(4) The 2023 MM category additional amount, for a day for a home or community place for an approved residential care home, means:
(a) for a home other than Injune—the amount specified in the following table for the 2023 MM category in which the home is located; or
(b) for Injune—the amount specified in the following table for the 2023 MM category known as MM 7.
MM category additional amount
Item Column 1 2023 MM category for the home’s location Column 2 Amount ($)
1 2023 MM category known as MM 2 0.00
2 2023 MM category known as MM 3 0.00
3 2023 MM category known as MM 4 1.22
4 2023 MM category known as MM 5 2.68
5 2023 MM category known as MM 6 17.72
6 2023 MM category known as MM 7 21.29
249‑40 Residential care place amount
The residential care place amount for a day for a residential care place for an approved residential care home of an approved provider is the sum of the following:
(a) $153.35;
(b) the viability supplement equivalent amount for the home for the day under this Division;
(c) the amount specified in the following table for the region that the home is in.
Amounts for regions
Item Column 1 Region Column 2 Amount ($)
New South Wales
1 Central Coast 13.72
2 Central West 11.77
3 Far North Coast 12.50
4 Hunter 13.85
5 Illawarra 12.80
6 Inner West 14.30
7 Mid North Coast 13.10
8 Nepean 12.75
9 New England 8.44
10 Northern Sydney 8.24
11 Orana Far West 15.40
12 Riverina Murray 13.71
13 South East Sydney 13.33
14 Southern Highlands 14.43
15 South West Sydney 16.13
16 Western Sydney 12.88
Victoria
17 Barwon South Western 8.40
18 Eastern Metro 7.59
19 Gippsland 7.97
20 Grampians 14.06
21 Hume 8.16
22 Loddon‑Mallee 12.98
23 Northern Metro 12.88
24 Southern Metro 8.38
25 Western Metro 8.32
Queensland
26 Brisbane North 12.54
27 Brisbane South 13.42
28 Cabool 13.48
29 Central West 11.77
30 Darling Downs 14.47
31 Far North 12.56
32 Fitzroy 7.36
33 Logan River Valley 14.67
34 Mackay 12.57
35 Northern 12.22
36 North West 18.40
37 South Coast 13.85
38 South West 12.57
39 Sunshine Coast 8.48
40 West Moreton 14.08
41 Wide Bay 12.85
Western Australia
42 Goldfields 7.36
43 Great Southern 8.35
44 Kimberley 18.00
45 Metropolitan East 13.48
46 Metropolitan North 13.67
47 Metropolitan South East 13.78
48 Metropolitan South West 15.07
49 Mid West 16.41
50 Pilbara 17.68
51 South West 12.57
52 Wheatbelt 12.92
South Australia
53 Eyre Peninsula 16.69
54 Hills, Mallee and Southern 14.61
55 Metropolitan East 13.48
56 Metropolitan North 13.67
57 Metropolitan South 13.78
58 Metropolitan West 15.07
59 Mid North 13.73
60 Riverland 15.24
61 South East 13.53
62 Whyalla, Flinders and Far North 13.91
63 Yorke, Lower North and Barossa 14.31
Tasmania
64 Northern 12.22
65 North Western 13.29
66 Southern 13.89
Australian Capital Territory
67 Australian Capital Territory 14.21
Northern Territory
68 Alice Springs 20.18
69 Barkly 23.13
70 Darwin 17.37
71 East Arnhem 23.13
72 Katherine 12.56
249‑45 Respite supplement equivalent amount
The respite supplement equivalent amount for an approved residential care home for a day is the amount specified in the following table for the number of residential care places for the home that are in effect on the day.
Respite supplement equivalent amount
Item Column 1 Number of residential care places that are in effect Column 2 Amount ($)
1 Less than 11 59.07
2 More than 10 but less than 21 94.51
3 More than 20 but less than 31 106.30
4 More than 30 but less than 41 118.09
5 More than 40 129.95
249‑50 Viability supplement equivalent amount—Category A residential care homes
The viability supplement equivalent amount for a Category A residential care home for a day is:
(a) if the home is located in a Statistical Local Area with a classification under the RRMA Classification mentioned in an item of the following table—the amount specified in the item in the table that relates to that classification and the number of residential care places for the home that are in effect on the day; or
(b) if paragraph (a) does not apply—$3.87.
Viability supplement equivalent amounts—Category A residential care homes
Item Column 1 Statistical Local Area classification for the home’s location Column 2 Number of residential care places for the home that are in effect Column 3 Amount ($)
1 Other Remote less than 16 63.46
2 Other Remote more than 15 but less than 30 39.02
3 Other Remote more than 29 3.96
4 Remote Centre less than 16 30.30
5 Remote Centre more than 15 but less than 30 21.52
6 Remote Centre more than 29 3.96
7 (a) Other Rural; or(b) Small Rural Centre less than 16 12.76
8 (a) Other Rural; or(b) Small Rural Centre more than 15 but less than 30 3.96
9 (a) Other Rural; or(b) Small Rural Centre more than 29 3.96
249‑55 Viability supplement equivalent amount—Category B residential care homes
(1) The viability supplement equivalent amount for a Category B residential care home for a day is the amount specified in the following table for the score attained by the home on the day under the scoring system set out in the table in subsection (2).
Viability supplement equivalent amounts—Category B residential care homes
1 40 3.96
2 50 4.42
3 60 12.76
4 70 21.52
5 80 30.30
6 90 39.02
7 100 63.46
(2) The following table sets out the scoring system for Category B residential care homes.
Category B residential care homes—scoring
1 ARIA value for the home’s location:(a) more than 9.08 but not more than 12;(b) more than 5.8 but not more than 9.08;(c) more than 3.51 but not more than 5.8;(d) more than 1.84 but not more than 3.51;(e) 1.84 or less 605040300
2 Residential care places for the home that are in effect:(a) less than 20;(b) more than 19 but less than 30;(c) more than 29 but less than 45 302010
3 More than 50% of individuals accessing funded aged care services in the home are diverse individuals 10
249‑60 Viability supplement equivalent amount—Category C residential care homes
(1) The viability supplement equivalent amount for a Category C residential care home for a day is the amount specified in the following table for the score attained by the home on the day under the scoring system set out in the table in subsection (2).
Viability supplement equivalent amounts—Category C residential care homes
1 50 9.53
2 55 14.28
3 60 21.36
4 65 26.10
5 70 38.08
6 75 47.44
7 80 59.27
8 85 71.24
9 90 83.06
10 95 92.54
11 100 104.42
(2) The following table sets out the scoring system for Category C residential care homes.
Category C residential care homes—scoring
1 ARIA value for the home’s location:(a) more than 9.08 but not more than 12;(b) more than 5.8 but not more than 9.08;(c) more than 3.51 but not more than 5.8;(d) more than 1.84 but not more than 3.51;(e) 1.84 or less 655540300
2 Residential care places for the home that are in effect:(a) less than 20;(b) more than 19 but less than 25;(c) more than 24 but less than 30;(d) more than 29 but less than 35;(e) more than 34 but less than 40;(f) more than 39 but less than 45 30252015105
3 More than 50% of individuals accessing funded aged care services in the home are diverse individuals 5
249‑65 Viability supplement equivalent amount—Category D residential care homes
(1) The viability supplement equivalent amount for a Category D residential care home for a day is the amount specified in the following table for the score attained by the home on the day under the scoring system set out in the table in subsection (2).
Viability supplement equivalent amounts—Category D residential care homes
1 50 9.53
2 55 14.28
3 60 21.36
4 65 26.10
5 70 38.08
6 75 47.44
7 80 59.27
8 85 71.24
9 90 83.06
10 95 92.54
11 100 104.42
(2) The following table sets out the scoring system for Category D residential care homes.
Category D residential care homes—scoring
1 The home is not Injune and the 2023 MM category for the home’s location is:(a) the 2023 MM category known as MM 2;(b) the 2023 MM category known as MM 3;(c) the 2023 MM category known as MM 4;(d) the 2023 MM category known as MM 5;(e) the 2023 MM category known as MM 6;(f) the 2023 MM category known as MM 7 0030405565
2 The home is Injune 65
3 Residential care places for the home that are in effect:(a) less than 20;(b) more than 19 but less than 25;(c) more than 24 but less than 30;(d) more than 29 but less than 35;(e) more than 34 but less than 40;(f) more than 39 but less than 45 30252015105
4 More than 50% of individuals accessing funded aged care services in the home are diverse individuals 5
Division 3—Amount of subsidy—Transition Care Program
249‑90 Amount of subsidy
For the purposes of subsection 249(1) of the Act, the amount of subsidy a registered provider is eligible for under section 248 of the Act on a day in relation to funded aged care services delivered to an individual through a service group under the TCP on the day is $262.62.
Part 10—Subsidy claims and payment
Division 1—Home support, assistive technology and home modifications (other than under specialist aged care programs)
251‑5 Relevant period—assistive technology
For the purposes of paragraph 251(2)(d) of the Act, the relevant period for ongoing funded aged care services delivered to an individual through the service group assistive technology is the account period for the notional assistive technology account established for the individual for the delivery of those services.
251‑10 Period within which claim must be given to the System Governor—prescribed events
For the purposes of subparagraph 251(3)(a)(ii) of the Act, the events are:
(a) the individual ceases accessing funded aged care services through the service delivery branch; or
(b) another registered provider provides a start notification to the System Governor and the Commissioner about starting the delivery of funded aged care services to the individual:
(i) through the classification type ongoing for the service group residential care; or
(ii) through the classification type ongoing or short term for the service group home support.
Division 1A—Residential care
256‑5 Timing of payments—working out amounts of advances
(1) This section is made for the purposes of subsection 256(3) of the Act.
(2) This section applies in relation to estimating, under subparagraph 256(2)(b)(i) of the Act, the amount of subsidy that will be payable under section 254 of the Act to a registered provider in relation to an approved residential care home for a payment period (the advance payment period) referred to in paragraph 256(2)(b) of the Act.
Requirements for estimating amount
(3) Subject to subparagraph 256(2)(b)(i) of the Act, the amount must be estimated using the following method:
Step 1: Using the information in the claim given to the System Governor by the provider under section 257 of the Act for subsidy in relation to the home for the second payment period (the base payment period) before the advance payment period, work out the sum of subsidy for which the provider is eligible in relation to individuals to whom the provider delivered funded aged care services in the home for the days in the base payment period.
Step 2: Divide the amount worked out under step 1 by the number of days in the base payment period.
Step 3: Divide the amount worked out under step 2 by the number of operational beds for the home on the last day of the base payment period.
Step 4: Multiply the amount worked out under step 3 by the number of days in the advance payment period that are within:
(a) the approval period for the home in relation to the provider; and
(b) the registration period for the provider.
Step 5: Multiply the amount worked out under step 4 by the number of operational beds for the home on the day the amount is being estimated.
Step 6: Round the amount worked out under step 5 to 2 decimal places (rounding up if the third decimal place is 5 or more).
Note 1: Any deductions under subsection 261(1) of the Act for the days in the advance payment period must also be taken into account in estimating the amount (see subparagraph 256(2)(b)(i) of the Act).
Note 2: The estimated amount must be increased or reduced to make any adjustments that are necessary to take account of any underpayments or overpayments in respect of advances previously paid under section 256 of the Act (see subparagraph 256(2)(b)(ii) of the Act).
Division 2—Specialist aged care programs
260‑5 Purpose of this Division
For the purposes of subsection 260(2) of the Act, this Division prescribes requirements relating to claims for, and payment of, subsidy under subsection 260(1) of the Act.
260‑10 Multi‑Purpose Service Program—timing of payments
Subsidy payable under subsection 260(1) of the Act to a registered provider for a day in a quarter in relation to the delivery of funded aged care services under the MPSP is payable by the Commonwealth:
(a) within 21 days after the start of that quarter; or
(b) on a day in that quarter or a subsequent quarter agreed between the System Governor and the provider.
260‑15 Transition Care Program—claims
For the purposes of obtaining payment of subsidy in relation to the delivery by a registered provider of funded aged care services under the TCP, the provider must, as soon as practicable after the end of each calendar month, give to the System Governor a claim, in the approved form, for subsidy that is payable to the provider under subsection 260(1) of the Act for the days in that month.
260‑20 Transition Care Program—payments
(1) This section applies to subsidy payable under subsection 260(1) of the Act to a registered provider in relation to the delivery of funded aged care services under the TCP.
Timing of payments
(2) Subsidy payable for a day in a calendar month is payable by the Commonwealth for the month at such times as the System Governor thinks fit.
Separate payments for each service delivery branch and approved residential care home
(3) Subsidy payable in relation to funded aged care services delivered through each service delivery branch or approved residential care home of the registered provider is separately payable by the Commonwealth.
Division 3—Transfers and mergers of service delivery branches
263‑5 Purpose of this Division
For the purposes of paragraph 263(1)(a) and subsection 263A(1) of the Act, this Division makes provision for, and in relation to:
(a) the transfer of a service delivery branch of a registered provider to another registered provider; and
(b) the merger of 2 or more service delivery branches of a registered provider into a single delivery branch of the provider.
263‑10 Application for approval to transfer service delivery branch
Application for approval
(1) A registered provider (the proposed transferor) may apply, in the approved form, to the System Governor for approval to transfer a service delivery branch of the proposed transferor to another registered provider (the proposed transferee).
(2) The application must be made at least 90 days, or such smaller number of days as is agreed in writing between the System Governor and the registered provider, before the day proposed in the application for the transfer of the service delivery branch.
(3) The System Governor must:
(a) consider an application made in accordance with this section and any further information given in accordance with a request under section 588 of the Act; and
(b) make a decision on the application within 28 days of receiving the application.
Note: For the consequence of not giving any requested further information in the requested time, and the extension of the decision‑making period if requested information is given in the requested time, see section 588 of the Act.
Notice of decision
(4) The System Governor must give notice of the System Governor’s decision to the proposed transferor and the proposed transferee.
(5) The notice under subsection (4) must:
(a) be given as soon as practicable after the System Governor makes the decision; and
(b) if the System Governor decides not to approve the transfer of the service delivery branch—include the reasons for the decision and how the proposed transferor or the proposed transferee may apply for reconsideration of the decision.
263‑15 Transfer of service delivery branch
(1) This section applies if the System Governor approves the transfer of a service delivery branch of a registered provider (the transferor) to another registered provider (the transferee).
Claims for subsidy for days before transfer day
(2) The transferor must ensure that, before the day (the transfer day) the transfer takes effect, the transferor has given to the System Governor claims under section 251 of the Act for subsidy payable to the transferor under section 250 of the Act for days before the transfer day.
Home support—transfer of service delivery account to the transferee
(3) On the transfer day, the notional service delivery branch account for the transferor in relation to the branch (including the available balance of that account) is transferred to the transferee in relation to the branch.
263A‑5 Merger of service delivery branches
(1) This section applies in relation to the merger of one or more service delivery branches (a merging service delivery branch) of a registered provider into an existing service delivery branch of the provider (the continuing service delivery branch).
Claims for subsidy for days before merger day
(2) The registered provider must ensure that, before the day (the merger day) the merger takes effect, the provider has given to the System Governor claims under section 251 of the Act for subsidy payable to the provider under section 250 of the Act for days before the merger day in relation to funded aged care services delivered through each merging service delivery branch.
Transfer of balance of service delivery account for merging service delivery branches
(3) On the merger day, the available balance of the notional service delivery branch account for the provider in relation to the merging service delivery branch is credited to the notional service delivery branch account for the provider in relation to the continuing service delivery branch.
Note: If the available balance of a notional service delivery branch account for a registered provider in relation to a merging service delivery branch is credited under this subsection, that notional service delivery branch account ceases: see section 203‑25.
Rollover credits
(a) a merging service delivery branch of a registered provider is merged during a financial year into a continuing service delivery branch of the provider; and
(b) an amount was credited to the notional service delivery branch account of the merging service delivery branch in the final quarter of that financial year in accordance with any of the following provisions:
(i) subsection 203(4) of the Act;
(ii) subsection 203(6) of the Act;
(iii) subsection 203(7) of the Act; and
(c) subsection 203‑15(4) of this instrument applies in relation to the notional service delivery branch account (the relevant account) of the continuing service delivery branch for the following financial year (the relevant financial year);
then the sum of the amounts referred to in paragraph (b) of this subsection are taken to be added to the amount referred to in paragraph 203‑15(5)(b) of this instrument for the relevant account for the relevant financial year.
Part 11—Grants
Division 1—Power to enter into other arrangements
265‑5 Grant of financial assistance—other purposes
(1) This section is made for the purposes of paragraph 265(2)(g) of the Act.
(2) It is a prescribed purpose to provide information to support independence, including information about healthy ageing, positive ageing, ageing well and active ageing.
(3) It is a prescribed purpose to carry out activities that assist older Australians who are experiencing sickness or are diverse individuals to access high quality care, including the following:
(a) activities that strengthen the capacity of the health and aged care sectors to provide services for older Australians, including consideration by those sectors for people experiencing behavioural or psychological symptoms of dementia;
(b) activities that support services for individual older Australians for whom eligibility determinations are in effect.
(4) It is a prescribed purpose to carry out activities that support the Commonwealth to implement an efficient and functional aged care system that keeps Australians ageing well, including the following:
(a) prevention, resilience, and early intervention activities that support older Australians:
(i) with continuity of care in emergency scenarios; or
(ii) by improving registered provider resilience, and early interventions; or
(iii) by improving workforce resilience;
(b) activities that promote equity and integration in the health and aged care systems and enable access, quality of care, and support for older Australians by doing any of the following:
(i) delivering outcomes which support the implementation or operation of the Act;
(ii) strengthening the capacity of the health and aged care sectors to provide services for older Australians;
(iii) providing support for services for individual older Australians for whom eligibility determinations are in effect;
(iv) supporting digital channels and online or technology‑delivered support;
(v) providing support for the health and aged care sectors using online or other technology platforms;
(vi) supporting informed decision making and information awareness for individuals, the aged care sector and government;
(vii) supporting activities which prepare Australians for ageing and reduce the financial burden on the health and aged care systems;
(viii) supporting reform, including by way of structural change, in the aged care sector so that medical services are available to older Australians;
(c) research, data development, modelling, and innovation projects that relate to national strategies and action plans;
(d) research, data development, modelling, and innovation projects that do any of the following:
(i) connect care outcomes across the aged care system and continuous care and care economy;
(ii) develop metrics and data capabilities which improve transparency of the aged care system; and
(iii) inform government and the aged care sector on ageing and aged care issues.
Division 2—Grantee Code of Conduct
268‑5 Purpose of this Division
This Division is made for the purposes of subsection 268(1) of the Act.
268‑10 Grantee Code of Conduct
(1) This section sets out the Grantee Code of Conduct, which applies to the following:
(a) a person or body to which money may be payable under an arrangement made under subsection 265(1) of the Act;
(b) a person or body that receives a grant of financial assistance made under subsection 265(1) of the Act.
(2) In undertaking an activity under such an arrangement or grant, the person or body (the grantee) must:
(a) undertake the activity in a safe and competent manner, with care and skill; and
(b) promptly take steps to raise and act on concerns about matters that may affect the quality and safety of the activity; and
(c) promptly disclose to the System Governor, and avoid or manage, any actual, perceived or potential conflicts of interest that could affect the proper undertaking of the activity by any of the following:
(i) the grantee;
(ii) key personnel of the grantee;
(iii) a person who is otherwise employed or engaged by the grantee; and
(d) act with integrity, honesty and transparency; and
(e) treat the following individuals with dignity and respect, and without bullying or harassment, including by valuing the individual’s diversity:
(i) any individual for whom the activity is being undertaken;
(ii) any family member, carer or supporter of the individual for whom the activity is being undertaken;
(iii) any individual engaged in, or participating in, the activity;
(iv) any individual administering the arrangement or grant (whether the individual is an official of the Department or otherwise); and
(f) not provide false or misleading information:
(i) when undertaking the activity; or
(ii) in response to a request for information made for the purposes of this Act in relation to the arrangement or grant.
(3) For the purposes of subsection 268(2) of the Act, the grantee breaches the Grantee Code of Conduct because of an act, or an omission to perform an act, by another person or body if:
(a) the other person or body is a member of the key personnel of the grantee, or is otherwise employed or engaged by the grantee; and
(b) the act, or the omission to perform the act, would be a breach of the Grantee Code of Conduct if it were done by the grantee; and
(c) the act, or the omission to perform the act, is done while the other person or body is doing any of the following (whether or not during their ordinary working hours):
(i) undertaking or participating in an activity for which money may be payable under an arrangement under subsection 265(1) of the Act or that is funded by a grant that has been made to the grantee under that subsection;
(ii) engaging with an individual or any family member, carer or supporter of the individual in relation to the individual’s participation in such an activity;
(iii) doing anything incidental to any of the matters mentioned in paragraph (a) or (b).
(4) In this section, the expression conflict of interest has its ordinary meaning.
Chapter 8—Funding of aged care services—individual fees and contributions
272‑5 Simplified outline of this Chapter
This Chapter provides for matters relating to individual fees and contributions for funded aged care services under Part 3 of Chapter 4 of the Act.
Division 1 of Part 2 of this Chapter relates to fees and contributions payable in a home or community setting, and deals with:
(a) matters relating to working out the individual contribution for individuals; and
(b) requirements for prices charged by registered providers; and
(c) circumstances in which the individual contribution is zero; and
(d) requirements relating to unspent care recipient portions.
Divisions 2 of Part 2 of this Chapter relates to fees and contributions payable in an approved residential care home, and deals with:
(a) matters relating to working out the maximum daily amount of resident contribution; and
(b) certain classes of individuals to whom the hotelling contribution and non‑clinical care contribution do not apply; and
(c) the maximum non‑clinical care contribution and matters relating to working out the non‑clinical care contribution; and
(d) requirements for fees, including refunds of amounts paid in advance in certain circumstances.
Division 2A of Part 2 of this Chapter relates to fees and contributions payable in an approved residential care home for transitional cohorts, and deals with:
(a) matters relating to working out the maximum daily amount of transitional resident contribution; and
(b) requirements for fees, including refunds of amounts paid in advance in certain circumstances.
Division 3 of Part 2 of this Chapter relates to fees and contributions for specialist aged care programs, and deals with:
(a) the amounts that registered providers delivering funded aged care services through a service group under a specialist aged care program may charge individuals; and
(b) refunds of amounts paid in advance in certain circumstances; and
(c) other requirements in relation to amounts that individuals may be charged.
Compliance with the requirements in this Chapter is a condition of registration under section 151 of the Act.
Part 2—Individual fees and contributions
Division 1—Fees and contributions payable in a home or community setting
Subdivision A—Individual contributions
273‑5 Working out individual contribution for assistive technology or home modifications—prescribed day
For the purposes of paragraph (b) of Step 1 of the method statement in subsection 273(2) of the Act (for working out the individual contribution for the delivery of a funded aged care service to an individual on a day), the day the individual agreed to the delivery of the service is prescribed.
273‑10 Working out individual contributions—circumstances and amounts
For the purposes of paragraph (b) of Step 3 of the method statement in subsection 273(2) of the Act (for working out the individual contribution for the delivery of a funded aged care service to an individual on a day), the following table sets out circumstances and amounts for those circumstances.
Amounts used to work out individual contributions in certain circumstances
Item Column 1For the following circumstances … Column 2the amount is …
1 (a) the funded aged care service is any of the following (which involve the sourcing and supply to the individual of included AT‑HM items and conditionally included AT‑HM items other than on loan):(i) managing body functions items (non‑loan);(ii) self‑care items (non‑loan);(iii) mobility items (non‑loan);(iv) domestic life items (non‑loan);(v) communication and information management items (non‑loan);(vi) home modifications items; and(b) the individual has an access approval in effect for, and the service is delivered to the individual through, the classification type ongoing or short‑term for the service group assistive technology or home modifications the amount of the cost for the delivery of the service
2 (a) the funded aged care service is any of the following (which involve the sourcing and supply to the individual of included AT‑HM items and conditionally included AT‑HM items on loan):(i) managing body functions items (loan);(ii) self‑care items (loan);(iii) mobility items (loan);(iv) domestic life items (loan);(v) communication and information management items (loan); and(b) the individual has an access approval in effect for, and the service is delivered to the individual through, the classification type ongoing or short‑term for the service group assistive technology the amount that is 33.3% of the cost for the delivery of the service
3 (a) a classification decision establishing the classification level HM High in a classification type for the service group home modifications is in effect for the individual; and(b) the service is delivered to the individual through that classification type for the service group; and(c) the individual resides at a street address, or in a suburb or locality, that is in the 2023 MM category known as MM 6 or 7 the amount that is 66.6% of the cost for the delivery of the service
4 (a) the individual is in the post‑2014 home contribution class; and(b) immediately before the transition time, there was an income tested care fee for the individual under section 52D‑2 of the old Act; and(c) the sum of any individual contributions charged to the individual under section 273 of the Act for the delivery of funded aged care services to the individual during the preceding fortnight exceeds the amount worked out by multiplying that incomes tested care fee by 14 zero
273‑15 Requirements for prices charged for directly sourced services
For the purposes of subsection 273(4) of the Act, the requirements for the price charged by a registered provider to an individual for the delivery of a funded aged care service are that:
(a) if, in accordance with an arrangement agreed with the registered provider, the individual directly sources the delivery of the funded aged care service at a particular price from an associated provider of the registered provider—the price charged by the registered provider must not exceed 110% of that particular price; and
(b) in any case—the price charged by the registered provider must not be unreasonable.
273‑20 When individual contribution is zero—other contributions or fees
For the purposes of paragraph 273(5)(c) of the Act, for an individual who was approved as a recipient of aged care under the old Act, the following contributions and fees are prescribed:
(a) the means tested care fees (within the meaning of section 52C‑3(3) of the old Act) (if any) for the individual under the old Act;
(b) the income tested care fees (within the meaning of subsection 52D‑2(3) of the old Act) (if any) for the individual under the old Act;
(c) for an individual in the post‑2014 home contribution class or the post‑2014 residential contribution class—the means tested care fees for the individual.
Subdivision B—Unspent care recipient portions
273A‑5 Unspent care recipient portions
For the purposes of subsection 273A(2) of the Act, this Subdivision prescribes requirements relating to unspent care recipient portions.
273A‑10 Agreement with individual
A registered provider that holds an unspent care recipient portion for an individual must, within 70 days after the transition time, agree in writing one of the following with the individual:
(a) that the provider will return the portion to the individual;
(b) that the provider will retain the portion and will deal with the portion in accordance with this Subdivision.
273A‑15 If agreement is to return portion
If the provider agrees that the provider will return the portion to the individual, the provider must:
(a) return the portion to the individual within 14 days after the day the agreement is made; or
(b) if the individual dies on or after the day the agreement is made and before the provider returns the portion to the individual—return the portion to the individual’s estate within 14 days after the provider is shown the probate of the individual’s will or letters of administration of the individual’s estate.
273A‑20 If agreement is to retain portion
If the provider agrees with the individual as mentioned in paragraph 273A‑10(b) of this instrument, the provider must:
(a) reduce (but not below zero) the amount of the portion by the individual contributions charged to the individual by the provider under section 273 of the Act; and
(b) if the provider ceases to deliver funded aged care services to the individual and the balance of the portion is not zero:
(i) if the cessation of delivery of services is because the individual dies—pay the balance of the portion to the individual’s estate within 14 days after the provider is shown the probate of the individual’s will or letters of administration of the individual’s estate; or
(ii) otherwise—pay the balance of the portion to the individual within 70 days after the cessation of delivery of services.
Note: For obligations relating to providing information about unspent care recipient portions, see sections 149‑45 and 155‑40.
Division 2—Fees and contributions payable in an approved residential care home
Subdivision A—Classes of individuals to which Division 2 of Part 3 of Chapter 4 of the Act does not apply
275A‑5 Division 2 of Part 3 of Chapter 4 of Act not to apply to transitional cohorts
For the purposes of section 275A of the Act, the following classes of individuals are prescribed:
(a) individuals in the pre‑2014 residential contribution class;
(b) individuals in the post‑2014 residential contribution class.
Subdivision C—Hotelling contribution and non‑clinical care contribution
279‑5 Maximum non‑clinical care contribution
For the purposes of subsection 279(3) of the Act, the amount is $107.32.
279‑10 When non‑clinical care contribution is zero—number of days
For the purposes of subsection 279(4) of the Act, the number of days is 1,460.
279‑15 When non‑clinical care contribution is zero—other contributions or fees
For the purposes of paragraph 279(5)(c) of the Act, for an individual who was approved as a recipient of aged care under the old Act, the following contributions and fees are prescribed:
(a) the means tested care fees (within the meaning of section 52C‑3(3) of the old Act) (if any) for the individual under the old Act;
(b) the income tested care fees (within the meaning of subsection 52D‑2(3) of the old Act) (if any) for the individual under the old Act;
(c) for an individual in the post‑2014 home contribution class or the post‑2014 residential contribution class—the means tested care fees (if any) for the individual.
