How the primary funding type is determined for a service user
A service user's care fees are often covered by multiple types of funding but it's useful to be able to identify a primary funding type for the purpose of reports. For example you may want to know what percentage of your occupancy is private, or the average weekly rate for LA residents across your portfolio.
Given that there can be multiple funding types contributing to the cost of a service user's care, how do we determine which is the primary funding type for the service user? CareHQ offers two methods for determining the primary funding type; we'll explain both methods in this article.
By default new CareHQ accounts are configured to use the Priority method, but if you'd like to use the Largest contributor method instead let us know and we'll make the switch for you.
Contribution types
When setting up billing contracts to cover a service user's care fees (booking), a contribution type is assigned to each contract using the Contribution type field. Users can select from the following types:
| Contribution type | Description |
|---|---|
| Private contribution | Private contributions are made by the service user either directly or indirectly (e.g. by family or an annuity). |
| Local authority | Local authority (LA) funding is where a service user's care costs are in part or in full covered by the local authority. |
| CHC | Continuing healthcare is where a service user's care costs are in part or in full covered by the NHS. |
| Private top-up | Private top-up is where a private contribution is made by the service user (directly or indirectly) to cover the difference between the local authority's contribution and the actual cost of care at the care home. |
| Lifestyle | Lifestyle choice contributions are where a private contribution is made by the service user (directly or indirectly) to cover fees outside of the service user's CHC assessed care and accommodation needs. |
| FNC | In England, Wales and Northern Ireland, NHS-Funded Nursing Care is a weekly payment from the NHS to care providers that contributes to the cost of nursing care. |
| FPC | In Scotland Free Personal (and Nursing) Care is a weekly payment from the council to care providers that contributes towards the cost of personal and nursing care. |
| DTA / Block bed | Discharge to Assess funding is provided by the NHS or local authority and covers a service user's care fees whilst their long term needs are assessed. |
| DTA / Spot purchase | DTA / Spot purchase funding is provided by the NHS or local authority and covers a service user's care fees for an unplanned move due to the existing care provider not being able to meet the service user's needs. |
Funding types
Funding types map one-to-one with the contribution type of the same with the following exceptions:
| Funding type | Description |
|---|---|
| Local authority + top-up | The local authority + top-up funding type is assigned to a service user where the primary funding type is identified as a private top-up (that is, they are funded primarily by a combination of the local authority and a top-up from the service user either directly or indirectly). |
| CHC + lifestyle | The CHC + lifestyle funding type is assigned to a service user where the primary funding type is identified as a lifestyle (that is, they are funded primarily by a combination of the CHC and a lifestyle contribution from the service user either directly or indirectly). |
These exceptions mean that Private top-up and Lifestyle are never assigned as the primary funding type for a resident.
Priority method (default)
The priority method sets a service user's primary contribution type based on a prioritised list as follows:
| Contribution type | Priority |
|---|---|
| Lifestyle | 4 |
| Private top-up | 3 |
| CHC | 2 |
| Local authority | 1 |
| Private contribution | 0 |
| DTA / Block bed | 0 |
| DTA / Spot purchase | 0 |
| FNC | -1 |
| FPC | -1 |
When determining the primary funding type for a service user using the priority method, CareHQ sorts the contracts contributing to a service user's care fees by the contract's funding type using the priority table. The funding type with the highest score is then selected.
So in the following example the primary funding type for the service user would be Local authority as this funding type has the highest priority:
| Funder | Contribution type | Fee | Priority |
|---|---|---|---|
| Dawn Watson | Private contribution | £822 per week | 0 |
| Worcestershire CC | Local authority | £640 per week | 1 |
If in our example we change Dawn Watson's contribution type to Private top-up then the primary funding type for the service user would be set as Local authority + Top-up:
| Funder | Contribution type | Fee | Priority |
|---|---|---|---|
| Dawn Watson | Private top-up | £822 per week | 3 |
| Worcestershire CC | Local authority | £640 per week | 1 |
Largest contributor method
The largest contributor method sets a service user's primary funding type based on the billing contract which makes the largest contribution to their care.
So in the following example the primary funding type for the service user would be set as Private:
| Funder | Contribution type | Fee | Largest contributor |
|---|---|---|---|
| Dawn Watson | Private contribution | £822 per week | Yes |
| Worcestershire CC | Local authority | £640 per week | - |