Check for valid approval before admitting a resident
When is an ACAT assessment needed?
An Aged Care Assessment Team (ACAT) assessment is required if the care recipient needs aged care that is funded by the Australian Government:
- residential care
- flexible care in the form of transition care or short-term restorative care
- residential respite care
- home care.
An ACAT approval is not required when the care recipient enters into flexible care other than transition care or short-term restorative care services.
Valid ACAT approval
Approved providers must check that the care recipient has a current approval for the care type and level they will be providing when a care recipient:
- moves from one service to another
- changes their care type
- needs a higher level of care
- has a time limit on their approval
- has a break in care.
A provider cannot receive subsidy for a day where a resident does not have valid ACAT approval for the care type received.
Aged care services that use the Department of Human Services (DHS) Medicare Aged Care Online Gateway should check if a potential care recipient’s approval is valid.
Residential Respite Allowance
Where a care recipient is accessing residential respite, providers are responsible for checking care recipients’ remaining respite care allowances. Providers can check this allowance with DHS.
No current approval
Where a person does not have a current approval for a care type they require under the Act, the person or provider (on their behalf) should contact the My Aged Care contact centre on 1800 200 422 to arrange a referral for a new assessment.
Emergency Case Application
An approved provider under the Aged Care Act 1997 can make an emergency case application for a person without an ACAT approval where the person urgently needed the care and it was not practical to apply for the approval beforehand.
If a person urgently enters residential care, residential respite or starts receiving short-term restorative care or flexible care services care without an approval, the provider must complete the Emergency Case section of the Application for Care form. The updated Application for Care form is found in the My Aged Care Provider Portal (in the Forms page of the ‘Reports and Documents’ tab) or under ‘Resources’ on the Information for service providers webpage.
The provider must ensure the ACAT receives the form within five business days of the date of the person’s care.
Following the assessment, the ACAT delegate is required to approve or not approve the person’s eligibility for the care and the emergency situation. If the ACAT delegate approves, the date of effect of the approval can start on the date the person started care. The delegate enters this date on the client record through the My Aged Care assessor portal. This information is sent to the DHS payment systems to ensure the provider can receive the Commonwealth subsidy from the date of the emergency care.
If it is impossible for the provider to submit the form to the ACAT within the five business days, the provider may write to the Secretary of the Department of Health requesting an extension. The Secretary has the power to grant or reject the extension application. Write to:
Department of Health
Attn: Aged Care Assessment Programme
GPO Box 9848
SYDNEY NSW 2001
Note that for home care, completion of the form may enable an earlier approval date to be applied for the person. However, a home care provider will not be eligible to receive a home care subsidy until a person has been assigned a home care package through My Aged Care.