280‑5 Hotelling contribution and non‑clinical care contribution taken to be zero in some circumstances—classes of individuals
For the purposes of paragraph 280(1)(b) of the Act:
(a) the classes of individuals for whom both the hotelling contribution and non‑clinical care contribution are taken to be zero for a day are the following:
(i) individuals who cease accessing funded aged care services in an approved residential care home, without starting to access funded aged care services in another approved residential care home, before the registered provider of the home has been informed of the individual’s hotelling contribution and non‑clinical care contribution;
(ii) individuals who start accessing funded aged care services in an approved residential care home, but who die before the registered provider of the home has been informed of the individual’s hotelling contribution and non‑clinical care contribution;
(iii) individuals whose start day was more than 6 months before the day they are informed of their daily means tested amount;
(iv) individuals who have one or more dependent children;
(v) individuals who are described in paragraph 85(4)(b) of the Veterans’ Entitlements Act (which describes former prisoners of war); and
(b) a class of individuals for whom the non‑clinical care contribution is taken to be zero for a day is individuals who have, before the day, elected in the approved form to cease being a member of the pre‑2014 residential contribution class; and
(c) a class of individuals for whom the non‑clinical care contribution is taken to be zero for a day is individuals who:
(i) were continuing home care recipients under the old Act on 12 September 2024; and
(ii) since that time, have been provided with funded aged care services through the service group residential care.
280‑10 Hotelling contribution and non‑clinical care contribution taken to be zero in some circumstances—matters to which System Governor must have regard
(1) For the purposes of subsection 280(4) of the Act, the matters to which the System Governor must have regard in deciding whether to make a determination under subsection 280(2) of the Act that the hotelling contribution and non‑clinical care contribution for an individual is to be taken to be zero are the following:
(a) the individual’s total assessable income (which is determined under section 322 of the Act) and the value of the individual’s assets (which is determined under section 329 of the Act);
(b) the individual’s financial arrangements;
(c) the individual’s entitlement to:
(i) an income support payment; or
(ii) income from any other source;
(d) whether the individual has taken steps to obtain information about the individual’s entitlement to income support payments;
(e) whether the individual:
(i) is eligible to make a request under section 1129 of the Social Security Act 1991 (relating to access to financial hardship rules for pensions); or
(ii) is qualified to participate in the home equity access scheme under Division 4 of Part 3.12 of the Social Security Act 1991; or
(iii) has access to financial assistance from any other source;
(f) whether any income of the individual is income that the individual does not reasonably have access to;
(g) whether there is a charge on the individual’s income over which the payment of fees and contributions cannot practically take precedence;
(h) whether any assets of the individual are unrealisable assets (within the meaning of the Social Security Act 1991);
(i) whether the individual is in Australia on a temporary basis.
281‑5 Fees for pre‑entry period—ongoing residential care—maximum amount of pre‑entry fee chargeable
For the purposes of paragraph 281(4)(a) of the Act, the amount for a day for an individual is the basic daily fee for the individual.
Subdivision D—Fees for reserving a bed—ongoing residential care
282‑5 Maximum amount of bed reservation fee chargeable
(1) For the purposes of subsection 282(3) of the Act, subsection (2) prescribes the maximum amount of the bed reservation fee that a registered provider delivering ongoing funded aged care services through the service group residential care to an individual in an approved residential care home may charge the individual under section 282 of the Act for a day.
(2) The amount is the sum of the following amounts, calculated as if the registered provider delivered an ongoing funded aged care service to the individual through that service group in that approved residential care home on the day:
(a) the maximum daily amount of the resident contribution that would have been payable by the individual for the day;
(b) the standard base provider amount for a day for the individual.
Subdivision E—Fees for delivery of funded aged care services—short‑term residential care
283‑15 Booking fee
(1) For the purposes of subsection 283(4) of the Act, this section makes provision in relation to the charging of a booking fee by a registered provider for or in connection with the delivery of short‑term funded aged care services through the service group residential care to an individual for a period (the respite period).
Maximum amount of booking fee
(2) The booking fee must not exceed the lesser of the following:
(a) the total of the resident respite fees that the provider would charge the individual for or in connection with the services for a period of 7 days;
(b) 25% of the total of the resident respite fees that the provider will charge the individual for the days in the respite period.
When booking fee must be refunded in full
(3) The provider must refund the whole of the booking fee if any of the following events occur:
(a) the individual does not access the services because the individual enters hospital before the respite period;
(b) the individual dies before the respite period;
(c) the individual cancels the booking for the respite period more than 7 days before the start of the respite period.
When booking fee must be refunded in part
(4) The provider must refund the part of the booking fee referred to in subsection (5) if, during the lesser of the following (the booking fee period):
(a) the first 7 days of the respite period;
(b) the first 25% of the respite period;
any of the following events occur:
(c) the individual enters hospital;
(d) the individual dies;
(e) the provider requires the individual to leave the approved residential care home in which the services are being delivered.
(5) For the purposes of subsection (4), the part of the booking fee required to be refunded is the amount equal to the proportion of the booking fee that corresponds to the proportion of the booking fee period that remains after the event occurs.
(6) The provider must pay a refund required by subsection (3) or (4):
(i) if, within 14 days after the provider becomes aware of the individual’s death, the provider is shown the probate of the will of the individual or letters of administration of the estate of the individual—to the individual’s estate within 14 days after the day on which the provider was so shown; or
(ii) if subparagraph (i) does not apply—to a person that the provider is reasonably satisfied that it is appropriate to pay the refund to within 28 days after the provider becomes aware of the individual’s death; or
(b) otherwise—to the individual within 14 days after the later of:
(i) the day the event mentioned in subsection (3) or (4) (as applicable) occurs; and
(ii) the day the provider becomes aware of the event.
When booking fee is not required to be refunded in whole or in part
(7) The provider is not required to refund the booking fee (in whole or in part) if:
(a) the booking for the respite period is cancelled within 7 days before the start of the period for a reason other than that the individual enters hospital or dies; or
(b) the individual chooses to leave the approved residential care home in which the services are being delivered before the end of the respite period.
Subdivision F—Fees for higher everyday living
284‑1 Purpose of this Subdivision
For the purposes of subsections 284(2), (3) and (6) of the Act, this Subdivision prescribes the following:
(a) requirements for entering into higher everyday living agreements;
(b) other requirements for higher everyday living agreements;
(c) how agreed amounts of higher everyday living fees are to be indexed;
(d) circumstances in which a registered provider must not charge an individual a higher everyday living fee;
(e) circumstances in which a registered provider must not enter into a higher everyday living agreement with an individual.
284‑2 Kinds of higher everyday living agreement
A higher everyday living agreement must be either:
(a) a standing higher everyday living agreement; or
(b) an ad hoc higher everyday living agreement.
Note 1: A standing higher everyday living agreement may contain an agreed amount for:
(a) a single service that is to be delivered on a single occasion; or
(b) services that are to be delivered on an ongoing basis; or
(c) services that are to be delivered for a fixed term.
Note 2: An ad hoc higher everyday living agreement may contain only an agreed amount for a single funded aged care service, or a single additional service, to be delivered on a single occasion (see subsection 284‑13(1)).
284‑5 Entry requirements—all higher everyday living agreements
Fees for services must be for services at a higher standard
(1) A registered provider and an individual must not enter into a higher everyday living agreement that contains an agreed amount for a funded aged care service unless the agreement requires the provider to deliver the service to the individual at a standard, specified in the agreement, that is higher than the standard that the Act requires the service to be delivered at.
Fees in connection with services must be for additional connected services
(2) A registered provider and an individual must not enter into a higher everyday living agreement that contains an agreed amount in connection with a funded aged care service unless the agreement requires the provider to deliver an additional service, specified in the agreement, that is connected to the funded aged care service, to the individual.
284‑6 Additional entry requirements—standing higher everyday living agreements
A registered provider and an individual must not enter into a standing higher everyday living agreement unless, before the agreement is entered into, the provider gives the individual the following:
(a) a list of each funded aged care service for which the provider charges a higher everyday living fee and the standard at which the provider delivers the service;
(b) a list of each additional service that the provider delivers in connection with a funded aged care service and the funded aged care service that the additional service is delivered in connection with;
(c) if the provider does not offer the option of bundling of the charging of higher everyday living fees—the higher everyday living fee for each of the services referred to in paragraph (a) or (b);
(d) if the provider offers the option of bundling of the charging of higher everyday living fees for one or more services referred to in paragraph (a) or (b):
(i) the standalone fee for each of those services and the bundled fee for each of those services; and
(ii) that the individual is not required to agree to the bundling of the charging of higher everyday living fees; and
(iii) that the provider must offer to deliver, and the individual may choose to access, any of those services individually and not as part of a bundle.
Note: See also subsection 284‑11(2), which deals with bundling the charging of higher everyday living fees.
284‑7 Additional entry requirements—ad hoc higher everyday living agreements
Matters about which the individual must be informed before entry
(1) A registered provider and an individual must not enter into an ad hoc higher everyday living agreement unless, before the agreement is entered into, the provider informs the individual of the following:
(a) if the agreement relates to the delivery of a funded aged care service—the service, the standard at which the provider delivers the service, and the higher everyday living fee for the service;
(b) if the agreement relates to an additional service—the additional service, the funded aged care service that the additional service is delivered in connection with, and the higher everyday living fee for the additional service;
(c) that the individual will be charged at the time the service or additional service is delivered;
(d) that the individual will not be charged if the individual chooses not to, or is unable to, have the service, or the additional service, delivered.
Timing of entry—immediately before, or at time of, delivery of service
(2) A registered provider and an individual may enter into an ad hoc higher everyday living agreement relating to a funded aged care service or additional service only immediately before, or at the time, the service or additional service is to be delivered.
284‑10 Requirements that higher everyday living agreements must comply with—all higher everyday living agreements
(1) A higher everyday living agreement must be expressed in plain language and be readily understandable by the individual.
Agreed amounts
(2) A higher everyday living agreement must:
(a) specify each agreed amount, the funded aged care service that it is charged for or in connection with, and the frequency at which it is charged; and
(b) for an agreed amount for a funded aged care service—specify the standard at which the provider must deliver the service; and
(c) for an agreed amount in connection with a funded aged care service—specify the additional service, connected to the funded aged care service, that the provider must deliver; and
(d) state that the agreed amounts are subject to indexation in accordance with section 284‑15 of this instrument; and
(e) require the provider to notify the individual of the replacement agreed amounts as soon as practicable after each indexation day (within the meaning of section 284‑15 of this instrument).
Note: An individual’s accommodation agreement sets out when an individual may be required to move rooms on a non‑voluntary basis: see section 294‑5.
Agreement must be a standalone agreement
(3) The agreement must not be incorporated into:
(a) a service agreement; or
(b) an accommodation agreement.
284‑11 Additional requirements—standing higher everyday living agreements
Agreements to be in writing
(1) A standing higher everyday living agreement must be in writing.
Bundling the charging of higher everyday living fees
(2) A standing higher everyday living agreement must not require the bundling of the charging of higher everyday living fees for one or more funded aged care services or additional services unless:
(a) the bundled fee for each of the services is agreed between the registered provider and the individual in the agreement; and
(b) the total of the bundled fees does not exceed the total of the standalone cost of the services within those bundled services that the person is able to use.
Fixed term services
(3) If a funded aged care service to which the agreement relates is to be delivered over a fixed term rather than on an ongoing basis, the agreement must specify the fixed term.
Annual review—individuals accessing ongoing funded aged care services
(4) If the provider is delivering ongoing funded aged care services to the individual, the agreement must provide for an annual review of the funded aged care services for or in connection with which agreed amounts are charged.
(5) If the agreement provides for an annual review, the agreement must also require the provider to keep a written record of:
(a) each annual review that has occurred; and
(b) the findings of each annual review; and
(c) if the individual and the provider agree to vary the agreement as a result of the annual review—the variations so agreed; and
(d) any other agreement with the individual that has been reached as a result of an annual review.
Note: For variations as a result of an annual review, see subsection (9).
Term of agreements—individuals accessing short‑term funded aged care services
(6) If the provider is delivering short‑term funded aged care services to the individual, the agreement must provide that the term of the agreement is the period for which the provider delivers those services to the individual.
Variation and termination—general
(7) A standing higher everyday living agreement must provide that:
(a) the individual may vary or terminate the agreement within 28 days after the agreement is entered into without giving notice to the provider and without the provider charging a fee for the variation or termination; and
(b) the individual or the provider may vary or terminate the agreement with 28 days’ notice to the other party, and without the provider charging a fee for the variation or termination, at any time after the end of 28 days after the agreement is entered into.
(8) The agreement must provide that a variation as mentioned in paragraph (7)(a) or (b) must not include a variation that consists only of a change to the agreed amount for a service.
Note: Examples of permitted variations include the addition of a funded aged care service or additional service connected to that service, the removal of such a service, or the frequency of such a service.
(9) To avoid doubt, if the agreement is varied or terminated as mentioned in paragraph (7)(b), the provider may continue to charge fees (other than a fee for the variation or termination) under the agreement until the end of the 28‑day notice period.
Variation—annual review
(10) If the agreement provides for an annual review under subsection (4), the agreement must provide that the individual and the provider may agree to vary any part of the agreement as a result of the annual review, other than a variation that consists only of a change to the agreed amount for a service.
Variation and termination—provider can no longer deliver a service at the specified standard
(11) The agreement must provide that, if the provider can no longer deliver a funded aged care service at the specified standard:
(a) the individual may terminate the agreement without giving notice to the provider and without the provider charging a fee for the termination; or
(b) the individual and provider may agree to vary the agreement to remove the service and the agreed amount for the service; or
(c) the individual and provider may agree to vary the agreement to specify a different standard at which the provider must deliver the service (which must still be a standard that is higher than the standard that the Act requires the service to be delivered at), and specify a different agreed amount for the service.
Variation and termination—provider can no longer deliver additional service
(12) The agreement must provide that, if the provider can no longer deliver an additional service, connected to a funded aged care service:
(a) the individual may terminate the agreement without giving notice to the provider and without the provider charging a fee for the termination; or
(b) the individual and provider may agree to vary the agreement to remove the additional service and the agreed amount in connection with the funded aged care service; or
(c) the individual and provider may agree to vary the agreement to specify a different additional service, and specify a different agreed amount in connection with the funded aged care service.
Suspension while individual is on leave
(13) The agreement must provide that:
(a) if the individual is on extended hospital leave, the agreement is suspended until the day the leave ends; and
(b) if the individual is on another kind of leave, the individual and the provider may agree:
(i) to suspend the agreement; and
(ii) the period for which the agreement is suspended.
Refunds relating to variation, termination or suspension—general
(14) The agreement must provide that:
(a) if the agreement is terminated as mentioned in subsection (7), the provider must, within 14 days after the agreement is terminated, refund to the individual any agreed amounts paid in advance in respect of a period after the agreement is terminated; and
(b) if the agreement is varied:
(i) as mentioned in subsection (7) or (10); and
(ii) in a way that reduces any of the agreed amounts;
the provider must, within 14 days after the agreement is varied, refund to the individual the amount of the reductions in the agreed amounts paid in advance in respect of a period after the agreement is varied; and
(c) if the agreement is suspended as mentioned in subsection (13), the provider must, within 14 days after the beginning of the suspension, refund to the individual any agreed amounts paid in advance in respect of the period of suspension.
(15) However, if the agreement is varied or terminated on the initiative of the individual (other than as mentioned in paragraph (7)(a) or subsection (10), (11) or (12)), or the agreement is suspended as mentioned in subsection (13), the agreement must provide that the provider:
(a) may recover from the individual any unavoidable service cost for the individual, including by deducting the unavoidable service cost from a refund the individual is entitled to under subsection (14); and
(b) must provide evidence to the individual (if requested) supporting the provider’s claim that a cost is an unavoidable service cost for the individual.
(16) An unavoidable service cost for an individual is a cost that:
(a) relates to a service that would have been delivered to the individual under the agreement, had the agreement not been varied, terminated or suspended; and
(b) the registered provider is required to pay to another party whether or not the provider delivers the service to the individual.
(17) A cost ceases to be an unavoidable service cost at the end of the period of 90 days from:
(a) for a variation—the end of the applicable notice period (if any); or
(b) for a termination—the day the termination takes effect.
(18) The agreement must specify the unavoidable service costs for the individual.
Refunds relating to termination or variation referred to in subsection (11) or (12)
(19) The agreement must provide that:
(a) if the individual terminates the agreement as mentioned in paragraph (11)(a) or (12)(a), the provider must, within 14 days after the agreement is terminated, refund to the individual any agreed amounts paid in advance in respect of a period after the agreement is terminated; and
(b) if the agreement is varied as mentioned in paragraph (11)(b) or (12)(b) to remove an agreed amount, the provider must, within 14 days after the agreement is varied, refund to the individual any amount of the removed agreed amount paid in advance in respect of a period after the agreement is varied; and
(c) if the agreement is varied as mentioned in paragraph (11)(c) or (12)(c) in a way that reduces an agreed amount, the provider must, within 14 days after the agreement is varied, refund to the individual the amount of any reductions in the agreed amount paid in advance in respect of a period after the agreement is varied.
Notification of variation or termination
(20) The agreement must provide that:
(a) if the individual initiates a variation or termination of the agreement without giving notice under paragraph (7)(a), (11)(a) or (12)(a); or
(b) the individual or the provider initiate a variation or termination under paragraph (7)(b) or subsection (10);
the provider must, by written notice given to the individual by the end of the period of 14 days beginning on the day the relevant initiation occurs:
(c) acknowledge the variation or termination, or the proposed variation or termination (as the case requires); and
(d) if the provider initiates the variation or termination—set out the reasons for doing so; and
(e) in the case of a variation—set out any changes to be made to the agreement; and
(f) set out any unavoidable service costs for the individual; and
(g) set out any refund payable to the individual under subsection (14) or subsection (19) (taking into account the effect of subsection (15) about unavoidable service costs).
284‑13 Additional requirements—ad hoc higher everyday living agreements
Agreement may relate only to single service on single occasion
(1) An ad hoc higher everyday living agreement may only contain an agreed amount for a single funded aged care service, or a single additional service, that is to be delivered on a single occasion.
Termination
(2) An ad hoc higher everyday living agreement terminates when both of the following have occurred:
(a) the funded aged care service or the additional service to which the agreement relates has been delivered to the individual;
(b) the individual has paid the agreed amount for the service.
284‑15 Indexation of agreed amounts—all higher everyday living agreements
(1) If the indexation factor on 1 July 2026 or a later 1 July (an indexation day) is greater than 1, an agreed amount specified in a higher everyday living agreement is replaced by the amount worked out using the following formula:
start formula Agreed amount immediately before the indexation day times Indexation factor for the indexation day end formula
(2) The amount worked out under subsection (1) is to be rounded to the nearest whole dollar (rounding 50 cents upwards).
Indexation factor
(3) The indexation factor for an indexation day is the number worked out using the following formula:
start formula start fraction Index number for the reference quarter over Index number for the base quarter end fraction end formula
base quarter means the March quarter that has the highest index number of the March quarters before the reference quarter (but not earlier than the March quarter 2025).
index number, for a quarter, means the All Groups Consumer Price Index number (being the weighted average of the 8 capital cities) published by the Australian Statistician for that quarter.
March quarter means a period of 3 months starting on 1 January.
reference quarter means the last March quarter before the indexation day.
(4) The indexation factor is to be worked out to 3 decimal places (rounding up if the fourth decimal place is 5 or more).
Changes to CPI index reference period and publication of substituted index numbers
(5) Amounts are to be worked out under this section:
(a) using only the index numbers published in terms of the most recently published index reference period for the Consumer Price Index; and
(b) disregarding index numbers published in substitution for previously published index numbers (except where the substitution is to transition to a new index reference period).
Application of replacement agreed amounts—services delivered on or after indexation day
(6) If an agreed amount for or in connection with a funded aged care service is replaced on an indexation day in accordance with subsection (1), the replacement agreed amount applies to delivery of the funded aged care service on or after the indexation day.
284‑20 Circumstances in which higher everyday living fee not to be charged to individuals—all higher everyday living agreements
Each of the following are circumstances in which a registered provider must not charge the individual a higher everyday living fee for or in connection with a particular funded aged care service:
(a) the service is in the service type residential accommodation;
(b) the fee is not agreed between the provider and the individual in a higher everyday living agreement that is in effect;
(c) the provider charges the individual a higher everyday living fee for or in connection with the service under another higher everyday living agreement.
284‑25 Circumstances in which higher everyday living agreements not to be entered into—all higher everyday living agreements
The following are circumstances in which a registered provider must not enter into a higher everyday living agreement with an individual:
(a) the agreement contains a higher everyday living fee for or in connection with a funded aged care service in the service type residential accommodation;
(b) the registered provider has not entered into a service agreement with the individual.
Subdivision G—Other matters
285‑5 Refund of amounts paid in advance if individual dies or stops accessing services
For the purposes of subsection 285(3) of the Act, if an individual dies or stops accessing funded aged care services, and has paid an amount that the individual may be charged under Division 2 of Part 3 of Chapter 4 of the Act in advance for a day occurring after the individual dies or stops accessing those services, the registered provider to whom the individual paid the amount must refund the amount:
(i) if, within 14 days after the provider becomes aware of the individual’s death, the provider is shown the probate of the will of the individual or letters of administration of the estate of the individual—to the individual’s estate within 14 days after the day on which the provider was so shown; or
(ii) if subparagraph (i) does not apply—to a person that the provider is reasonably satisfied, on the basis of other evidence shown to the provider, that it is appropriate to pay the refund to within 14 days after the provider was shown the other evidence; or
285‑10 Resident respite fees to be reduced by booking fee
For the purposes of subsection 285(4) of the Act, if a registered provider charges an individual a booking fee for or in connection with the delivery of short‑term funded aged care services through the service group residential care to the individual for a period (the respite period), the total amount of the resident respite fees charged by the provider to the individual for the days in the respite period must be reduced by the amount of the booking fee.
Division 2A—Fees and contributions payable in an approved residential care home for transitional cohorts
Subdivision A—Prescribed amounts
285A‑3 Purposes of this Subdivision
For the purposes of subsection 285A(1) of the Act, this Subdivision prescribes amounts that a registered provider delivering ongoing funded aged care services through the service group residential care to an individual in a class of individuals referred to in section 275A of the Act may charge the individual for a day for or in connection with those services.
285A‑5 Contributions for delivery of funded aged care services
(1) For the purposes of subsection 285A(1) of the Act, a registered provider delivering ongoing funded aged care services through the service group residential care to an individual in a class of individuals referred to in section 275A of the Act may charge the individual an amount (the transitional resident contribution) for or in connection with those services.
(2) Subject to section 285A‑25, the transitional resident contribution charged to the individual for the day must not exceed the maximum daily amount of the transitional resident contribution worked out for the day under section 285A‑10.
(3) If the registered provider does not, or is taken not to, deliver funded aged care services to the individual on the day, the registered provider must not charge the individual a transitional resident contribution under this section for the day.
Note: The registered provider may charge an individual certain amounts for a day on which the provider does not deliver funded aged care services to the individual: see sections 285A‑15 and 285A‑20.
285A‑10 Maximum daily amount of transitional resident contribution
(1) The maximum daily amount of the transitional resident contribution payable by an individual for a day is the amount worked out as follows:
Step 1. Work out the transitional basic daily fee for the individual (see section 285A‑11).
Step 2. Add the transitional compensation payment fee (if any) for the individual for the day (see subsection (2)).
Step 3. Add:
(a) for an individual in the pre‑2014 residential contribution class—any income tested fee (see section 285A‑13); or
(b) for an individual in the post‑2014 residential contribution class—any means tested care fee (see section 285A‑14).
(2) The transitional compensation payment fee for the individual for the day is the amount equal to the transitional compensation payment reduction applicable to the individual on that day (see sections 242B‑50 and 242B‑55).
285A‑11 Transitional basic daily fee
(1) The transitional basic daily fee for an individual for a day is the amount worked out in accordance with this section.
Pre‑2014 residential contribution class—general
(2) If the individual is in the pre‑2014 residential contribution class, the amount is whichever of the following applies:
(a) if the individual was a protected resident within the meaning of the Aged Care (Transitional Provisions) Act 1997 immediately before the transition time—the amount obtained by rounding down to the nearest cent an amount equal to 77.5% of the basic age pension amount (worked out on a per day basis);
(b) if section 58‑3C of the Aged Care (Transitional Provisions) Act 1997 applied to the individual immediately before the transition time—the amount obtained by rounding down to the nearest cent an amount equal to 96.5% of the basic age pension amount (worked out on a per day basis);
(c) for any other individual—the amount obtained by rounding down to the nearest cent the amount equal to 85% of the basic age pension amount (worked out on a per day basis).
Post‑2014 residential contribution class
(3) If the individual is in the post‑2014 residential contribution class, the amount is the amount obtained by rounding down to the nearest cent the amount equal to 85% of the basic age pension amount (worked out on a per day basis).
285A‑13 Income tested fee
(1) Subject to subsections (2), (3), (4) and (5) the income tested fee for an individual in the pre‑2014 residential contribution class is equal to the daily means tested amount for the individual for the day (see section 319‑15).
Circumstances in which income tested fee is taken to be zero
(2) Despite subsection (1), the individual’s income tested fee is zero on a day if any of the following apply on the day:
(a) the individual has one or more dependent children;
(b) the individual is an individual described in paragraph 85(4)(b) of the Veterans’ Entitlements Act (which describes former prisoners of war);
(c) the individual:
(i) was provided with residential care (within the meaning of the Aged Care (Transitional Provisions) Principles 2014, as in force before the transition time) at any time after 30 September 1997 and before 1 March 1998; or
(ii) was, before 1 March 1998, on leave, as described in subsection 42‑3(3) of the Aged Care (Transitional Provisions) Act 1997 (as in force before the transition time);
(d) the daily means tested amount for the individual for the day (see section 319‑15) is less than $1.
Individual dies before being informed of the individual’s income tested fee
(a) at a time that is after the transition time, the individual is accessing funded aged care services at an approved residential care home of a registered provider; and
(b) the individual dies before the registered provider is informed of the individual’s income tested fee (as it would be but for the application of this subsection);
then, despite subsection (1), the individual’s income tested fee is zero on each day starting after that time.
Individual is not informed of the individual’s income tested fee within 6 months
(4) If the individual is not informed of the individual’s income tested fee (as it would be but for the application of this subsection) within 6 months after the earlier of the following days (the applicable day):
(a) the individual’s start day;
(b) the individual’s day of entry (within the meaning of the old Act) (if any);
then, despite subsection (1), the individual’s income tested fee is zero for each day beginning on the applicable day until the day the individual is informed of the individual’s income tested fee.
Registered provider not informed of individual’s income tested fee before individual ceases service
(a) at a time that is after the transition time, the individual is accessing funded aged care services at an approved residential care home of a registered provider on a day; and
(b) on a later day the individual ceases accessing funded aged care services at the approved residential care home without starting to access funded aged care services at another approved residential care home of the registered provider or any other registered provider; and
(c) the registered provider is not informed of the individual’s income tested fee (as it would be but for the application of this subsection) before the later day;
then, despite subsection (1), the individual’s income tested fee is zero on each day starting after that time.
285A‑14 Means tested care fee
(1) Subject to subsections (2) to (8), the means tested care fee for an individual in the post‑2014 residential contribution class for a day is worked out as follows:
Step 1. Work out the daily means tested amount for the individual for the day (see section 319‑20).
Step 2. Subtract from the amount worked out under Step 1 the amount referred to in subparagraph 230‑15(1)(a)(i) (which is the highest maximum accommodation supplement amount that can apply in relation to an individual to whom Division 4 of Part 2 of Chapter 4 of the Act applies).
Step 3. If the amount worked out under Step 2 is a negative amount, the means tested care fee for the individual for the day is nil.
Step 4. If the amount worked out under Step 2 is greater than zero, work out the sum of the following amounts for the day (as if Division 4 of Part 2 of Chapter 4 of the Act applied in relation to the individual):
(b) the provider’s base provider amount (see section 238‑5) as if item 8 of the table in subsection 238‑5(1) applies to the provider;
(c) the oxygen supplement (see section 230‑11) (if applicable);
(d) the enteral feeding supplement (see section 230‑12) (if applicable).
Step 5. If the amount worked out under Step 2 does not exceed the amount worked out under Step 4, and the individual does not have means not disclosed status, the means tested care fee for the individual for the day is the amount worked out under Step 2.
Step 6. If the amount worked out under Step 2 exceeds the amount worked out under Step 4, or the individual has means not disclosed status, the means tested care fee for the individual for the day is the amount worked out under Step 4.
Circumstances in which the individual’s means tested care fee is taken to be zero—contribution caps
(2) The annual cap period for the individual is the period of 12 months starting on the day, in the 12 month period before the transition time, that is:
(a) the day (the first day) on which the individual first entered an aged care service (within the meaning of the old Act) other than as a continuing care recipient (within the meaning of the old Act); or
(b) a day that is an anniversary of the first day.
(3) Despite subsection (1), the individual’s means tested care fee on a day is zero if:
(a) the day occurs during the annual cap period for the individual; and
(b) on a previous day the sum of the individual’s means tested care fees under this instrument and the combined care subsidy reductions under sections 44‑21 and 48‑7 of the Act during the annual cap period for the individual exceeded $35,910.43.
