1. ACFI All questions regarding this presentation should be directed to Adrian Lambert, Business Analyst - Operations

2. 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

3. 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

4. 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

5. 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

6. 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?

7. 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

8. 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.

9. 2 Mobility Does resident have a walker?
Does resident have a history of falls?
Does the resident have hypertension?
Does the resident shuffle?

10. 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

11. 3 Personal Hygiene Any range of movement issues?
Does Client wear dirty/soiled clothes?
Can the Client put on own shoes and socks?

12. 4 Toileting Based on Assessed Care Needs
Only the specified activities to be taken into account in the appraisal

13. 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?

14. 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

15. 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

16. 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

17. 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

18. 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

19. 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

20. 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

21. 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

22. 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

23. 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

24. 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.

25. 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

26. Questions

27. 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

28. 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

29. 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