Document ID: chunk:federal_register_of_legislation:F2024C00744:reg:18:p2
Version: federal_register_of_legislation:F2024C00744
Segment Type: reg
Provision Reference: reg 18 (pt 2/47)
Character Range: 178739–181650

whom an entitled person can be referred under paragraph 7.3.3(a).

         (b) a community nursing provider, pursuant to an arrangement with the Commission, has undertaken a nursing assessment of the entitled person prior to the commencement of care and assessed that the person has a clinical need or a personal care need, or both, for the community nursing service.

7.3.4 All of an entitled person's care documentation prepared by a  community nursing provider shall be provided to the Department upon request by the Department to the community nursing provider.

7.3.5 An entitled person whose care needs, due to their complexity and care regime, are significantly outside of the scope of the community nursing classification to which they belong, is treated under the exceptional case process.  Before a person can be treated under the exceptional case process, prior approval must be obtained from the Commission.

7.3.6  A referral to a community nursing provider is to be made only to a community nursing provider that has entered into, and is bound by, an agreement with the Commission or the Department to provide community nursing services during the relevant period of treatment and in the geographical area in which the entitled person resides.

7.3.6A If no community nursing provider referred to in paragraph 7.3.6 can provide the relevant community nursing care within a reasonable time, the Commission may approve a referral to another community nursing provider.

7.3.7 The Commission will not accept, as part of a community nursing service, financial responsibility for any domestic help services such as cooking, shopping, cleaning, laundry, transport and companionship.

7.3AA Sustainability payments—community nursing
7.3AA.1 This subpart deals with a quarterly payment made to a community nursing provider (a sustainability payment):

         (a) for the costs incurred by the provider in delivering care coordination and management necessary for the provision of a community nursing service; and
         (b) that is to be paid between 1 July 2024 and 30 June 2026.

7.3AA.2 The Commission will, on its own initiative, pay a sustainability payment to a community nursing provider, for a quarter between 1 April 2024 and 31 March 2026 (the claim processed period), if:

         (a) the provider delivers a community nursing service under the program to an entitled person in accordance with this Part; and
         (b) the service is delivered under an agreement with the Commission that is in force at the time the eligibility for the payment is determined; and
         (c) a claim for payment for the service is approved during the quarter.

7.3AA.3 A sustainability payment for a quarter within the claim processed period that is payable to a community nursing provider under paragraph 7.3AA.2 is worked out using the following steps:

         (a) work out the number of entitled