(4) Despite subsection (1), the individual’s means tested care fee on a day is zero if, on a previous day, the sum of all the individual’s means tested care fees under this instrument and the combined care subsidy reductions under sections 44‑21 and 48‑7 of the old Act exceeds $86,185.23.
Circumstances in which the individual’s means tested care fee is taken to be zero—other
(5) Despite subsection (1), the individual’s means tested care fee on a day is zero if any of the following apply on the day:
(a) the individual has one or more dependent children;
(b) the individual is an individual described in paragraph 85(4)(b) of the Veterans’ Entitlements Act (which describes former prisoners of war);
(c) the individual was a continuing home care recipient (within the meaning of the old Act) on 12 September 2024;
(d) the individual’s means tested care fee is worked out as less than $1.
Individual dies before being informed of the individual’s means tested care fee
(a) at a time that is after the transition time, the individual is accessing funded aged care services at an approved residential care home of a registered provider; and
(b) the individual dies before the registered provider is informed of the individual’s means tested care fee (as it would be but for the application of this subsection);
then, despite subsection (1), the individual’s means tested care fee is zero.
Individual is not informed of the individual’s means tested care fee within 6 months
(7) If the individual is not informed of the individual’s means tested care fee (as it would be but for the application of this subsection) within 6 months after the earlier of the following days (the applicable day):
(a) the individual’s start day;
(b) the individual’s day of entry (within the meaning of the old Act) (if any);
then, despite subsection (1), the individual’s means tested care fee is zero for each day beginning on the applicable day until the day the individual is informed of the individual’s means tested care fee.
Registered provider not informed of individual’s means tested care fee before individual ceases services
(8) If:
(a) at a time that is after the transition time, the individual is accessing funded aged care services at an approved residential care home of a registered provider; and
(b) on a later day the individual ceases accessing funded aged care services at the approved residential care home without starting to access funded aged care services at another approved residential care home of the registered provider or any other registered provider; and
(c) the registered provider is not informed of the individual’s means tested care fee (as it would be but for the application of this subsection) before the later day;
then, despite subsection (1), the individual’s means tested care fee is zero on each day starting after that time.
285A‑15 Fees for transitional pre‑entry period
(1) For the purposes of subsection 285A(1) of the Act, a registered provider delivering funded aged care services through the service group residential care in an approved residential care home may charge an individual an amount (the transitional pre‑entry fee) for each day in the period set out in subsection (2) if:
(a) the individual is in a class of individuals referred to in section 275A of the Act; and
(b) the individual’s access approval includes the ongoing classification type for the service group residential care.
(2) The period (the transitional pre‑entry period) is the period:
(a) starting on the later of the following:
(i) the day the individual enters into a service agreement with the provider;
(ii) the day that is 7 days before the individual’s start day; and
(b) ending at the end of the day before that start day.
Note: The registered provider is taken not to be delivering funded aged care services to the individual on a day in the transitional pre‑entry period, so section 285A‑5 does not apply to the day.
(3) The maximum amount of the transitional pre‑entry fee that the registered provider may charge the individual under this section for a day in the transitional pre‑entry period is the amount of the transitional basic daily fee for the individual.
285A‑20 Fees for reserving a bed
(1) For the purposes of subsection 285A(1) of the Act, a registered provider delivering ongoing funded aged care services through the service group residential care to an individual in a class of individuals referred to in section 275A of the Act in an approved residential care home may charge the individual an amount (the transitional bed reservation fee) for a day to reserve a bed if subsection (2) applies to the individual on that day.
(2) This subsection applies to the individual on the day if the individual:
(a) is absent from the approved residential care home on the day; and
(b) is not on leave from the approved residential care home on the day (see section 244 of the Act); and
(c) would have been on social leave from the approved residential care home on the day except that the individual has previously been on social leave during the current financial year for 52 days.
Note: The registered provider is taken not to be delivering funded aged care services to the individual on a day if subsection (2) applies to the individual on the day, so section 285A‑5 does not apply to the day.
(3) The maximum amount of the transitional bed reservation fee that the registered provider may charge the individual under this section for the day is the sum of the following amounts:
(a) the maximum daily amount of the transitional resident contribution that would have been payable by the individual for the day (see section 285A‑10);
(b) the individual’s base rate (worked out as if Division 4 of Part 2 of Chapter 4 of the Act applied in relation to the individual);
(c) the standard base provider amount for a day for the individual (worked out as if Division 4 of Part 2 of Chapter 4 of the Act applied in relation to the individual);
calculated as if the registered provider delivered an ongoing funded aged care service to the individual through that service group in that approved residential care home on the day and as if item 8 of the table in subsection 238‑5(1) applied to the provider.
285A‑25 Fees for higher everyday living
(1) For the purposes of subsection 285A(1) of the Act, a registered provider that delivers funded aged care services through the service group residential care to an individual in a class of individuals referred to in section 275A of the Act may charge the individual an additional amount (the transitional higher everyday living fee) for or in connection with a particular funded aged care service.
(2) The transitional higher everyday living fee for the individual for the service is the amount agreed (the transitional agreed amount) between the registered provider and the individual in an agreement (the transitional higher everyday living agreement):
(a) entered into in accordance with the requirements prescribed by Subdivision F of Division 2 of Part 2 of this Chapter; and
(b) that meets the requirements prescribed by that Subdivision.
Note: See also subsection (7) for how that Subdivision applies to transitional higher everyday living fees.
(3) The registered provider must not charge the individual the transitional higher everyday living fee for a service delivered on a day that occurs prior to the day the registered provider and individual enter into the transitional higher everyday living agreement.
(4) The registered provider must not, before the individual’s start day:
(a) ask the individual to pay a transitional higher everyday living fee for a service; or
(b) offer to enter a transitional higher everyday living agreement with the individual.
(5) Despite subsection (1), the registered provider must not:
(a) charge the individual a transitional higher everyday living fee in circumstances prescribed by Subdivision F of Division 2 of Part 2 of this Chapter; or
(b) enter into a transitional higher everyday living agreement with the individual in circumstances prescribed by Subdivision F of Division 2 of Part 2 of this Chapter.
Note: See also subsection (7) for how that Subdivision applies to transitional higher everyday living fees.
(6) To avoid doubt, a transitional higher everyday living fee may be charged in accordance with subsection (1) for a service that is not included on the list of services referred to in subsection 8(1) of the Act if the service is incidental to, or capable of enhancing the quality of, a particular funded aged care service that is included on that list.
(7) For the purposes of subsections (2) and (5), Subdivision F of Division 2 of Part 2 of this Chapter applies as if:
(a) Division 2 of Part 3 of Chapter 4 of the Act applied in relation to the individual; and
(b) a reference in that Subdivision to a higher everyday living fee were a reference to a transitional higher everyday living fee; and
(c) a reference in that Subdivision to an agreed amount were a reference to a transitional agreed amount; and
(d) a reference in that Subdivision to a higher everyday living agreement were a reference to a transitional higher everyday living agreement.
Subdivision B—Other matters
285A‑30 Refund of amounts paid in advance if individual dies or stops accessing services
For the purposes of subsection 285A(3) of the Act, if an individual dies or stops accessing funded aged care services, and has paid an amount that the individual may be charged under Division 2A of Part 3 of Chapter 4 of the Act in advance for a day occurring after the individual dies or stops accessing those services, the registered provider to whom the individual paid the amount must refund the amount:
(i) if, within 14 days after the provider becomes aware of the individual’s death, the provider is shown the probate of the will of the individual or letters of administration of the estate of the individual—to the individual’s estate within 14 days after the day on which the provider was so shown; or
(ii) if subparagraph (i) does not apply—to a person that the provider is reasonably satisfied, on the basis of other evidence shown to the provider, that it is appropriate to pay the refund to within 14 days after the provider was shown the other evidence; or
Division 3—Fees and contributions for specialist aged care programs
286‑5 Fees and contributions for delivery of funded aged care services
For the purposes of subsections 286(1), (4) and (5) of the Act, this Division makes provision for:
(a) the amounts that a registered provider delivering funded aged care services through a service group under a specialist aged care program to an individual may charge the individual; and
(b) refunds of amounts paid in advance if the individual dies or stops accessing funded aged care services; and
(c) other requirements relating to amounts that may be charged under section 286 of the Act.
286‑10 Amounts that may be charged—specialist aged care program fee (for programs other than CHSP)
(1) A registered provider delivering funded aged care services through a service group under a specialist aged care program other than the CHSP on a day to an individual may charge the individual an amount (the specialist aged care program fee) for or in connection with those services.
(2) Subject to subsection (3), the specialist aged care program fee for an individual for a day is the amount agreed between the registered provider and the individual in a written agreement.
(3) The specialist aged care program fee for an individual for a day must not exceed:
(a) if the funded aged care services are delivered through the residential care service group—the amount obtained by rounding down to the nearest cent the amount equal to 85% of the basic age pension amount (worked out on a per day basis); or
(b) if the funded aged care services are delivered through the home support, assistive technology or home modifications service group—the amount obtained by rounding down to the nearest cent the amount equal to 17.5% of the basic age pension amount (worked out on a per day basis).
286‑15 Amounts that may be charged—CHSP contribution (for CHSP only)
(1) A registered provider delivering funded aged care services through a service group under the CHSP on a day to an individual may charge the individual an amount (the CHSP contribution) for or in connection with those services.
(2) The CHSP contribution for the delivery of the funded aged care service to the individual on the day is the amount agreed between the registered provider and the individual in a written agreement.
(3) The written agreement must include how and when CHSP contributions are to be paid.
286‑17 Refund of amounts paid in advance if individual dies or stops accessing services
If an individual dies or stops accessing funded aged care services, and has paid an amount that the individual may be charged under section 286 of the Act in advance for a day occurring after the individual dies or stops accessing those services, the registered provider to whom the individual paid the amount must refund the amount:
(i) if, within 14 days after the provider becomes aware of the individual’s death, the provider is shown the probate of the will of the individual or letters of administration of the estate of the individual—to the individual’s estate within 14 days after the day on which the provider was so shown; or
(ii) if subparagraph (i) does not apply—to a person that the provider is reasonably satisfied that it is appropriate to pay the refund to within 28 days after the provider becomes aware of the individual’s death; or
286‑20 Other requirements—financial hardship policy
(1) A registered provider delivering funded aged care services through a service group under a specialist aged care program must have a financial hardship policy that covers the following:
(a) how an individual can apply for a waiver or reduction of the specialist aged care program fee or CHSP contribution for the individual due to financial hardship;
(b) what evidence of financial hardship the individual must submit to the provider, and how that evidence must be submitted;
(c) the principles or calculations the provider will use to determine the amount and duration of the waiver or reduction of the fee or contribution if the individual’s application is successful.
(2) The registered provider must make the financial hardship policy publicly available.
286‑25 Other requirements—CHSP and NATSIFACP—consumer contribution policy
(1) A registered provider delivering funded aged care services through a service group under the CHSP or the NATSIFACP must:
(a) have a consumer contribution policy that takes into account the capacity of individuals to contribute toward the cost of the services delivered to them; and
(b) set their specialist aged care program fees and CHSP contributions in accordance with that policy.
(2) The registered provider must make the consumer contribution policy publicly available.
Chapter 9—Funding of aged care services—accommodation payments and accommodation contributions etc.
287‑5 Simplified outline of this Chapter
This Chapter provides for matters relating to payments made by individuals under Part 4 of Chapter 4 of the Act in relation to the delivery of ongoing funded aged care services to the individual through the service group residential care in an approved residential care home.
Part 2 of this Chapter prescribes requirements in relation to accommodation bonds, accommodation charges and entry contributions for individuals in the pre‑2014 accommodation class, and deals with:
(a) circumstances in which registered providers may enter into accommodation bond agreements with individuals and requirements for the accommodation bond agreements; and
(b) requirements for the charging of accommodation bonds, the maximum amount of accommodation bonds, permitted uses of accommodation bonds and matters relating to the payment of accommodation bonds; and
(c) the retention, deduction, refund and transfer of accommodation bond balances; and
(d) the payment of interest in relation to the refund of accommodation bond balances; and
(e) circumstances in which registered providers may enter into accommodation charge agreements with individuals and requirements for the accommodation charge agreements; and
(f) the maximum daily accrual amount of accommodation charges and matters relating to the payment of accommodation charges; and
(g) the payment of interest in relation to the refund of entry contribution balances.
Part 3 of this Chapter relates to accommodation payments and accommodation contributions, and deals with:
(a) prescribing certain provisions of Part 4 of Chapter 4 of the Act that do not apply in relation to certain specialist aged care programs; and
(b) maximum accommodation payment amounts and publication of certain amounts by the System Governor; and
(c) matters relating to accommodation agreements, including what must be set out in accommodation agreements, other requirements for agreements, and methods for working out payments, contributions and refunds; and
(d) requirements of registered providers in relation to charging accommodation payments and accommodation contributions; and
(e) matters relating to the charging of daily payments, including interest, indexation and refunds; and
(f) matters relating to refundable deposits, including deductions from refundable deposit balances, requirements for the use of refundable deposits, refunds of refundable deposits, transfers of refundable deposits between registered providers and payments of interest.
Compliance with the requirements in this Chapter is a condition of registration under section 151 of the Act.
Part 2—Accommodation bonds, accommodation charges and entry contributions
Division 1—Application of this Part
287‑10 Application of this Part
(1) For the purposes of subsection 287(2) of the Act, the class of individuals in the pre‑2014 accommodation class is prescribed.
(2) For the purposes of subsection 287(3) of the Act, this Part prescribes requirements in relation to the following:
(a) the entering of agreements for, and the charging, payment and use of, accommodation bonds for the delivery of ongoing funded aged care services to an individual in the pre‑2014 accommodation class;
(b) the retention of, deduction of amounts from, transfer of, refund of, and payment of interest in relation to the refund of, an accommodation bond balance in relation to an individual in the pre‑2014 accommodation class;
(c) the entering of agreements for, and the charging and payment of, accommodation charges for the delivery of ongoing funded aged care services to an individual in the pre‑2014 accommodation class;
(d) the transfer of, and the payment of interest in relation to the refund of, entry contribution balances in relation to an individual in the pre‑2014 accommodation class.
Division 2—Accommodation bond agreements
287‑13 Entry into accommodation bond agreements
A registered provider may enter into an accommodation bond agreement with an individual in the pre‑2014 accommodation class after the transition time in relation to an approved residential care home (the new home) if:
(a) one of the following applies to the individual:
(i) immediately before the transition time, a formal agreement (within the meaning of the old Act) or an accommodation bond agreement (within the meaning of the Aged Care (Transitional Provisions) Act 1997) was in effect for the individual;
(ii) at the transition time, the most recent agreement under the old Act that had been in effect for the individual was an agreement of a kind mentioned in subparagraph (i);
(iii) immediately before the transition time, the individual was eligible under the old Act to enter into an accommodation bond agreement (within the meaning of the Aged Care (Transitional Provisions) Act 1997); and
(b) the individual ceased (whether before or after the transition time) accessing funded aged care services in another approved residential care home and will start, or has started, accessing funded aged care services in the new home.
Note 2: An individual in the pre‑2014 accommodation class may change homes before the transition time and still be a member of that class: see paragraph (b) of the definition of pre‑2014 accommodation class.
287‑15 Information to be given before registered provider enters into an accommodation bond agreement with an individual
Before a registered provider enters into an accommodation bond agreement with an individual, the provider must:
(a) give the individual a copy of the proposed agreement that meets the requirements set out in section 287‑25; and
(b) inform the individual of the following:
(i) that if the individual has given the provider sufficient information to determine the value of the individual’s assets, the provider is required to leave the individual, after paying the accommodation bond, with assets with a value at least equal to the individual’s pre‑2014 minimum permissible asset value;
(ii) the interest rate to be charged on amounts owed under the agreement;
(iii) the capacity for amounts owed under the agreement and accrued interest to be deducted from the balance of the amount paid under the agreement before it is refunded;
(iv) the amount to be charged under the agreement;
(v) the accommodation bond retention amount charged;
(vi) the interest rate on the accommodation bond if there is a delay in payment of the lump sum or the amount is paid in whole or in part by periodic payments;
(vii) the periods when the accommodation bond retention amount and interest are charged;
(viii) payment options (that is, by lump sum, periodic payment, or a combination of lump sum and periodic payment);
(ix) refund arrangements;
(x) the prudential arrangements applying to the accommodation bond balance;
(xi) when an accommodation bond is not required or, if paid, is refundable.
287‑20 Time within which registered providers must enter into accommodation bond agreements
A registered provider must enter into an accommodation bond agreement with an individual in relation to an approved residential care home before, or within 21 days after, the individual’s start day for the home.
287‑25 Accommodation bond agreements
(1) An accommodation bond agreement between a registered provider and an individual for the delivery of ongoing funded aged care services to the individual through the service group residential care in an approved residential care home of the provider must set out the following:
(a) the individual’s start day, or proposed start day, for the home;
(b) the accommodation bond that:
(i) will be payable if the individual starts accessing the services in the home; or
(ii) is payable if the individual has already started to access the services in the home;
(c) how the accommodation bond is to be paid, and if the bond is to be paid by periodic payment, the conditions relating to the payments (which must comply with the requirements of section 287‑70);
(d) when the accommodation bond is payable;
(e) the amount of each accommodation bond retention amount that will be deducted from the accommodation bond balance;
(f) when accommodation bond retention amounts and other amounts permitted by section 287‑90 to be deducted from the accommodation bond balance will be deducted;
(g) the individual’s room that the accommodation bond entitles the individual to be provided with;
(h) any services that the accommodation bond entitles the individual to be provided with;
(i) that a transitional fee reduction supplement under section 242B‑27 may apply to the individual and reduce the accommodation bond, including to nil;
(j) that, if the individual changes the individual’s room in the home, this will not change the individual’s start day for the home;
(k) the circumstances in which the accommodation bond balance must be refunded and the way the amount of the refund will be worked out;
(l) the rate of interest, or interest equivalent, payable if the accommodation bond:
(i) is paid in whole or in part as a lump sum after the due date; or
(ii) is paid by periodic payment; or
(iii) is not paid when it is due to be paid;
(m) the way interest, or interest equivalent, charges are calculated;
(n) the total amount of interest, or interest equivalent, charges payable under the agreement:
(i) if they can be calculated when the agreement is made; and
(ii) assuming that the individual will make all payments when they are due;
(o) the accommodation bond retention amounts payable if the provider delivers the services to the individual in the home for 2 months or less;
(p) the frequency at which interest, or interest equivalent, charges will be debited.
Additional matters in relation to periodic payments
(2) Subsection (3) applies if the individual elects to pay the accommodation bond by periodic payment, in whole or in part.
(3) In addition to the matters specified in subsection (1), the accommodation bond agreement must state:
(a) the amount of the lump sum equivalent; and
(b) the amount and frequency of the periodic payments; and
(c) the components of each periodic payment representing:
(i) the amount of the retention component; and
(ii) interest; and
(d) that the individual may, at any time, pay as a lump sum the whole or a part of the lump sum equivalent.
Additional matters in relation to voluntary moves to an approved residential care home of another registered provider
(4) The accommodation bond agreement must state that, if the individual wishes to move from the approved residential care home of the registered provider (the original home) to an approved residential care home of another registered provider (the new home), the registered provider of the original home may ask the individual for permission to provide the following information to the registered provider of the new home:
(a) whether the individual has agreed to pay an accommodation bond;
(b) if so, the amount agreed and, if the individual has agreed to pay the amount in whole or in part by periodic payments, the lump sum equivalent;
(c) the period remaining during which, under sections 287‑95 and 287‑100, accommodation bond retention amounts may be deducted from the individual’s accommodation bond balance;
(d) amounts that may be deducted from the accommodation bond balance.
287‑30 Accommodation bond agreements may be incorporated into other agreements
For the purposes of this Division, an individual is taken to have entered into an accommodation bond agreement if the individual has entered into an agreement that contains the provisions required by section 287‑25.
287‑35 Accommodation bond agreements cannot affect requirements of this Division
The requirements of this Division apply despite any provision of an accommodation bond agreement, or any other agreement, to the contrary.
Division 3—Accommodation bonds
Subdivision A—Charging of accommodation bonds
287‑40 Charging of accommodation bonds
A registered provider must comply with the following in relation to the charging of an accommodation bond to an individual for the delivery of ongoing funded aged care services to the individual through the service group residential care in an approved residential care home (the new home) of the provider:
(a) subject to this section, an accommodation bond must be charged if:
(i) the individual ceased accessing the services in another approved residential care home (the former home) and started accessing the services in the new home; and
(ii) the individual paid an accommodation bond or entry contribution, or an accommodation bond was payable by the individual, to access the services in the former home;
Note 2: An individual in the pre‑2014 accommodation class may change homes before the transition time and still be a member of that class: see paragraph (b) of the definition of pre‑2014 accommodation class.
(b) the accommodation bond must not exceed the maximum amount under section 287‑45, and the individual must not be charged more than one accommodation bond to access the services in the home;
(c) if a transitional fee reduction supplement under section 242B‑27 applies to the individual—the accommodation bond must be reduced (but not below zero) to reflect any amount of the supplement that is applied towards the payment;
(d) payment of the accommodation bond can only be required during a period specified in section 287‑65;
(e) payment of the accommodation bond by periodic payments must meet the requirements set out in section 287‑70;
(f) the registered provider must not use the accommodation bond unless the use of the bond is permitted (see section 287‑101);
(g) the registered provider is entitled to income derived from investing the accommodation bond balance (see section 287‑85);
(h) amounts must not be deducted from the accommodation bond balance, except for amounts deducted under section 287‑90.
Subdivision B—Accommodation bonds
287‑45 Maximum amount of accommodation bonds
(1) Subject to subsection (2), the maximum accommodation bond that may be charged for the delivery of ongoing funded aged care services to an individual through the service group residential care in an approved residential care home of a registered provider is the lowest of the following:
(a) the amount of the accommodation bond that was specified in the most recent accommodation bond agreement that was in effect for the individual;
(b) an amount that, when subtracted from an amount equal to the value of the individual’s assets at the start of the individual’s start day for the home, leaves an amount at least equal to the individual’s pre‑2014 minimum permissible asset value (see subsection (3));
(c) if paragraph 287‑40(a) applies in relation to an individual who paid an accommodation bond—the accommodation bond balance that was refunded or is payable to the individual under section 287‑102 in respect of the accommodation bond referred to in subparagraph 287‑40(a)(ii);
(d) if paragraph 287‑40(a) applies in relation to an individual who paid an entry contribution—the entry contribution balance that was refunded or is payable to the individual in respect of the entry contribution referred to in subparagraph 287‑40(a)(ii).
Note: The operation of this section may be modified if, before entering an accommodation bond agreement, the individual gives the registered provider a determination under section 329 of the Act of the value of the individual’s assets: see subsection (5).
(2) If an individual seeking to access ongoing funded aged care services through the service group residential care in an approved residential care home of a registered provider does not, before entering into an accommodation bond agreement, give the provider sufficient information about the individual’s assets for the provider to be able to determine the amount referred to in paragraph (1)(b), the maximum amount of the individual’s accommodation bond is the lesser of:
(a) the amount referred to in paragraph (1)(a); and
(b) the amount referred to in paragraph (1)(c) or (d), as applicable.
(3) An individual’s pre‑2014 minimum permissible asset value is:
(a) if the individual’s start day is before 20 September 2009—the amount obtained by rounding to the nearest $500.00 (rounding $250.00 upwards) an amount equal to 2.5 times the basic age pension amount at the start of the individual’s start day for the home; and
(b) if the individual’s start day is on or after 20 September 2009—the amount obtained by rounding to the nearest $500.00 (rounding $250.00 upwards) an amount equal to 2.25 times the basic age pension amount at the start of the individual’s start day for the home.
(4) The value of an individual’s assets is to be worked out in accordance with section 330 of the Act, but:
(a) taking into account only the assets of the individual of the kinds referred to in subsection 44(2) of the Aged Care (Transitional Provisions) Principles 2014 as in force immediately before the transition time; and
(b) disregarding subsection 330(7) of the Act (value of home).
(5) However, subsections (1), (2) and (3) are modified as described in the following table, and subsection (4) does not apply, if, before entering the accommodation bond agreement, the individual gives the registered provider a copy of a determination that:
(a) is a determination under section 329 of the Act of the value of the individual’s assets at a time (the valuation time) that is before or at the start of the individual’s start day for the home; and
(b) is in force at the start of the start day, if that is after the valuation time.
Modifications of subsections (1), (2) and (3)
Item Column 1 If … Column 2 subsections (1), (2) and (3) have effect as if …
1 the valuation time is before the start of the start day for the home (a) the references in paragraph (1)(a) and subsection (3) to the start of the individual’s start day for the home were references to the valuation time; and(b) the value of the individual’s assets at the valuation time were the value specified in the determination
2 the valuation time is at the start of the start day for the home the value of the individual’s assets at the start of the individual’s start day for the home were the value specified in the determination
Subdivision C—Payment of accommodation bonds
287‑65 Period for payment of accommodation bond
An individual must not be required to pay an accommodation bond before the day that is 6 months after the individual’s start day for the approved residential care home to which the payment relates.
Note: However, under sections 287‑85 and 287‑95, amounts representing income derived and accommodation bond retention amounts are payable from the day an individual starts accessing ongoing funded aged care services.
287‑70 Payment of accommodation bonds by periodic payment
(1) An individual may elect to pay an accommodation bond, in whole or in part, by periodic payment.
(2) If the individual elects to pay the bond by periodic payment, the registered provider for the approved residential care home to which the bond relates and the individual must agree on:
(a) the frequency of payments; and
(b) the amount of a payment, worked out in accordance with subsection (3).
(3) For the purposes of paragraph (2)(b), the formula for working out the amount of a periodic payment is as follows:
start formula start fraction open bracket LSE times IR close bracket plus RC over NPP end fraction end formula
LSE is the amount of the individual’s lump sum equivalent.
NPP is the number of periodic payments payable by the individual in the relevant year.
RC is the amount of the retention component worked out:
(a) if no part of the accommodation bond is paid as a lump sum—in accordance with subsection (4); or
(b) if part of the accommodation bond is paid as a lump sum—in accordance with subsections (5) and (6) and, if applicable, (7).
Note: See also section 287‑95.
(4) The amount of the retention component must not exceed the maximum accommodation bond retention amount that may be deducted under section 287‑95, during the year beginning on the individual’s start day for the home, from the amount that would have been the accommodation bond balance if the individual had paid the whole of the accommodation bond as a lump sum.
Note: An amount deducted from an accommodation balance in accordance with section 57‑19 of the old Act before the transition time is taken to have been deducted from an accommodation bond balance in accordance with section 287‑90 of this instrument.
(5) If part of the accommodation bond is paid as a lump sum, the amount of the retention component of the periodic payments is reduced, on a proportionate basis, in accordance with the ratio of the lump sum equivalent to the amount of the accommodation bond.
(6) However, if the lump sum is sufficient to cover the total of the accommodation bond retention amounts for the period of 5 years for the whole of the accommodation bond, including the lump sum equivalent, and the individual elects:
(a) the amount of the retention component is nil; and
(b) the total of the accommodation bond retention amounts, including the retention component that would otherwise be payable on the lump sum equivalent, may be deducted from the amount paid as a lump sum.
(7) For the purposes of subsection (6):
(a) the period of 5 years begins on the individual’s start day for the home; and
(b) the individual’s election must be made in writing and given to the registered provider.
287‑75 Minimum amount of periodic payments
(1) The minimum amount of a periodic payment payable by an individual is the amount representing the periodic payments that would have been payable for 3 calendar months.
(2) If a registered provider ceases to deliver ongoing funded aged care services to an individual through the service group residential care in an approved residential care home of the provider, the provider may charge the individual the full amount of a periodic payment that is payable for the month in which the provider ceases to deliver the services.
287‑80 Payment if agreed accommodation bond not paid
(a) an individual has agreed to pay an accommodation bond to a registered provider in whole or in part as a lump sum; and
(b) the provider ceases to deliver ongoing funded aged care services to the individual through the service group residential care in the approved residential care home to which the payment relates; and
(c) the provider delivered the services to the individual for more than 2 months; and
(d) the individual does not pay the accommodation bond before the provider ceases to deliver the services to the individual.
(2) The individual may be required to pay an amount (the interest equivalent amount) worked out in accordance with subsection (3), in relation to the individual’s accommodation bond balance, to the registered provider.
(3) For the purposes of subsection (2), the interest equivalent amount, in relation to the individual’s accommodation bond balance, is the amount worked out in accordance with the following formula:
start formula start fraction I times LS times D over 365 end fraction end formula
D is the number of days in the period:
(a) beginning on the first day of the month in which the lump sum was to be paid; and
(b) ending on the last day of the month in which the individual ceases to access the services.
I is the lower of:
LS is the amount of the accommodation bond agreed to be paid as a lump sum.
Subdivision D—Retention, deduction and transfer of accommodation bond balances
287‑85 Registered provider may retain income derived
(1) A registered provider may retain income derived from the investment of an accommodation bond balance in respect of an accommodation bond paid to the provider for the delivery of ongoing funded aged care services to an individual through the service group residential care in an approved residential care home of the provider.
