Aged care means assessment - home care pre-entry 065-18082330

Complete the Aged care means assessment – preliminary checks including action required when care recipient is RCA/CUR.

Determine the relevant dates for a home care pre-entry means assessment.

• Date of event (DOV), and
• Date of receipt (DOR) will be the same and be either:
• receipt date of the Aged Care - Calculation of your cost of care (means assessment) form, or
• contact date of the verbal means assessment
• Date of effect (DOE) where applicable for care recipients who receive an income support payment and have advised of changes to income and assets
• If the DOV for means assessment is prior to the date of death of the customer’s partner, 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
• Go to Step 2

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?

• Verbal means assessment (ISP/CUR only), go to Step 3
• Aged Care Calculation of your cost of care form, see Table 2
• Care recipient withdraws claim, see Table 3, Step 1

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:

• Use their income details to get an aged care means assessment
• Advise that maximum aged care fees may be payable where permission to use income information is not given
• Discuss when the care recipient’s details were last updated
• Update new information as needed
• If needed, use the questions on the Aged Care Calculation of your cost of care as a guide while on the phone with the care recipient

Can the home care means assessment be completed verbally?

• Yes, see Table 3
• No,
• An Aged Care Calculation of your cost of care form is needed. Request required documents. See Verifying income and assets and Requesting information (CLK)
• Update status of Aged Care Means Assessment to Not Required
• The care recipient has the option to call back to do a verbal means assessment or, when home care commences, the assessment will complete automatically
• Create a DOC to record advice provided
• Procedure ends here

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:

• Person Permitted to Enquire (PPE), or
• Person Permitted to Update (PPU)

To view paper claims and scanned supporting documents:

• select Quick link from the bottom of the open Process Direct window, or
• select Documents from the Icon Menu

Check the date the document was scanned. There may also be older documents not related to the claim.

Check details recorded by selecting .

• Select Tasks to view documents requested online or via ACC or documents provided and their status, for example, accepted
• Select Notes to view claim progress notes and details of any changes since the claim was submitted
• Refer to Creating, reviewing and deleting documents (including Fast Notes and DOA DOCs) for more information.

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.

• Use Verifying income and assets to determine if supporting documents are required for ISP care recipients
• If the Aged Care Calculation of your cost of care form contains details of a partner not currently linked to the care recipient's record, and the partner has not signed the form, a Partner Details (MOD P) form is required. See Change in relationship status from single to partnered
• If the previous Complex Assessment Officers (CAO) assessment is within the last 12 months and is recorded on the Trust/Company Income/Assets Summary screen (TRCIAS) screen, no further referral is needed

Is more information needed to finalise the means assessment?

• Yes, and required information/documents have:
• not previously been asked for, go to Step 3
• previously been asked for, go to Step 5
• No, see Table 3

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?

• Yes, and
• only verbal confirmation is required, see Table 3
• supporting documentation is required, go to Step 4
• No, and the:
• outbound call was unsuccessful, go to Step 4
• supporting documentation is required, go to Step 4
• care recipient wants a written request for information, go to Step 4
• care recipient does not want to disclose their means, see Table 5

• Issue a written request for information notice to the care recipient (and partner if applicable) using > Request Documents, see Requesting information - Process Direct of Aged care letters - creating manual letters
• Review the CAO Assessment Doc to make sure the most recent information is applied to the previous CAO assessment
• Complete a Complex Assessment Officer (CAO) referral (if needed)
• Procedure ends here until documents returned

Is it 21 days plus allow extra time for mail delivery since the RFI was issued to the care recipient?

• Yes, finalise the means assessment RCA/HOM activity, see Table 3
• No:
• Code DL in Super Key or select Notes to annotate existing Fast Note
• hold the means assessment RCA/HOM activity for remainder of the 21 days plus an allowance to receive the notice

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:

• Select SOA Shell from the Process Direct Landing page
• Key the appropriate details in these fields:
• Benefit Type: Aged Care Means Assessment
• Customer CRN
• Date of Receipt
• Please select the care type
• Select Create Claim
• The Circumstance Data screen displays

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 rejected 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), or
• a care recipient withdraws their means assessment request

Is this claim being rejected or withdrawn?

• Yes, go to Step 7
• No, go to Step 2

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:

• RCA Specific Screens
• Personal Details
• Income and Assets

Select all task selectors and then select Next.

