Click here for more information about How dementia changes the way you hear the world, By Michael Mackenzie, 16 November 2017
Click here for more information about The Gardens Gazette 3rd Quarter 2017
Click here for more information about The Gardens Gazette 2nd Quarter 2017
Click here for more information about Budget: Funding for aged care workforce measures – By Darragh O’Keeffe on 10 May, 2017
Click here for more information about Aged care Budget Review 2016–17 – Alex Grove and Anna Dunkley on 10 May, 2017
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Asset test for aged pension should include family home, Australian Chamber of Commerce By Peter Ryan, ABC
Click here for more information about Rads lag against rising value of property prices
As we approach the Winter months, Kew Gardens Aged Care will be planning the provision of pneumococcal and/or flu vaccines to our residents and staff. However, we have been recently advised by our Doctors at Kew Gardens that there is an unusual strain of influenza present in the USA. As a consequence, the vaccines to Australia have been slightly delayed until April. When they do arrive, we will commence the Vaccination programme for our Residents (and staff who wish to have it), as per usual.For more information on influenza and remedies, please visit http://www.betterhealth.vic.gov.au/bhcv2/bhcarticles.nsf/pages/Flu_influenza
We had the pleasure of having a private viewing of government house last week which proved to be a most wonderful tour.
Residents felt honoured to be in the inner sanctum and were in awe of the magnificent ballroom and original fixtures and fittings.
We were given a history of government house and viewed the prominent governors and their wives down through the ages to our current governor His Excellency Sir Alex Chernov and his wife, Elizabeth.
We also viewed the famous billiard room where Robert Lindum played.
We finished our day continuing onto the Royce hotel where we dined on fine wines and delicious food.
A wonderful day had by all.
Kew Gardens Aged Care
I had the pleasure of taking 12 residents to a ‘Christmas in July’ luncheon at the Sky High Restaurant, Mt. Dandenong.
Although this was set in winter, we were blessed on leaving Kew Gardens with beautiful sunshine, although we all still donned our coats and scarves.
Our journey from Kew Gardens to the Dandenongs was relaxing with music filtering through the bus and the scenery with the sun coming through the bus windows was quite magical. All residents were in good spirits and very much looking forward to the day’s outing.
As we made our way up the hills, we had a few light showers but on arrival at the restaurant the sun shone in our favour.
We were seated in the Restaurant by the window with beautiful views although due to the cold, we could not see the city clearly. It was lovely that feeling of being amongst the clouds.
We enjoyed a traditional Christmas lunch, turkey, ham cranberry sauce followed by plum pudding and custard. We also shared our bon bons, wore our party hats and partook of beautiful wines offered to us. Many memorable photos were taken.
We were serenaded throughout the lunch by a pianist playing many old songs, Christmas songs and it was lovely background music to a perfect day.
On returning to Kew Gardens, with high spirits, full stomachs and big smiles, the residents delighted in the outing and were happy to retire to their rooms for some down time.
A most successful day.
Kew Gardens Aged Care
A small number of aged care providers will not be able to charge an accommodation payment to new residents from 1 July because they are yet to publish their pricing information on the My Aged Care website.
Changes to aged and disability care dominate a long list of federal policy changes to kick on from July 1.
Older Australians are handing over million-dollar bonds to spend their final years at some of the nation’s most lavish aged care centres.
The Australian Government is redirecting $1.5 billion from the Aged Care Workforce Supplement into the general pool of aged care funding.
A message from the Aged Care Pricing Commissioner on issues raised during public consultation on the draft Application Form and Application Guide for accommodation prices that are above the maximum amount determined by the Minister.I would like to thank those who have responded to the invitation for comments on the draft Application Form and Application Guide for accommodation prices that are above the maximum amount determined by the Minister. A number of the changes that have been made to the Application Form and Application Guide are set out below. In addition, the submissions received highlighted a number of areas where further clarification would be beneficial, and these are also set out below. Where issues raised relate to matters that are within the purview of the Department of Social Services or the Minister, those issues will be communicated to the Department. In particular, I would like to clarify the following points:
Grandfathering of existing arrangementsAmendments to the Aged Care Act 1997 which commence on 1 July 2014 allow for the ‘grandfathering’ of agreements to pay accommodation payments entered into with residents before 1 July 2014. In particular, from 1 July 2014, the Aged Care Act introduces the concept of ‘continuing residential care recipients’. Generally speaking, continuing residential care recipients are individuals who entered residential care before 1 July 2014 without a break in residential care for more than 28 days in a row. However, this ‘grandfathering’ does not apply to agreements to pay accommodation payments that are entered into with residents on or after 1 July 2014. Where providers seek to enter into agreements on or after 1 July 2014 which involve charging residents more than $550,000 as a Refundable Accommodation Deposit (RAD), or its equivalent as a Daily Accommodation Payment (DAP), they must have approval from the Aged Care Pricing Commissioner. In the event that providers do not have this approval, they will not be able to charge more than $550,000.
