W&L ACFI Specialised Registered Nurse

Maximising ACFI claims is part of our core business and Wellness & Lifestyles now has specialised resitered nurses to help us and your facility with this process!

Wellness & Lifestyles Australia has identified that residents at aged care facilities rarely receive the interventions that are clinically indicated.  Either this, or the residents are receiving the interventions but the site is not receiving remuneration for their costs.  The implementation of the ACFI however has lead to a unique situation where, if documented correctly, a resident can receive the interventions and the site’s funding increases to a point greater than the cost of providing the service.

By adopting an approach where we work closely with the nursing staff, especially those involved in the ACFI process, we have often been able to identify residents whose funding does not match their needs.  In some facilities this has led to increases in funding of several hundred thousand dollars per year.  In other sites, the site staff are so busy with their clinical caseload that they just can’t find the time to perform resident reappraisals.

Wellness & Lifestyles Australia has now developed a system where we can help facilities through the re-appraisal process, to access the funding available to the facilities:

INITIAL MEETING: By meeting with key clinical staff on-site and reviewing some basic information, we will be able to quickly determine whether or not implementing this process would be feasible for your facility.

There would be no cost for this meeting, and it is obligation free.

SYSTEM REVIEW: In order to establish what current systems are in place in order to more effectively target the reappraisal process, this involves a meeting with key site staff regarding:

• Current documentation systems
• Current ACFI scheduled review plan
• Care plan evaluation process
• Appraisal/reappraisal process
• Cost analysis of projected financial outcomes

IMPLEMENTATION: After the system review, a reappraisal process is implemented which resembles:

Resident Identification
↓
Residents’ Case Conferencing
↓
Evaluation of Current Evidence/Assessments
↓
Individual Resident Cost Analysis/Calculation (to determine individual resident feasibility)
↓
Care Plan Review & Evidence Collation
↓
Reappraisal

This process ensures care plans are developed to match the appraisal packs for validation and accreditation purposes, and that only those residents where it will be deemed financially viable will have the actual ACFI reappraisal initiated.

As part of the service we will help you train your staff to do this too!

OUTCOMES: If we could only help you reappraise six residents so their funding matched their clinical needs, an example of the financial outcomes could be:

LML to MML = $35.08/day                 LNH to MNH = $35.08/day
LNL to MLM = $66.66/day                 MHL to MHH = $41.72/day
NLL to LLM = $54.55/day                  HLL to HLM = $24.77/day

If you have just six residents in your facility that look like this, this is an increase of funding for services you’re already providing of just under $100,000 per year! Every day you wait could be costing your facility hundreds of dollars per day… imagine if you had more than 10 residents waiting to be reappraised?

How many residents do you have in your facility awaiting reappraisal?

For more information on how we can help your facility, please call Wellness & Lifestyles Australia on (08) 8331 3000.