A list of Aged Care (RCA) specific screens will be displayed. Select required screens to complete a home care assessment:

• RMND - Residential care assessment – means test details
• RCIRC - Residential Care Assessment Circumstance
• RDEP - Residential care assessment – dependants (if required)

Select Next.

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:

• Select the +Add button
• In Care Type, select Home Care
• Select Save
• The Lapse date will set at 120 days after date of event (DOE)

If the customer is choosing not to disclose their means, from the Means not disclosed table:

• Select the +Add button
• A prompt box is displayed. Key the Event date
• Select the ‘Y’ radio button next to Means not disclosed
• Select Save

Note: if MND was previously coded as ‘Y’, this may require updating to ‘N’ 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:

• ‘As you have elected not to disclose your means we are unable to issue you a letter until you start receiving care. You may need to negotiate the cost of your care directly with the service provider.’

Once completed, select Next.

Check the RCIRC tabs are populated as below:

• Income Test Details: confirm date of effect is correct
• To edit, select the pencil button under Action
• Grandfathered Details: confirm date of effect is correct

Once completed, select Next.

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:

• Select the Add+ button
• Key the Date of Event
• Select the number children from the drop down menu
• Select Save to update this information

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.

Go to Benefit Action (BA) screen by typing BA in Super Key field. Select +Add New and complete the following fields:

• Benefit Type Code: will default to RCA
• Benefit Action: will default to REJ
• Notes: key ‘REJ-OTH RCA/HOM REJ – failed to provide information’ or ‘REJ-OTH Home Care pre-entry assessment withdrawn’
• Reason: OTH – Other
• Select Save

Are there other updates that need to be made before finalising means assessment?

• Yes, see Table 4
• No,
• on the BA screen, select Assess
• on Circumstance Data screen select Assess
• check any warnings or errors on SWE screen and select Assess
• RCA Asset assessment (RCAA) screen displays, select Next
• Entitlements (ELD) screen will be displayed and confirm RCA/REJ
• Select Finish
• Update note with any extra information
• Select Finalise
• Procedure ends here

Select required screens to update from the list presented:

• MS - Partner Details
• AD – Address
• ACS - Accommodation
• OC - Office Code
• TDS - Telephone Details
• EMA - Email Address Details

Or check Select all tasks.

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?

• Yes, Select Next to proceed to the next screen
• No,
• Partner Details can only be updated before processing the assessment
• The activity must be regenerated to continue
• Note the claim ID for reference
• Select the Back button
• Select the button > Regenerate, and select an appropriate reason and select Save
• Go to the MS screen using Super Key
• See Table 3, Step 2 for the process to update Partner Details
• When partner details updates are complete, use the claim ID or customer CRN to access the claim from the Transactions menu
• Once the partner details have been addressed, select Process

Update a postal address when requested by:

• a care recipient
• a court appointed guardian or administrator
• a power of attorney (POA), or
• an existing Centrelink correspondence nominee, when the postal address is not the same as their own postal address

A postal address is not updated when requested by:

• an existing Centrelink correspondence nominee, when the postal address is the same as their own postal address

For additional information on updating addresses (including postal), see:

• Updating address details
• Adding or rejecting a nominee request
• Aged care request for a nominee or executor
• Accepting information from and disclosing information to Power of Attorney

To add new address details:

• From the Address (ADH) table, select the + (plus) button
• Complete all required fields and select the Save button

If the care recipient provides new information, update as required:

• Review and confirm accommodation details on Accommodation (ACS) screen
• Check Office Code (OC) screen
• Update any new contact number on the Telephone Summary
• Update the email address on the Email Address Details

Once personal details completed, see Table 5

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:

• the DOV should include the date of the change as stated in supporting documents, and
• if further changes occurred, the date of receipt

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?

• Yes, go to Step 2
• No, go to Step 3

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 task selector will pre-select and flag any modules that have provisional data from the assessment
• If means assessment is being coded from a scanned form, check all income and asset screens for existing information
• Partner income and assets will not display in the customer's record
• To view and update partner income and assets, select and select the partner from the menu slider
• To return to the customer's record use

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:

• Coding income and assets for Centrelink payments and services
• Financial Investments
• Exempt income and assets for Centrelink payments
• Assessing deprivation/gifting
• Foreign income and assets
• Income streams
• Aged Care means assessment with total assessable assets equal to or greater than $10,000,000 (an applicable assessable income)

Does the care recipient (or their partner) get any income from employment?

