What is ACFI and how does it affect my care?

Key points

• ACFI is funding from the Government for aged care facilities to provide you with care
• A lot of assessment and reports are required when an aged care home is applying to receive ACFI funding
• The Royal Commission into Aged Care Quality and Safety is looking into whether ACFI funding needs to change

How it works

The Aged Care Funding Instrument (ACFI) is a tool used to measure how much subsidy a residential aged care facility receives to cover the cost of care for each resident.

Every resident is assessed on the level of care they require, their daily living activities, behaviour and complex health care needs.

The ACFI mainly focusses on your day-to day care in a nursing home and the frequency of care you require.

Things that can be included in an ACFI assessment are continence, mobility, nutrition, personal hygiene, toileting, cognitive ability, wandering, verbal behaviour, physical behaviour, depression, medication, and complex health care.

Using ACFI criteria, a resident will be categorised as either low or high care.

There are a number of other paperwork hurdles the aged care facility needs to organise to receive funding from the Government for a resident’s care.

Depending on the assessment of residents, the Federal Government provides an allocated subsidy to the aged care provider to deliver care to a resident.

It is important to know that the ACFI payment does not go to an individual resident, but is allocated to the aged care facility to provide you care.

If your needs change, your aged care facility can reassess you for ACFI, for example if you require a new form of care, or if you require a higher classification, such as if you become a high or complex care resident.

The Federal Government describes ACFI as essentially a “resource allocation instrument”.

Aged care organisations are required to keep all ACFI records for up to three years after permanent care finishes for a care recipient.

Who handles ACFI?

A range of care staff can undertake ACFI assessments, this could include nurses or care coordinators.

Some facilities may even have ACFI focussed staff to handle the assessments of all the residents they have in the nursing home.

Alternatively, some facilities hire consultant contractors to undertake the ACFI assessment workload and requirements for them.

Royal Commission looking into the success of ACFI

ACFI had changes in 2017, resulting in the downgrading of ACFI claims. A report from the Federal Government shows that 43.2 percent of ACFI claims were downgraded.

According to Dementia Australia, ACFI downgrading has resulted in under-funded care homes who still need to provide the level of care but without the appropriate subsidy.

They also say it has resulted in homes not taking on residents who may have complex care needs because they won’t receive appropriate Government subsidies while these residents are in their care.

An additional problem pointed out during the Tasmania hearings for the Royal Commission into Aged Care Quality and Safety is that ACFI doesn’t go to individual residents through the aged care provider, but actually goes into a pool of money and the aged care provider decides how to spend the funds.

The Commissioners were sceptical about whether or not providers whether their funding requests were accurately reflecting the needs of their residents.

The interim report says, “We will consider whether the current ACFI system incentivises approved providers to overstate the care needs of their residents in order to receive a greater level of funding as part of our broader work on funding in the aged care system.”

What do you think about the way funding is allocated? Let us know down below.

Related content –

Introduction to Nursing Homes
Assessment and finding a home
Daily living in a nursing home