residential aged care - hostel and nursing home care

see also:

• aged care index
• home care for the elderly

• nursing homes generally have both high and low level care accommodation
• hostels are low level care accommodation

• 5 steps are required:
  • assessing eligibility via an Aged Care Assessment Team (ACAT) assessment (referred by local doctor or hospital) who can:
    • approve eligibility for entry into residential aged care, in either low level care or high level care;
    • give information about residential aged care and home care services in your area;
    • help arrange special respite care if needed; and
    • approve eligibility for a package of community care to help you continue living at home or refer you to other services that will help you to continue living at home.
  • finding a residential care facility
  • determination of costs
  • applying
  • moving in and settling in
• respite care is another potential option

• the Australian Government sets the maximum level of the daily fees and accommodation payments a resident can be asked to pay to the aged care home.
• a resident may be charged for the care and services provided, as follows:
  • Basic daily fee
    • as a contribution toward accommodation and costs of daily living.
    • the maximum basic daily fee for all permanent residents who first enter an aged care home on or after 20 September 2009 is 84% of the annual single basic age pension. This is also the maximum fee for all respite residents, excluding those receiving respite care on an extra service basis.
  • Income tested fee
    • as a contribution towards the costs of care.
    • only residents with total assessable income above the maximum income of a full pensioner are asked to pay an income tested fee
    • the applicable income tested fee payable is calculated at 5/12th of assessable income above the income tested fee threshold.
    • see information sheet
  • Accommodation payment
    • as a contribution towards capital accommodation costs.
    • the two types of accommodation payment are:
      • accommodation bonds if low level care
        • residents with sufficient assets who require low (hostel) level care or who enter an extra service place may be asked to pay a bond.
        • a resident cannot be charged a bond amount that would leave them with less than the minimum retained asset amount which is set the by government
        • the aged care home is able to retain a monthly amount from the bond for the first five years, and the balance of the bond is repaid to the resident or their estate when they leave the aged care home.
        • some facilities will repay the full bond amount however, may have clauses that this will not happen until 6 months following termination of care
        • bonds often start at $250,000, and thus often require the resident to sell their family home
      • accommodation charges if high level care
        • resident with sufficient assets who requires high (nursing home) level care (but not on an extra service basis) may be asked to pay an accommodation charge. Whether a resident requires high level care is determined at the time of entry to a permanent place by the evidence available at that time.
        • the maximum ammount payable is deetermined by the residents assets value but the actual amount can be negotiated lower.
        • financial hardship provisions are there for residents who would face genuine financial hardship if they were required to pay residential aged care fees and charges
  • Extra services charge
    • applies to residents occupying extra service places (both permanent and respite) for the provision of a significantly higher standard of accommodation services and food.
  • Additional service fee
    • where the resident requests or agrees to additional services (such as newspapers and hairdressing).

• income for aged care purposes is not the same as taxable income.
• income, for aged care purposes, includes:
  • income support payments from the Australian Government, such as the age pension, a service pension or an income support supplement;
  • deemed (ie. how much one “should” be earning from assets, not actual) income from financial investments;
  • net income from rental property (see below for concessional treatment for some residents);
  • war widow/widower pensions and some disability pensions;
  • net income from businesses, including farms;
  • superannuation and overseas pensions, income from income stream products such as annuities and allocated pensions;
  • family trust distributions or dividends from private company shares; and
  • deemed income from excess gifting.
• rental income from the former home will be exempt in full from the pension income test and for aged care fees while they are paying the accommodation charge or paying an accommodation bond by periodic payment;
• the value of the home will be exempt from the pension asset test while they are paying the accommodation charge or paying an accommodation bond by periodic payment.