• Yes, and care recipient (or partner):
• receives an ISP, go to Step 4
• does not receive an ISP, go to Step 5
• No, go to Step 6

Employment income reporting requirements for a care recipient (or partner) in receipt of an ISP:

• Statement reporter
• have employment income
• must advise of income, hours worked and any other changes on their reporting day
• Notification reporter
• no employment income or stable employment income and exception is met
• must advise starting work or any changes within 14 days
• See Reporting overview

If this is the first time that the care recipient (or partner) is declaring income, see Recording and correcting employment income details.

Go to Step 6.

Care recipients not in receipt of an ISP:

• are not able to update their income each fortnight as a non-continuous frequency such as Income for One period (IOP)
• have their income assessed in the same way as a continuous income exception notification reporter
• income is coded as 1WE (weekly) or 2WE (fortnightly) if income is variable it will be averaged over a suitable period

See Determining the Date of Event for employment income for help coding income.

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:

• Yes, go to Step 7
• No,
• Referral required to DVA Clearance Team
• Go to Payments from the Department of Veterans' Affairs (DVA) and referrals to the DVA Clearance Team for referral and Fast Note information
• Place the claim on hold for 5 days pending return
• Procedure ends here until DVA clearance team have completed coding

Update the Real Estate and Business (REBS) screen if the care recipient indicates:

• rental income for their own home or other real estate
• income from a business – sole trader or partnership
• an involvement in a Private Company or Private Trust (including Special Disability Trust)

Does the care recipient have income from any of the above?

• Yes, go to Step 8
• No, go to Step 11

Does the care recipient (or partner) receive rental income from real estate, including their principal home?

• Yes, go to Step 9
• No, go to Step 10

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.

• Update existing property details:
• Update rental income
• Do not change the previously coded asset value

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?

• Yes, code income only then, go to Step 11
• For sole trader business coding, see Sole traders
• For business partnership coding, see Partnerships
• No, go to Step 11

Does the care recipient have an interest in a private trust or private company?

• Yes, go to Step 12
• No, see Table 6

the care recipient (or partner) has an interest in a private trust or private company:

• See Trusts or Companies for details on documents needed and Complex Assessment Officer (CAO) referrals
• See Identifying and making suitable referrals to the Complex Assessment Officer (CAO) for information on referring to a CAO for assessment
• Select Back to return to Customer and activity information
• Select the button > Referral and complete required information
• Means assessment will change to Status: On Hold with reason Referral to CAO and Note will be recorded
• Once CAO assessment complete, see Table 6

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:

• review any warnings or errors appearing under Message Log
• Digital Assistant (DA) can be used to assist with resolving errors. Key the error message into the DA for help. See Using Digital Assistance Roxy in Process Direct.
• resolve all warnings and errors
• select Assess for the SWE screen to display again
• select Assess again for the data to be sent to ISIS. Note: repeat the previous steps if more errors occurs

The RCAA Assessment Determination (RCAD) screen will display once all errors have been resolved.

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:

• The first ATH line and RCA Benefit line have a ‘Period End’ date equal to the date of event (DOV) of the assessment
• any arrears or overpayments calculated are correct (based on DOV and date of receipt (DOR))

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.

• Payment Delivery Summary (RAD)
• Payment Summary (PS)
• Rate Summary (RATS)
• Rate Component (RAC)
• Assessment Consequences (ASC)

Once the claim outcome is correct, select Finish.

Claim finalisation note template will display and be available to update where required. Most information will be pre-populated from coding:

• Document if an update was made that differs from the details lodged (for example a care recipient failed to provide bank account balances on the Aged Care - Calculation of your cost of care form but later provides a verbal balance)
• When a verbal assessment was completed with changes coded, read the verbal declaration and document: verbal declaration has been read out and agreed to
• 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/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.

Determine if action is needed:

• Complete any progress of claim DOCs or scans
• Check if further action is needed on the partner’s record, including an outstanding RCA/HOM activity
• If the means assessment is completed verbally and there is not a nominee recorded, issue an Authorising a person or organisation to enquire or act on your behalf form (SS313)
• See also Adding or rejecting a nominee request

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)

Complete the Aged care means assessment – preliminary checks including action required when care recipient is RCA/CUR

Determine the relevant dates for a home care pre-entry means assessment.

