custody.

For CP

Tell the carer that CP will continue to be paid for 14 weeks from the first date the carer did not provide constant care. In most cases, this will be the day after the person enters the institution. Discuss whether they wish to apply for any other appropriate income support payments before the cancellation date.

If the carer was getting CP (XWP), CP will be automatically cancelled from the date that their only or last payment level CA is cancelled.

The carer can complete the transfer to Age Pension online, via Assisted Customer Claim (ACC) if they:

• are of Age Pension age, and
• meet the residence requirements, and
• want to claim Age Pension

Note: Transfer to Age Pension (SA383) forms can no longer be issued manually from the OMLD screen.

If the carer insists on a paper version, explain they will need to complete a full claim for Age Pension and if needed run the First Contact Service Offer (FCSO) workflow to send out the correct claim forms.

See Transfer to Age Pension.

Has the care receiver permanently or temporarily left the institution?

• Yes, Factors to consider:
• Is the care receiver intending to return to the institution after a certain period?
• Have they left the institution for a particular family/social event?
• Are they maintaining a place at the institution?
• Go to Step 2
• No, procedure ends here

• Yes, go to Step 3
• No, go to Step 4

• Yes, go to Step 6
• No, go to Step 4

See Temporary cessation of care (respite) for more than 63 days before returning here.

• Yes, go to Step 6
• No, go to Step 5

• Yes, go to Step 6
• No, and the carer is/was in receipt of:
• CA, the carer will need to reclaim CA
• CP, if current, CP can continue without the need for the carer to reclaim
• CP, if cancelled and absence was more than 63 days but less than 14 weeks, CP can be restored. Delete the previous coding on the CRCI screen in the care receiver’s record before restoring. See Restoration of Carer Payment
• CP and the total absence was more than 14 weeks the carer will need to reclaim CP
  

If the care receiver is a member of a couple and was assessed as a member of an illness separated couple, see Assessment of circumstances for a couple separated due to illness

If the carer is getting CP, delete the date of event previously coded on the CRCI screen. If the carer is in receipt of:

• CA only, go to Step 7
• CP or CP and CA (if current), CP can continue without the need for the carer to reclaim. If not current, the carer will need to reclaim CP. If the care receiver is a
• member of a couple and was assessed as a member of an illness separated couple, see Assessment of circumstances for a couple separated due to illness
• not an illness separated couple, go to Step 7

Payment of CA should be restored. See Restoration of Carer Allowance. If the carer has requested a review within 13 weeks of the cancellation of CA then arrears can be paid from the date paid to, otherwise the standard arrears provisions apply.

Cancel CA in Customer First by using the Carer cancellation and suspension workflow in the carer's record. For workflow action, see Step 5 in Table 3.

Manual coding in Customer First > Customer Record is only to be done when the workflow or Customer First is not available or not working.

Is manual cancellation of CA needed?

• Yes, go to Step 2
• No, go to Step 4

In the carer's record, go to the Care Receiver Summary (CRS) screen and select the appropriate care receiver.

Go to the Care Receiver Benefit Action (CJBA) screen:

• Code the Action field with 'CAN'
• If the care receiver is:
• an adult, code the Reason field with PMI (Permanently moved to an institution)
• a child, code the Reason field with 'CRM' (Care Requirements not Met)
• In most cases, the date of cessation of care will be the day after the person enters the institution and this is the date that should be used for the Date of Event (DOV).
• Complete the Source and Receipt Date fields
• Source (if referring to an RCA Assessment, this would be INT)
• Date of Receipt (if referring to an RCA assessment, see finalisation DOC on care receiver’s record)

Code the Assessment Date field with the first date the carer did not provide care and attention. Note: the assessment date cannot be after Date of Receipt of activity, as per warning edit shown on the CJBA screen:

• In Customer First, click on the Continue button, or if in Customer Record press Enter
• Record details on a DOC in the carer's record and finalise the activity on the Assessment Results (AR) screen

Is the carer also receiving CP?

• Yes, go to Step 4
• No, or carer is receiving CP (XWP), go to Step 8

Is the CP care receiver a child?

• Yes, go to Step 5
• No, go to Step 6

Go to the CRS screen in the carer's record and select the care receiver. If the child has Customer Reference Number (CRN) (that is, has a record of their own) the selection from the CRS screen must be done in the child's record.

The Care Receiver Task Selector (CETS) screen will show. 'S'elect the Care Receiver Care and Institution Details (CRCI) screen.

Go to Step 7.

