NASC Reassessment NZ: How to Request More Home Support Hours

Your parent's care plan was set six months ago, but since then they've had two falls, a new diagnosis, and you're now providing care every day instead of twice a week. The original allocation of support hours no longer matches reality — and the system won't adjust automatically. You have to trigger a reassessment.

When to Request a Reassessment

Care plans are formally reviewed at least once every 12 months through a routine check-in, usually by phone. But you can request an urgent reassessment at any time if there's been a significant change. Clinical triggers that justify an immediate reassessment include:

• A fall resulting in injury or hospitalisation
• A new diagnosis (dementia, stroke, Parkinson's, cancer)
• Rapid cognitive decline — increased confusion, wandering, inability to recognise family
• Carer breakdown — you physically or emotionally cannot continue at the current level of support
• Hospital discharge with new clinical needs
• Loss of a co-carer (spouse dies, family member moves away)
• Safety incidents — leaving the stove on, wandering outside, medication errors

Don't wait for the annual review if any of these apply. The longer you delay, the longer your family absorbs the full burden of increased care needs without funded support.

How the Referral Process Works

Self-referral: Contact your regional NASC directly and explain the change in circumstances. You don't need a GP referral to request a reassessment — any family member can call.

GP referral: Your parent's GP can submit a referral to NASC with clinical documentation supporting the need for more support. This carries additional weight because it includes medical evidence.

Hospital referral: If your parent is currently in hospital, the discharge team's social worker should initiate a NASC reassessment before discharge. If they're not doing this, ask explicitly — hospitals sometimes push for rest home placement when a reassessment might justify returning home with increased support.

Urgent vs Routine Timelines

Urgent reassessments: NASC must make contact within two working days. Urgent classification applies when there's an immediate safety risk, a hospital discharge in progress, or imminent carer breakdown. When you call, use the word "urgent" and describe the specific safety risk.

Routine reassessments: NASC responds within 14 days. This covers gradual declines where the parent is currently safe but needs more hours than currently allocated.

Annual reviews: these happen on NASC's schedule, typically by phone, and may not involve a full interRAI reassessment. If a phone review doesn't result in enough additional hours, request a full in-home reassessment with the interRAI tool.

Preparing for the Reassessment

The reassessment uses the same interRAI Home Care tool as the original assessment. Everything that applied the first time applies again — but now you have the advantage of knowing how the system works.

Keep a diary of incidents since the last assessment. Document falls (dates, injuries, whether an ambulance was called), confusion episodes, missed medications, sleep disturbances, and any tasks your parent can no longer do that they could do at the last assessment. Present this diary to the assessor as evidence of clinical decline.

If you've been providing more care hours yourself, quantify it: "I was coming twice a week for two hours; now I'm here every day for four hours." The interRAI measures carer distress specifically — your burnout is clinically relevant to the reassessment outcome.

What Changes After a Reassessment

If the reassessment confirms increased needs, the NASC coordinator updates the care plan with additional funded hours. This may include:

• More personal care visits per week
• Household management hours (if your parent holds a Community Services Card)
• Increased Carer Support allocation for respite
• A referral for equipment or home modifications
• Escalation to discuss Aged Residential Care if home-based support is no longer safe

Changes to funded hours typically take effect within one to two weeks of the updated care plan, once the provider agency adjusts their scheduling.

For the complete NASC navigation toolkit — including reassessment request templates, the five-day incident diary, and interRAI preparation guides — the Home and Community Support Services guide covers every step.

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