• Date of event (DOV), and
• Date of receipt (DOR) will be the same and be either:
• receipt date of the Aged Care - Calculation of your cost of care (means assessment) form, or
• contact date of the verbal means assessment
• Date of effect (DOE) where applicable for care recipients who receive an income support payment and have advised of changes to income and assets
• Go to Step 2

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?

• Verbal means assessment (ISP/CUR only), go to Step 3
• Aged Care Calculation of your cost of care form, see Table 2
• Care recipient withdraws claim, see Table 5, Step 5

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:

• Use their income details to get an aged care means assessment
• Advise that maximum aged care fees may be payable where permission to use income information is not given
• Discuss when the care recipient’s Customer First record was last updated
• Update new information as needed
• If needed, use the questions on the Aged Care Calculation of your cost of care as a guide while on the phone with the care recipient

Can the home care means assessment be completed verbally?

• Yes, see Table 3
• No,
• An Aged Care Calculation of your cost of care form is needed. Request required documents. See Verifying income and assets and Requesting information (CLK)
• Cancel RCA/HOM activity
• The care recipient has the option to call back to do a verbal means assessment or, when home care commences, the assessment will complete automatically
• Create a DOC to record advice provided
• Procedure ends here

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:

• Person Permitted to Enquire (PPE), or
• Person Permitted to Update (PPU)

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.

• Confirm documents provided by checking Document List (DL) and Document Tools
• Use the Aged Care Calculation of your cost care form ‘checklist’ to confirm all supporting documents have been provided
• Use Verifying income and assets to determine if supporting documents are required for ISP care recipients
• If the Aged Care Calculation of your cost of care form contains details of a partner not currently linked to the care recipient's record, and the partner has not signed the form, a Partner Details (MOD P) form is required. See Change in relationship status from single to partnered
• If a previous CAO assessment is within the last 12 months and is recorded on the TRCIAS screen, no further referral is needed

Is more information needed to finalise the RCA/HOM activity?

• Yes, and required information/documents have:
• not previously been asked for, go to Step 3
• previously been asked for, go to Step 5
• No, see Table 3

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?

• Yes, and
• only verbal confirmation is required, see Table 3
• supporting documentation is required, go to Step 4
• No, and the:
• outbound call was unsuccessful, go to Step 4
• supporting documentation is required, go to Step 4
• care recipient wants a written request for information, go to Step 4
• care recipient does not want to disclose their means, see Table 5

• Issue an aged care RFI letter, see Aged care letters - creating manual letters
• Use Fast Note - select Auto text, use Aged Care > Assessment > Progress of Aged Care Assessment with documents that have been requested
• Review the CAO Assessment Doc to make sure the most recent information is applied to the previous CAO assessment
• Complete a Complex Assessment Officer (CAO) referral (if needed)
• Place claim on hold allowing 21 days plus an allowance for the letter to be received for the care recipient to respond to the request
• Procedure ends here

Is it 21 days plus allow extra time for mail delivery since the RFI was issued to the care recipient?

• Yes, finalise the means assessment RCA/HOM activity , see Table 5
• No:
• Use Fast Note - select Auto text, use Aged Care > Assessment > Progress of Aged Care Assessment with any action taken
• hold the means assessment RCA/HOM activity for remainder of the 21 days plus an allowance to receive the notice

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:

• Number of Dependants Date of Event: DOV of means assessment
• Total Number of Dependants: enter number of dependent children

See the References page for a link to the Aged Care Act 1997 definition of a dependent child.

If the care recipient provides a new home address, telephone details or alternate names:

• Select the RCA/HOM activity from the Activity List (AL) screen
• Go to the Contact Detail Task Selector (CDTS) screen
• Select Customer Details to update alternate names on Customer Person Detail (CPD) screen. See Changing the Legal name of customers or their children
• Select Address to update the care recipient’s home address on the Address Details (AD) screen
• Update the contact number on the Telephone Details (TD) screen
• Update the email address on the Email Address (EMA) screen
• Check Office Code (OC) screen and change RCA back to home office

Update a postal address in Customer First when requested by:

• a care recipient
• a court appointed guardian or administrator
• a power of attorney (POA), or
• an existing Centrelink correspondence nominee, when the postal address is not the same as their own postal address

A postal address is not updated in Customer First when requested by:

• an existing Centrelink correspondence nominee, when the postal address is the same as their own postal address

For additional information on updating addresses (including postal) see:

• Updating address details
• Adding or rejecting a nominee request
• Aged care request for a nominee or executor
• Accepting information from and disclosing information to Power of Attorney

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:

• the DOV should include the date of the change as stated in supporting documents, and
• if further changes occurred, the date of receipt

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?

