|Title:||Acute Care Certification|
|Document ID:||Operational Directive OD 0450/13|
|Date of issue:||Thursday, 29 August 2013|
|Description:||This OD details revised processes for the certification of ongoing acute care for long-stay inpatients in WA public hospitals.|
|Framework:||Purchasing and Resource Allocation Policy Framework|
|Period of effect:||from 1 July 2013 to 30 June 2018|
|Review date:||30 June 2018|
|Authorised by:||Professor Bryant Stokes, Acting Director General, Department of Health WA, 09-Aug-2013|
|Print version:||View print version|
Acute Care Certification
This directive defines the requirements for the completion of Acute Care Certificates (ACCs) by public hospitals in WA.
In April 2007 the Commonwealth Government repealed Section 3B of the Health Insurance Act 1973. This section underpinned the requirement to complete ACCs for long stay inpatients. In repealing Section 3B, the Commonwealth stipulated that delineation of care type (acute, maintenance, etc) was an issue to be resolved between hospitals and insurers. The Commonwealth version of the acute care certificate (the former ‘3B’ certificate) was withdrawn.
The requirement to accurately designate ‘care type’ under national data reporting obligations remains. In addition, the provisions for designating a patient as ‘Nursing Home Type’, after day 35 of continuous hospitalisation, are still in place.
To ensure consistency across WA public hospitals, the Department of Health has, since 2008, produced its own standardised ACC form.
C. REPORTING REQUIREMENTS
Hospitals must ensure that an ACC is provided for any patient (e.g. Public, Private Insured, Private Uninsured, Veterans’ Affairs, Overseas Visitor and Student) who remains in hospital after day 35, due to the need for ongoing acute care (this includes ‘Hospital in the Home’ (HITH) patients).
An ACC is not required for patients who, after day 35, remain in hospital for:
Patients who, after day 35, remain in hospital for maintenance care only, are deemed nursing home type patients (NHTP). Such patients are reclassified from acute to maintenance care. The hospital may raise the applicable NHTP charges.
Public and Veterans’ Affairs patients who, after day 35, remain in hospital for sub-acute care (e.g. rehabilitation, palliative care etc.) do not require an ACC.
Private patients (including Overseas Visitors & Students) who after day 35, remain in hospital for sub-acute care (e.g. rehabilitation, palliative care, etc), may require at the discretion of their insurer, provision of an ACC.
Some scenarios are provided in the attachments to assist in understanding the ACC requirement, along with a sample copy of the ACC.
Electronic copies of the ACC will be available via TOPAS and HCARe. The HCN generated version has been amended. The WA Health standardised ACC will be generated from the new billing system Patient Billing Revenue & Collection (PBRC).
It is recommended that all ACCs are filed in the patient’s medical record and copies stored centrally within the Health Corporate Network for future reference. The availability of ACCs will ensure the State’s compliance with various contractual obligations and assist with any inquiries from private health insurers.
Professor Bryant Stokes
This circular last updated: Thursday, 29 August 2013 at 10:14am