ACFIAll questions regarding this presentation should be directed

to Adrian Lambert, Business Analyst - Operations

Overview

12 ACFI Questions

Client Dashboard to be Used

Each Client to be reviewed at least annually

ACFI Committee in place

ACFI Summary page forms part of ACFI pack

Overview

Client transfer on an RCS rate requires compulsory ACFI

The ACFI for a Client on the RCS rate must increase by $15 or do not submit

Measures usual assessed care need and not care provided

Focuses on current diagnosis

Overview

3 streams of funding – ADL’s, Behaviours and CHC

Each have four funding levels – High, Medium, Low and Nil.

Late ACFI’s have funding reduced by $25 per day

Overview

ACFI completion to be reflective of IRT core values – Integrity, Respect, Trust

Respect privacy of Clients when completing ACFI’s – close office doors etc..

If Client separates prior to ACFI being submitted the ACFI can be completed but only based on documentation already obtained

IRT Documentation being reviewed eg Mobility

1 Nutrition

Based on Assessed Care Needs

Only the specified activities to be taken into account in the appraisal

Ask – what assessed care need would be identified to be provided if the Client was not resistive?

1 Nutrition

For a Client that is vision impaired and a lip plate is provided – this is regarded as part of normal setting up of cutlery and cannot be claimed under readiness to eat

2 Mobility

Based on Assessed Care Needs

Only the specified activities to be taken into account in the appraisal

Link diagnosis to assessment

Transfers to/from shower Chair sometimes overlooked.

2 Mobility

Does resident have a walker?

Does resident have a history of falls?

Does the resident have hypertension?

Does the resident shuffle?

3 Personal Hygiene

Based on Assessed Care Needs

Only the specified activities to be taken into account in the appraisal except for Grooming

Grooming includes dental care, hair care, shaving as well as hearing aids, deodorant and make-up

3 Personal Hygiene

Any range of movement issues?

Does Client wear dirty/soiled clothes?

Can the Client put on own shoes and socks?

4 Toileting

Based on Assessed Care Needs

Only the specified activities to be taken into account in the appraisal

4 Toileting

If resident has an assessed care need for personal hygiene there should be a similar physical assist claim for adjusting clothing and wiping

If resident is prone to UTI’s, what is the cause?

5 Continence

Only the specified activities to be taken into account in the appraisal

To claim scheduled toileting you must provide documentary evidence of incontinence prior to the implementation of the intervention

6 Cognition

PAS to be current within 6 months and continue to reflect the care needs of the Client

Validator can redo PAS because cognition rarely improves

7 Wandering Behaviour

Behaviour Chart to be current within 6 months and continue to reflect the care needs of the Client

Behaviour chart to be signed and dated

Behaviour extra description to be completed and should not relate to an unmet need

7 Wandering Behaviour

Behaviours to be coded correctly

Daily episodes to be tallied

All behavioural symptoms must disrupt others to the extent of requiring staff assistance to be able to be claimed

8 Verbal Behaviour

Behaviour Chart to be current within 6 months and continue to reflect the care needs of the Client

Behaviour chart to be signed and dated

Behaviour extra description to be completed and should not relate to an unmet need

8 Verbal Behaviour

Behaviours to be coded correctly

Daily episodes to be tallied

All behavioural symptoms must disrupt others to the extent of requiring staff assistance to be able to be claimed

9 Physical Behaviour

Behaviour Chart to be current within 6 months and continue to reflect the care needs of the Client

Behaviour chart to be signed and dated

Behaviour extra description to be completed and should not relate to an unmet need

9 Physical Behaviour

Behaviours to be coded correctly

Daily episodes to be tallied

All behavioural symptoms must disrupt others to the extent of requiring staff assistance to be able to be claimed

10 Depression

CSD to be current within 6 months and continue to reflect the care needs of the Client

Depression diagnosis required for claiming a C or D rating

11 Medication

New medication timing form

Time taken excludes preparation of medications and includes medication refusal time

Medications include tablets except PRN, puffers, nebulisors, medicated drinks, eye drops, medicated creams

11 Medication

Medications exclude food supplements and emollients eg sorbolene cream

A copy of the medication chart to be included in the ACFI pack

Medication rounds applicable are to be circled as part of ACFI 11, Page 9 of application.

12 Complex Health Care

New medication timing formNew directives forms3/4a/4b claims – does Client have any pain, would Client benefit from3 4a/4b, would Client accept massage, heat pack or physiotherapy12 - does Client have diagnosis and would Client accept tubigrip, ted stockings etc..To couple 4a & 12 claim a diagnosis of arthritis should be in placeNo IRT fee for low care physiotherapyYou cannot claim for multiple chronic wounds

Questions

Validation Training - Congruence

Mobility Claim v Wandering Claim v Repositioning Claim

Depression Anxiety Score v Anxiety Behaviours Claimed

PAS Score v Personal Hygiene Claims unless a physical diagnosis accounts for ACFI 3 Assistance

Medications v Resident Diagnosis

Validation Training - Congruence

The times of Behaviours on the Behaviour Charts are checked against the normal time the activity occurs eg spitting at meal times or refusal to shower at shower times

Other Information

ACFI Application for Classification as well as the ACFI Summary page form part of the ACFI pack

Signature logs to be kept up to date

A general observation is that most behaviours occur Monday to Friday day shift rather than afternoon/night/weekends