The 35-Day Rule

NURSING HOME TYPE PATIENTS AND THE NATIONAL ACUTE CARE CERTIFICATE PURPOSE This Policy Directive advises requirements in relation to administration of the Nursing Home Type Patient (NHTP) contribution and the National Acute Care Certificate (NACC). MANDATORY REQUIREMENTS All public hospitals are required to comply with the attached procedures. Patients who remain in a public hospital bed after 35 days must have their care type assessed by a medical practitioner and the need for continuing hospital level care documented in the patient’s medical record prior to day 35. In addition for Private and DVA patients a NACC must be issued by a medical practitioner to certify the need for continuous hospital level care beyond 35 days. A key change advised in this policy is that NACC’s are no longer required for Public patients. Patients no longer requiring hospital level care beyond 35 days must have their care type changed to Maintenance Care and financial class to NHTP. Fees are to be raised for NHTP’s consistent with the attached procedures. https://www1.health.nsw.gov.au/pds/Pages/doc.aspx?dn=PD2016_011

Even though I spend an awful lot of time looking at health and welfare stuff, I have A LOT to learn about the stuff that affects older people (generally 65 years + in Australia) outside of my brief grasp of the Aged Pension and how it differs from DSP.

This week’s learnings were about the 35-day rule in NSW public hospitals for “Nursing Home Type Patients“. A “Nursing home type patient is when you’re finished needing the hospital treatment for whatever you came in with (and also anything else that came up along the way) and you’re basically just receiving the level of care a car home would give – this include regular medications if they don’t need adjusting, toileting and shower and other personal care support, and accommodation and meals. After 35 days at this level of care they can start charging “at a rate equivalent to 85% of the aged pension” for care and board.

If you get sick in that time (eg you have another stroke or you get a UTI or a hospital acquired infection) you can moved back to being a regular patient and not charged, but the clock doesn’t reset. Once you’re deemed back in maintenance mode they start charging again.

This is meant to encourage people to get their wiggle on in getting their Nan into an aged care placement. Which might be a nice idea to the bean counters, but families have very little influence on getting those placements once they paperwork is all done. Which are usually done within a month if there’s social work support to do so.

There are no aged care beds anywhere, so charging a daily fee isn’t going to get Grandma into care sooner, it’s just another stressor on the family regardless of whether they can “Afford” it or not. There’s no bed for fee paying residents or fully commonwealth supported ones. If anything this fee should be on the federal government if it’s to incentivise a placement.

After 35 in a hospital after you're deemed well enough for discharge but are stuck because you're waiting for an aged care placement NSW health starts billing you an amount equiv to 85% of the pension for board and care. It can be waived for hardship but yeah should be billed to the feds.

💜 phonakins 🍉🌲 (@phonakins.com) 2026-08-20T11:18:31.961Z

The 85% is of the single pension rate, which is going to be $1237.70 a fortnight from September 20, or $933 for a member of a couple. It can be waived for “financial stress” which would anyone relying on the pension for their income, and certainly screwing over the partner of the person stuck in hospital.

Social Security Payment Parameters 20 September 2026 indexation Rates Pension Rates Pension — Single — Resident Component (per fortnight) Previous Amount 20 Sep 2026 Increase Basic Rate $1,100.30 $1,135.40 $35.10 Pension Supplement $86.50 $88.20 $1.70 Energy Supplement $14.10 $14.10 - Typical Total Rate $1,200.90 $1,237.70 $36.80 Note: also applies to residents temporarily absent (weeks 1 to 6). Note: also includes illness separated, respite care or partner in gaol. Pension — Partnered (each) — Resident Component (per fortnight) Previous Amount 20 Sep 2026 Increase Basic Rate $829.40 $855.90 $26.50 Pension Supplement $65.20 $66.50 $1.30 Energy Supplement $10.60 $10.60 - Typical Total Rate $905.20 $933.00 $27.80 Note: also applies to residents temporarily absent (weeks 1 to 6).

The other indexation rates for September 20 are here.

With the scaremongering news that rents are looking to go up 30%, the $2 a week rent assistance increases are, as always, laughable. My rent will increase in December, waiting to see by how much. Last year it was $50/week with the signing of another 12 month lease.

Commonwealth Rent Assistance Commonwealth Rent Assistance — SSAct — Maximum rates Family situation (per fortnight) Previous Amount 20 Sep 2026 Increase Single $219.40 $223.80 $4.40 Single — Sharer $146.27 $149.20 $2.93 Partnered — Illness separated $219.40 $223.80 $4.40 Partnered — Temporarily separated $206.80 $211.00 $4.20 Couple $206.80 $211.00 $4.20 Commonwealth Rent Assistance — SSAct — Rent thresholds Family situation (per fortnight) Previous Amount 20 Sep 2026 Increase Single $154.80 $157.80 $3.00 Single — Sharer $154.80 $157.80 $3.00 Partnered — Illness separated $154.80 $157.80 $3.00 Partnered — Temporarily separated $154.80 $157.80 $3.00 Couple $250.80 $255.80 $5.00 Commonwealth Rent Assistance — SSAct — Rent ceilings Family situation (per fortnight) Previous Amount 20 Sep 2026 Increase Single $447.34 $456.20 $8.86 Single — Sharer $349.83 $356.74 $6.91 Partnered — Illness separated $447.34 $456.20 $8.86 Partnered — Temporarily separated $430.54 $439.14 $8.60 Couple $526.54 $537.14 $10.60

And with the increasing unemployment rate, more are waiting on their extra $8.10 a week and for it to have already disappeared into the nether. Jobseeker Payment Rates Note: some of the following rates may apply to Special Benefit recipients. JobSeeker Payment — Single — No dependent children Component (per fortnight) Previous Amount 20 Sep 2026 Increase Basic Rate $808.70 $824.90 $16.20 Energy Supplement $8.80 $8.80 - Typical Total Rate $817.50 $833.70 $16.20 JobSeeker Payment — Single — With dependent children Component (per fortnight) Previous Amount 20 Sep 2026 Increase Basic Rate $866.00 $883.30 $17.30 Energy Supplement $9.50 $9.50 - Typical Total Rate $875.50 $892.80 $17.30 JobSeeker Payment — Single — Principal carer of a dependent child Component (per fortnight) Previous Amount 20 Sep 2026 Increase Basic Rate $866.00 $883.30 $17.30 Energy Supplement $9.50 $9.50 - Pharmaceutical Allowance $7.00 $7.00 - Typical Total Rate $882.50 $899.80 $17.30

So, mum’s in purgatory, but a slightly quieter one after moving to a smaller hospital, but not the private one that rejected other the day they said she was moving and was packed up and transport on the way, the one that at least two staff at the current hospital have said she should go to and a couple more expressed surprise at the rejection.

A lime green paper coffee cup with a black lid and sleeve sits on a dark wooden picnic table. The cup sleeve features black text and graphics including Central Catering, Go Market, and a small illustration of a building on a hill. To the right of the cup is a clear rectangular plastic container with a blue latch holding two rectangular slices of frosted pink cake. A metal fork rests inside the container on top of the cake. In the blurred background other drink cups are partially visible including one with a yellow logo. Bright sunlight creates a strong glare from the upper left.

So we wait, drink lots of coffee, keep calling the same places just to see and I unfortunately am getting a new area of welfare and health to specialise in complaining about.

It’s August apparently.

If you like this post, have learned something from this or my blaterings on the socials, or just want to help me pay for coffee and petrol (the new hospital is just as far a drive but parking is less crap), my wishlists an paylinks are here.


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