(2) Despite section 287‑65, if an individual pays an accommodation bond to a registered provider in whole or in part as a lump sum after the individual’s start day for the home to which the payment relates, the individual may be required to pay to the provider an amount (the interest equivalent amount) worked out in accordance with subsection (3) that is equivalent to the income the provider could be expected to have derived, through investing the accommodation bond balance, during the period:
(a) beginning on the start day for the home; and
(b) ending on the day on which the accommodation bond was paid.
(3) For the purposes of subsection (2), the interest equivalent amount, in relation to the individual’s accommodation bond balance, is the amount worked out in accordance with the following formula:
start formula start fraction IR times LS times ND over 365 end fraction end formula.
(a) beginning on the individual’s start day for the home; and
(b) ending on the day when the accommodation bond was paid in whole or in part as a lump sum.
(4) If a registered provider delivers ongoing funded aged care services to an individual through the service group residential care at an approved residential care home of the provider for 2 months or less, the individual may be required to pay to the provider an amount (the interest equivalent amount) worked out in accordance with subsection (5) or (6) representing the income the provider could be expected to have derived, through investing the accommodation bond balance, during:
(a) the whole of the month in which the provider delivered the services; and
(b) the 2 following months.
Example: If a registered provider started delivering ongoing funded aged care services to an individual through the service group residential care at an approved residential care home of the provider on 20 January and the individual left on 3 March, the amount would be the amount the registered provider could have been expected to have derived if the provider delivered the services to the individual for the whole of January, February and March.
(a) the individual pays the accommodation bond in whole or in part as a lump sum; and
(b) the amount paid as a lump sum is refunded to the individual within 3 months after the individual’s start day for the home;
the interest equivalent amount, in relation to the individual’s accommodation bond balance, is the amount worked out in accordance with the following formula:
start formula start fraction IR times LS times ND over 365 end fraction end formula.
(a) the interest rate stated in the individual’s accommodation bond agreement to which the payment relates; and
(a) beginning on the day when the lump sum was refunded; and
(b) ending 3 months after the start day for the home.
(6) If the individual:
(a) has agreed to pay the accommodation bond in whole or in part as a lump sum; and
(b) does not pay the lump sum before the individual ceases to access ongoing funded aged care services in the home;
the interest equivalent amount, in relation to the individual’s accommodation bond balance, is the amount worked out in accordance with the following formula:
start formula start fraction IR times LS times ND over 365 end fraction end formula.
ND is the number of days in 3 calendar months from the individual’s start day for the home.
(7) An individual cannot be required to pay the interest equivalent amounts worked out under both subsections (3) and (6).
(8) The registered provider may require payment of an amount less than the interest equivalent amount required to be paid under subsection (2) or (4).
287‑86 Restriction on retention of income derived
Despite subsections 287‑80(2) and 287‑85(1), (2) and (4), if a transitional fee reduction supplement under section 242B‑27 applies to an individual and is reducing the individual’s accommodation bond, a registered provider must not do either of the following in respect of the period for which the supplement applies to the individual:
(a) retain income derived from the investment of the individual’s accommodation bond balance in accordance with subsection 287‑85(1);
(b) require the individual to pay an interest equivalent amount under subsection 287‑80(2) or 287‑85(2) or (4) in relation to the individual’s accommodation bond balance.
287‑90 Amounts to be deducted from accommodation bond balance
(1) A registered provider to whom an accommodation bond was paid by an individual for the delivery of ongoing funded aged care services to the individual through the service group residential care in an approved residential care home of the provider may deduct from the accommodation bond balance:
(a) an accommodation bond retention amount in respect of the accommodation bond (see section 287‑95); and
(b) an amount owed to the registered provider by the individual under an accommodation bond agreement or a service agreement; and
(c) subject to subsection (3), an amount of interest on the amount referred to in paragraph (b) that does not exceed the pre‑2014 maximum permissible interest rate for the individual’s start day for the home.
(2) The registered provider must not deduct any other amounts from the accommodation bond balance.
(3) The registered provider may only charge interest for the period:
(a) beginning on the day that is 1 month after the day on which the amount was payable under the accommodation bond agreement or service agreement; and
(b) ending on the earlier of the following days:
(i) the day on which the amount was paid;
(ii) the day the provider ceased delivering the services to the individual at the home of the provider.
287‑95 Accommodation bond retention amounts
(1) The maximum accommodation bond retention amount that may be deducted, from an individual’s accommodation bond balance, during a year (the first year) beginning on the individual’s start day for an approved residential care home, or a year (a later year) beginning on the anniversary of the individual’s start day for the home, is:
(a) if the accommodation bond is not more than the lower threshold amount—10% of the lower threshold amount; or
(b) if the accommodation bond is more than the lower threshold amount but not more than the higher threshold amount—10% of the accommodation bond; or
(c) if the accommodation bond is more than the higher threshold amount—10% of the higher threshold amount.
(2) However, despite subsections (3) and (4), the maximum accommodation bond retention amount for the individual for a later year is the same as the maximum accommodation bond retention amount for the first year.
(3) In subsection (1):
higher threshold amount is:
(a) for a year beginning in a financial year beginning on or after 1 July 1997 and before 1 July 2025—an amount equal to the amount Y worked out for the year in accordance with sections 97 and 98 of the Aged Care (Transitional Provisions) Principles 2014, as in force immediately before the transition time; or
(b) for a year beginning in a later financial year—the amount specified in column 3 of the table in subsection (4) for the financial year.
lower threshold amount is:
(a) for a year beginning in a financial year beginning on or after 1 July 1997 and before 1 July 2025—the amount equal to the amount X worked out for the year in accordance with sections 97 and 98 of the Aged Care (Transitional Provisions) Principles 2014, as in force immediately before the transition time; or
(b) for a year beginning in a later financial year—the amount specified in column 2 of the table in subsection (4) for the financial year.
(4) For the purposes of paragraph (b) of the definitions of lower threshold amount and higher threshold amount in subsection (3), the amount for a financial year is specified in the following table:
Amounts for financial years beginning on or after 1 July 2025
Item Column 1 For the financial year beginning on … Column 2 the lower threshold amount is … Column 3 and the higher threshold amount is …
1 1 July 2025 $28,200 $54,540
(5) The maximum monthly accommodation bond retention amount is the amount worked out in accordance with subsection (1) divided by 12.
287‑100 Restriction on deduction of accommodation bond retention amounts
(1) If a transitional fee reduction supplement under section 242B‑27 applies to an individual and is reducing the accommodation bond balance, the registered provider delivering ongoing funded aged care services to the individual through the service group residential care in an approved residential care home of the provider must not deduct any accommodation bond retention amounts from the individual’s accommodation bond balance during the period for which the supplement applies to the individual.
(2) Subject to subsections (3) and (5), a registered provider may deduct an accommodation bond retention amount from an accommodation bond balance for each month, or part of a month, during which the provider is delivering ongoing funded aged care services to the individual in an approved home of the provider in respect of which the accommodation bond was paid.
(3) Subject to subsection (5), accommodation bond retention amounts may only be deducted during the period of 5 years beginning on the individual’s start day for the first approved residential care home for which the individual paid an accommodation bond.
(4) The 5 year period referred to in subsection (3) is extended by one day for each day during any period:
(a) for which a transitional fee reduction supplement under section 242B‑27 applies to the individual and is reducing the accommodation bond balance; or
(b) during which the individual is not accessing ongoing funded aged care services in an approved residential care home.
(5) If, before the accommodation bond was paid, amounts had already been deducted from an accommodation bond balance in respect of another accommodation bond previously paid by the individual for another approved residential care home, the period of 5 years referred to in subsection (3) is reduced by each month in respect of which an accommodation bond retention amount was so deducted.
Note: The effect of this subsection is that all periods spent accessing ongoing funded aged care services in the service group residential care after an accommodation bond is first paid will count towards the 5 year maximum under subsection (3) for deducting accommodation bond retention amounts.
Example: If an individual initially receives 6 weeks of ongoing funded aged care services through the service group residential care in an approved residential care home and then moves to another home, accommodation bond retention amounts can be deducted for 3 months in respect of the 6 weeks (see subsection (6)), but after that only for up to 4 years and 9 months.
(6) For the purposes of this section, if the registered provider delivers the services to the individual for 2 months or less, the individual is taken, for the purposes of working out the accommodation bond retention amounts payable, to have received the services during:
(a) the whole of the month in which the provider started delivering the services to the individual; and
(b) the 2 following months.
Example: An individual who started receiving ongoing funded aged care services on 20 January and left on 3 March would be taken to have received care for the whole of January, February and March. Therefore, accommodation bond retention amounts could be deducted for each of these months.
287‑101 Accommodation bonds to be used only for permitted purposes
(1) A registered provider must not use an accommodation bond unless the use is permitted by this section.
Permitted uses
(2) A registered provider is permitted to use an accommodation bond for the following:
(a) for capital expenditure of a kind covered by subsection (3);
(b) to invest in a financial product (within the meaning of Division 3 of Part 7.1 of the Corporations Act 2001) covered by subsection (4);
(c) to make a loan in relation to which the following conditions are satisfied:
(i) the loan is not made to an individual;
(ii) the loan is made on a commercial basis;
(iii) there is a written agreement in relation to the loan;
(iv) it is a condition of the agreement that the money loaned will only be used as mentioned in paragraph (a), (b), (d) or (e) of this subsection;
(d) to refund, or to repay debt accrued for the purposes of refunding, accommodation bond balances, entry contribution balances or refundable deposit balances;
(e) to repay debt accrued for the purposes of capital expenditure of a kind covered by subsection (3);
(f) to meet reasonable businesses losses that are incurred in the course of delivering funded aged care services within the period of 12 months after the day the registered provider begins to deliver funded aged care services to the individual through the service group residential care;
(g) to invest in a fund, but not a controlling entity of a fund, listed in item 2 of the first Schedule to Banking exemption No. 1 of 2021 made under the Banking Act 1959.
(3) For the purposes of paragraphs (2)(a) and (e), the following kinds of capital expenditure are covered by this subsection:
(a) expenditure to acquire land on which are, or are to be built, the premises needed for delivering funded aged care services through the service group residential care, but only to the extent that the expenditure relates to those premises;
(b) expenditure to acquire, erect, extend or significantly alter premises used or proposed to be used for delivering funded aged care services through the service group residential care, but only to the extent that the expenditure relates to the delivery of those funded aged care services;
(c) expenditure to acquire or install furniture, fittings or equipment for premises used or proposed to be used for delivering funded aged care services through the service group residential care, when those premises are initially erected or following an extension, a significant alteration or a significant refurbishment, but only to the extent that the expenditure relates to the delivery of those funded aged care services;
(d) expenditure that is directly connected to expenditure covered by paragraph (a), (b) or (c).
(4) For the purposes of paragraph (2)(b), the following financial products are covered by this subsection:
(a) any deposit‑taking facility made available by an ADI in the course of its banking business (within the meaning of the Banking Act 1959), other than an RSA;
(b) a debenture, stock or bond issued, or proposed to be issued, by the Commonwealth, a State or a Territory;
(c) a security;
(d) any of the following in relation to a registered scheme (within the meaning of the Corporations Act 2001):
(i) an interest in the scheme;
(ii) a legal or equitable right or interest in an interest covered by subparagraph (i);
(iii) an option to acquire, by way of issue, an interest or right covered by subparagraph (i) or (ii);
(e) an interest in a scheme established for the purpose of investment in the delivery of funded aged care services through the service group residential care in an approved residential care home that:
(i) is a managed investment scheme within the meaning of the Corporations Act 2001; and
(ii) is not a registered scheme within the meaning of the Corporations Act 2001;
(f) a legal or equitable right or interest in an interest covered by paragraph (e);
(g) an option to acquire, by way of issue, an interest or right covered by paragraph (e) or (f).
287‑102 Refund of accommodation bond balance
Circumstances in which accommodation bond balance must be refunded
(1) If an accommodation bond is paid to a registered provider, the provider must refund the accommodation bond balance if:
(a) the individual dies; or
(i) the registered provider ceases to deliver ongoing funded aged care services to the individual through the service group residential care in the approved residential care home to which the payment relates (other than because the individual is on leave);
(ii) the registered provider has not transferred, or is not required to transfer, the accommodation bond balance to another registered provider under section 287‑103.
Period within which accommodation bond balance must be refunded
(2) If paragraph (1)(a) applies, the accommodation bond balance must be refunded:
(a) if the registered provider is shown the probate of the will of the individual or letters of administration of the estate of the individual—within 14 days after the day on which the provider was so shown; or
(b) if the registered provider is not shown the probate of the will of the individual or letters of administration of the estate of the individual and the registered provider is shown other evidence that satisfies the provider that the accommodation bond balance is to be refunded to a person—within 14 days after the other evidence is shown to the provider.
(3) If paragraph (1)(b) applies, the accommodation bond balance must be refunded in accordance with the following table.
When an accommodation bond balance must be refunded if paragraph (1)(b) applies
Item Column 1 If … Column 2 the accommodation bond balance must be refunded …
1 both of the following apply:(a) the individual is to move to another approved residential care home to receive ongoing funded aged care services through the service group residential care;(b) the individual notified the registered provider of the move more than 14 days before the day on which the provider ceased delivering the services mentioned in subparagraph (1)(b)(i) on the day on which the registered provider ceased delivering the services mentioned in subparagraph (1)(b)(i)
2 both of the following apply:(a) the individual is to move to another approved residential care home to receive ongoing funded aged care services through the service group residential care;(b) the individual notified the registered provider of the move within 14 days before the day on which the provider ceased delivering the services mentioned in subparagraph (1)(b)(i) within 14 days after the day on which the notice was given to the provider
3 both of the following apply:(a) the individual is to move to another approved residential care home to receive ongoing funded aged care services through the service group residential care;(b) the individual did not notify the provider of the move before the day on which the provider ceased delivering the services mentioned in subparagraph (1)(b)(i) within 14 days after the day on which the provider ceased delivering the services mentioned in subparagraph (1)(b)(i)
4 items 1, 2 and 3 of this table do not apply either:(a) within 14 days after the day on which the provider ceased delivering the services mentioned in subparagraph (1)(b)(i); or(b) if the individual has agreed with the registered provider as mentioned in subsection (4) and the individual has notified the registered provider, in writing, that they wish to cease that agreement—within 14 days after the day on which the individual has notified the provider.
(4) The agreement is an agreement between the individual and the registered provider to delay refunding the accommodation bond balance on condition that, if the individual requests re‑entry to the approved residential care home, the registered provider must allow entry to the individual if:
(a) a room, or part of a room, is vacant in the approved residential care home; and
(b) the individual has an access approval in effect that includes the classification type ongoing for the service group residential care.
287‑103 Transfer of accommodation bond balance to another registered provider
(a) an accommodation bond was paid by an individual to a registered provider (the outgoing provider) for accommodation in an approved residential care home through which the provider delivers ongoing funded aged care services through the service group residential care to the individual; and
(b) the accommodation bond was paid in whole or in part as a lump sum; and
(c) the outgoing provider ceases to deliver ongoing funded aged care services through the service group residential care in the residential care home; and
(d) there is continuity of the delivery of those services to the individual through that service group in the same residential care home by another registered provider (the incoming provider).
(2) The accommodation bond balance must not be transferred to the incoming provider if:
(a) the incoming provider delivers ongoing funded aged care services through the service group residential care only under one or more specialist aged care programs; or
(b) the registered provider does not deliver any ongoing funded aged care services through the service group residential care.
Note: This means the accommodation bond balance is not required to be transferred under section 287‑103 in these circumstances and instead must be refunded in accordance with section 287‑102: see subparagraph 287‑102(1)(b)(ii).
(3) The outgoing provider must, by written notice, give the following information in relation to the individual to the incoming provider before the transfer day:
(a) the transfer day;
(b) any amount of interest payable on or before the transfer day under section 287‑103A in relation to the individual’s accommodation bond balance and the amount of that interest;
(c) the entry in the refundable deposit register of the provider that relates to the individual.
(4) The outgoing provider must give written notice to the individual of the proposed transfer of the individual’s accommodation bond balance before the transfer day, including:
(a) details of the incoming provider; and
(b) the transfer day.
(5) If the transfer day is changed, the outgoing provider must give written notice to the individual of the new transfer day as soon as practicable before that day.
(6) The outgoing provider must transfer the accommodation bond balance to the incoming provider on the transfer day, as notified to the individual in accordance with this section.
287‑103A Payment of interest—refund of accommodation bond balances—circumstances and amount
Circumstances in which payment of interest required
(1) If a registered provider is required under section 287‑102 to refund an accommodation bond balance, the registered provider must pay an amount of interest in relation to the refund, worked out in accordance with this section, on the day on which the registered provider refunds the accommodation bond balance, unless subsection (2) of this section applies to the refund of the accommodation bond balance.
(2) This subsection applies to the refund of the accommodation bond balance if:
(a) item 1 of the table in subsection 287‑102(3) applies to the refund of the accommodation bond balance; and
(b) the registered provider refunds the accommodation bond balance on the day referred to in column 2 of that item.
Amounts of interest if there is a refund period
(3) Subsections (4) and (5) of this section apply if subsection 287‑102(2), or item 2, 3 or 4 of the table in subsection 287‑102(3), applies to the refund.
If accommodation bond balance refunded on or before last day of refund period
(4) If the registered provider refunds the accommodation bond balance on or before the last day of the refund period in relation to the refund, the amount of interest is the amount worked out in accordance with the following formula:
Start formula start fraction BIR times AB times ND over 365 end fraction end formula
BIR is the base interest rate on the first day of the refund period.
ND is the number of days in the period:
(a) beginning on the day after the day on which the refunding event in relation to the refund occurred; and
If accommodation bond balance refunded after last day of refund period
(5) If the registered provider refunds the accommodation bond balance after the last day of the refund period, the amount of interest is the amount worked out in accordance with the following formula:
Start formula start fraction BIR times AB times ND(RP) over 365 end fraction plus start fraction MPIR times AB times ND(PP) over 365 end fraction end formula
BIR is the base interest rate on the first day of the refund period.
MPIR is the pre‑2014 maximum permissible interest rate for the day after the last day in the refund period.
ND(PP) is the number of days in the period:
(a) beginning on the day after the last day of the refund period; and
ND(RP) is the number of days in the period:
(a) beginning on the day after the day on which the refunding event occurred; and
(b) ending on the last day of the refund period.
Amount of interest if there is a refund day—accommodation bond balance refunded after refund day
(6) If item 1 of the table in subsection 287‑102(3) applies to the refund, and the registered provider refunds the accommodation bond balance after the day (the refund day) referred to in column 2 of that item, the amount of interest is the amount worked out in accordance with the following formula:
Start formula start fraction MPIR times AB times ND(PP) over 365 end fraction end formula
MPIR is the pre‑2014 maximum permissible interest rate for the day after the refund day.
ND(PP) is the number of days in the period:
Division 4—Accommodation charge agreements
287‑104 Entry into accommodation charge agreement
A registered provider may enter into an accommodation charge agreement with an individual in the pre‑2014 accommodation class after the transition time in relation to an approved residential care home (the new home) if:
(a) one of the following applies to the individual:
(i) immediately before the transition time, an accommodation charge agreement (within the meaning of the Aged Care (Transitional Provisions) Act 1997, as in force immediately before the transition time) was in effect for the individual;
(ii) at the transition time, the most recent agreement that had been in effect for the individual was an agreement of the kind mentioned in subparagraph (i);
(iii) immediately before the transition time, the individual was eligible under the old Act to enter into an agreement of the kind mentioned in subparagraph (i); and
(b) the individual ceased (whether before or after the transition time) accessing funded aged care services in another approved residential care home and will start, or has started, accessing funded aged care services in the new home.
Note 2: An individual in the pre‑2014 accommodation class may change homes before the transition time and still be a member of that class: see paragraph (b) of the definition of pre‑2014 accommodation class.
287‑105 Information to be given before registered provider enters into an accommodation charge agreement with an individual
Before a registered provider enters into an accommodation charge agreement with an individual, the provider must:
(a) give the individual a copy of the proposed accommodation charge agreement that meets the requirements set out in section 287‑115; and
(b) inform the individual of the following:
(i) that, if the individual has given the provider sufficient information to determine the value of the individual’s assets, the provider is required to leave the individual with assets with a value at least equal to the individual’s pre‑2014 minimum permissible asset value;
(ii) the interest rate to be charged on amounts owed under the accommodation charge agreement;
(iii) the accommodation charge;
(iv) when an accommodation charge is not required;
(v) when an accommodation charge must not be charged at more than a specified daily amount because a transitional fee reduction supplement under section 242B‑27 applies to the individual and is reducing the individual’s accommodation charge;
(vi) if an accommodation charge is paid—when the charge is refundable.
287‑110 Time within which registered providers must enter into accommodation charge agreement
A registered provider must enter into an accommodation charge agreement with an individual in relation to an approved residential care home before, or within 21 days after, the individual’s start day for the home.
287‑115 Accommodation charge agreements
An accommodation charge agreement between a registered provider and an individual for the delivery of ongoing funded aged care services to the individual through the service group residential care in an approved residential care home of the provider must set out the following:
(a) the individual’s start day, or proposed start day, for the home;
(b) the accommodation charge that:
(i) will accrue for each day (including a day on which the individual is on leave from the home) if the individual starts accessing the services at the home; or
(ii) if the individual has already started to access the services at the home—has accrued and will accrue for each day (including a day on which the individual is on leave from the home);
(c) how the accommodation charge is to be paid;
(d) when the accommodation charge is payable;
(e) the individual’s room that the accommodation charge entitles the individual to be provided with;
(f) any services that the accommodation charge entitles the individual to be provided with;
(g) that a transitional fee reduction supplement under section 242B‑27 may apply to the individual and reduce the accommodation charge, including to nil;
(h) that if the individual wishes to move from the approved residential care home (the original home) of the provider to another approved residential care home (the new home) of another registered provider, the registered provider of the original home may ask the individual for permission to provide the following information to the registered provider of the new home:
(i) whether the individual has agreed to pay an accommodation charge;
(ii) if so, the payment agreed;
(iii) the number of days for which the payment accrued under the agreement.
287‑120 Accommodation charge agreements may be incorporated into other agreements
For the purposes of this Division, an individual is taken to have entered into an accommodation charge agreement if the individual has entered into an agreement that contains the provisions required by section 287‑115.
287‑125 Accommodation charge agreements cannot affect requirements of this Division
The requirements of this Division apply despite any provision of an accommodation charge agreement, or any other agreement, to the contrary.
Division 5—Accommodation charges
Subdivision A—Charging of accommodation charges
287‑130 Charging of accommodation charges
A registered provider must comply with the following in relation to the charging of an accommodation charge to an individual for the delivery of ongoing funded aged care services to the individual through the service group residential care in an approved residential care home (the new home) of the provider:
(a) subject to this section, an accommodation charge must be charged if:
(i) the individual ceased accessing the services in another approved residential care home (the former home) of the provider or another registered provider and started accessing the services in the new home; and
(ii) the individual paid an accommodation charge to access the services in the former home;
(b) the daily amount at which the accommodation charge accrues must not exceed the maximum provided for by section 287‑135, and the individual must not be charged more than one accommodation charge to access the services in the home;
(c) the accommodation charge must not accrue after the day on which the registered provider ceases to deliver the services to the individual in the new home;
(d) if a transitional fee reduction supplement under section 242B‑27 applies to the individual—the accommodation charge must be reduced (but not below zero) to reflect any amount of the supplement that is applied towards the payment;
(e) the registered provider must comply with the requirements of section 287‑150 relating to payment of the accommodation charge;
(f) the individual may be required to pay interest to the registered provider in accordance with section 287‑155 if some or all of the accommodation charge is not paid within the time that section permits.
Subdivision B—Daily accrual amounts of accommodation charges
287‑135 Maximum daily accrual amount of accommodation charge
(1) Subject to subsection (2) and paragraph 287‑130(d), the maximum daily amount at which an accommodation charge accrues is the lowest of the following:
(a) the amount of the daily accrual of the accommodation charge that was specified in the most recent accommodation charge agreement that was in effect for the individual;
(b) the amount (rounded down to the nearest cent) obtained by:
(i) taking the amount that, when subtracted from an amount equal to the value of the individual’s assets at the start of the individual’s start day for the approved residential care home to which the payment relates, leaves an amount at least equal to the individual’s pre‑2014 minimum permissible asset value; and
(ii) dividing the result by 2,080;
(c) if sections 117 and 119, or section 118, of the Aged Care (Transitional Provisions) Principles 2014, as in force immediately before the transition time, applied to the individual as at that time—the amount worked out in accordance with whichever of those sections was applicable.
Note: The operation of this section may be modified if, before entering into an accommodation charge agreement, the individual gives the registered provider a determination under section 329 of the Act of the value of the individual’s assets: see subsection (4).
(2) If an individual seeking to access ongoing funded aged care services through the service group residential care at an approved residential care home of a registered provider does not, before entering into an accommodation charge agreement, give the provider sufficient information about the individual’s assets for the provider to be able to determine the amount referred to in paragraph (1)(b), the maximum daily amount at which the individual’s accommodation charge accrues is:
(a) if sections 117 and 119, or section 118, of the Aged Care (Transitional Provisions) Principles 2014, as in force immediately before the transition time, applied to the individual as at that time—the lesser of:
(i) the amount referred to in paragraph (1)(a); and
(ii) the amount referred to in paragraph (1)(c); and
(b) otherwise—the amount referred to in paragraph (1)(a).
(3) The value of an individual’s assets is to be worked out in accordance with section 330 of the Act, but:
(a) taking into account only the assets of the individual of the kinds referred to in subsection 44(2) of the Aged Care (Transitional Provisions) Principles 2014 as in force immediately before the transition time; and
(b) disregarding subsection 330(7) of the Act (value of home).
(4) However, subsections (1) and (2) are modified as described in the following table, and subsection (3) does not apply, if, before entering into the accommodation charge agreement, the individual gives the registered provider a copy of a determination that:
(a) is a determination under section 329 of the Act of the value of the individual’s assets at a time (the valuation time) that is before or at the start of the individual’s start day for the home; and
(b) is in force at the start of the start day, if that is after the valuation time.
Modifications of subsections (1) and (2)
Item Column 1 If … Column 2 subsections (1) and (2) have effect as if …
1 the valuation time is before the start of the start day for the home (a) the reference in paragraph (1)(b) to the start of the individual’s start day for the home were a reference to the valuation time; and(b) the value of the individual’s assets at the valuation time were the value specified in the determination; and(c) subsection 287‑45(3) defined pre‑2014 minimum permissible asset value by reference to the basic age pension amount at the valuation time (instead of the start of the start day)
2 the valuation time is at the start of the start day for the home the value of the individual’s assets at the start of the individual’s start day for the home were the value specified in the determination
Subdivision C—Payment of accommodation charges
287‑150 Accommodation charge may be payable not more than one month in advance
(1) An individual may be required to pay an accommodation charge from the day that is one month before the day for which the payment will accrue.
(2) If the accommodation charge does not in fact accrue, the individual is entitled to a refund of the amount paid.
287‑155 Registered provider may charge interest
(a) an individual is required, under an accommodation charge agreement, to pay an amount of accommodation charge to a registered provider; and
(b) the individual does not pay the required amount before the day that is one month after the day for which the payment accrues; and
(c) the agreement provides for interest to be charged on the balance outstanding at a specified rate;
the individual may be required to pay interest to the registered provider from the day that is one month after the day for which the payment accrues while the balance remains unpaid.
(2) However, the rate at which interest is charged in respect of a day must not be more than twice the below threshold rate on the day.
Division 6—Entry contributions
287‑160 Payment of interest—refund of entry contribution balances
(1) A registered provider must pay an amount of interest relating to a refund of an entry contribution balance, worked out in accordance with subsection (2), to an individual in the pre‑2014 accommodation class on the day on which the registered provider refunds the entry contribution balance to the individual if:
(a) the formal agreement between the registered provider and the individual requires the registered provider to refund the entry contribution balance to the individual; and
(i) the registered provider has not made an agreement with the individual to delay refunding the balance; or
(ii) such an agreement was made, but has ceased to be in effect between the registered provider and the individual.
(2) If the registered provider refunds the entry contribution balance after the last day specified in the formal agreement for the entry contribution balance to be refunded to the individual (the refund day), the amount of interest on the entry contribution balance is the amount worked out in accordance with the following formula:
start formula start fraction MPIR times ECB times ND(PP) over 365 end fraction end formula
ECB is the amount of the entry contribution balance.
MPIR is the pre‑2014 maximum permissible interest rate for the day after the refund day.
(b) ending on the day on which the entry contribution balance is refunded.
(3) Subsection (2) applies as if the reference in paragraph (a) of the definition of ND(PP) to the day after the refund day were a reference to the day after the day on which probate of the will of the individual is, or letters of administration of the estate of the individual are, shown to the registered provider if:
(a) the registered provider is required, under the formal agreement, to refund the entry contribution balance because the individual in relation to whom the entry contribution was paid has died; and
(b) the entry contribution balance is refunded after the refund day; and
(c) the entry contribution balance is refunded after the refund day because neither the probate of the will nor letters of administration of the estate were shown to the registered provider before the refund day.
