Convalescent care information for providers

Learn about how to arrange convalescent care for eligible clients. If you are a client you can visit our client convalescent care page.

What is convalescent care

Convalescent care is short-term non-acute care that is medically necessary for recovery following a stay in hospital.

Who can receive convalescent care

Convalescent care is available to entitled people who hold:

• a Veteran Gold Card or
• a Veteran White Card (when DVA has paid for the original hospital admission).

Discharging hospitals

A client’s discharge into convalescent care needs to be arranged by one of the following people:

• a hospital discharge planner;
• a treating doctor;
• a social worker; or
• a nurse.

Arranging care in a hospital

Convalescent care should generally be provided in an approved residential care facility, and should only be provided in hospital for a limited period of time when a suitable residential care facility is not available.

Convalescent care provided in a hospital does not need prior approval from DVA.

Convalescent care may be accessed by an entitled person in a public hospital when medically necessary following an acute or sub-acute admission to hospital. Convalescent care may also be provided at a private hospital if the hospital is contracted by DVA to provide the service.

If a hospital has any queries regarding funding for convalescent care services, they should contact their hospital’s finance department for clarification regarding DVA funding arrangements and data submission requirements.

Arranging care in a non-hospital institution

Convalescent care provided in a non-hospital institution needs prior approval and has a limit of 21 nights per financial year.

Non-hospital institutions include:

• Australian Government-funded residential aged care facilities;
• supported residential services (Victoria only); and
• other suitable institutions.

Where practical and appropriate, Australian Government-funded residential aged care facilities listed on the My Aged Care website are the preferred option.

Please seek DVA approval for convalescent care before the client is discharged. Call the Health Approvals and Home Care team on 1800 550 457 (option 3, option 1) or email health.approval [at] dva.gov.au (health[dot]approval[at]dva[dot]gov[dot]au) and provide the following information:

• client’s name and DVA file number;
• provider number of the discharging hospital;
• name, address, telephone number, email address and provider number of the facility providing the convalescent care;
• date of admission to convalescent care;
• number of nights required;
• reason for the original hospital admission; and
• if requesting a facility other than an Australian Government-funded My Aged Care facility, reason for requesting this facility.

The DVA team member will approve, decline or, in exceptional circumstances, escalate the request.

To ensure quality and safety of care, DVA does not approve convalescent care at facilities that have a current Sanction or Notice of Requirement to Agree listed on My Aged Care.

The My Aged Care website also provides Star Ratings for residential aged care facilities. It is useful to consider this information, as well as the client’s specific circumstances, in choosing a suitable facility. DVA does not specify a minimum Star Rating for convalescent care approval.

Arranging care in a multi-purpose service

Arrangements for care in a multi-purpose service (MPS) vary depending on the nature of the bed:

• arrangements for care provided in an aged care bed in a MPS are the same as for other non-hospital institutions
• arrangements for care in a hospital bed in a MPS are the same as for care in other hospitals.

Residential facilities providing convalescent care

If approved, DVA will send an approval email to the facility providing convalescent care. This email will set out the approved dates and fees, as well as billing information.

Standard fees apply for convalescent care in non-hospital institutions. The client is not to be charged a co-payment.

DVA expects that facilities will provide care in accordance with the Aged Care Quality Standards.

Other services

In some circumstances, convalescent care is not the most appropriate option. DVA and My Aged Care offer a range of other services, including residential respite care, home care, transition care and short-term restorative care. To learn more, see Aged care resources.