Support at Home: What Counts as Care Management?

Care management is the work of helping a Support at Home participant receive care that matches their needs, goals and preferences. It is not a label for every task a provider performs behind the scenes. A coordinator can spend the same morning discussing a changed care plan, allocating staff to visits and updating an internal compliance register. Those tasks do not all have the same funding treatment.

The Department’s care-management funding guidance, checked on 12 October 2026, identifies funded activity groups and exclusions. Use that guidance and the current program manual when reviewing individual records. This article describes a practical review method, with fictional examples, rather than promising that any activity name guarantees a claim will be accepted.

Ask what the activity did for this participant. Did it establish or update an agreed care approach, coordinate services around a specific need, review how the arrangement was working or help the person understand their choices? Record that purpose in ordinary language. A note saying only “care management” does not explain the work.

Include who participated and how the person’s preferences were considered. A family member may assist, but involvement and authority depend on consent and any applicable decision-making arrangements. Do not assume that a contact on the client record can agree to every change.

Link the activity to the relevant care plan or service issue. That connection helps another reviewer distinguish individual support from general provider administration. It also gives the next care partner a useful starting point when following up, without needing to reconstruct the conversation from a calendar entry.

The Department lists care planning, service planning and management, monitoring or review or evaluation, and support and education as funded care-management activity groups. The list is not a substitute for the detailed conditions in Chapter 8 of the program manual.

A care-planning discussion might explore a changed mobility need and agree what support the person wants. Service planning may coordinate the agreed services around that need. Monitoring can check whether an existing arrangement is meeting the person’s goals. Support and education can help the participant understand the care choices relevant to them.

Keep the distinction between a participant-focused service-planning discussion and staff scheduling. The first can concern how the person’s care will be coordinated; the second is provider administration. When a task contains both, separate the activity and time records rather than choosing whichever category has funds remaining.

The Department explicitly excludes scheduling or rostering staff, staff training, staff travel or education, program governance or compliance or record-keeping, and human-resources activities from care-management claims. These are real business costs, but describing them as participant support does not change their nature.

For example, preparing the staff roster for next week is not care management for every participant on that roster. Training a new coordinator is not care management for the clients used in the training examples. Maintaining the provider’s compliance register is not a billable participant activity because the register contains their name.

Review mixed-purpose meetings carefully. A participant-specific discussion about changing services may be followed by an internal conversation about staff availability. Record the participant activity and administrative activity separately. If the record cannot explain the split, resolve it with the staff member before claiming rather than applying a standard percentage to every meeting.

Providers must deliver at least one direct care-management activity (communicating or meeting with the participant or their registered supporter) to every participant each month. That does not mean a complete formal care-plan rewrite is required every month. The activity should be appropriate to the person’s circumstances and recorded accurately.

The care-plan guidance says care partners should review plans with participants at least every twelve months and on relevant triggers. Those include changing needs or goals, new risks or incidents, a higher classification, AT-HM approval and changes to services. A provider may choose a more frequent review cadence, but should distinguish its operating policy from the program minimum.

Use a monthly coverage view to find missing activity, then review the underlying record. A recurring diary appointment or automatically generated reminder is not evidence that the care-management activity happened.

For ongoing services delivered under the home and community services, AT-HM or advisory and support categories, section 148-80(3)(c) of the Aged Care Rules 2025 requires the care and services plan to be reviewed at least once every 12 months; providers in categories 4–6 must ensure plans are regularly reviewed under Outcome 3.1. Aged Care Rules 2025.

For ongoing services, ten percent of each participant’s quarterly funding is deducted for care management and pooled at service delivery branch level. The provider claims eligible care-management services from that account. The allocation is not a fixed personal maximum for each participant; activity can vary according to need within the available pooled funding.

Restorative Care and End-of-Life care management is claimed against the relevant pathway funding. The Department says it must be proportionate and in the participant’s best interests, rather than subject to the ongoing ten-percent pooling rule. AT-HM funding has its own arrangements for sourcing and wraparound services; do not treat it as another source for ordinary care-management claims.

Care management is clinical support, so participants do not contribute to its cost. Keep the funding route visible in the record before finance reviews it. A correct activity with the wrong account can still create a claiming error.

A fictional participant tells their care partner that a recent fall has made shopping difficult. During a twenty-five-minute conversation, they discuss the person’s preferences, current support and whether a clinical review is needed. The care partner then spends fifteen minutes coordinating the agreed next step with the relevant service and records the outcome against the care plan.

Later, the coordinator spends ten minutes filling a vacant worker shift and another ten updating a provider compliance spreadsheet. Those tasks must not be combined with the earlier participant-focused work and claimed as one hour of care management.

The illustrative participant record explains the concern, discussion, agreed action, people involved and follow-up owner. It separates the forty minutes of potentially eligible participant activity from the twenty minutes of administration. Eligibility still depends on the actual service and program conditions; a time total alone is insufficient. No participant or outcome in this example is a real customer claim.

A practical record identifies the participant, activity date, activity group, actual duration, staff member, purpose, outcome and next action. Include the applicable branch and funding context. Refer to the relevant plan version rather than copying a large clinical history into every activity entry.

Use specific outcomes such as “participant agreed to discuss changed support after the clinician review” instead of “all good”. Record when no change was agreed as well as when a plan was updated. Where information is sensitive, apply the provider’s access and consent controls.

Statura’s Support at Home care-management page describes care-management activity records, participant context and budget review. Evaluate those existing workflows with your own example. Confirm how a reviewer follows the activity to its plan and funding account, and how corrections remain distinguishable from the original record.

Before approving an activity, check its participant purpose, funded activity group, actual delivery, duration and funding route. Confirm that administration, travel and staff development have not been folded into the claim. Check whether the outcome changes the care plan, service arrangement or next review date.

For each month, inspect missing activity and unresolved follow-ups. For each quarter, reconcile eligible activity with the branch pool and the participant allocations that support it. Do not substitute a fixed monthly fee or identical activity note for records of actual work.

Read the Support at Home program guide and wellness and reablement guide for related context. Keep your procedures tied to the latest official guidance and review them when funding or program instructions change. Clear activity records support continuity of care as well as a defensible financial review.