Division 7—Miscellaneous
287‑165 Pre‑2014 maximum permissible interest rate
The pre‑2014 maximum permissible interest rate for a day is worked out as follows:
Step 1. Work out the general interest charge rate for the day under subsection 8AAD(1) of the Taxation Administration Act 1953.
Step 2. Multiply the rate worked out at step 1 by the number of days in the calendar year in which the day falls.
Step 3. Subtract 3 percentage points from the amount worked out at step 2.
Part 3—Accommodation payments and accommodation contributions
Division 1—Application to specialist aged care programs
288‑5 Provisions that do not apply in relation to certain specialist aged care programs
MPSP
(1) For the purposes of paragraph 288(1)(a) of the Act, the following provisions of the Act are prescribed in respect of the delivery of funded aged care services to an individual under the MPSP:
(a) paragraph 294(1)(c);
(b) paragraph 294(1)(d);
(c) subsection 294(3);
(d) subsection 294(4) (to the extent that it relates to subsection 294(3));
(e) section 298;
(f) subsection 307(3);
(g) section 309.
NATSIFACP
(2) For the purposes of paragraph 288(1)(a) of the Act, the provisions of Part 4 of Chapter 4 of the Act are prescribed in respect of the delivery of funded aged care services to an individual under the NATSIFACP.
288‑10 Specialist aged care programs for which specified provisions do not apply
For the purposes of paragraph 288(1)(c) of the Act, the following specialist aged care programs are prescribed:
(b) NATSIFACP.
288‑20 Specialist aged care programs—accommodation agreements
For the purposes of paragraph 288(2)(a) of the Act, an accommodation agreement between a registered provider delivering funded aged care services to an individual under the MPSP and the individual must set out information for the individual about accessing the provider’s financial hardship policy.
Note: The accommodation agreement also must comply with the requirements in section 294‑5.
288‑25 Specialist aged care programs—charging of accommodation payments and accommodation contributions
MPSP
(1) For the purposes of paragraph 288(2)(b) of the Act, if a registered provider is satisfied that an individual to whom the registered provider is delivering ongoing funded aged care services through the service group residential care in an approved residential care home under the MPSP is experiencing financial hardship, the provider must:
(a) provide the individual with a copy of the provider’s financial hardship policy referred to in section 286‑20; and
(b) comply with the policy (including reducing or waiving the accommodation payment in accordance with the terms of the policy).
Note: The registered provider also must comply with section 296‑5 (which deals with the charging of accommodation payments).
NATSIFACP
(2) For the purposes of paragraph 288(2)(b) of the Act, a registered provider delivering funded aged care services to an individual through the service group residential care in an approved residential care home under the NATSIFACP must not charge the individual an accommodation payment for the delivery of those services.
MPSP and NATSIFACP
(3) For the purposes of paragraph 288(2)(c) of the Act, a registered provider delivering funded aged care services to an individual through the service group residential care in an approved residential care home under the MPSP or NATSIFACP must not charge the individual an accommodation contribution for the delivery of those services.
Division 2—Maximum accommodation payment amounts and publication of certain amounts by the System Governor
For the purposes of subsection 289(1) of the Act, $758,627 is prescribed as the maximum amount of accommodation payment (expressed as a refundable accommodation deposit amount).
289‑10 Maximum accommodation payment amount—daily accommodation payment amount
For the purposes of subsection 289(3) of the Act, the method for working out the maximum accommodation payment amount expressed as a daily accommodation payment amount for a day is as follows:
Step 1. Work out the maximum permissible interest rate for the day.
Step 2. Multiply the rate worked out at step 1 by the maximum accommodation payment amount.
Step 3. Divide the amount worked out at step 2 by 365 (rounding the result to 2 decimal places, rounding up if the third decimal place is 5 or more).
Subdivision B—Application to Pricing Authority for approval of higher maximum accommodation payment amount
290‑15 Requirements for application
For the purposes of paragraph 290(3)(a) of the Act, the application must:
(b) be in a form approved by the Pricing Authority; and
(c) be accompanied by any information or documents specified by the approved form; and
(d) relate to only one residential care home; and
(e) specify each room, or each part of a room, in the residential care home for which approval is sought to charge a higher maximum accommodation payment amount; and
(f) specify each of those higher maximum accommodation payment amounts (expressed as a refundable accommodation deposit amount).
Note: Although applications may be made under section 290 of the Act in relation to residential care homes that are not approved residential care homes, only a registered provider delivering funded aged care services through the service group residential care in an approved residential care home may charge, under Part 4 of Chapter 4 of the Act, an amount of accommodation payment.
290‑20 Restriction on application period
For the purposes of subparagraph 290(3)(b)(i) of the Act, the period of 4 months is prescribed.
290‑25 Decision of Pricing Authority on application
Purpose and application of this section
(1) This section is made for the purposes of subsections 290(6) and (12) of the Act and applies to an application, of any kind mentioned in subsection 290(2) of the Act, by a registered provider for approval of a higher maximum accommodation payment amount in relation to a room, or a part of a room, in a residential care home.
Matters that must be considered
(2) In deciding whether to approve the higher maximum accommodation payment amount for the room, or the part of the room, the Pricing Authority must consider the following:
(a) the proposed higher maximum accommodation payment amount;
(b) the location of the residential care home;
(c) the quality, condition, size and amenity of the room or the part of the room;
(d) whether the room has access to a shared bathroom or has a private ensuite;
(e) whether the room, or the part of the room, has any specific accommodation or design features;
(f) the number of individuals to whom ongoing funded aged care services may be delivered through the service group residential care in the room;
(g) the quality, condition, size and amenity of the common areas in the residential care home that would be accessible to those individuals;
(h) whether the residential care home has any specific accommodation or design features that would be accessible to those individuals.
Notification of decision
(3) If the Pricing Authority makes a decision to approve the higher maximum accommodation payment amount for the room, or the part of the room, the Pricing Authority must include the following in the notice of the decision given to the registered provider:
(a) the unique identification number that corresponds to the registered provider’s application;
(b) if the approval is not subject to conditions:
(i) the day on which the approval takes effect; and
(ii) the period during which the approval is in effect (see subsection (8));
(c) if the approval is subject to conditions in accordance with section 290‑30—the conditions to which the approval is subject.
Note 1: An approved higher maximum accommodation payment amount applies only to certain individuals: see subsections 290(8) and (9) of the Act.
Note 2: If the application relates to a room, or a part of a room, that is subject to construction or refurbishment, the approval is subject to the condition in subsection 290‑30(2).
(4) If the Pricing Authority makes a decision not to approve the higher maximum accommodation payment amount for the room, or the part of the room, the Pricing Authority must include the following in the notice of the decision given to the registered provider:
(a) details of the decision;
(b) reasons for the decision;
(c) details about how the provider may apply for the reconsideration of the decision.
Note: A decision of the Pricing Authority not to approve a higher maximum accommodation payment amount in relation to a registered provider is a reviewable decision under section 558 of the Act.
(5) The notice may relate to more than one decision for a room or a part of a room.
Period within which decision must be made and notification given
(6) The Pricing Authority must make, and give notice of, a decision on an application made in accordance with subsection 290(3) of the Act within 60 days after the Pricing Authority receives the application.
(7) If the registered provider is required, under subsection 290(4) of the Act, to give the Pricing Authority further information for the purposes of making a decision on the application, the 60 day period referred to in subsection (6) of this section does not include the period beginning on the day the request was made and ending on the day the information was received.
When approval is in effect—approval not subject to conditions
(8) An approval of a higher maximum accommodation payment amount for a room, or a part of a room, that is not subject to conditions:
(a) takes effect at the start of the day specified in the notice given to the registered provider (as mentioned in subparagraph (3)(b)(i)); and
(b) is in effect during the period of 4 years beginning on that day.
Note: See subsection 290‑30(6) for the time when, and the period during which, an approval that is subject to conditions in accordance with section 290‑30 is in effect.
290‑30 Condition on approval relating to a room, or part of a room, subject to construction or refurbishment
Purpose and application of section
(1) This section is made for the purposes of subsections 290(7) and (12) of the Act and applies if the Pricing Authority approves a higher maximum accommodation payment amount for a room, or a part of a room, that is being, or is proposed to be, constructed or refurbished.
Condition on approval
(2) The approval is subject to the condition that the approval does not take effect unless the requirements in subsection (3) are met.
(3) The requirements are that, within the period of 4 years beginning on the day the Pricing Authority gave notice of the approval to the registered provider:
(a) the registered provider gives the following information, in writing, to the Pricing Authority:
(i) information showing that the construction or refurbishment of the room, or the part of the room, has been completed and that the completed or refurbished room, or the part of the room, is equivalent to or better than the proposal described in the application;
(ii) the total actual cost (the actual cost) of the completed construction or refurbishment; and
(b) the Pricing Authority notifies the registered provider, under subsection (4), that the Pricing Authority is satisfied, having regard to the information given under paragraph (a) of this section, that the requirements referred to in subparagraph (a)(i) have been met in relation to the room, or the part of the room, and that:
(i) the actual cost of the completed construction or refurbishment is not significantly lower than the proposed cost of the construction or refurbishment; or
(ii) if the actual cost of the completed construction or refurbishment is significantly lower than the proposed cost of the construction or refurbishment and if the lower actual cost had been provided to the Pricing Authority with the application as the proposed cost—the Pricing Authority would still have approved the higher maximum accommodation payment amount applied for.
Decision on information and notification of decision
(4) If the registered provider gives the Pricing Authority information in accordance with paragraph (3)(a), the Pricing Authority must, within 28 days of receiving the information:
(a) decide whether the Pricing Authority is satisfied, as referred to in paragraph (3)(b); and
(b) notify the registered provider, in writing, of the decision.
(5) If the Pricing Authority decides it is not so satisfied, the Pricing Authority must include the following in the notice of the decision given to the registered provider:
(a) details of the decision;
(b) reasons for the decision;
(c) details about how the provider may apply for the reconsideration of the decision.
Note: A decision of the Pricing Authority that it is not so satisfied, as referred to in paragraph (3)(b), is a reviewable decision under section 557 of the Act: see section 558‑5 of this instrument.
When approval is in effect
(6) If the Pricing Authority decides it is so satisfied:
(a) the Pricing Authority must include the following in the notice of the decision given to the registered provider:
(a) the day on which the approval takes effect;
(b) the period during which the approval is in effect; and
(b) the approval of the higher maximum accommodation payment amount for the room, or the part of the room:
(i) takes effect at the start of the day specified in that notice; and
(ii) is in effect for the period of 4 years beginning on that day.
290‑40 Indexation of higher maximum accommodation payment amount
(1) For the purposes of subsection 290(11) of the Act, a higher maximum accommodation payment amount that may be charged by a registered provider (the relevant registered provider) may be indexed by the registered provider no earlier than the first day of the second, or a later, approval year (the current approval year) for the amount, by multiplying the amount by the amount worked out using the formula:
start formula start fraction Most recent index number over Previous index number end fraction end formula
most recent index number means the index number for the most recent quarter ending before the first day of the current approval year.
previous index number means the index number for the most recent quarter ending before the first day of the previous approval year.
(2) If a higher maximum accommodation payment amount is indexed under this section, the Act and this instrument have effect as if the indexed amount were substituted for the higher maximum accommodation payment amount.
(3) If a higher maximum accommodation payment amount is indexed on a day under this section, the indexed amount applies only in relation to an individual if:
(i) the individual has not, before that day, entered into an accommodation agreement with the relevant registered provider;
(ii) the registered provider starts delivering funded aged care services to the individual in the approved residential care home on or after that day; or
(b) all of the following apply:
(i) the individual’s start day occurred before the date of the approval by the Pricing Authority;
(ii) the individual had entered into an accommodation agreement with the registered provider before the date of the approval;
(iii) the individual moves to another bed, whether in another room (the new room) or another part of a room (the new part), in the residential care home and the move is voluntary;
(iv) the higher maximum accommodation payment amount applies in relation to the part of the residential care home that includes the new room or the new part of a room.
(4) If, apart from this subsection, a higher maximum accommodation payment amount indexed under this section would be an amount of dollars and cents:
(a) the amount is to be rounded to the nearest whole dollar; and
(b) if the amount to be rounded is 50 cents, the amount is to be rounded down.
(5) If, at any time (whether before or after the commencement of this section), the Australian Statistician publishes an index number for a quarter in substitution for an index number previously published by the Australian Statistician for that quarter, the publication of the later index number is to be disregarded for this section.
(6) If, at any time (whether before or after the commencement of this section), the Australian Statistician changes the index reference period for the Consumer Price Index, then, in applying this section after the change is made, regard is to be had only to index numbers published in terms of the new index reference period.
Subdivision C—Notification and publication of accommodation payment amounts
291‑5 Notification
(1) For the purposes of subsection 291(1) of the Act, the requirements are that the registered provider must give the System Governor a notice setting out the following information in relation to an accommodation payment the registered provider proposes to charge an individual for a room or part of a room in the approved residential care home:
(a) a statement describing the key accommodation features of the room or the part of the room;
(b) the maximum accommodation payment amount (expressed as a refundable accommodation deposit amount, and as a daily accommodation payment amount worked out in accordance with section 294‑10) that the provider could charge an individual for the room or the part of the room;
(c) if the registered provider proposes to charge an accommodation payment in relation to the room or the part of the room that exceeds the maximum accommodation payment amount—a copy of the notice given to the provider by the Pricing Authority under subsection 290(6) of the Act, and section 290‑30 of this instrument (if applicable), that covers the charging of the higher amount.
(2) For the purposes of paragraph (1)(a), the statement describing the key accommodation features of the room or the part of the room must include the following information:
(a) a description of the quality, condition, size and amenity of the room or the part of the room;
(b) whether the room or the part of the room has access to a shared bathroom or has a private ensuite;
(c) a description of any specific accommodation or design features in the room or the part of the room;
(d) the number of individuals to whom ongoing funded aged care services may be delivered through the service group residential care in the room;
(e) a description of the quality, condition, size and amenity of the common areas in the approved residential care home that would be accessible to those individuals;
(f) a description of any specific accommodation or design features in the approved residential care home that would be accessible to those individuals.
291‑10 Publication of notification
For the purposes of paragraph 291(4)(d) of the Act, the information is the information in paragraphs 291‑5(2)(a) to (f).
Division 3—Accommodation agreements
292‑5 Information to be given before provider enters into an accommodation agreement with an individual—daily accommodation payment amount
For the purposes of subparagraph 292(b)(ii) of the Act, the method for working out a daily accommodation payment amount in relation to a published accommodation payment amount (expressed as a refundable accommodation deposit amount) that an individual is informed of is as follows:
Step 1. Work out the maximum permissible interest rate for the day the individual is informed of the published accommodation payment amount (expressed as a refundable accommodation deposit amount).
Step 2. Multiply the rate worked out at step 1 by the published accommodation payment amount (expressed as a refundable accommodation deposit amount).
Step 3. Divide the amount worked out at step 2 by 365 (rounding the result to 2 decimal places, rounding up if the third decimal place is 5 or more).
294‑5 Accommodation agreements—other matters to be included in accommodation agreement
(1) For the purposes of paragraph 294(1)(l) of the Act, this section prescribes other matters that must be set out in an accommodation agreement between a registered provider and an individual.
Note: An accommodation agreement between a registered provider and an individual to whom the provider is delivering funded aged care services under the MPSP must also comply with section 288‑20.
General matters
(2) The accommodation agreement must set out the following in relation to any accommodation payment the individual will pay:
(a) the individual’s room that the accommodation payment entitles the individual to be provided with;
(b) any services that the accommodation payment entitles the individual to be provided with;
(c) that, if the individual changes the individual’s room in the approved residential care home, this will not change the individual’s start day for the approved residential care home.
Additional matters in relation to voluntary moves within the approved residential care home
(3) The accommodation agreement must set out that, if the individual proposes to change the individual’s room in the approved residential care home, and the move is voluntary:
(a) the accommodation agreement must be varied, before the move occurs, to specify the new room; and
(b) the day on which the agreement is varied will become the price agreement day for the individual and the approved residential care home; and
(c) the individual may be charged an accommodation payment amount, after the move, that is higher or lower than the accommodation payment amount the individual is paying before the move; and
(d) the individual must not be charged an accommodation payment amount that is higher than the published accommodation payment amount for the individual’s new room on the day the agreement is varied; and
(e) if the individual is to be charged a higher accommodation payment amount for the individual’s new room—the individual may choose to pay the additional accommodation payment amount by:
(i) daily payments; or
(ii) refundable deposit; or
(iii) a combination of refundable deposit and daily payments.
Additional matters in relation to non‑voluntary moves within the approved residential care home
(4) The accommodation agreement must set out that, if an individual’s room in the approved residential care home is to be changed for less than 28 days, and the move is not voluntary:
(a) the registered provider must, before the move occurs, notify the individual, in writing, of the change to the individual’s room; and
(b) there will be no change to the individual’s price agreement day for the approved residential care home; and
(c) the individual will continue to be charged the same accommodation payment amount that the individual is paying before the move.
(5) The accommodation agreement must set out that, if the individual’s room in the approved residential care home is to be changed for 28 days or longer, and the move is not voluntary:
(a) the registered provider must, before the move occurs, notify the individual, in writing, of the change to the individual’s room; and
(b) the day on which the notice is given will become the individual’s price agreement day for the approved residential care home; and
(c) the individual must not be charged:
(i) an accommodation payment amount that is higher than the accommodation payment amount the individual is paying before the move; or
(ii) if the published accommodation payment amount for the individual’s new room on the day the notice is given is lower than the amount the individual is paying before the move—an accommodation payment amount that is higher than that published accommodation payment amount.
(6) For the purposes of subsections (4) and (5), a move by an individual to a new room in an approved residential care home is not voluntary if:
(a) the move is necessary on genuine medical grounds as assessed by:
(i) an approved needs assessor; or
(ii) at least 2 medical or other health practitioners who meet the criteria mentioned in subsection (7); or
(b) the move is necessary to carry out repairs or improvements to the premises of the approved residential care home.
(7) For the purposes of subparagraph (6)(a)(ii), the criteria are:
(a) one practitioner must be independent of the registered provider and the approved residential care home, and must be chosen by the individual; and
(b) both practitioners must be competent to assess the aged care needs of the individual.
For the purposes of subparagraph 294(2)(b)(iii) of the Act, the method to work out an individual’s daily accommodation payment amount in relation to an agreed accommodation payment amount is the method referred to in subsection 296‑5(3).
294‑15 Accommodation agreements—method for working out amounts payable as a combination of refundable accommodation deposit and daily accommodation payments
For the purposes of paragraph 294(2)(d) of the Act, the method for working out amounts that would be payable as a combination of refundable accommodation deposit and daily accommodation payments is the method referred to in subsection 296‑5(4).
294‑20 Accommodation agreements—method for working out amounts payable by refundable accommodation contributions
For the purposes of subparagraph 294(3)(c)(i) of the Act, the method for working out an individual’s refundable accommodation contribution is the method referred to in subsection 298‑10(3).
294‑25 Accommodation agreements—method for working out amounts payable by combination of refundable accommodation contributions and daily accommodation contributions
For the purposes of subparagraph 294(3)(c)(ii) of the Act, the method for working out amounts payable by a combination of refundable accommodation contribution and daily accommodation contributions is the method referred to in subsection 298‑10(4).
Division 4—Charging of accommodation payments
296‑5 Charging of accommodation payments—requirements
(1) For the purposes of paragraph 296(d) of the Act, this section sets out requirements a registered provider must comply with in relation to the charging of an accommodation payment to an individual.
Note: If the registered provider is delivering funded aged care services to the individual under the MPSP the registered provider must also comply with subsection 288‑25(1).
(2) The registered provider must ensure that there is equivalence between:
(a) the refundable accommodation deposit amount that the provider could charge the individual for a day (the relevant day); and
(b) the daily accommodation payment amount that the provider could charge the individual for the relevant day.
(3) For the purpose of complying with subsection (2), the daily accommodation payment amount that the registered provider could charge the individual for the relevant day if the individual has paid no refundable accommodation deposit on or before that day is worked out as follows:
Step 1. Work out the maximum permissible interest rate for the individual’s price agreement day.
Note: If the individual’s accommodation agreement is varied because the individual’s room changes, the individual’s price agreement day and agreed accommodation payment amount may change for the purposes of this section.
Step 2. Multiply the rate worked out at step 1 by the agreed accommodation payment amount.
Step 3. Work out the individual’s maximum possible daily accommodation payment amount by dividing the amount worked out at step 2 by 365 (rounding the result to 2 decimal places, rounding up if the third decimal place is 5 or more).
Step 4. Apply any applicable indexation to the step 3 amount in accordance with section 302‑10.
Note: Indexation is not applied for certain classes of individuals: see section 302‑17.
(4) For the purposes of complying with subsection (2), the daily accommodation payment amount that the registered provider could charge the individual for the relevant day if the individual has paid a refundable accommodation deposit on or before that day is worked out as follows:
Step. 1 Work out under subsection (3) the amount the registered provider could charge as a daily accommodation payment amount (as if no refundable accommodation deposit had been made).
Step. 2 Work out the individual’s refundable deposit balance for the relevant day (including if this is a zero amount) and add to that amount the sum of any deductions made under section 308 of the Act on or before the relevant day.
Step. 3 Divide the step 2 amount by the agreed accommodation payment amount.
Step. 4 Subtract the step 3 amount from 1.
Step. 5 Multiply the step 4 amount by the step 1 amount (rounding the result to 2 decimal places, rounding up if the third decimal place is 5 or more).
Division 5—Charging of accommodation contributions
298‑5 Charging of accommodation contributions—prescribed circumstances
(1) For the purposes of paragraph 298(c) of the Act, subsection (2) prescribes the circumstances in which that paragraph of the Act does not apply in relation to the charging of an accommodation contribution for the delivery of ongoing funded aged care services to an individual through the service group residential care in an approved residential care home.
(2) The circumstances are that:
(a) the individual is in the post‑2014 residential accommodation class; and
(b) immediately before the transition time, the individual was receiving residential care through a residential care service (within the meaning of the old Act); and
(c) since the transition time, the individual has not ceased accessing ongoing funded aged care services through the residential care service group in an approved residential care home.
298‑10 Charging of accommodation contributions—requirements
(1) For the purposes of paragraph 298(e) of the Act, this section prescribes requirements a registered provider must comply with in relation to the charging of an accommodation contribution to an individual for the delivery of ongoing funded aged care services to the individual in an approved residential care home.
(2) The registered provider must ensure that, for a day (the relevant day), there is equivalence between:
(a) the individual’s daily accommodation contribution amount; and
(b) the maximum refundable accommodation contribution amount that the individual may be charged.
(3) For the purpose of complying with subsection (2), the maximum refundable accommodation contribution amount that the registered provider could charge the individual for the relevant day must be the amount worked out as follows:
Step 1. Work out the maximum amount of daily accommodation contribution the individual could be charged for the relevant day having regard to paragraphs 298(b) and (c) of the Act.
Step 2. Multiply the amount worked out at step 1 by 365 (rounding the result to 2 decimal places, rounding up if the third decimal place is 5 or more).
Step 3. Divide the amount worked out at step 2 by the maximum permissible interest rate for the individual’s start day for the classification type ongoing for the service group residential care in relation to the approved residential care home.
Step 4. Subtract from the amount worked out at Step 3 the sum of any deductions made on or before the relevant day from the refundable accommodation contribution in accordance with section 308 of the Act.
(4) For the purposes of complying with subsection (2), if the individual has paid part of the accommodation contribution in relation to the approved residential care home by refundable accommodation contribution on or before the relevant day, the daily accommodation contribution amount that the registered provider could charge the individual for the relevant day must be the amount worked out as follows:
Step 1. Work out the maximum permissible interest rate for the individual’s start day for the classification type ongoing for the service group residential care in relation to the approved residential care home.
Step 2. Work out the amount that is the difference between:
(a) the maximum refundable accommodation contribution amount for the individual for the relevant day worked out under subsection (3); and
(b) the individual’s refundable deposit balance for the relevant day.
Step 3. Multiply the rate worked out at step 1 by the amount worked out at step 2.
Step 4. Divide the amount worked out at step 3 by 365 (rounding the result to 2 decimal places, rounding up if the third decimal place is 5 or more).
Division 6—Charging of daily payments
301‑5 Charging interest
For the purposes of subsection 301(3) of the Act, the maximum rate for a day is worked out as follows:
Step 1. Work out the general interest charge rate for the day under subsection 8AAD(1) of the Taxation Administration Act 1953.
Step 2. Multiply the rate worked out at step 1 by the number of days in the calendar year in which the day falls.
Step 3. Subtract 3 percentage points from the amount worked out at step 2.
302‑10 Daily accommodation payments—indexation
(1) For the purposes of paragraphs 302(b) and (c) of the Act, the maximum possible daily accommodation payment amount for an individual is indexed on an indexation day by replacing the amount with the amount worked out using the following method:
Step 1. Work out the individual’s maximum possible daily accommodation payment amount (disregarding any indexation previously applied to that amount in accordance with this section).
Step 2. Work out the indexation factor by dividing the DAP index number for the indexation day by the DAP index number for the individual’s reference indexation day (rounding the result to 4 decimal places, rounding up if the fifth decimal place is 5 or more).
Note: For DAP index numbers see section 302‑15.
Step 3. Multiply the amount worked out under step 1 by the indexation factor worked out under step 2 (rounding the result to 2 decimal places, rounding up if the third decimal place is 5 or more).
(2) In this section:
indexation day means:
(a) 20 March; and
(b) 20 September.
reference indexation day for an individual and an approved residential care home means the indexation day before the first indexation day that occurs after the later of the following:
(a) the individual’s start day in relation to the approved residential care home;
(b) if the individual moves to a new room, or part of a room, in the approved residential care home—the day the individual occupies the new room or the part of the room.
302‑15 Daily payments—DAP index numbers
For the purposes of step 2 of the method in section 302‑10, the DAP index number for an indexation day is worked out using the following table:
Indexation factor
Item Column 1For the following indexation day … Column 2the DAP index number is …
1 20 September 2025 1.0
2 20 March 2026 1.02
302‑17 Daily payments—circumstances in which daily accommodation payment is not to be indexed
For the purposes of paragraph 302(ca) of the Act, the circumstance of being an individual in either of the following classes of individuals is prescribed:
(a) the post‑2014 residential accommodation class;
(b) the post‑2014 flexible accommodation class.
302‑20 Daily payments—circumstances in which an amount of daily payment may be refunded
(1) For the purposes of paragraph 302(cb) of the Act, this section prescribes requirements that apply to registered providers in relation to the refund of an overpaid amount of daily accommodation payment or daily accommodation contribution.
Note: For the refund of an overpayment of refundable accommodation deposit or refundable accommodation contribution, see section 304‑5.
(2) This section applies if an individual to whom funded aged care services are, or were, being delivered through the service group residential care in an approved residential care home has paid a higher amount of daily accommodation payment or daily accommodation contribution than was properly payable.
(3) The registered provider of the approved residential care home must refund to the individual the difference (the overpaid amount) between the amount of daily accommodation payment or daily accommodation contribution that was properly payable and the amount of daily accommodation payment or daily accommodation contribution that was paid.
(4) The individual may request the registered provider, in writing, to refund the overpaid amount to the individual.
(5) If the registered provider does not refund the overpaid amount to the individual within 28 days after the earlier of:
(a) the day the registered provider becomes aware of the overpaid amount; and
(b) if the individual makes a request under subsection (4)—the day the registered provider receives the request;
the registered provider must pay an amount of interest relating to the overpaid amount, worked out in accordance with the following formula:
MPIR is the maximum permissible interest rate for the day that is 28 days after the day referred to in paragraph (a) or (b) (as the case requires) of this subsection.
(a) beginning on the day that is 28 days after the day referred to in paragraph (a) or (b) (as the case requires) of this subsection; and
(b) ending on the day on which the overpaid amount is refunded.
OA is the overpaid amount.
Division 7—Refundable deposits
304‑5 Refundable deposits—circumstances in which an amount of refundable deposit may be refunded
(1) For the purposes of paragraph 304(a) of the Act, this section prescribes requirements that apply to registered providers in relation to the refund of an overpaid amount of refundable accommodation deposit or refundable accommodation contribution.
Note: For the refund of an overpayment of daily accommodation payment or daily accommodation contribution, see section 302‑20.
Overpaid amount of refundable accommodation deposit or refundable accommodation contribution
(2) This section applies if an individual to whom funded aged care services are, or were, being delivered through the service group residential care in an approved residential care home has paid a higher amount of refundable accommodation deposit or refundable accommodation contribution than was properly payable.
(3) The registered provider of the approved residential care home must refund to the individual the difference (the overpaid amount) between the amount of refundable accommodation deposit or refundable accommodation contribution that was properly payable and the amount of refundable accommodation deposit or refundable accommodation contribution that was paid.
(4) The individual may request the registered provider, in writing, to refund the overpaid amount to the individual.
