Aged Care Reviews – Residential Care Pre 1 July 2014 - processing reviews and reassessments 065-09010040

Obtain details of the original decision

The MTA result is displayed on the MTA Assessment Determination (RCAD) screen. The RCAD screen also displays:

• the assessment's date of effect in the ATH DOE: field
• the asset values included in the assessment (half combined if partnered)
• the RCAA activity number (AMR)

Finalisation date

The date that the MTA was finalised is recorded on a DOC on the DL screen.

This date can also be found by a search in the Act ID field on the Event Summary (ES) screen using the AMR obtained from the RCAD screen.

The date the MTA was finalised is the start of the 13 week period. Customer initiated requests for MTA reviews must be made within 13 weeks of receiving the notice of the original decision. Allow a few extra days for delivery of the notice of the assessment.

Has the customer notified the change of circumstances or value of assets within 13 weeks of the original assessment?

• Yes, go to Step 5
• No, the review is not processed. Go to Step 3

Has the customer provided new information with the request for a review that satisfies the decision maker that the original MTA assessment was incorrect in some way, for example, an incorrect asset value had been taken into account?

• Yes, the original Aged Care Means Test Assessment (MTA) assessment can be revoked. The customer can lodge a new application form and when this is processed, they will obtain a new assets assessment based on their correct circumstances at the date they entered care. Procedure ends here
• No, go to Step 4

• Yes, the customer can lodge an application for a new MTA based on what their circumstances and what the value of their assets was at the date they entered care. This is not a reassessment of the original MTA, it is a new decision with a new date of effect, for example the date the customer entered care. Procedure ends here
• No, procedure ends here

• Yes, the reassessment of the original decision cannot be processed until the verification is lodged. Procedure ends here
• No, go to Step 6

Do the changes apply from the date of effect of the original MTA decision?

• Yes, go to Step 7
• No, the reassessment of the original decision cannot be processed. Changes in the customer's circumstances or the value of their assets that apply from a date after the date of effect of the original MTA decision are not relevant to that assessment. Note: if the customer receives an income support payment, the changes applying from a later date would still be relevant to that income support payment. Procedure ends here

Make relevant updates to the customer's financial investments or other assets in the RCA system.

In the same activity code the following fields on the Benefit Action (BA) screen:

• Service Reason: code 'RCA'
• Action: code 'FRE' (assets testing health reassessment)
• Effect date: code the assessment date of event (DOV) as per the ATH DOE: field on the RCAA Assessment Determination (RCAD) screen. DOV for the updates is the date of effect of the original assessment as per the RCAD screen
• DOR: The date of receipt of the information

Once the activity has flowed to the Assessment Results (AR) screen, it is possible to go back and check the RCAD screen to see:

• if the Resident Status has changed
• the revised amount of total assets as a result of the updates made

Note: the resident status and the asset amount will need to be recorded on the DOC.

Still use the Income/Assets Update and Reviews script and link it to the activity.

(For pre 1 July 2014 residents only). In the DOC state: 'Assets reassessed for Residential Care Purposes, customer is a [insert one: 'Fully Supported resident', 'Partially Supported resident' or 'Not Supported resident']. Total Assets $[insert amount] under the Aged Care Act 1997.'

Fully Supported, Partially Supported and Not supported resident statuses to not apply to post 1 July 2014 residents.

Annotate the MTA claim DOC with the above information as well, if applicable.

Issue new letter

Letters will not be available to view on the HS screen until the following day. The BLST screen will have an RCA event.

Is an urgent issue of a revised statement required?

• Yes, once the activity is finalised (including QOL checking if applicable) run the Residential Care Assessments script and select: 'New Letter (paper based assessed)'. Note: if the customer has multiple pages of the RCAD screen, this option will only apply to the most recent
• No, once the activity is finalised the revised letter will auto issue from Central Print overnight