I strongly encourage providers who seek to charge prices above this amount in new arrangements after 1 July 2014 to make an application shortly.The arrangements for existing residents continue under their existing provisions, unless the resident re-enters care after leaving care for a period of 28 days or more, or if they move aged care homes and decide to enter under the new arrangements. This is not a decision at the discretion of the Pricing Commissioner, but is a legislative requirement of the Aged Care Act.
Approval of maximum priceWhere providers seek and obtain approval to charge a price for a group of rooms that is above the threshold, this price is the maximum price that can be charged only. It does not limit the provider from charging prices below that maximum, at their discretion.
TimeframesA number of submissions drew attention to the statutory timeframes applying to the consideration of applications. It is my intention that the actual time taken to consider applications will be a great deal shorter than the statutory limits. In particular, I acknowledge that in many instances notification will be required within a short timeframe. The application process allows an applicant to nominate a critical date by which notification is required. For example, a critical date may be necessary for an application that relates to a proposed facility which requires an approval to secure finance or to acquire land. In a previous exposure draft of the Fees and Payments Principles, applicants were not able to make a new application to the Pricing Commissioner (following either an approval or a refusal to approve) within a 12 month period of a previous decision. Given the difficulty that this may have presented to providers, I have asked, that this timeframe be reduced to 4 months.
Re-applyingWhile providers will be given approval to charge prices above the threshold for a four year period, this does not limit their ability to re-apply within that four year period. Provided that an application is made four months after the date of an original decision, a provider may re-apply at any time. If approval is given for a new price, providers do not have to wait for the expiry of the previous approval period to charge that price. Accordingly, should particular business factors emerge which influence pricing, including price indexation, applicants are able to reapply after a period of 4 months from the previous decision. The proposed four year approval period is not at the discretion of the Commissioner, but is a requirement under the draft Fees and Payments Principles 2014. While approvals will be given for a four year period at this time, and it is envisaged that this four year approval period will apply in the future, I will ensure a streamlined approach for subsequent approvals is provided. Where an initial approval has been given, and where there have been no substantial material changes to the condition of rooms to which prices above the threshold are proposed to apply then a simple certification process will be established.
Publishing of pricesProviders are reminded that the date on which approved prices should be published from is 19 May 2014. This date has been revised from earlier requirements that prices be published by 1 April 2014, in order to provide additional preparation time for providers while still allowing some time for adjustment to the new regime before 1 July 2014.
Cost of supply and financial informationWhile some submissions questioned the need for seeking cost and financial information, others have welcomed the opportunity to explain their business models and the impact of cost and financial elements on their proposed pricing. In these circumstances, and given the opportunity for applicants to explain their proposed pricing in a way that is as non-prescriptive as possible while still allowing for consistency in assessment, I see this approach as having an overall benefit. In using this information as one factor for consideration (and not as the only factor for consideration), assessment by the Pricing Commissioner is not undertaken to query substantiated costs or to set parameters in a way which interferes with the market or sets artificial parameters that do not relate to market conditions, but to understand the significance of cost and financial considerations and other business imperatives as they apply to pricing. I reiterate that any information submitted by providers will be held confidentially by the Office of the Aged Care Pricing Commissioner, and will not be shared with another person or agency.
External reference informationWhere references are made to external reference information, this includes but is not limited to data on median house prices by locality and provider bond levels in geographical regions. This is not information that providers are expected to include. This information will not be used in a deterministic manner, but is one factor that the Commissioner may have regard to in making a decision.
AssessmentA copy of the Aged Care Pricing Commissioner’s Assessor Manual will be published shortly on the website at www.acpc.gov.au While the Application Guide should contain all information required for applicants to complete the Application Form, reference to the Assessor Manual will give providers further information about how applications will be assessed.
Specific issuesThe following issues raised will be reflected in the final versions of the Form and Guide.
Risk marginsThe Guide contains reference to risk margins, where relevant, at s 3.2.1. This section intends to capture all relevant factors influencing a proposed price. This could, for example, be relevant in respect of the risk in operating in a certain geographic location, or where a provider engages with any other particular risk in establishing or maintaining a facility.
ValuationsThe Guide indicates that in the case of applications for prices in existing facilities, applicants should include information relating to land and/or building valuation. An exception may be made where the applicant is a not-for-profit provider who is entitled, for accounting purposes, to prepare financial statements according to the historical cost convention (cost less depreciation and impairment). In this instance, applicants should provide a statement of land and building value as reflected in financial statements. In seeking valuations, the intention has been to derive cost information that would be generally available to applicants without incurring substantial additional cost or onerous requirements, but which would still allow applicants sufficient scope to justify their proposed price. Accordingly, it has been assumed based on advice that valuations will have been obtained for normal business purposes in a significant number of cases. Where not-for-profit applicants are of the view that the historical cost convention will disadvantage them, an insured value may be provided. Alternatively, applicants may obtain a valuation. In general, it has been recognised that there will be a degree of variance in costs of supply for existing facilities, proposed refurbished facilities and proposed new facilities, and that particular cost factors may have more relevance in particular applications, in the same way as different capital structures and business models are of relevance. In particular, valuations for existing facilities may have a lesser degree of relevance in some cases. For this reason, historical bond prices and median house prices by Local Government Area are additional factors for the Commissioner to consider.