(5) If the registered provider does not refund the overpaid amount to the individual within 28 days after the earlier of:
(a) the day the registered provider becomes aware of the overpaid amount; and
(b) if the individual makes a request under subsection (4)—the day the registered provider receives the request;
the registered provider must pay an amount of interest relating to the overpaid amount, worked out in accordance with the following formula:
MPIR is the maximum permissible interest rate for the day that is 28 days after the day referred to in paragraph (a) or (b) (as the case requires) of this subsection.
(a) beginning on the day that is 28 days after the day referred to in paragraph (a) or (b) (as the case requires) of this subsection; and
(b) ending on the day on which the overpaid amount is refunded.
OA is the overpaid amount.
307‑5 Amounts to be deducted from refundable deposit balances—deductible amount
For the purposes of paragraph 307(3)(a) of the Act, any amount of daily payment that is outstanding on the day the registered provider ceases to deliver ongoing funded aged care services to the individual through the service group residential care in an approved residential care home is prescribed.
308‑10 Amounts that must be deducted from refundable deposit balances—retention amounts—timing of deductions
For the purposes of paragraph 308(3)(a) of the Act, the registered provider may deduct a retention amount from a refundable deposit balance if:
(a) there is a retention amount outstanding on the day the registered provider ceases to deliver ongoing funded aged care services to the individual through the service group residential care in an approved residential care home; and
(b) the provider deducts the retention amount prior to:
(i) refunding the refundable deposit balance to the individual; or
(ii) transferring the refundable deposit balance to another registered provider.
Note: Retention amounts must be deducted from a refundable deposit balance at least once in each 3 month period starting on the day the individual paid the refundable deposit, and must not be deducted more than once in any one month period or in certain other circumstances: see subsections 308(3A) and (4) of the Act.
308‑11 Amounts that must be deducted from refundable deposit balances—retention amounts—circumstances in which a retention amount may be refunded
(1) For the purposes of paragraph 308(3)(b) of the Act, this section prescribes requirements that apply to registered providers in relation to the refund of an overcharged retention amount.
Overcharged retention amount
(2) This section applies if an individual to whom funded aged care services are, or were, being delivered through the service group residential care in an approved residential care home has been charged a higher retention amount than was properly chargeable.
(3) The registered provider of the approved residential care home must refund to the individual’s refundable deposit balance the difference (the overcharged amount) between the retention amount that was properly chargeable and the retention amount that was charged.
(4) The individual may request the registered provider, in writing, to refund the overcharged amount to the individual’s refundable deposit balance.
(5) The registered provider must refund the overcharged amount to the individual’s refundable deposit balance within 14 days after the earlier of:
(a) the day the registered provider becomes aware of the overcharged amount; and
(b) if the individual makes a request under subsection (4)—the day the registered provider receives the request.
(6) If the registered provider does not refund the overcharged amount to the individual’s refundable deposit balance before the day (the cessation day) funded aged care services cease to be delivered to the individual through the service group residential care in the approved residential care home, the registered provider must pay an amount of interest relating to the overcharged amount, worked out in accordance with the following formula:
MPIR is the maximum permissible interest rate for the day that is the day after the cessation day.
(a) beginning on the day that is the day after the cessation day; and
(b) ending on the day on which the overcharged amount is refunded.
OA is the overcharged amount.
308‑12 Amounts that must be deducted from refundable deposit balances—retention amounts—classes of individuals for whom amounts must not be deducted
For the purposes of subsection 308(7) of the Act, the following classes of individuals are prescribed:
(a) the post‑2014 residential accommodation class;
(b) the post‑2014 flexible accommodation class;
(c) the class of individuals that have ceased to be in the pre‑2014 accommodation class.
Note: An individual ceases to be in the pre‑2014 accommodation class if the 28 day period referred to in paragraph (b) of the definition of pre‑2014 accommodation class is exceeded, or the individual gives an election in accordance with subparagraph (c)(i) of that definition.
309‑5 Rules about deductions
For the purposes of section 309 of the Act, deductions are to be made in the following order:
(a) amounts referred to in subsection 307(2) of the Act;
(b) amounts referred to in paragraph 307(3)(b) of the Act;
(c) amounts referred to in section 307‑5 of this instrument;
(d) amounts referred to in section 308 of the Act.
310‑5 Refundable deposits to be used only for permitted purposes—capital expenditure
For the purposes of paragraph 310(2)(a) of the Act, the following kinds of capital expenditure are prescribed:
(a) expenditure to acquire land on which are, or are to be built, the premises needed for delivering funded aged care services through the service group residential care, but only to the extent that the expenditure relates to those premises;
(b) expenditure to acquire, erect, extend or significantly alter premises used or proposed to be used for delivering funded aged care services through the service group residential care, but only to the extent that the expenditure relates to the delivery of those funded aged care services;
(c) expenditure to acquire or install furniture, fittings or equipment for premises used or proposed to be used for delivering funded aged care services through the service group residential care, when those premises are initially erected or following an extension, a significant alteration or a significant refurbishment, but only to the extent that the expenditure relates to the delivery of those funded aged care services;
(d) expenditure that is directly connected to expenditure covered by paragraph (a), (b) or (c).
310‑15 Refundable deposits to be used only for permitted purposes—capital expenditure debt
For the purposes of paragraph 310(2)(e) of the Act, the kinds of capital expenditure are the kinds referred to in section 310‑5.
310‑20 Refundable deposits to be used only for permitted purposes—other
For the purposes of paragraph 310(2)(f) of the Act, the registered provider may use an individual’s refundable deposit for the following purposes:
(a) to meet reasonable business losses that are incurred in the course of delivering funded aged care services within the period of 12 months after the day the registered provider begins to deliver funded aged care services to the individual through the service group residential care;
(b) to invest in a fund, but not a controlling entity of a fund, listed in item 2 of the first Schedule to Banking exemption No. 1 of 2021 made under the Banking Act 1959.
310‑30 Refundable deposits to be used only for permitted purposes—financial product
For the purposes of paragraph 310(3)(e) of the Act, each of the following financial products is prescribed:
(a) an interest in a scheme established for the purpose of investment in the delivery of funded aged care services through the service group residential care in an approved residential care home that:
(i) is a managed investment scheme within the meaning of the Corporations Act 2001; and
(ii) is not a registered scheme within the meaning of the Corporations Act 2001;
(b) a legal or equitable right or interest in an interest covered by paragraph (a);
(c) an option to acquire, by way of issue, an interest or right covered by paragraph (a) or (b).
Note: A registered provider may use a refundable deposit to invest in a financial product specified in this section: see paragraphs 310(2)(b) and (3)(e) of the Act.
311‑5 Refund of refundable balances—manner of refund
For the purposes of subsection 311(2) of the Act, the prescribed manner is cash, cheque, bank cheque or electronic transfer.
311‑15 Refund of refundable deposit balances—death of individual—circumstances and period
For the purposes of paragraph 311(3)(b) of the Act:
(i) the registered provider is not shown the probate of the will of the individual or letters of administration of the estate of the individual; and
(ii) the registered provider is shown other evidence that satisfies the provider that the refundable deposit balance is to be refunded to a person; and
(b) the period is 14 days after the day the evidence mentioned in subparagraph (a)(ii) is shown to the provider.
311‑20 Refund of refundable deposit balances—registered provider ceases services and has not transferred refundable deposit balance—circumstances and period
(1) For the purposes of paragraph (b) of the column headed “the refundable deposit balance must be refunded…” in item 4 of the table in subsection 311(4) of the Act, this section prescribes:
(a) the circumstances in which a registered provider must refund a refundable deposit balance; and
(b) the period within which the refundable deposit balance must be refunded.
(2) If:
(a) the individual has agreed with the registered provider as mentioned in subsection (3); and
(b) the individual has notified the registered provider, in writing, that they wish to cease that agreement;
the registered provider must refund the refundable deposit balance within 14 days after the day on which the individual has notified the provider as mentioned in paragraph (b).
(3) The agreement is an agreement between the individual and the registered provider to delay refunding the refundable deposit balance on condition that, if the individual requests re‑entry to the approved residential care home, the registered provider must allow entry to the individual if:
(a) a room, or part of a room, is vacant in the approved residential care home; and
(b) the individual has an access approval in effect that includes the classification type ongoing for the service group residential care.
312‑5 Transfer of refundable deposit balance to another registered provider—requirements
(1) For the purposes of subsection 312(2) of the Act, this section prescribes requirements for the transfer of the individual’s refundable deposit balance between the outgoing provider and the incoming provider referred to in subsection 312(1) of the Act.
(2) The outgoing provider must, by written notice, give the following information in relation to the individual to the incoming provider before the transfer day:
(a) the transfer day;
(b) any amount of interest payable on or before the transfer day under section 313‑5 in relation to the individual’s refundable deposit balance and the amount of that interest;
(c) the entry in the refundable deposit register of the provider that relates to the individual.
(3) The outgoing provider must give written notice to the individual of the proposed transfer of the individual’s refundable deposit balance before the transfer day, including:
(a) details of the incoming provider; and
(b) the transfer day.
(4) If the transfer day is changed, the outgoing provider must give written notice to the individual of the new transfer day as soon as practicable before that day.
(5) The outgoing provider must transfer the refundable deposit balance to the incoming provider on the transfer day, as notified to the individual in accordance with this section.
312‑10 Circumstances in which refundable deposit balance must not be transferred to another registered provider
For the purposes of subsection 312(4) of the Act, the prescribed circumstances are that:
(a) the incoming provider delivers ongoing funded aged care services through the service group residential care only under one or more specialist aged care programs; or
(b) the registered provider does not deliver any ongoing funded aged care services through the service group residential care.
313‑5 Payment of interest—refund of refundable deposit balances—circumstances
(1) For the purposes of subsection 313(1) of the Act, the circumstances in which interest is to be paid in relation to the refund of a refundable deposit balance by a registered provider are all the circumstances in which the registered provider is required under section 311 of the Act to refund the refundable deposit balance, other than the circumstances covered by subsection (2).
(2) The circumstances covered by this subsection are that:
(a) item 1 of the table in subsection 311(4) of the Act applies to the refund of the refundable deposit balance; and
(b) the registered provider refunds the refundable deposit balance on the day referred to in column 2 of that item.
313‑10 Payment of interest—refund of refundable deposit balances—amount
(1) For the purposes of subsection 313(2) of the Act, this section prescribes the amount of interest to be paid in relation to the refund of a refundable deposit balance by a registered provider.
Amounts of interest if there is a refund period
(2) Subsections (3) and (4) of this section apply if subsection 311(3) of the Act, or item 2, 3 or 4 of the table in subsection 311(4) of the Act, applies to the refund.
If refundable deposit balance refunded on or before last day of refund period
(3) If the registered provider refunds the refundable deposit balance on or before the last day of the refund period in relation to the refund, the amount of interest is the amount worked out in accordance with the following formula:
Start formula start fraction BIR times RDB times ND over 365 end fraction end formula
BIR is the base interest rate on the first day of the refund period.
(a) beginning on the day after the day on which the refunding event in relation to the refund occurred; and
If refundable deposit balance refunded after last day of refund period
(4) If the registered provider refunds the refundable deposit balance after the last day of the refund period, the amount of interest is the amount worked out in accordance with the following formula:
Start formula start fraction BIR times RDB times ND(RP) over 365 end fraction plus start fraction MPIR times RDB times ND(PP) over 365 end fraction end formula
BIR is the base interest rate on the first day of the refund period.
MPIR is the maximum permissible interest rate for the day after the last day in the refund period.
(a) beginning on the day after the last day of the refund period; and
ND(RP) is the number of days in the period:
(a) beginning on the day after the day on which the refunding event occurred; and
(b) ending on the last day of the refund period.
Amount of interest if there is a refund day—refundable deposit balance refunded after refund day
(5) If item 1 of the table in subsection 311(4) of the Act applies to the refund, and the registered provider refunds the refundable deposit balance after the day (the refund day) referred to in column 2 of that item, the amount of interest is the amount worked out in accordance with the following formula:
Start formula start fraction MPIR times RDB times ND(PP) over 365 end fraction end formula
MPIR is the maximum permissible interest rate for the day after the refund day.
Chapter 10—Funding of aged care services—means testing
314‑5 Simplified outline of this Chapter
This Chapter provides for matters relating to means testing for funded aged care services under Part 5 of Chapter 4 of the Act.
Division 1 of Part 2 relates to means testing in a home or community setting, and deals with:
(a) determining individual contribution rates for individuals for means testing categories; and
(b) working out means testing classes for individuals; and
(c) when an individual accessing funded aged care services in a home or community setting has means not disclosed status; and
(d) requirements for notifying of events or changes in circumstances; and
(e) varying or revoking individual contribution rate determinations.
Division 2 of Part 2 relates to means testing in an approved residential care home, and deals with:
(a) working out daily means tested amounts; and
(b) when an individual accessing funded aged care services in an approved residential care home has means not disclosed status; and
(c) determining an individual’s total assessable income and the value of an individual’s assets; and
(d) varying or revoking income determinations and asset determinations;
(e) requirements for notifying of events or changes in circumstances.
Part 2—Means testing
Division 1—Means testing in a home or community setting
Subdivision A—Determination of individual contribution rates for individuals for means testing categories
314‑10 Method for determining individual contribution rate
(1) For the purposes of paragraph 314(1)(a) of the Act, the method for determining the individual contribution rate for an individual for a means testing category is as follows:
Step 1. Work out the individual’s means testing class in accordance with Subdivision B.
Step 2. Work out the percentage for the category and the class under subsection (2) to (10) (as applicable).
(2) The following table sets out percentages for individual contribution rates for individuals for means testing classes and categories, for an individual not covered by any of subsections (3) to (10).
Percentages for individual contribution rates—general
Item Column 1For an individual in the following means testing class … Column 2the percentage for the means testing category clinical supports is … Column 3and the percentage for the means testing category independence is … Column 4and the percentage for the means testing category everyday living is …
1 Full‑pensioner 0% 5% 17.5%
2 Part‑pensioner 0% the amount of the percentage calculated in accordance with section 314‑55 the amount of the percentage calculated in accordance with section 314‑55
3 Seniors health card holder 0% the amount of the percentage calculated in accordance with section 314‑55 the amount of the percentage calculated in accordance with section 314‑55
4 Self‑funded retiree 0% 50% 80%
(3) The following table sets out percentages for individual contribution rates for individuals for means testing classes and categories, for an individual in the post‑2014 home contribution class who:
(a) immediately before the transition time, was not a continuing home care recipient within the meaning of the old Act; and
(b) is not covered by any of subsections (6) to (12).
Percentages for individual contribution rates—individuals in the post‑2014 home contribution class
Item Column 1For an individual in the following means testing class … Column 2the percentage for the means testing category clinical supports is … Column 3and the percentage for the means testing category independence is … Column 4and the percentage for the means testing category everyday living is …
1 Full‑pensioner 0% 0% 0%
2 Part‑pensioner 0% the amount of the percentage calculated in accordance with section 314‑55 the amount of the percentage calculated in accordance with section 314‑55
3 Seniors health card holder 0% the amount of the percentage calculated in accordance with section 314‑55 the amount of the percentage calculated in accordance with section 314‑55
4 Self‑funded retiree 0% 25% 25%
Individuals in the post‑2014 home contribution class who were continuing home care recipients under the old Act
(4) The percentage for the individual contribution rate for each means testing category is 0% for an individual in the post‑2014 home contribution class who:
(a) immediately before the transition time, was a continuing home care recipient within the meaning of the old Act; and
(b) is not covered by any of subsections (6) to (12).
Individuals with classification level STRC class in classification type short‑term for service group home support
(5) The percentage for the individual contribution rate for each means testing category is 0% for an individual who:
(a) is accessing funded aged care services through the service group home support; and
(b) has the classification level STRC class in the classification type short‑term for that service group; and
(c) is not covered by any of subsections (6) to (12).
Individuals accessing flexible care through an innovative care service
(6) The percentage for the individual contribution rate for each means testing category is 0% for an individual who, immediately before the transition time, was accessing flexible care through an innovative care service (within the meaning of the old Principles).
Individuals who are former prisoners of war
(7) The percentage for the individual contribution rate for each means testing category is 0% for an individual who is described in paragraph 85(4)(b) of the Veterans’ Entitlements Act (which describes former prisoners of war).
Individuals who have been awarded the Victoria Cross or the Victoria Cross for Australia
(8) The percentage for the individual contribution rate for each means testing category is 0% for an individual who has been awarded the Victoria Cross or the Victoria Cross for Australia (both within the meaning of the Veterans’ Entitlements Act).
Individuals who die before contribution rate first determined
(9) The percentage for the individual contribution rate for each means testing category is 0% for an individual who dies before the individual’s contribution rate is first determined under subsection 314(1) of the Act.
Individuals who cease receiving services before contribution rate first determined
(10) The percentage for the individual contribution rate for each means testing category is 0% for an individual who:
(a) is being delivered funded aged care services through a service group; and
(b) ceases being delivered funded aged care services through that service group before the individual’s contribution rate is first determined under subsection 314(1) of the Act.
Individuals who do not have contribution rate determined within 6 months of being provided with home care
(11) The percentage for the individual contribution rate for each means testing category is 0% for an individual:
(a) who was, immediately before the transition time, approved under section 22‑1 of the old Act as a recipient of home care; and
(b) who provided the System Governor the information required to enable the working out of the individual’s care subsidy reduction under sections 48‑7 and 48‑8 of the old Act; and
(c) whose individual contribution rate was not determined within 6 months of first being provided with home care.
Individuals in the post‑2014 home contribution class with an income tested care fee less than $1
(12) The percentage for the individual contribution rate for each means testing category is 0% for an individual in the post‑2014 home contribution class for whom, immediately before the transition time, the income tested care fee for the individual under section 52D‑2 of the old Act was less than $1.
314‑15 Period for determining individual contribution rate
(1) For the purposes of paragraph 314(1)(b) of the Act, this section sets out the period for determining the individual contribution rate for an individual for each means testing category.
(2) This section applies to an individual if a registered provider provides a start notification on a day (the start notification day) to the System Governor and the Commissioner about the delivery of funded aged care services to the individual, other than a start notification given in connection with:
(a) the transfer of a service delivery branch of a registered provider to another registered provider; or
(b) the merger of 2 or more service delivery branches of a registered provider into a single delivery branch of the provider.
(3) If, on the start notification day, the System Governor has the information referred to in paragraphs 314A‑5(1)(a) to (d) in relation to the individual (the required information), the period is 28 days from the start notification day.
(b) within 3 days from the start notification day, the individual provides the required information to the System Governor;
(b) within 3 days from the start notification day, the individual does not provide the required information; and
(c) the System Governor makes one or more requests for the required information from the individual under subsection 343(1) of the Act; and
(d) within 43 days from the day the System Governor first requested the required information, the individual provides the required information to the System Governor;
If individual does not provide required information or makes an election under section 314B of the Act
(i) the individual does not, within the period mentioned in paragraph (5)(d), provide the required information to the System Governor; or
(ii) the individual makes an election under section 314B of the Act before the end of the period mentioned in paragraph (5)(d);
314‑20 Other matters to be included in notice of determination
For the purposes of paragraph 314(3)(e) of the Act, the other matters that must be included in a notice under subsection 314(2) of the Act in relation to an individual contribution rate determination for an individual are as follows:
(a) the previous individual contribution rate (if any) for the individual for each means testing category;
(b) the date of effect of the determination as worked out in accordance with section 314‑25 of this instrument.
314‑25 Day determination takes effect
For the purposes of subsection 314(4) of the Act, the day at the start of which an individual contribution rate determination for an individual takes effect is:
(a) if, on the day the determination was made, an individual contribution rate determination was not in force for the individual—the day the start notification mentioned in subsection 314‑15(2) of this instrument relating to the individual was provided to the System Governor and the Commissioner; or
(b) in any other case—the day the determination was made.
Note: For the day of effect for determinations made following revocation of individual contribution rate determinations, see subsection 318A(5) of the Act.
Subdivision B—Working out means testing classes for individuals
314‑30 Full‑pensioner
Individuals not permanently blind and receiving maximum income support payments
(1) An individual is in the means testing class full‑pensioner on a day if:
(a) the individual is not permanently blind; and
(b) the individual is receiving an income support payment; and
(c) the individual’s payment rate for the income support payment is the maximum payment rate for that payment for that individual.
Note: For example, the maximum payment rate for age and disability support pensions and carer payment for people who are not blind is the rate worked out at step 4 of the method statement in Module A of Pension Rate Calculator A.
Individuals permanently blind or not receiving income support payments
(2) An individual is in the means testing class full‑pensioner on a day if:
(i) the individual is permanently blind; or
(ii) the individual is not receiving an income support payment; and
(b) if the individual were receiving age pension calculated in accordance with Pension Rate Calculator A, the individual’s payment rate would be the maximum payment rate for age pension under that calculator for that individual if the value of the individual’s assets were worked out in accordance with Division 1 of Part 3.12 of the Social Security Act.
Individuals in the post‑2014 home contribution class for whom the income tested care fee under section 52D‑2 of the old Act was nil
(3) An individual is in the means testing class full‑pensioner on a day if:
(a) the individual is in the post‑2014 home contribution class; and
(b) immediately before the transition time, the income tested care fee for the individual under section 52D‑2 of the old Act was nil.
Individual where certain events occur before the individual’s contribution rate is first determined
(4) Despite any other provision of this Subdivision, an individual is in the means testing class full‑pensioner on a day if:
(a) the individual has accessed funded aged care services on or after the transition time; and
(b) the individual has provided the System Governor the information referred to in paragraphs 314A‑5(1)(a) to (d) to enable the first determination of the individual’s contribution rate under subsection 314(1) of the Act; and
(c) the individual’s contribution rate has not been determined within 6 months of the day that information was provided.
314‑35 Part‑pensioner
Individuals not permanently blind and receiving income support payments at less than maximum payment rates
(1) An individual is in the means testing class part‑pensioner on a day if:
(a) the individual is not permanently blind; and
(b) the individual is receiving an income support payment; and
(c) the individual’s payment rate for the income support payment is less than the maximum payment rate for that payment for that individual.
Note: For example, the maximum payment rate for age and disability support pensions and carer payment for people who are not blind is the rate worked out at step 4 of the method statement in Module A of Pension Rate Calculator A.
Individuals permanently blind or not receiving income support payments
(2) An individual is in the means testing class part‑pensioner on a day if:
(i) the individual is permanently blind; or
(ii) the individual is not receiving an income support payment; and
(b) if the individual were receiving age pension calculated in accordance with Pension Rate Calculator A, the individual’s payment rate would be less than the maximum payment rate for age pension under that calculator for that individual, but not nil, if the value of the individual’s assets were worked out in accordance with Division 1 of Part 3.12 of the Social Security Act.
314‑40 Seniors health card holder
Holders of seniors health cards
(1) An individual is in the means testing class seniors health card holder on a day if:
(a) the individual is not receiving age pension; and
(b) the individual holds a seniors health card.
Individuals who are not holders of seniors health cards
(2) An individual is in the means testing class seniors health card holder on a day if:
(a) the individual is not receiving age pension; and
(b) the individual does not hold a seniors health card; and
(c) the individual would satisfy the seniors health card income test in section 1071 of the Social Security Act if the value of the individual’s assets were worked out in accordance with Division 1 of Part 3.12 of that Act.
314‑45 Self‑funded retiree
An individual is in the means testing class self‑funded retiree on a day if:
(a) the individual is not in the means testing class full‑pensioner, part‑pensioner or seniors health card holder; or
(b) the individual has means not disclosed status; or
(c) the individual is an individual in relation to whom subsection 48‑7(3) of the old Act applied to as at immediately before the transition time.
Subdivision C—Calculating amounts of percentages for the means testing categories independence and everyday living
314‑55 Calculation method
(1) For the purposes of columns 3 and 4 of items 2 and 3 in the table in subsection 314‑10(2), the method for calculating the amounts of the percentages is as follows:
Step 1. Work out the income reduction amount under section 314‑60.
Step 2. Work out the assets reduction amount under section 314‑65.
Step 3. Work out the maximum reduction amount under section 314‑70.
Step 4. Work out the input contribution rate under subsection 314‑75(1).
Step 5. Work out the amount of the percentage:
(a) for the means testing category independence—under subsection 314‑80(1); and
(b) for the means testing category everyday living—under subsection 314‑85(1).
(2) For the purposes of columns 3 and 4 of items 2 and 3 in the table in subsection 314‑10(3), the method for calculating the amounts of the percentages is as follows:
Step 1. Work out the income reduction amount under section 314‑60.
Step 2. Work out the maximum reduction amount under section 314‑70.
Step 3. Work out the input contribution rate under subsection 314‑75(2).
Step 4. Work out the amount of the percentage:
(a) for the means testing category independence—under subsection 314‑80(2); and
(b) for the means testing category everyday living—under subsection 314‑85(2).
314‑60 Working out the income reduction amount
The method for working out the income reduction amount is as follows:
Step 1. Work out the amount that would be worked out as the individual’s ordinary income for the purpose of applying Module E of Pension Rate Calculator A.
Step 2. Work out the amount that would be worked out as the individual’s ordinary income free area under point 1064‑E4 of that Module.
Step 3. Subtract the amount under Step 2 from the amount under Step 1.
Step 4. Multiply the amount under Step 3 by 0.5 and round to the nearest dollar.
The result is the income reduction amount.
314‑65 Working out the assets reduction amount
The method for working out the assets reduction amount is as follows:
Step 1. Work out the value of the individual’s assets in accordance with:
(a) Division 1 of Part 3.12 of the Social Security Act; and
(b) if the individual is a member of a couple—point 1064‑G2 of Module G of Pension Rate Calculator A.
Step 2. Work out the amount that would be worked out as the individual’s assets value limit under point 1064‑G3 of Module G of Pension Rate Calculator A.
Step 3. Subtract the amount under step 2 from the amount under step 1 and round down to the nearest multiple of $250.
Step 4. Multiply the amount under step 3 by 0.078 and round to the nearest dollar.
The result is the assets reduction amount.
314‑70 Working out the maximum reduction amount
The method for working out the maximum reduction amount is as follows:
Step 1. Work out the individual’s senior’s health card income limit under point 1071‑12 of the Seniors Health Card Income Test Calculator at the end of section 1071 of the Social Security Act.
Step 2. Subtract the individual’s ordinary income free area (worked out under Step 2 of the method statement in section 314‑60 of this instrument) from the individual’s senior’s health card income limit.
Step 3. Multiply the amount under Step 2 by 0.5 and round to the nearest dollar.
The result is the maximum reduction amount.
314‑75 Working out the input contribution rate
(1) The method for working out the input contribution rate for individuals covered by subsection 314‑10(2) is as follows:
Step 1. Divide the greater of the income reduction amount and the assets reduction amount by the maximum reduction amount.
Step 2. Multiply the step 1 amount by 100.
The result is the input contribution rate.
(2) The method for working out the input contribution rate for individuals covered by subsection 314‑10(3) is as follows:
Step 1. Divide the income reduction amount by the maximum reduction amount.
Step 2. Multiply the step 1 amount by 100.
The result is the input contribution rate.
314‑80 Working out the amount of the percentage for the means testing category independence
(1) The method for working out the percentage for the means testing category independence for individuals covered by subsection 314‑10(2) is as follows:
Step 1. Multiply the input contribution rate by 0.45.
Step 2. Add 5 to the Step 1 amount and round to 2 decimal places.
The result is the amount of the percentage for the means testing category independence.
(2) The method for working out the percentage for the means testing category independence for individuals covered by subsection 314‑10(3) is as follows:
Step 1. Multiply the input contribution rate by 0.25 and round to 2 decimal places.
The result is the amount of the percentage for the means testing category independence.
314‑85 Working out the amount of the percentage for the means testing category everyday living
(1) The method for working out the percentage for the means testing category everyday living for individuals covered by subsection 314‑10(2) is as follows:
Step 1. Multiply the input contribution rate by 0.625.
Step 2. Add 17.5 to the Step 1 amount and round to 2 decimal places.
The result is the amount of the percentage for the means testing category everyday living.
(2) The method for working out the percentage for the means testing category everyday living for individuals covered by subsection 314‑10(3) is as follows:
Step 1. Multiply the input contribution rate by 0.25 and round to 2 decimal places.
The result is the amount of the percentage for the means testing category everyday living.
Subdivision D—Means not disclosed status
314A‑5 Determination that individuals have means not disclosed status
Specified information
(1) For the purposes of subsection 314A(2) of the Act, the specified information is the following:
(a) information relating to the individual’s marital status;
(b) information relating to whether the individual is a homeowner;
(c) information relating to the individual’s total assessable income under section 322 of the Act;
(d) information relating to the value of the individual’s assets under section 329 of the Act.
Specified period
(2) For the purposes of subsection 314A(2) of the Act, the specified period is 43 days from the day the System Governor first requests the specified information from the individual under subsection 343(1) of the Act (whether or not the System Governor makes a subsequent request for the specified information from the individual).
314A‑10 Day determination takes effect
For the purposes of subsection 314A(3) of the Act, if the day specified by the System Governor in the notice under subsection 314A(5) of the Act as the day the determination takes effect is a day before the day the determination is made, the specified day must be the start day for the delivery of funded aged care services to the individual to which the start notification mentioned in subsection 314‑15(2) of this instrument for the individual relates.