• Yes, go to Step 2
• No, go to Step 3

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:

• select the screens to update from Residential Care Task Selector (RCTS) screen, or
• manually go to them individually

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:

• Coding income and assets for Centrelink payments and services
• Financial Investments
• Exempt income and assets for Centrelink payments
• Assessing deprivation/gifting
• Foreign income and assets
• Income streams
• Aged Care means assessment with total assessable assets equal to or greater than $10,000,000 (an applicable assessable income)

Does the care recipient (or their partner) get any income from employment?

• Yes, and care recipient (or partner):
• receives an ISP, go to Step 4
• does not receive an ISP, go to Step 5
• No, go to Step 6

Employment income reporting requirements for a care recipient (or partner) in receipt of an ISP:

• Statement reporter
• have employment income
• must advise of income, hours worked and any other changes on their reporting day
• Notification reporter
• no employment income or stable employment income and exception is met
• must advise starting work or any changes within 14 days
• See Reporting overview

If this is the first time that the care recipient (or partner) is declaring income, see Recording and correcting employment income details.

Go to Step 6.

Care recipients not in receipt of an ISP:

• are not able to update their income each fortnight as a non-continuous frequency such as Income for One period (IOP)
• have their income assessed in the same way as a continuous income exception notification reporter
• income is coded as 1WE (weekly) or 2WE (fortnightly) if income is variable it will be averaged over a suitable period

See Determining the Date of Event for employment income for help coding income.

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:

• Yes, Go to Step 7
• No,
• Referral required to DVA Clearance Team
• Go to Payments from the Department of Veterans' Affairs (DVA) and referrals to the DVA Clearance Team for referral and Fast Note information
• Place the claim on hold for 5 days pending return
• Procedure ends here until DVA clearance team have completed coding

Update the Real Estate and Business (REBS) screen if the care recipient indicates:

• rental income for their own home or other real estate
• income from a business – sole trader or partnership
• an involvement in a Private Company or Private Trust (including Special Disability Trust)

Does the care recipient have income from any of the above?

• Yes, go to Step 8
• No, go to Step 11

Does the care recipient (or partner) receive rental income from real estate, including their principal home?

• Yes, go to Step 9
• No, go to Step 10

For help with coding rental income, see Assessing and coding the Real estate details Mod R and Income from boarders and lodgers.

• Add new property details:
• Update rental income
• Code asset value as $0
• For care recipients in receipt of a means tested ISP, issue a Real Estate details Mod R form (see the Resources page for a link to the form). See Requesting information (CLK)
• Update existing property details:
• Update rental income
• Do not change the previously coded asset value

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?

• Yes, code income only then, go to Step 11
• For sole trader business coding, see Sole traders
• For business partnership coding, see Partnerships
• No, go to Step 11

Does the care recipient have an interest in a private trust or private company?

• Yes, go to Step 12
• No, see Table 5

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?

• Yes, a new referral is not required, see Table 5
• No,
• See Trusts or Companies for details on documents needed and Complex Assessment Officer (CAO) referrals
• If a new referral is needed, see Identifying and making suitable referrals to the Complex Assessment Officer (CAO) for information on referring to a CAO for assessment
• Go to Step 13

• Use the CAO Referral guided procedure to complete in the RCA system
• Place the claim on hold for 28 days pending return from the CAO
• The CAO will document their assessment on the care recipient record
• The assessment may include coding instructions for the actioning Service Officer
• When the CAO assessment is complete, see Table 5

A pre-entry means assessment is rejected 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), or
• a care recipient withdraws their means assessment request

Is this claim being rejected or withdrawn?

• Yes, go to Step 5
• No, go to Step 2

Check the RCIRC screen fields are populated as below:

• DSS Require Income Details displays Yes
• Date of Effect displays the date of receipt (DOR) of the assessment
• Update the DOE if required

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:

• enter the date assessment was completed in the Reform Enquiry Means Test DOE field
• key ‘Y’ in the Reform Enquiry Means Test Ind field
• key ‘HOM’ in the Reform Enquiry Care Type field

Existing Reform Enquiry Means Test data prevents the above coding. In these cases:

• key ‘D’ to delete any previous and existing data
• press [ENTER]
• key ‘Y‘ to confirm deletion and
• prior to pressing [ENTER] key ‘RMND’ in the Nxt field
• press [ENTER]
• update the blank Reform Enquiry Means Test DOE entry
• the RMND screen may display 2 pages of data (DOR and date assessment completed), once completed

Is this assessment being finalised as means not disclosed (MND)?

