ACFI All 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 form New directives forms 3/4a/4b claims – does Client have any pain, would Client benefit from3 4a/4b, would Client accept massage, heat pack or physiotherapy 12 - does Client have diagnosis and would Client accept tubigrip, ted stockings etc.. To couple 4a & 12 claim a diagnosis of arthritis should be in place No IRT fee for low care physiotherapy You 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