Subdivision E—Requirement to notify event or change in circumstances
315‑5 Circumstances in which notification of event or change in circumstances is required
For the purposes of subsection 315(1) of the Act, the circumstances in which an individual for whom an individual contribution rate determination is in force must notify the System Governor of the occurrence of an event or a change in the individual’s circumstances are as follows:
(a) a decision under the social security law (within the meaning of the Social Security Act) relating to the individual has been made;
(b) the individual’s income changes;
(c) the individual’s partner’s income changes;
(d) the value of the individual’s assets changes;
(e) the value of the individual’s partner’s assets changes;
(f) the individual starts or stops being a member of a couple;
(g) the individual is a member of a couple that stops or starts being an illness separated couple (within the meaning of the Social Security Act);
(h) the individual is a member of a couple that stops or starts being a respite care couple (within the meaning of the Social Security Act);
(i) the individual leaves Australia permanently.
315‑10 Period for notification of event or change in circumstances
For the purposes of paragraph 315(2)(a) of the Act, the period within which an individual must notify the System Governor of the occurrence of an event or a change in the individual’s circumstances is 28 days from the day the event or change of circumstances occurs.
315‑15 Manner for notification of event or change in circumstances
For the purposes of paragraph 315(2)(b) of the Act, the manner in which an individual must notify the System Governor of the occurrence of an event or a change in the individual’s circumstances is the approved form.
Subdivision F—Varying or revoking individual contribution rate determination
316‑5 Other matters to be included in notice of determination
For the purposes of paragraph 316(4)(f) of the Act, the other matter that must be included in a notice under subsection 316(3) of the Act in relation to a varied individual contribution rate determination for an individual is the individual contribution rate for the individual for each means testing category specified in the notice given under subsection 314(2) of the Act in relation to the old determination for the individual.
317‑5 Period for deciding if individual contribution rate determination is no longer correct following certain social security decisions
For the purposes of subsection 317(2) of the Act, the period is 28 days from the day the decision mentioned in subparagraph 317(1)(b)(i) of the Act is made.
318‑5 Period for deciding whether to vary individual contribution rate determination following event or change in circumstances
For the purposes of subsection 318(2) of the Act, the period is 28 days from the day the System Governor is notified as mentioned in paragraph 318(1)(b) of the Act.
318‑10 Variation following event or change in circumstances to take effect on specified day in specified circumstances
For the purposes of subsection 318(6) of the Act, in the circumstances that:
(a) a variation for an individual is made following the System Governor being notified, as mentioned in paragraph 318(1)(b) of the Act, of the occurrence of an event or change after the end of the period prescribed by section 315‑10 of this instrument; and
(b) the variation results in an increase to the individual contribution rate for the individual for a means testing category;
the variation takes effect on the day the System Governor was notified as mentioned in paragraph 318(1)(b) of the Act of the event or change.
318A‑5 Period for deciding whether to revoke incorrect individual contribution rate determination
For the purposes of subsection 318A(2) of the Act, the period is 28 days from the day the System Governor is satisfied as mentioned in paragraph 318A(1)(b) of the Act.
Division 2—Means testing in approved residential care home
Subdivision A—Daily means tested amounts
319‑5 Income and asset thresholds
(1) This section is made for the purposes of subsection 319(4) of the Act.
Income thresholds
(2) The first income threshold is:
(a) for an individual who is a member of an illness separated couple—$87,219.60; or
(b) for an individual who is not a member of a couple—$87,947.60.
(3) The second income threshold is $101,105.00.
(4) The third income threshold is $117,230.20.
(5) The fourth income threshold is:
(a) for an individual who is a member of an illness separated couple—$138,340.80; or
(b) for an individual who is not a member of a couple—$141,252.80.
Asset thresholds
(6) The first asset threshold is $214,884.00.
(7) The second asset threshold:
(a) for an individual in the post‑2014 residential contribution class—is $515,652.00; or
(b) in any other case—is $258,000.00.
(8) The third asset threshold is $361,366.66.
(9) The fourth asset threshold is $536,384.00.
319‑10 Working out the daily means tested amount—classes of individuals
For the purposes of subsection 319(5) of the Act, the classes are the following:
(a) the pre‑2014 residential contribution class;
(b) the post‑2014 residential contribution class.
319‑15 Working out the daily means tested amount—individuals in pre‑2014 residential contribution class
(1) For the purposes of subsection 319(5) of the Act, the daily means tested amount for an individual in the pre‑2014 residential contribution class is worked out as follows:
Step 1. Work out the individual’s total assessable income (which is determined under section 322 of the Act).
Step 2. Work out the individual’s total assessable income free area (see subsection (2)).
Step 3. If the individual’s total assessable income does not exceed the individual’s total assessable income free area, the daily means tested amount is zero.
Step 4. If the individual’s total assessable income exceeds the individual’s total assessable income free area, the smallest of the following amounts (rounded down to the nearest cent) is the daily means tested amount:
(a) the amount equal to 5/12 of that excess, divided by 364;
(b) the amount equal to 135% of the basic age pension amount for that day, divided by 364;
(c) the sum of the following amounts for the day (as if Division 4 of Part 2 of Chapter 4 of the Act applied in relation to the individual):
(i) the individual’s base rate (see section 229‑5);
(ii) the provider’s base provider amount (see section 238‑5) as if item 8 of the table in subsection 238‑5(1) applies to the provider;
(iii) the oxygen supplement (see section 230‑11) (if applicable);
(iv) the enteral feeding supplement (see section 230‑12) (if applicable).
Step 5: If the individual has means not disclosed status, the daily means tested amount is the amount equal to 135% of the basic age pension amount for that day divided by 364.
(2) For the purposes of this section, an individual’s total assessable income free area is:
(a) if the individual was a protected resident within the meaning of the Aged Care (Transitional Provisions) Act 1997 immediately before the transition time—the sum of:
(i) the amount for the day for the individual worked out by applying point 1064‑B1 of Pension Rate Calculator A at the end of section 1064 of the Social Security Act, as in force on 19 September 2009; and
(ii) the amount worked out under point 1064‑BA4 of Pension Rate Calculator A at the end of section 1064 of the Social Security Act; and
(iii) the amount worked out by applying point 1064‑E4 of Pension Rate Calculator A at the end of section 1064 of the Social Security Act; or
(b) for any other individual—the sum of:
(i) the amount for the day for the individual worked out by applying point 1064‑B1 of Pension Rate Calculator A at the end of section 1064 of the Social Security Act; and
(ii) the amount worked out under point 1064‑BA4 of Pension Rate Calculator A at the end of section 1064 of the Social Security Act; and
(iii) the amount worked out by applying point 1064‑E4 of Pension Rate Calculator A at the end of section 1064 of the Social Security Act.
319‑20 Working out the daily means tested amount—individuals in post‑2014 residential contribution class
Daily means tested amount
(1) For the purposes of subsection 319(5) of the Act, the daily means tested amount for an individual in the post‑2014 residential contribution class is the sum of:
(a) the per day income tested amount worked out under subsection (2); and
(b) the per day asset tested amount worked out under subsection (3).
Per day income tested amount
(2) The per day income tested amount is worked out as follows:
Step 1. Work out the individual’s total assessable income (which is determined under section 322 of the Act).
Step 2. Work out the individual’s total assessable income free area (see subsection 319(2) of the Act).
Step 3. If the individual’s total assessable income does not exceed the individual’s total assessable income free area, the per day income tested amount is zero.
Step 4. If the individual’s total assessable income exceeds the individual’s total assessable income free area, the per day income tested amount is 50% of that excess divided by 364.
Per day asset tested amount
(3) The per day asset tested amount is worked out as follows:
Step 1. Work out the value of the individual’s assets (which is determined under section 329 of the Act).
Step 2. If the value of the individual’s assets does not exceed the asset free area (see subsection 319(3) of the Act), the per day asset tested amount is zero.
Step 3. If the value of the individual’s assets exceeds the asset free area but not the first asset threshold, the per day asset tested amount is 17.5% of the excess, divided by 364.
Step 4. If the value of the individual’s assets exceeds the first asset threshold but not the second asset threshold, the per day asset tested amount is the sum of the following, divided by 364:
(a) 1% of the excess;
(b) 17.5% of the difference between the asset free area and the first asset threshold.
Step 5. If the value of the individual’s assets exceeds the second asset threshold, the per day asset tested amount is the sum of the following, divided by 364:
(a) 2% of the excess;
(b) 1% of the difference between the first asset threshold and the second asset threshold;
(c) 17.5% of the difference between the asset free area and the first asset threshold.
Subdivision B—Means not disclosed status
320‑5 Determination that individuals have means not disclosed status
For the purposes of subsection 320(2) of the Act:
(a) the specified information is information required to enable the System Governor to work out the individual’s total assessable income in accordance with section 323 of the Act and the value of the individual’s assets in accordance with section 330 of the Act; and
(b) the specified period is 28 days from the day the System Governor requests the specified information from the individual under subsection 343(1) of the Act.
320‑10 Day determination takes effect
For the purposes of subsection 320(3) of the Act, the day specified by the System Governor as the day the determination takes effect must be the start day for the delivery of funded aged care services to the individual to which the start notification mentioned in subsection 322‑5(2) or 329‑5(2) of this instrument for the individual relates.
Subdivision C—Determining an individual’s total assessable income
322‑5 Period for determining an individual’s total assessable income
(1) For the purposes of subsection 322(1) of the Act, this section sets out the period for determining an individual’s total assessable income.
(2) This section applies to an individual if a registered provider provides a start notification on a day (the start notification day) to the System Governor and the Commissioner about the delivery of funded aged care services to the individual.
(3) If, on the start notification day, the System Governor has the information (the required information) required to work out the individual’s total assessable income in accordance with section 323 of the Act, the period is 28 days from the start notification day.
(b) within 3 days from the start notification day, the individual provides the required information to the System Governor;
(b) within 3 days from the start notification day, the individual does not provide the required information to the System Governor; and
(c) the System Governor requests the required information from the individual under subsection 343(1) of the Act; and
(d) within 28 days from the day the System Governor requested the required information, the individual provides the required information to the System Governor;
If individual does not provide required information or makes an election under section 321 of the Act
(i) the individual does not, within the period mentioned in paragraph (5)(d), provide the required information to the System Governor; or
(ii) the individual makes an election under section 321 of the Act before the end of the period mentioned in paragraph (5)(d);
322‑10 Day determination takes effect
For the purposes of subsection 322(6) of the Act, the day specified by the System Governor as the day the determination takes effect must be the start day for the delivery of funded aged care services to the individual to which the start notification mentioned in subsection 322‑5(2) of this instrument for the individual relates.
322‑15 Other matters to be included in notice of determination
For the purposes of paragraph 322(9)(g) of the Act, the other matters that must be included in a notice under subsection 322(8) of the Act are as follows:
(a) a summary of the individual’s sources of income;
(b) the assessed amounts for each of those sources of income.
Subdivision D—Working out an individual’s total assessable income—excluded amounts
323‑5 Purpose of this Subdivision
For the purposes of subsection 323(7) of the Act, this Subdivision prescribes amounts that are to be taken, in relation to specified kinds of individuals, to be excluded from a determination under subsection 323(1) of the Act or paragraph 323(2)(b), (3)(b), (4)(b) or (5)(b) of the Act.
323‑10 Disability pensions and permanent impairment compensation payments
Certain amounts of disability pensions under the Veterans’ Entitlements Act
(1) In relation to an individual who has qualifying service under section 7A of the Veterans’ Entitlements Act, or the partner of such an individual, the amount (if any) of disability pension (within the meaning of subsection 5Q(1) of the Veterans’ Entitlements Act) paid to the individual that is exempt under section 5H of that Act is prescribed.
Compensation for permanent impairment or Special Rate Disability Pensions
(2) In relation to an individual who is a member or former member (within the meaning of the MRC Act) or the partner of such an individual, each of the following is prescribed:
(a) any amount of compensation for permanent impairment paid to the individual under Part 2 of Chapter 4 of the MRC Act;
(b) any amount of Special Rate Disability Pension paid to the individual under Part 6 of Chapter 4 of the MRC Act.
323‑15 Gifts
Disposal of ordinary income
(1) In relation to an individual who, on or before 20 August 1996, disposed of ordinary income, the amount of ordinary income disposed of on or before 20 August 1996 that is included in the individual’s ordinary income under:
(a) sections 1106, 1107, 1108 and 1109 of the Social Security Act; or
(b) sections 48, 48A, 48B and 48C of the Veterans’ Entitlements Act;
Note: Sections 1106, 1107, 1108 and 1109 of the Social Security Act, and sections 48, 48A, 48B and 48C of the Veterans’ Entitlements Act, deal with disposal of ordinary income.
Disposal of assets
(2) In relation to an individual who, on or before 20 August 1996, disposed of assets, the amount of ordinary income the individual is taken to receive because assets disposed of on or before 20 August 1996 are assessed as financial assets under:
(a) section 1076, 1077 or 1078 of the Social Security Act; or
(b) sections 46D and 46E of the Veterans’ Entitlements Act;
Note: Section 1076, 1077 or 1078 of the Social Security Act, and sections 46D and 46E of the Veterans’ Entitlements Act, deal with deemed income from financial assets.
323‑20 Rent receipts
(a) for whom an accommodation contribution or an accommodation payment is payable; and
(b) who first entered residential care (within the meaning of the old Act) on or before 31 December 2015; and
(c) for whom, since the individual first entered residential care, there has not been a continuous period of more than 28 days in which the individual was not either:
(2) The amount of any income received by the individual, or the individual’s partner, from rental of the individual’s principal home to another person is prescribed.
323‑25 GST compensation
(1) This section applies in relation to:
(a) an individual receiving a pension under Part II or IV of the Veterans’ Entitlements Act at a rate determined under or by reference to one or more of the following provisions of that Act:
(i) for an individual receiving a disability pension payable at the general rate—section 22;
(ii) for an individual receiving a disability pension payable at the general rate including an increased rate for a war‑caused injury or disease—sections 22 and 27;
(iii) for an individual receiving a disability pension payable at the intermediate rate—section 23;
(iv) for an individual receiving a disability pension payable at the intermediate rate including an increased rate for a war‑caused injury or disease—sections 23 and 27;
(v) for an individual receiving a disability pension payable at the special rate—section 24;
(vi) for an individual receiving a war widow or widower pension—subsection 30(1); and
(b) an individual receiving a pension under Part 6 of Chapter 4, or a weekly amount of compensation under Part 2 of Chapter 5, of the MRC Act at a rate determined under or by reference to one or more of the following provisions of that Act:
(i) for an individual receiving a Special Rate Disability Pension—sections 198 and 204;
(ii) for an individual receiving a weekly amount of compensation for the death of the individual’s partner—subsection 234(5).
(2) The amount that is equal to 4% of the amount of pension, or the weekly amount of compensation, payable to an individual under a provision referred to in subsection (1), as applicable from time to time, is prescribed.
Note 1: Part II of the Veterans’ Entitlements Act deals with pensions, other than service pensions, payable to veterans and their dependants.
Note 2: Part IV of the Veterans’ Entitlements Act deals with pensions payable to members of the Defence Forces or a Peacekeeping Force and their dependants.
Note 3: Part 6 of Chapter 4 of the MRC Act gives former members who are entitled to compensation for incapacity for work a choice to receive a Special Rate Disability Pension instead of compensation.
Note 4: Part 2 of Chapter 5 of the MRC Act gives wholly dependent partners of deceased members an entitlement to compensation in respect of the death of the members. The compensation may be taken as a lump sum or as a weekly amount.
323‑30 Energy payments
In relation to an individual to whom funded aged care services are being delivered through the service group residential care, each of the following is prescribed:
(a) any amount of clean energy advance, energy supplement or quarterly energy supplement paid to the individual under the Social Security Act;
(b) any amount of clean energy advance, energy supplement or quarterly energy supplement paid to the individual under the Veterans’ Entitlements Act.
Subdivision E—Working out an individual’s total assessable income—application of social security law provisions
323‑35 Application of Social Security Act provisions
(a) who first entered residential care (within the meaning of the old Act) on or after 1 January 2016; and
(b) for whom, since the individual first entered residential care, there has not been a continuous period of more than 28 days in which the individual was not either:
(2) For the purposes of subparagraph 323(8)(c)(ii) of the Act, paragraph 8(8)(znaa) of the Social Security Act is prescribed.
Note: Paragraph 8(8)(znaa) of the Social Security Act is about rental income from an individual’s principal home.
323‑40 Application of Veterans’ Entitlements Act provisions
(a) who first entered residential care (within the meaning of the old Act) on or after 1 January 2016; and
(b) for whom, since the individual first entered residential care, there has not been a continuous period of more than 28 days in which the individual was not either:
(2) For the purposes of subparagraph 323(9)(b)(ii) of the Act, paragraph 5H(8)(nf) of the Veterans’ Entitlements Act is prescribed.
Note: Paragraph 5H(8)(nf) of the Veterans’ Entitlements Act is about rental income from an individual’s principal home.
Subdivision F—Varying or revoking an income determination
324‑5 Day variation of income determination takes effect
(1) For the purposes of subsection 324(5) of the Act, the day specified by the System Governor as the day a variation of an income determination in relation to an individual takes effect must be in accordance with this section.
Variation results in a decreased means tested amount
(2) If the variation does not result in an increase to the individual’s daily means tested amount, the day specified must be the day the event or change in circumstances occurred.
Variation results in an increased means tested amount
(3) If the variation results in an increase to the individual’s daily means tested amount, the day specified must be:
(a) if the decision under subsection 324(1) of the Act to vary the income determination is made within 28 days of the day the event or change in circumstances occurred—the day notice of the decision is given; or
(b) otherwise—28 days before the day notice of the decision under subsection 324(1) of the Act is given.
(4) Despite paragraph (3)(b), the day specified may instead be a day earlier than 28 days before the day notice of the decision is given, if the individual has provided false or misleading information under section 326 or 336 of the Act in relation to the decision.
325‑5 Period for varying income determination—on notification of event or change in circumstances
For the purposes of subsection 325(2) of the Act, the period for varying the income determination is 28 days from the day the notification is made.
326‑5 Period for varying or revoking income determination—on application
For the purposes of paragraph 326(2)(b) of the Act, the period for making a decision on an application by an individual for the purposes of paragraph 324(2)(b) of the Act is 28 days from the day the application is made.
327‑5 Period for varying or revoking income determination—on System Governor’s initiative
For the purposes of paragraph 327(6)(b) of the Act, the period for making a decision under that paragraph is 28 days from:
(a) if no submission is made in accordance with the invitation in the notice under paragraph 327(2)(b) of the Act—the end of the period specified in the notice (including that period as extended (if applicable) under subsection 327(5) of the Act); or
(b) the later of:
(i) if a submission is made in accordance with the invitation in the notice under paragraph 327(2)(b) of the Act and no further information is requested under subsection 327(4) of the Act—the day the submission is made; and
(ii) if a submission is made in accordance with the invitation in the notice under paragraph 327(2)(b) of the Act and further information is requested under subsection 327(4) of the Act—the day the individual gives the System Governor the further information.
328‑10 Other matters to be included in notices of decisions other than reviewable decisions
For the purposes of paragraph 328(4)(b) of the Act, a notice given under subsection 328(3) of the Act must include the reasons for the decision.
Subdivision G—The value of an individual’s assets
329‑5 Period for determining the value of an individual’s assets
(1) For the purposes of subsection 329(1) of the Act, this section sets out the period for determining the value of an individual’s assets.
(2) This section applies to an individual if a registered provider provides a start notification on a day (the start notification day) to the System Governor and the Commissioner about the delivery of funded aged care services to the individual.
(3) If, on the start notification day, the System Governor has the information (the required information) required to work out the value of the individual’s assets in accordance with section 330 of the Act, the period is 28 days from the start notification day.
(b) within 3 days from the start notification day, the individual provides the required information to the System Governor;
(b) within 3 days from the start notification day, the individual does not provide the required information to the System Governor; and
(c) the System Governor requests the required information from the individual under subsection 343(1) of the Act; and
(d) within 28 days from the day the System Governor requested the required information, the individual provides the required information to the System Governor;
If individual does not provide required information or makes an election under section 321 of the Act
(i) the individual does not, within the period mentioned in paragraph (5)(d), provide the required information to the System Governor; or
(ii) the individual makes an election under section 321 of the Act before the end of the period mentioned in paragraph (5)(d);
329‑10 Day determination takes effect
For the purposes of subsection 329(6) of the Act, the day specified by the System Governor as the day the determination takes effect must be the start day for the delivery of funded aged care services to the individual to which the start notification mentioned in subsection 322‑5(2) of this instrument for the individual relates.
329‑15 Other matters to be included in notice of determination
For the purposes of paragraph 329(9)(g) of the Act, the other matters that must be included in a notice under subsection 329(8) of the Act are as follows:
(a) a summary of the individual’s assets;
(b) the assessed amounts for each of the individual’s assets.
Subdivision H—Working out the value of an individual’s assets—excluded amounts
330‑5 Value of home
For the purposes of subsection 330(7) of the Act, the amount is $214,884.00.
330‑10 Other amounts
(1) For the purposes of subsection 330(9) of the Act, this section prescribes amounts that are to be taken, in relation to specified kinds of individuals, to be excluded from a determination under paragraph 330(2)(a) or (b) or (3)(a) or (b) or subsection 330(4) of the Act.
(2) In relation to all individuals, the following are prescribed:
(a) any compensation payments received by the individual under the following:
(i) the Compensation (Japanese Internment) Act 2001;
(ii) the Veterans’ Entitlements (Compensation—Japanese Internment) Regulations 2001;
(iii) Part 2 of the Veterans’ Entitlements (Clarke Review) Act 2004;
(iv) Schedule 5 to the Social Security and Veterans’ Affairs Legislation Amendment (One‑off Payments and Other 2007 Budget Measures) Act 2007;
(b) any redress payment paid to the individual, or to an administrator for the individual, under section 48 of the National Redress Scheme for Institutional Child Sexual Abuse Act 2018.
Subdivision J—Varying or revoking an asset determination
331‑5 Day variation of asset determination takes effect
(1) For the purposes of subsection 331(5) of the Act, the day specified by the System Governor as the day a variation of an asset determination in relation to an individual takes effect must be in accordance with this section.
Variation results in a decrease
(2) If the variation does not result in an increase to:
(a) the amount of person‑centred subsidy reduction for the individual for a day under section 235 of the Act; or
(b) the amount of provider‑based subsidy reduction for the registered provider for the individual for a day under section 242 of the Act; or
(c) the amount of accommodation contribution that the individual may be charged under section 298 of the Act;
the day specified must be the day the event or change in circumstances occurred.
Variation results in an increase
(3) If the variation results in an increase to:
(a) the amount of person‑centred subsidy reduction for the individual for a day under section 235 of the Act; or
(b) the amount of provider‑based subsidy reduction for the registered provider for the individual for a day under section 242 of the Act; or
(c) the amount of accommodation contribution that the individual may be charged under section 298 of the Act;
the day specified must be:
(d) if the decision under subsection 331(1) of the Act to vary the asset determination is made within 28 days of the day the event or change in circumstances occurred—the day notice of the decision is given; or
(e) otherwise—28 days before the day notice of the decision under subsection 331(1) of the Act is given.
(4) Despite paragraph (3)(e), the day specified may instead be a day earlier than 28 days before the day notice of the decision is given, if the individual has provided false or misleading information under section 333 or 336 of the Act in relation to the decision.
332‑5 Period for varying asset determination—on notification of event or change in circumstances
For the purposes of subsection 332(2) of the Act, the period for varying the asset determination is 28 days from the day the notification is made.
333‑5 Period for varying or revoking asset determination—on application
For the purposes of paragraph 333(2)(b) of the Act, the period for making a decision on an application by an individual for the purposes of paragraph 331(2)(b) of the Act is 28 days from the day the application is made.
334‑5 Period for varying or revoking asset determination—on System Governor’s initiative
(1) For the purposes of paragraph 334(6)(b) of the Act, the period for making a decision under that paragraph is 28 days from:
(a) if no submission is made in accordance with the invitation in the notice under paragraph 334(2)(b) of the Act—the end of the period specified in the notice (including that period as extended (if applicable) under subsection 334(5) of the Act); or
(b) the later of:
(i) if a submission is made is made in accordance with the invitation in the notice under paragraph 334(2)(b) of the Act and no further information is requested under subsection 334(4) of the Act—the day the submission is made; and
(ii) if a submission is made in accordance with the invitation in the notice under paragraph 334(2)(b) of the Act and further information is requested under subsection 334(4) of the Act—the day the individual gives the System Governor the further information.
335‑10 Other matters to be included in notices of decisions other than reviewable decisions
For the purposes of paragraph 335(4)(b) of the Act, a notice given under subsection 335(3) of the Act must include the reasons for the decision.
Subdivision K—Notifying of event or change in circumstances
336‑5 Notifications by individuals—manner and period
For the purposes of subsection 336(2) of the Act:
(a) the manner in which an individual must make a notification of the occurrence of an event or a change in the individual’s circumstances under subsection 336(1) of the Act is in the approved form; and
(b) the period in which the notification must be made is 28 days from the day the event or change of circumstances occurs.
337‑5 Notifications by registered providers—manner and period
(1) For the purposes of subsection 337(2) of the Act, and subject to subsection (2) of this section:
(a) the manner in which a registered provider must make a notification of the occurrence of an event or a change in an individual’s circumstances under subsection 337(1) of the Act is:
(i) in a claim made under section 257 of the Act (claim for subsidy); or
(ii) in the approved form; and
(b) the period in which the notification must be made is as soon as practicable after the end of the payment period in which the event or change of circumstances occurs.
(2) If the event or change in circumstances is a change in an individual’s refundable deposit balance that has occurred since the most recent claim made by the registered provider under section 257 of the Act for subsidy for the delivery of a funded aged care service to the individual:
(a) the manner in which a registered provider must make a notification of the occurrence of the event or change under subsection 337(1) of the Act is in the next claim (the subsequent claim) made under section 257 of the Act for subsidy for the delivery of a funded aged care service to the individual; and
(b) the period in which the notification must be made is the period within which the subsequent claim may be made.
Chapter 11—Governance of the aged care system
338‑1 Simplified outline of this Chapter
This Chapter provides for matters relating to governance of the aged care system under Chapter 5 of the Act.
Part 2 prescribes certain requirements for identity cards issued by the System Governor to approved needs assessors.
Division 1 of Part 3 set out the other functions of the Commissioner, being the function to reconsider certain decisions made personally by the Complaints Commissioner.
Division 2 of Part 3 sets out how the Commissioner may deal with reportable incidents notified by registered providers of funded aged care services.
Division 3 of Part 3 prescribes requirements in accordance with which the Complaints Commissioner must give the Minister written reports in relation to complaints and feedback received by the Complaints Commissioner.
Division 4 of Part 3 establishes a scheme for dealing with feedback given to the Complaints Commissioner about registered providers or a responsible person or aged care worked of a registered provider and complaints made to the Commissioner about the following matters:
(a) the compliance with the Act of a registered provider or a responsible person or aged care worker of a registered provider;
(b) a registered provider acting in a way that is incompatible with the Statement of Rights.
If the Commissioner receives a complaint, the Commissioner must decide to take no further action in relation to the complaint or decide to undertake a resolution process.
Certain persons may apply for the reconsideration of a decision to take no further action in relation to a complaint, or to not undertake a resolution process in relation to a complaint.
Division 5 of Part 3 prescribes certain matters that must be included in an annual report mentioned in section 372 of the Act for a reporting period.
Part 2—System Governor
343A‑5 Identity cards for approved needs assessors—form requirements
(1) For the purposes of paragraph 343A(2)(a) of the Act, an identity card must satisfy the requirements prescribed by this section.
Size of card
(2) The identity card must have dimensions of 85.60 mm by 53.98 mm (CR80 standard).
Front of card
(3) The identity card must contain the following elements on the front of the card:
(a) the logo (if any) of the entity the approved needs assessor is employed or otherwise engaged by, as referred to in section 7‑8 of this instrument;
(b) the name or an abbreviation of the name of the entity;
(c) the full name of the assessor;
(d) the photograph of the assessor required by paragraph 343A(2)(b) of the Act.
(4) The photograph referred to in paragraph (3)(d) must:
(a) be a coloured photograph; and
(b) show the assessor’s full face; and
(c) have a resolution of at least 300 dpi; and
(d) have an aspect ratio (being width divided by height) of 0.75; and
(e) have dimensions of:
(i) 35 mm to 40 mm in width; and
(ii) 45 mm to 50 mm in height.
Back of card
(5) The identity card must contain the following elements on the back of the card:
(a) the Australian Government logo and the words “Department of Health, Disability and Ageing”;
(b) a serial number;
(c) an address for the card to be returned to if it is found;
(d) the words in subsection (6).
(6) The words mentioned in paragraph (5)(d) must be the following:
“The bearer of this card is an approved needs assessor under the Aged Care Act 2024 and may perform the functions and exercise the powers of an approved needs assessor.
A registered provider delivering funded aged care services under the Aged Care Act 2024 must, in accordance with section 177 of that Act, cooperate with the bearer of this card, including by providing access to an approved residential care home of the provider when necessary for the needs assessor to perform the functions and exercise the powers of an approved needs assessor.”