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

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:

• ‘As you have elected not to disclose your means we are unable to issue you a letter until you start receiving care. You may need to negotiate the cost of your care directly with the service provider.’

Ensure the RCIRC screen fields DSS Require Income Details and Date of Effect (DOE) are populated as below:

• DSS Require Income Details field, key Yes
• Date of Effect field: enter date of receipt (DOR) of the assessment
• DOE, update if needed

Navigate to the RCA Means Test Details (RMND) screen within the RCA/HOM activity. Key the following:

• Upper section of RMND, key:
• Means Not Disclosed Date of Event field: DOR of the Aged Care calculation of your cost of care in the
• Means Not Disclosed Indicator field: 'Y'
• Lower section of RMND, key:
• Reform Enquiry Means Test DOE field: pre-populated, cannot update
• Reform Enquiry Means Test Ind field: 'Y'
• Reform Enquiry Care Type field: 'HOM'

Existing Reform Enquiry Means Test data prevents the above coding. To display a blank Reform Enquiry Means Test entry to update:

• key ‘D’ to delete data (current and historical)
• press [ENTER]
• key ‘Y’ to confirm deletion
• before pressing [ENTER], key ‘RMND’ in the Nxt field
• press [ENTER]
• complete details using correct date
• Use Fast Note - select Auto Text, use Aged Care > Assessment > HOM Care Assessment – FIN to document MND action taken

Go to Step 7.

If a care recipient is currently in care, the

• claim cannot be rejected
• the activity must be cancelled. A Fast Note is recorded and a Final Notification issued.

To reject the means assessment:

• key ‘S’ in the RCA/HOM activity
• go to the BA screen
• code the fields:
• Key ‘RCA’ in the SVC RSN field
• Key ‘REJ’ in the Action field
• Key ‘OTH’ in the Reason field
• Enter the Date of Event (DOV) in the Effect Date field
• Key ‘REJ-OTH RCA/HOM REJ – failed to provide information’ or ‘REJ-OTH Home Care pre-entry assessment withdrawn’ in the Notes field
• attach Fast Note to claim activity and finalise via AR:
• For Rejected claims. Use Fast Note - select Auto text, use Aged Care > Assessment > Aged Care MA Rejected-OTHER
• For Withdrawn claims. Use Fast Note - select Auto text, use Aged Care > Assessment > Aged Care means assessment Withdrawn
• issue a AC - Request Further Information - Final notification - CR-NM letter to care recipient and nominee.
• a letter is not issued for withdrawn claims
• scan and upload the aged care final notification to Customer First. The PDF file shows in the Document Tools tab

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.

When the RCA/HOM activity coding is complete, exit and attach a Fast Note to record the assessment outcome.

• Locate and open the Fast Note - select Auto Text, use Aged Care > Assessment > HOM Care Assessment – FIN to document the assessment outcome
• Complete the following fields:
• Who contacted: CUS - Customer or CSO - Customer Service Officer
• Service Reason: RCA
• Date of receipt: code today’s date
• Channel: select from drop down
• Source: select from drop down
• Link the Fast Note to the open RCA/HOM activity
• Complete the applicable Fast Note including all relevant details. For example:
• When a verbal assessment was completed with changes coded, read the verbal declaration and document that this was agreed to
• Document if an update was made that differs from the details lodged (for example a care recipient failed to provide bank account balances on the Aged Care - Calculation of your cost of care form but later provides a verbal balance)

When the Fast Note is complete:

• select (S) RCA/HOM activity from Activity List (AL) screen and navigate to the AR screen
• check the assessment results on AR
• The first ATH line and RCA Benefit line have a ‘Period End’ date equal to the date of event (DOV) of the assessment
• any arrears or overpayments calculated are correct (based on DOV and date of receipt (DOR))

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.

Determine if action is needed:

• Complete any progress of claim DOCs or scans
• Check if further action is needed on the partner’s record, including an outstanding RCA/HOM activity
• If the means assessment is completed verbally and there is not a nominee recorded, issue an Authorising a person or organisation to enquire or act on your behalf form (SS313)
• See also Adding or rejecting a nominee request
• 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)