Take a note of the carer's CRN if it does not default in the care receiver's record. The care receiver's CRN should be written on the CRS screen of the carer's record. Go to the care receiver's record:

• Access the CRS screen and select 'Self'
• The Care Receiver Task Selector (CETS) screen will show
• Select the Care and Institution Details (CRCI) screen

When using CF both Carer Allowance Care Summary and Carer Payment Care Details will present.

CP coding in Carer Payment Care Details

Complete the Date of Event field using the first date the carer did not provide constant care. In most cases, this will be the day after the person permanently enters the institution. Note: because circumstances may change, it is possible to record and view multiple events of a care receiver moving permanently into or out of an institution.

If the date of cancellation is the following day, code a review to record via the RVR screen for the expected date the care receiver is to enter the institution. The Date of Receipt will need to be changed to the cancellation date, however a DOC is required to clearly state the correct Date of Receipt.

Text to include in the DOC: “the Date of Receipt has been coded as the Date of Effect due to a system limitation which prevents an earlier date of receipt. In this case the carer was eligible for payment on the date of receipt, and the date of effect was the following day”.

If the day the care receiver enters the institution (such as a nursing home) is a:

• respite day, the date the care receiver entered the nursing home or institution permanently, as the carer was not providing care to the care receiver on that day. A respite absence should have already been coded on the carers record
• hospitalisation day (hospitalisation absence) and is then transferred to a nursing home or institution, the carer is still considered to be providing daily care and attention on that day. As such, the event date will be the day after the person enters the institution
• Carer Number/CRN field:
• In Customer First, use dropdown box to select the care receiver
• In Customer Record, code carer's CRN (noted earlier), or if the Care Giver field has the name of the carer listed, code the number written immediately before the carer's name
• Carer is field:
• In Customer First, use dropdown box to select the correct option
• In Customer Record, use field help '?' for appropriate code
• Constant Care field:
• In Customer First, use dropdown box to select the correct option
• In Customer Record, key 'N' as the carer is not providing care
• In Customer First, Add data
• Care Receiver in Institution field:
• In Customer First, code date of event and select 'Yes'
• In Customer Record, key 'Y'
• Complete the Source and Receipt Date fields. The Source, if referring to an RCA Assessment would be INT. For the Date of Receipt, if referring to an RCA assessment, see finalisation DOC on the care receiver’s record
• Continue

This action can be reversed. If the care receiver comes back home after a few weeks the Permanently in Institution indicator can be changed back to 'No' or 'N', and the absence details should be considered, as it may be necessary to code the details on the Absence Details (ABSN) screens as respite Temporary Cessation of Care, if the absence was temporary and not permanent.

Update the change of address details for the care receiver. For assistance, see Updating address details and Change of address to an aged care home.

Record the details on a DOC in the carer's record.

Finalise the activity on the AR screen.

If the carer is receiving Family Tax Benefit (FTB) for a child care receiver, follow up to see if FTB is still payable. For more information, see Child leaves customer's care/custody.

Rent Assistance (RA)

From 1 October 1997, residents who receive an income support payment and are in a funded place (bed) in an accredited aged care home, are not entitled to RA. The aged care home can advise the resident whether they are in a funded place (bed) in the facility, approved by the Department of Social Services (DSS). For more information, see Completing the Accommodation Details (AC) screen and assessing Rent Assistance (RA).

Tell the carer that CP will continue to be paid for 14 weeks from the first date the carer did not provide constant care. In most cases, this will be the day after the person enters the institution. Discuss whether they wish to apply for any other appropriate income support payments before their cancellation date.

If the carer was getting CP (XWP), CP will be automatically cancelled from the date that their only or last payment level CA is cancelled.

The carer can complete the transfer to Age Pension online, via Assisted Customer Claim (ACC) if they:

• are of Age Pension age, and
• meet the residence requirements, and
• want to claim Age Pension

Note: Transfer to Age Pension (SA383) forms can no longer be issued manually from the OMLD screen.

If the carer insists on a paper version, explain they will need to complete a full claim for Age Pension and if needed run the First Contact Service Offer (FCSO) workflow to send out the correct claim forms.

For more information, see Transfer to Age Pension.

Lump sum bereavement

If the care receiver passes away during the 14 weeks and the carer and care receiver:

• are a couple, if the care receiver passes away during the 14 weeks from the date of their entry into an institution, and the carer and care receiver were a couple, the carer may be eligible for a LBP. A new 14 week period will then start from the date the care receiver passed away
• are not a couple, if the care receiver passes away during the 14 weeks from the date of their entry into an institution, and the carer and care receiver are not a couple, the carer is not entitled for a LBP, but their CP will continue to be payable until the 14 week period ends