Proposed price and cost considerationsA number of submissions have queried whether particular costs can be included as part of the justification for a proposed price. In simple terms, these factors should be included where they are a relevant factor in the proposed accommodation price, and where they are not provided for by another source of revenue or, for example, are care and services provided for in the Quality of Care Principles. This may include, for example, a proportion of centralised services (such as human resources or information technology), and facilities that are relevant to the activities of residents. In a similar way, where areas such as gardens have a particular cost or are of significance in determining the proposed price, these may be included for consideration. It is reiterated that, while the Commissioner seeks cost of supply information where relevant, an assessment of the degree to which the proposed price is reflective of cost is one consideration amongst a number.
Applications for multiple room configurationsIt is observed that in some cases rooms may be offered in a range of configurations in different circumstances i.e. where a room (or an interconnected set of rooms) may be offered as a double room in some circumstances, or a room for a single occupant in others. Some configurations may not require approval because the maximum accommodation payment amount will be below the threshold. However, where different possible configurations mean that an applicant wishes to seek more than one approval for a price above the threshold for the same room, depending upon the configuration, different configurations should be treated as different accommodation groups for the purpose of the application. The Guide at 1.8 has been amended to reflect this.
Total floor areaThe requirement to provide the total floor area of the accommodation group has been removed from the Form.
Description of common areasTo ensure there is no duplication, the requirement to “describe” the common areas at Table A.1 (v) has been amended.
LocationThe requirement to provide a description of the location of the accommodation group in the facility has been removed from Table A.1. However, applicants should include enough information for the Commissioner to identify rooms in the accommodation group.
Information and Communications TechnologyThe Guide will be amended to indicate that ICT facilities, whether included in the room or in accessible areas, may be included as part of a justification for a price.
FormatA number of headings have been revised to ensure there is congruency between the Form and Guide.
Attachments and word limitsBusiness cases or extracts from relevant documents can be attached to the form in addition to the 2000 words provided for at Table 2.1. The provision of documents such as floor plans for the relevant accommodation group, while not a requirement, will obviously enable applicants in many cases to further support their proposed price and to ensure that applications are dealt with in a timely manner. Provision of information in this manner will also remove the requirement for applicants to supply this information in the body of the Application Form. Where provided, these documents or images should be supplied at the same time as the completed Application Form (but not included in the body of the Form itself). I have very much appreciated the feedback and look forward to ongoing consultation with industry. Yours faithfully, Kim Cull Aged Care Pricing Commissioner
- Service Type reviews Quality reviews involve an assessment of the policies, systems and procedures that a service provider has in place at each of its outlets to ensure it is providing care and services in accordance with the Horne Care Standards (the Standards) across all the service types delivered. Service providers need to demonstrate that they have rigorous systems and processes in place which meet the Standards across all service types, regardless of the type of care being delivered. The quality of care should be consistent across all service types.For large service providers, Standard 1 is reviewed in detail at the first service outlet. The service provider is required to give the quality review team evidence demonstrating that each expected outcome has been met. The results from the first service outlet are then tested at subsequent outlets.Standards 2 and 3 are thoroughly reviewed at all service outlets. Assessment of the evidence provided by the service outlets focuses on confirming the delivery of quality outcomes for care recipients. This is supported by interviews with staff and care recipients and/or their families.Adopting this approach means that if the evidence is satisfactory, and systems and processes are in place at the first service outlet, it will be evidenced at any additional outlets. This allows for a risk-based approach to quality monitoring.
- Interim and Final Quality Review Report
A number of changes have been made to the Quality Review Report (QRR) throughout the streamlining process.
- The QRR now contains a Met or Not Met finding for each expected outcome, accompanied by a Statement of Reasons for the finding, supported by evidence. The Statement of Reasons aims to clearly establish the findings, reference material on which the findings were based and the reason for the decision.
- An interim QRR gives service outlets an opportunity to see the preliminary findings of the quality review. It details the findings within a Statement of Reasons. On receiving the interim QRR, service providers have 14 calendar days to submit evidence, or reference existing evidence that may support the reconsideration of a Not Met finding.
- Service providers that receive one or more Not Met findings are placed on a Timetable
- For Improvement (TFI). The TFI provides a time frame for action, generally 12 weeks. These service providers are required to update their Plan for Continuous Improvement (PCI) with activities to be undertaken to rectify Not Met expected outcomes. The service provider has 14 calendar days to identify appropriate actions. When the actions are approved, the 12-week period starts.
- Outcome Score The outcome score (ie. Outcome 1, 2 or 3), which reflected the level of compliance with the Standards, has been removed from the QRR. The findings of a review now reflect the Met or Not Met outcomes supported by evidence, rather than an overall outcome score.
- Plan for Continuous Improvement Service providers are no longer required to submit an Annual Improvement Plan. Instead, service provides will continue to develop and maintain their PCI throughout the three-year review cycle to demonstrate compliance with the Standards. The Department may request a service provider’s PCI at any time during the review cycle.The PCI will need to be updated to include strategies and treatments to rectify any Not Met expected outcomes that may be identified in the Final QRR.