General Medical issues thread

[TheRealTMA]

Not great news

Healthscope collapses into receivership

Australia's second-largest private hospital operator, which runs 37 hospitals across the country and employs about 19,000 people, has appointed receivers.

www.abc.net.au

Inevitable outcome of venture capital group stripping assets for profit it seems. Been coming for sometime apparently.

 

[Quickstatus]

Inevitable outcome of venture capital group stripping assets for profit it seem

i think there was asset stripping. Brookfield bought with a lot of debt then sold off some assets and then entered into lease agreements.
The Govt (Federal and NSW0 have said they will not bail out private equity. So it seems they will take a massive haircut. i hope the Govt does not blink.

Note that not for profit operators may be in a better position to buy it because they dont have to pay payroll tax. But some in the industry have suggested that there are too many small private hospitals, and that there is now a period of consolidation. Ramsay health can't buy because of their dominant position vis-vis ACCC. There is sometalk of a private health fund buying parts - ? managed care ?

As for Northern Beaches Hopsital, I suspect the NSW Govt will be the owner operator

 

[JohnK]

Thanks @andye, @love_the_life and @Quickstatus.

I think dad is already on Home Care package level 4 and he could get an hour or so help in morning and evening. He does not need to go on waitlist. From what we understand he has unused funds so this could begin immediately. The only problem is dad may need more and brother and mum cannot really assist.

At some point we need to look at full time aged care and they've been advised that he can go on waitlist but could take a long time. Mum and dad have no income other than pension. Mum will still live at home. We have to find option with 0% RAD. My brother and I do not want to end up owing any money for RAD where we have to sell home to pay funds. I don't know if this option exists.

From what I understand once we've decided what we want to do then Home Care will take up the next steps for us. I think best we leave to them to see what they'll offer or at least what options we have available.

I've already had a quick look at private aged care without assistance and it's $70,000 - $100,000 a year without assistance or $500,000+ RAD and then $30,000 - $60,000 a year. They cannot afford.

 

[Quickstatus]

I've already had a quick look at private aged care without assistance and it's $70,000 - $100,000 a year without assistance or $500,000+ RAD and then $30,000 - $60,000 a year. They cannot afford.

@JohnK
I'm not sure you understand.

I think all aged care in Australia are privately run.

If your dad is only on the pension with no other assets, then the only payment is the 85% of the aged pension, the govt pays the accomodation costs.

There is a wait list for everyone regardless of Means and aged care providers cannot discriminate on the basis of means.

All aged care providers take people with 0% RAD. Your father's financial situation only affects the amount he pays, NOT access to aged care. Though the wait list may be longer for a specific facility if there are a lot of people who can't pay RAD waiting for that specific facility.

The most important thing is to get the Means Assessment done first before checking out aged care facilities

 

[JohnK]

@JohnK
I'm not sure you understand.

I think all aged care in Australia are privately run.

If your dad is only on the pension with no other assets, then the only payment is the 85% of the aged pension, the govt pays the accomodation costs.

There is a wait list for everyone regardless of Means and aged care providers cannot discriminate on the basis of means.

I've been trying to understand but boy its hard.

If we want aged care now without government funding then we have to pay? That's very expensive.

If we want to wait for government funding, yes do the means assessment and its still a longer waitlist. Mum and dad have nothing other than family home.

I'll head to Sydney next week for a day and discuss with mum and brother. We'll have to see if level 4 home care is enough. Dad may start moving again once he's home. At the moment he's doing nothing because nurses doing everything for him.

Thanks for your patience.

 

[andye]

I've been trying to understand but boy its hard.

If we want aged care now without government funding then we have to pay? That's very expensive.

If we want to wait for government funding, yes do the means assessment and its still a longer waitlist. Mum and dad have nothing other than family home.

I'll head to Sydney next week for a day and discuss with mum and brother. We'll have to see if level 4 home care is enough. Dad may start moving again once he's home. At the moment he's doing nothing because nurses doing everything for him.

Thanks for your patience.

My understanding is that if a spouse is still living in the home, it doesn't count as an asset towards means-testing for government-funded nursing home funding.

 

[Quickstatus]

If we want aged care now without government funding then we have to pay? That's very expensive.

No. Even if there was cash equivalent to 100% RAD in the bank you still have to do the Means assessment. Aged care will generally not accept an application without that.

If we want to wait for government funding

There is no wait for government funding. You have to do the means assessment. Once that's done, Services Australia determines how much your father pay - likely nothing except 85% of aged pension. His application must include the Means assessment. Once a spot is offered to your father, the subsidies will be paid by the govt - there is NO waiting for funding.

Everyone including those with 100% RAD is waitlisted according to need not financial means. However there might a longer wait for a specific facility has too many low means patients. All aged care facilities must have a certain number of patients with low means (except for some places called extra services facilities which are not funded by govt at all) . Some facilities must have up to 40% low means patients.

it doesn't count as an asset towards means-testing for nursing home funding

Correct - see my post #11440 above about this

@JohnK just do the Means assessment first. Then look for suitable aged care facilities. They will help you from there. Also please use the my aged care website - as suggested by @love_the_life upthread. It's a valuable resource.

We have just done the above for my mother.

