How the ACFI changes will affect your facility in 2017

How the ACFI changes will affect your facility in 2017

A second round of ACFI changes will occur as of the 1st January 2017

This will be further changes to the complex health care scoring matrix and a reduction in points for some complex health care procedures (e.g. 4b treatments)

This now means:

  1. It will now be less common to achieve the highest rating in Q11 (Medication), and
  2. It will be more difficult to achieve each category within Q12 (Complex health)

Changes to the Scoring Matrix

The changes to the matrix will relate to there now only being 3 medication ratings:

* A-Claim – no assistance required

* B-Claim – assistance needed

* C-Claim – Injections

Changes to Scores & Eligibility Requirements for Complex Health Procedures

The following changes will occur:

* Q12.1 Blood pressure measurement will now be 1-point

* Q12.4a Complex pain management at least weekly for 20 mins will now be 2-points

* Q12.4b Complex pain management 4-days weekly now 120 mins and 4-points

* Q12.12 Tubigrip for arthritic joints and arthritic oedema now 1-point

Residents with an B-Claim in Medication

Due to the changes in the Medication rating system, an initial analysis indicates that over 97% of residents will now fall into this category.

Where there are residents with this medication claim and common combinations of complex health care procedures, these changes combined will have the following impact:


That is, for a complex health care procedure to contribute to a residents’ funding, in these scenarios the resident must have an assessed need for complex pain management by an allied health professional at least 4-days per week (Q12.4b)

In each of these scenarios, the contribution to the residents’ ACFI claim exceeds the cost of providing the service (despite the additional time requirements)

Minimising the Impact of these Changes

These changes only apply to new appraisals or reappraisals – appraisals that are submitted before January 1st will not be affected.

Click here for more information about an ACFI Complex Health Care Audit (Gap Analysis)

This will identify which residents in your facility you’re eligible to receive funding for now… But you’ll miss out on after January 1st