Client enters public hospital - process

If the residential service provider advises that the client has entered public hospital, you must find out whether the client is expected to be returning to the service provider's care within 13 weeks.

The redirection to the service provider should only remain in place if:

• the client is expected to be in hospital for less than 13 weeks
• the service provider is holding the client's bed
• the service provider is continuing to provide support to the client (such as maintaining contact, visiting, checking on their condition etc) and
• the client has not withdrawn their consent for the redirection to continue

If the client is to be in hospital less than 13 weeks, and the service provider is holding the client's bed and providing support to the client, the benefit contribution can continue to be paid.

On receipt of the Resident's Details Notification form from the service provider, the date of admission to hospital needs to be added to the SHODA screen for the client, and a Client Event added.

The client should be paid their full benefit entitlement and the redirection of benefit to the service provider should be cancelled from the earliest of the following dates:

• the date the client enters hospital if it is known at the time that the client will not be returning to the residential care facility or
• the date the service provider is advised the client will not be returning to their care, if this occurs after the client entered hospital or
• the date the service provider stops holding the client's bed and providing support to the client or
• the date the client withdraws their consent in writing for the redirection of benefit payment to the service provider or
• the beginning of the 14th week in hospital (at which time the benefit being paid to the client will reduce to the hospital rate of payment, unless they have dependent children)

An Exception Notification will be generated for the beginning of the 14th week.

From the beginning of the 14th week, you should stop the Residential Support Subsidy and the benefit contribution. From that date, the client's benefit reduces to the hospital rate of payment.

This reduction does not apply to clients who have dependent children or clients receiving Veteran's Pension.

If the client returns to live in the community, advise the client to contact Work and Income to update their change in circumstances.

For more information see:

• Changes and reviews, hospitalisation in relevant Main benefits