Also it sounds like your father is still in hospital. In that case (as suggested by @love_the_life ) the hospital social workers will be able to assist in this process. They are invaluable. Generally when a patient is in hospital they are a higher priority for an aged care place - whatever their financial means

 

[love_the_life]

No. Even if there was cash equivalent to 100% RAD in the bank you still have to do the Means assessment. Aged care will generally not accept an application without that.


There is no wait for government funding. You have to do the means assessment. Once that's done, Services Australia determines how much your father pay - likely nothing except 85% of aged pension. His application must include the Means assessment. Once a spot is offered to your father, the subsidies will be paid by the govt - there is NO waiting for funding.

Everyone including those with 100% RAD is waitlisted according to need not financial means. However there might a longer wait for a specific facility has too many low means patients. All aged care facilities must have a certain number of patients with low means (except for some places called extra services facilities which are not funded by govt at all) . Some facilities must have up to 40% low means patients.

Correct - see my post #11440 above about this

@JohnK just do the Means assessment first. Then look for suitable aged care facilities. They will help you from there. Also please use the my aged care website - as suggested by @love_the_life upthread. It's a valuable resource.

We have just done the above for my mother.

Also it sounds like your father is still in hospital. In that case (as suggested by @love_the_life ) the hospital social workers will be able to assist in this process. They are invaluable. Generally when a patient is in hospital they are a higher priority for an aged care place - whatever their financial means

See line one - a residential aged care facility will accept someone without the assessment if there is space but (and this is the big bit) the person will pay full rate (ie no government subsidy) until Services Australia has assessed income/assets. My mother's assessment was never completed (think brother had sent it off) as she passed away before it could be done. As it was, there was only one or two weeks at full cost as she had DVA respite weeks and a free 'try us and see' for 2 weeks, From memory this was about $800 per week (noting this was a country RACF).
There are some private (non government subsidised} homes as well but these are not subject to Aged Care Quality and Safety Commission regulations.
And yes, if still in hospital I would push for Transition Care.

 

[Quickstatus]

a residential aged care facility will accept someone without the assessment if there is space

We spoke with several and they all said no they won't accept an application without a means assessment - even when we said we are happy to pay the RAD.

 

[JohnK]

Also it sounds like your father is still in hospital. In that case (as suggested by @love_the_life ) the hospital social workers will be able to assist in this process. They are invaluable. Generally when a patient is in hospital they are a higher priority for an aged care place - whatever their financial means

Yes still in hospital. I'm not sure if the social workers are the ones helping or Home care.

We'll try to look at St Basil's or something similar. Dads English is pretty much non existent.

My understanding is that if a spouse is still living in the home, it doesn't count as an asset towards means-testing for government-funded nursing home funding.

Yes mum still living at home and no other assets.

 

[Quickstatus]

I'm not sure if the social workers are the ones helping or Home care.

The hospital social workers will assist with the process they are invaluable. Ask to speak with them - even over the phone.

Yes mum still living at home and no other assets.

But that's why the means assessment needs to be completed. All that is taken into account

 

[Seat0B]

Never thought I’d say this, but I am so glad my dear dad died in hospital just 5 weeks after his diagnosis with Stage 4 lung cancer.

The hospital was pressing us to get him into aged care (he also has quite significant vascular dementia) and so we had everything ready for an application to the facility closest to home so mum could visit him.

The process is totally appalling and very confusing (yes it is @JohnK) - and we are a family full of experienced public servants who were almost defeated by it all. Here’s the pile of papers we needed for his application. He died the day we submitted it, so we never had to go through with the whole thing.


But after a blaze of late in life vigour once she no longer had to care for my dad, my now almost 91 year old mum is coming to the point of needing more care. At the moment we are getting by with Level 4 Hone Care and visits 2 days per week by me and 2 days a week by my sister, but she has started having frequent falls. It’s only a matter of time .

 

[Quickstatus]

Here’s the pile of papers we needed for his application.

And it's actually a lot easier for those without financial means. Services Australia will already have most of the details - in order to qualify for the OAP.

 

[Seat0B]

And it's actually a lot easier for those without financial means. Services Australia will already have most of the details - in order to qualify for the OAP.

Yes, Dad was a partial pensioner only as he also had some government super from his uni lecturing days. So we had to prepare for the whole thing.

 

[Hvr]

Having been through this with Mum last year I am glad we used an aged care broker. When a room came up in her chosen home we literally had seconds to grab it. The broker knew where Mum wanted and grabbed the room knowing how popular the place was.

It's a hell of a process and the paperwork shown above is typical. Spending hours on the phone with Centrelink is the norm. For Mum it's taken >12 months to get everything finalised with Centrelink.

Probably time to start looking for a home nearby and seeing if you can visit it. Some are good, some aren't. He might end up in a room with another person or even in a three person room.

The hospital will start pressuring your father to leave. Or they may move him to a less full hospital.

Hang in there John, it's a hell of a journey tthat will suck up a lot of time and emotional effort.

 

[cove]

In Perthwe used a financial advisor to prepare the documents for Mrscove’s mother. It cost $3000 to get the documents prepared and we were happy with the results as he was skilled and accurate so there was no delay.