343A‑10 Identity cards for approved needs assessors—requirements for carrying and producing identity cards
(1) For the purposes of subsection 343A(3) of the Act, an approved needs assessor must carry and produce the assessor’s identity card in accordance with this section.
(2) When performing functions or exercising powers under the Act as an approved needs assessor, the assessor must:
(a) at all times, carry the assessor’s identity card issued under subsection 343A(1) of the Act; and
(b) if a person who apparently represents a registered provider requests the assessor to show the assessor’s identity card—do so when requested, or, if it is not reasonably practicable to do so when requested, do so as soon as reasonably practicable after that.
Part 3—Aged Care Quality and Safety Commission
Division 1—Other functions of the Commissioner
348‑5 Other functions of the Commissioner—reconsideration of certain decisions made personally by the Complaints Commissioner
For the purposes of paragraph 348(1)(d) of the Act, the Commissioner has the function to reconsider, under section 361‑60 of this instrument, decisions made personally by the Complaints Commissioner.
Division 2—Safeguarding functions of the Commissioner
349‑5 Actions the Commissioner may take in dealing with reportable incidents
(1) The Commissioner must, upon receiving a notice about a reportable incident given by a registered provider under section 165A‑25 or 165A‑30, do the following:
(a) acknowledge receipt of the notice;
(b) take steps to consider the notice and the appropriateness of taking action in relation to that notice.
(2) The Commissioner may, upon receiving a notice about a reportable incident given by a registered provider under section 165A‑25 or 165A‑30, do one or more of the following:
(a) refer the incident to whichever of the following the Commissioner considers appropriate:
(i) the Australian Federal Police;
(ii) the police force or police service of a State or Territory;
(iii) a person or body with responsibilities in relation to the incident;
(b) require or request the provider to undertake specified remedial action in relation to the incident within a specified period, including remedial action to ensure the safety, health and well‑being of individuals receiving funded aged care services affected by the incident;
(c) carry out an inquiry in relation to the incident in accordance with section 349‑10;
(d) take any other action to deal with the reportable incident that the Commissioner considers reasonable in the circumstances.
(3) The Commissioner may, upon receiving 2 or more notices about reportable incidents given by a registered provider under section 165A‑30, and in circumstances where the Commissioner considers it appropriate to do so, manage 2 or more notices about such reportable incidents through a single action, including one or more of the following:
(a) refer the incidents to whichever of the following the Commissioner considers appropriate:
(i) the Australian Federal Police;
(ii) the police force or police service of a State or Territory;
(iii) a person or body with responsibilities in relation to the incidents;
(b) require or request the provider to undertake specified remedial action in relation to the incidents within a specified period, including remedial action to ensure the safety, health and well‑being of the individuals accessing funded aged care services affected by the incident;
(c) carry out an inquiry in relation to the incidents in accordance with section 349‑10;
(d) take any other action to deal with the reportable incidents that the Commissioner considers reasonable in the circumstances.
349‑10 Commissioner’s inquiries in relation to reportable incidents
(1) The Commissioner may inquire into any of the following:
(a) a reportable incident for a registered provider;
(b) a series of reportable incidents that relate to the delivery of funded aged care services delivered by one or more registered providers;
(c) the compliance of one or more registered providers with:
(i) Division 1 of Part 10 of Chapter 4; or
(ii) Division 2 of Part 2 of Chapter 5.
(2) An inquiry may be carried out under subsection (1) whether or not any of the reportable incidents have been notified to the Commissioner under section 165A‑25 or 165A‑30.
(3) An inquiry may be carried out as the Commissioner thinks fit.
(4) Without limiting subsection (3), the Commissioner may:
(a) consult with other persons, organisations and governments on matters relating to the inquiry; and
(b) request information or documents that are relevant to the inquiry from any person; and
(c) provide opportunities for individuals accessing funded aged care services to participate in the inquiry.
(5) The Commissioner may prepare and publish a report setting out the Commissioner’s findings in relation to the inquiry.
349‑15 Taking of other action not prevented by this Division
Nothing in this Division prevents the Commissioner from taking action under the Act in relation to:
(a) a reportable incident for a registered provider; or
(b) information or documents given to the Commissioner under:
(i) this Division; or
(ii) Division 1 of Part 10 of Chapter 4; or
(iii) Division 2 of Part 2 of Chapter 5.
Division 3—Establishment and functions of the Complaints Commissioner
358‑5 Complaints functions of the Complaints Commissioner—requirements for giving written reports to the Minister
For the purposes of paragraph 358(m) of the Act, the requirements in accordance with which the Complaints Commissioner must give the Minister written reports, in relation to complaints and feedback received by the Complaints Commissioner, are that:
(a) a report must be for a period (the reporting period) of 6 months beginning on 1 January or 1 July; and
(b) the report for a reporting period must contain the following for the reporting period:
(i) the matters referred to in section 372‑5 of this instrument;
(ii) any other matters that the Complaints Commissioner considers relevant; and
(c) the report for a reporting period must be given to the Minister within 3 months after the end of the reporting period.
Division 4—Complaints Commissioner—complaints and feedback
361‑5 Purpose of this Division
This Division is made for the purposes of subsection 361(1) of the Act.
Subdivision B—How complaints may be made and withdrawn, and how feedback may be given
361‑10 How complaints may be made and feedback may be given
Complaints
(1) A person (the complainant) may make a complaint to the Complaints Commissioner about:
(a) the compliance with the Act of a registered provider or a responsible person or aged care worker of a registered provider; or
(b) a registered provider acting in a way that is incompatible with the Statement of Rights.
Feedback
(2) A person may give the Complaints Commissioner feedback about a registered provider or a responsible person or aged care worker of a registered provider.
Complaints and feedback
(3) A complaint may be made, and feedback may be given, orally or in writing.
(4) A complaint may be made, and feedback may be given, anonymously.
(a) a complainant makes a complaint or a person gives feedback; and
(b) the complainant or person giving the feedback requests that any of the following information be kept confidential:
(i) the identity of the complainant or person giving the feedback;
(ii) the identity of a person identified in the complaint or feedback;
(iii) any other details included in the complaint or feedback;
the Complaints Commissioner must take such steps as are reasonable in the circumstances to keep the information confidential.
Note: See also section 549 of the Act in relation to complaints or feedback that are disclosures that qualify for protection under section 547 of the Act (whistleblower protections), where the individual making the disclosure requests that the individual, or any other individual named in the request, remain anonymous.
361‑15 How complaints may be withdrawn
If a complainant makes a complaint to the Complaints Commissioner under section 361‑10, the complainant may withdraw the complaint, either orally or in writing, at any time.
Note 1: The Complaints Commissioner must deal with complaints (see section 361‑40), and must do so by deciding to take no further action in relation to the complaint for a reason referred to in section 361‑50 or deciding to undertake a resolution process under this Division in relation to the complaint (see section 361‑42).
Note 2: The withdrawal of a complaint is a reason for which the Complaints Commissioner may decide to take no further action in relation to the complaint or decide to end a resolution process in relation to the complaint (see paragraph 361‑50(b)).
Note 3: A complainant who withdraws a complaint will not receive certain communications under this Division (see paragraphs 361‑25(2)(e), 361‑30(2)(d) and 361‑35(2)(d)) or be able to apply under Subdivision D for the reconsideration of a decision of the Complaints Commissioner in relation to the complaint.
Subdivision C—Processes for dealing with complaints and feedback
361‑20 Requirements for processes
(1) The Complaints Commissioner’s processes for dealing with complaints and feedback must provide appropriate support and assistance (including access to advocates and language services) to:
(a) complainants and persons giving feedback; and
(b) individuals accessing funded aged care services to whom complaints or feedback relate.
Note: One of the complaints functions of the Complaints Commissioner is to uphold the rights under the Statement of Rights, and protect and enhance the safety, health, wellbeing and quality of life, of individuals accessing funded aged care services, by maintaining independent, transparent, accountable, accessible, safe and culturally safe processes for making complaints and giving feedback (see paragraph 358(a) of the Act).
Complaints that are also disclosures that qualify for protection under section 547 of the Act (whistleblower protections)
(2) The Complaints Commissioner’s processes for dealing with complaints and feedback must include processes for dealing with complaints and feedback that are also disclosures that qualify for protection under section 547 of the Act (whistleblower protections).
361‑25 Acknowledging receipt of complaints and feedback
(a) a complainant makes a complaint to the Complaints Commissioner as mentioned in subsection 361‑10(1); or
(b) a person gives the Complaints Commissioner feedback as mentioned in subsection 361‑10(2);
the Complaints Commissioner must, within 3 business days from the day the complaint was made or the feedback was given, give the complainant or the person who gave the feedback an acknowledgement of the receipt of the complaint or feedback.
(2) Subsection (1) does not apply to a complaint or feedback if:
(a) giving the complainant or the person who gave the feedback an acknowledgement of the complaint or feedback would contravene a provision of Chapter 7 of the Act (information management); or
(b) the complaint was made or the feedback was given anonymously; or
(c) the complainant or the person who gave the feedback cannot be contacted because of a request for confidentiality under subsection 361‑10(5); or
(d) the complainant or the person who gave the feedback requested not to receive an acknowledgement of receipt of the complaint or feedback; or
(e) for a complaint—the complainant has withdrawn the complaint.
361‑30 Referral of complaints and feedback to other persons or bodies
(1) This section applies if the Complaints Commissioner refers a complaint or feedback to another person or body under paragraph 358(e) of the Act.
Note: One of the complaints functions of the Complaints Commissioner is, for complaints and feedback that is better dealt with by other persons or bodies, to refer the complaints and feedback to those persons or bodies (see paragraph 358(e) of the Act).
Giving written notice of referral
(2) The Complaints Commissioner must give written notice of the referral to the complainant or person who gave the feedback, unless:
(a) giving written notice of the referral to the complainant or person who gave the feedback would contravene a provision of Chapter 7 of the Act (information management); or
(b) the complaint was made or the feedback was given anonymously; or
(c) the complainant or person who gave the feedback cannot be contacted because of a request for confidentiality under subsection 361‑10(5) of this instrument; or
(d) for a complaint—the complainant has withdrawn the complaint.
Giving information and documents to other person or body
(3) Subject to Chapter 7 of the Act (information management) and subsection 361‑10(5) of this instrument, the Complaints Commissioner must give the other person or body any information or documents that relate to the complaint or feedback and that are in the Complaints Commissioner’s possession or under the Complaints Commissioner’s control.
361‑35 Communications with complainant, entity against which complaint made and other persons
Communications with complainant
(1) If a complainant makes a complaint to the Complaints Commissioner as mentioned in subsection 361‑10(1), the Complaints Commissioner must:
(a) communicate regularly with the complainant, as agreed with the complainant, about progress in dealing with the complaint; and
(b) give the complainant a proposed complaint determination (see section 361‑40) and seek the complainant’s views on the proposed complaint determination.
(2) Subsection (1) does not apply if:
(a) communicating regularly with the complainant or giving the complainant a proposed complaint determination would contravene a provision of Chapter 7 of the Act (information management); or
(b) the complaint was made anonymously; or
(c) the complainant cannot be contacted because of a request for confidentiality under subsection 361‑10(5) of this instrument; or
(d) the complainant has withdrawn the complaint; or
(e) the complainant has requested not to receive communications about the complaint.
Communications with entity against which complaint made
(3) The Complaints Commissioner must give the entity against which the complaint is made written notice of the complaint as soon as practicable after the complaint was made.
(4) Subsection (3) does not apply if:
(a) the giving of the notice would contravene a provision of Chapter 7 of the Act (information management); or
(b) the Complaints Commissioner considers that the giving of the notice will, or is likely to:
(i) place the safety, health or well‑being of the complainant, an individual accessing funded aged care services or any other person at risk; or
(ii) place the complainant or an individual accessing funded aged care services at risk of intimidation or harassment; or
(iii) interfere with the performance of any of the Commissioner’s safeguarding functions under paragraphs 349(a), (d) and (e) of the Act.
Communications with other persons
(5) If the complaint was made on behalf of an individual accessing funded aged care services, the Complaints Commissioner must communicate regularly with the following persons, as agreed with those persons, about progress in dealing with the complaint:
(a) the individual;
(b) the individual’s supporter (if any);
(c) an independent aged care advocate who is providing support to the individual (if any), if the individual has consented to the Complaints Commissioner communicating with the advocate about the complaint.
(6) Subsection (5) does not apply in relation to a person if:
(a) communicating regularly with the person would contravene a provision of Chapter 7 of the Act (information management); or
(b) the person cannot be contacted because of a request for confidentiality under subsection 361‑10(5) of this instrument; or
(c) the complaint has been withdrawn and the Complaints Commissioner has decided to take no further action in relation to the complaint, or to end a resolution process in relation to the complaint; or
(d) the person has requested not to receive communications about the complaint; or
(e) it is not appropriate to communicate with the person.
Note: For paragraph (e):
(a) an example of when it is not appropriate to communicate with an individual accessing funded aged care services about progress in dealing with a complaint is if the individual lacks capacity for the communication; and
(b) an example of when it may not be appropriate to communicate with an individual accessing funded aged care services, or supporters or advocates for such individuals, about progress in dealing with a complaint is if the complaint was made on behalf of a large number of such individuals.
361‑40 Complaint determinations and seeking feedback
Complaint determinations
(1) If a complaint is made to the Complaints Commissioner about:
(a) the compliance with the Act of a registered provider or a responsible person or aged care worker of a registered provider; or
(b) a registered provider acting in a way that is incompatible with the Statement of Rights;
the Complaints Commissioner must, by the end of the period referred to in subsection (2):
(c) deal with and resolve the complaint; and
(d) prepare a written statement (a complaint determination) setting out:
(i) what action (if any) the Complaints Commissioner took to deal with and resolve the complaint; and
(ii) what action (if any) should be taken by another person to deal with and resolve the complaint; and
(iii) information relating to the review or reconsideration of decisions made under the scheme; and
(e) give the complainant a copy of the complaint determination.
(2) For the purposes of subsection (1), the period is:
(a) 90 days from the day the complaint is made, unless paragraph (b) or (c) applies; or
(b) 120 days from the day the complaint is made, if:
(i) the Complaints Commissioner is satisfied that there are circumstances requiring a period of more than 90 days; and
(ii) the Complaints Commissioner has communicated the circumstances to the complainant; and
(iii) paragraph (c) does not apply; or
(c) 120 days from the day the complaint is made plus one or more additional periods of 30 days, for each of which:
(i) the Complaints Commissioner is satisfied that there are exceptional circumstances requiring the additional period and the Complaints Commissioner has communicated the exceptional circumstances to the complainant; or
(ii) the complainant has agreed to the additional period.
(3) The Complaints Commissioner must also give a copy of the complaint determination to:
(a) each person with whom the Complaints Commissioner has been communicating under subsection 361‑35(5); and
(b) the entity against which the complaint is made.
Seeking feedback
(4) The Complaints Commissioner must also seek feedback from the following about how the complaint was dealt with and resolved:
(a) the complainant, if the Complaints Commissioner has been communicating with the complainant under subsection 361‑35(1);
(b) each person with whom the Complaints Commissioner has been communicating under subsection 361‑35(5);
(c) the entity against which the complaint is made.
361‑42 Dealing with complaints—general
The Complaints Commissioner must deal with a complaint by:
(a) deciding to take no further action in relation to the complaint for a reason referred to in section 361‑50; or
(b) deciding to undertake a resolution process under this Division in relation to the complaint.
361‑45 Dealing with complaints—resolution processes
(1) This section applies if the Complaints Commissioner decides to undertake a resolution process under this Division in relation to the complaint.
Actions that may be taken
(2) The Complaints Commissioner may take any one or more of the following actions:
(a) require the entity against which the complaint is made to attempt to resolve the complaint and report back to the Complaints Commissioner within a specified period;
(b) require the entity against which the complaint is made to take other specified action in relation to the complaint within a specified period;
(c) investigate (other than under Part 3 of the Regulatory Powers Act (see Part 3 of Chapter 6 of the Act)) the circumstances giving rise to the complaint, including by:
(i) requiring the entity against which the complaint is made to give the Complaints Commissioner information or documents (or copies of documents); or
(ii) attending an approved residential care home or a home or community setting in which funded aged care services are delivered;
(d) consider information and documents;
(e) subject to Chapter 7 of the Act (information management), discuss the complaint, in person or by other means, with any of the following entities:
(i) the complainant;
(ii) the entity against which the complaint is made;
(iii) any other relevant person;
(f) facilitate a conciliation process, including by requesting any of the entities mentioned in paragraph (e) to participate in the process;
(g) conduct a restorative engagement process, including by requesting the entities mentioned in paragraph (e) to participate in the process.
Note: Other actions that the Complaints Commissioner may take under the Act are the following:
(a) request persons to give the Complaints Commissioner information or documents relevant to the Complaints Commissioner’s functions (see section 359 of the Act);
(b) give a registered provider a required action notice in relation to a matter that relates to the registered provider that is raised in a complaint (see section 474 of the Act);
(c) require persons to attend before an authorised Commission officer to answer questions or give information or documents (or copies of documents) relevant to whether a registered provider, or a former registered provider, is complying with the Act in relation to a matter that relates to the Complaints Commissioner’s functions (see section 488 of the Act).
Ending resolution process
(3) The Complaints Commissioner may decide to end the resolution process for a reason referred to in section 361‑50.
361‑50 Dealing with complaints—reasons for taking no further action or ending resolution processes
For the purposes of paragraph 361‑42(a) and subsection 361‑45(3), the reasons for which the Complaints Commissioner may decide to take no further action in relation to a complaint, or to end a resolution process in relation to a complaint, are as follows:
(a) the complaint has been resolved because:
(i) the complainant and the entity against which the complaint was made have agreed on an outcome; and
(ii) the entity against which the complaint was made has addressed the complaint to the satisfaction of the Complaints Commissioner;
(b) the complaint has been withdrawn;
(c) the Complaints Commissioner refers the complaint to another person or body under paragraph 358(e) of the Act;
(d) the circumstances giving rise to the complaint cannot be determined;
(e) the complainant has been provided with an explanation in relation to the complaint and is satisfied with the explanation;
(f) the complaint is frivolous, vexatious or not raised in good faith;
(g) the complaint is, or has been, the subject of legal proceedings;
(h) the complaint is already being dealt with, or has already been dealt with, under section 361 of the Act or a former complaints scheme;
(i) the complaint is better dealt with, or is already being dealt with, through a different process (for example, through the Commissioner’s safeguarding functions or under Chapter 6 of the Act (regulatory mechanisms));
(j) the circumstances giving rise to the complaint occurred more than one year before the complaint was made, and no longer exist;
(k) the complaint is subject to a coronial inquiry;
(l) an individual accessing funded aged care services who is identified in the complaint does not wish the complaint to be considered by the Complaints Commissioner;
(m) having regard to all the circumstances, no further action is required, or the continuation of the resolution process is not required.
Subdivision D—Reconsideration of decisions to take no further action or to end resolution processes
361‑55 Requesting reconsideration of decisions
(1) If the Complaints Commissioner decides to take no further action in relation to a complaint, or to end a resolution process in relation to a complaint, the following entities may request the Complaints Commissioner to reconsider the decision:
(a) the complainant, unless:
(i) the complainant withdrew the complaint before the decision was made; or
(ii) the reason for the decision was that the complaint is frivolous, vexatious or not raised in good faith;
(b) the entity against which the complaint was made.
(2) The request:
(a) may be made orally or in writing; and
(b) must identify the reasons for the request; and
(c) must be made within the following period:
(i) 42 days after the entity making the request receives the complaint determination for the complaint;
(ii) if the Complaints Commissioner determines a longer period for the request than would otherwise apply under subparagraph (i)—that period.
361‑57 Withdrawing requests for reconsideration of decisions
(1) If an entity requests the reconsideration of a decision, the entity may withdraw the request, either orally or in writing, at any time.
(2) If the entity withdraws the request before a reconsideration decision is made under section 361‑60 in relation to the decision, the Complaints Commissioner must end the reconsideration of the decision.
361‑60 Reconsideration of decisions
(1) This section is subject to section 361‑57.
(2) If a request is made under section 361‑55 for reconsideration of a decision that was not made personally by the Complaints Commissioner, the Complaints Commissioner must:
(a) personally reconsider the decision; or
(b) cause the decision to be reconsidered by a person:
(i) to whom the Complaints Commissioner has delegated the Complaints Commissioner’s functions and powers under this Division; and
(ii) who was not involved in making the decision; and
(iii) who occupies a position that is at least the same level as that occupied by the person who made the decision.
(3) If a request is made under section 361‑55 for reconsideration of a decision that was made personally by the Complaints Commissioner, the Complaints Commissioner must cause the decision to be reconsidered by the Commissioner.
(4) The person who reconsiders the decision is the internal decision reviewer.
Reconsideration decision
(5) After reconsidering the decision, the internal decision reviewer must:
(a) affirm the decision; or
(b) set the decision aside and:
(i) if the decision was to take no further action in relation to a complaint—make a new decision under section 361‑42 in relation to the complaint; or
(ii) if the decision was to end a resolution process in relation to a complaint—decide to undertake a new resolution process under this Division in relation to the complaint.
(6) The decision made by the internal decision reviewer is the reconsideration decision.
(7) After the internal decision reviewer makes the reconsideration decision, the internal decision reviewer must, within the period referred to in subsection (8), give the entity who requested the reconsideration written notice of:
(a) the reconsideration decision; and
(b) the reasons for the decision.
(8) For the purposes of subsection (7), the period is:
(a) 60 days from the day the reconsideration request is made, unless paragraph (b) applies; or
(b) 60 days from the day the reconsideration request is made plus one or more additional periods, for each of which the Complaints Commissioner:
(i) is satisfied that there are reasonable grounds to believe that the additional period is required; and
(ii) has communicated the grounds to the entity who requested the reconsideration.
Note: For subparagraph (b)(i), an example of when a period of more than 60 days may be required is if the complaint is particularly complex.
Application of sections 588 and 589 of the Act to internal decision reviewers
(9) If the internal decision reviewer is a delegate of the Complaints Commissioner, section 588 and subsection 589(2) of the Act apply to the internal decision reviewer in the same way that those provisions would apply to the Complaints Commissioner if the Complaints Commissioner were the internal decision reviewer.
361‑65 Period for completing resolution process following reconsideration decision
(a) a reconsideration decision under section 361‑60 is to make a new decision under section 361‑42 in relation to a complaint, and that new decision is to undertake a resolution process under this Division in relation to the complaint; or
(b) a reconsideration decision under section 361‑60 is to undertake a new resolution process under this Division in relation to a complaint.
(2) The internal decision reviewer must complete the resolution process within:
(a) 90 days from the day the reconsideration request is made, unless paragraph (b) applies; or
(b) 120 days from the day the reconsideration request is made, if the Complaints Commissioner:
(i) is satisfied that there are reasonable grounds to believe that a period of more than 90 days is required; and
(ii) has communicated the grounds to the entity who requested the reconsideration.
Note: For paragraph (b), the following are examples of when a period of more than 90 days may be required to complete a resolution process:
(a) if the complaint is particularly complex;
(b) if the internal decision reviewer requires extensive further information to assist in completing the process.
Division 5—Reporting and planning
372‑5 Annual report—other matters relating to complaints functions of the Complaints Commissioner
For the purposes of paragraph 372(i) of the Act, the other matters that an annual report mentioned in section 372 of the Act for a reporting period (within the meaning of that section) must include are the following:
(a) the total number of complaints received by the Complaints Commissioner in the reporting period about the following:
(i) the compliance with the Act of a registered provider or a responsible person or aged care worker of a registered provider;
(ii) a registered provider acting in a way that is incompatible with the Statement of Rights;
(b) of that total, the numbers of complaints that relate to the following:
(i) each State or Territory;
(ii) each provider registration category;
(iii) each registered provider;
(iv) each approved residential care home;
(c) of that total, the numbers of complaints:
(i) that have been dealt with by the Complaints Commissioner; and
(ii) that are ongoing; and
(iii) of the numbers mentioned in subparagraphs (i) and (ii), the numbers of each that relate to each State and Territory;
(d) a summary of the topics of complaints;
(e) for each topic—the number of complaints that relate to the following:
(i) each provider registration category;
(ii) each registered provider;
(iii) each approved residential care home;
(f) a summary of the outcomes of complaints;
(g) a summary of the feedback received under subsection 361‑40(4);
(h) the average time taken to deal with complaints;
(i) the percentage of complaints in relation to which subsection 361‑40(1) (complaint determinations) was complied with within each of the periods mentioned in subsection 361‑40(2);
(j) for complaints in relation to which subparagraph 361‑40(2)(c)(i) applied—a summary of the exceptional circumstances mentioned in that subparagraph relating to those complaints;
(k) the number of decisions to take no further action reconsidered under Subdivision D of Division 4, and of that number:
(i) the number for which the reconsideration decision was to affirm the decision; and
(ii) the number for which the reconsideration decision was to set the decision aside and decide to make a new decision under section 361‑42 in relation to the complaint;
(l) the number of decisions to end resolution processes reconsidered under Subdivision D of Division 4 and, of that number:
(i) the number for which the reconsideration decision was to affirm the decision; and
(ii) the number for which the reconsideration decision was to set the decision aside and decide to undertake a new resolution process under Division 4;
(m) a summary of activities undertaken by the Complaints Commissioner in performing the complaints functions mentioned in paragraphs 358(f), (g), (h), (i) and (j) of the Act.
Chapter 12—Regulatory mechanisms
396‑5 Simplified outline of this Chapter
This Chapter relates to regulatory mechanisms under Chapter 6 of the Act.
Part 2 of this Chapter relates to the register of banning orders under Division 3 of Part 11 of Chapter 6 of the Act, and deals with:
(a) information that must be included in the register; and
(b) accessing and correcting information included in the register; and
(c) publication of the register.
Part 3 of this Chapter prescribes the method for working out certain amounts in certain circumstances under Division 3 of Part 13 of Chapter 6 of the Act.
Part 2—Banning orders
507‑5 Information that must be included in the register of banning orders in relation to individuals
For the purposes of paragraph 507(1)(i) of the Act, the following information is prescribed in relation to each individual against whom a banning order has been made at any time:
(a) the State or Territory, suburb or locality, and postcode of the individual’s last known place of residence;
(b) if the Commissioner considers that further information is necessary to identify the individual—further information, including personal information, that the Commissioner considers is sufficient to identify the individual.
Note 1: For other information that must be included in the register in relation to each entity against which a banning order has been made at any time, see subsection 507(1) of the Act.
Note 2: For the application of subsection 507(1) of the Act to banning orders, see subsection 507(2) of the Act.
Example: For paragraph (b), if 2 individuals, each of whom is or was an aged care worker or responsible person of a registered provider, have the same name, suburb or locality, and postcode, and a banning order is made in relation to one of those individuals, the Commissioner could include information in the register to identify the individual in relation to whom the banning order is made.
507‑10 Accessing and correcting information included in the register of banning orders in relation to individuals
Accessing information in the register
(2) An individual against whom a banning order has been made may request that the Commissioner provide the individual with access to information (if any) that is included in the register of banning orders in relation to the individual.
Note: The Commissioner must, in certain circumstances, give an individual access to personal information that the Commissioner holds about the individual (see Australian Privacy Principle 12 in Schedule 1 to the Privacy Act 1988).
Seeking correction of information in the register
(3) An individual against whom a banning order has been made may request that the Commissioner make a correction to information that is included in the register of banning orders in relation to the individual.
Note: The Commissioner must, in certain circumstances, take reasonable steps to correct personal information that is wrong or misleading so that the information is accurate, up to date, complete, relevant and not misleading (see Australian Privacy Principle 13 in Schedule 1 to the Privacy Act 1988).
Corrections on the Commissioner’s initiative
(4) If the Commissioner considers that information that is included in the register of banning orders in relation to an individual is inaccurate, out‑of‑date, incomplete, irrelevant or misleading, the Commissioner may correct the information.
Note: The Commissioner must, in certain circumstances, take reasonable steps to correct personal information that is wrong or misleading so that the information is accurate, up to date, complete, relevant and not misleading (see Australian Privacy Principle 13 in Schedule 1 to the Privacy Act 1988).
507‑15 Accessing information included in the register of banning orders in relation to entities other than individuals
(2) An entity (other than an individual) against which a banning order has been made may request that the Commissioner provide the entity with access to information (if any) referred to in subsection 507(1) of the Act that is included in the register of banning orders in relation to the entity.
(3) If the Commissioner receives a request, the Commissioner must provide the entity with access to the requested information.
507‑20 Correcting information included in the register of banning orders in relation to entities other than individuals—corrections sought by entities
(2) An entity (other than an individual) may request that the Commissioner make a correction to information that is included in the register of banning orders in relation to the entity.
(3) If the Commissioner receives a request, the Commissioner must:
(a) make the requested correction; or
(b) decide to not make the requested correction.
Note: The Commissioner is not required to make a correction or decision on the request unless any further information or documents requested by the Commissioner are provided (see section 589 of the Act).
(4) The Commissioner must notify the entity of a correction or decision made under subsection (3).
507‑25 Correcting information included in the register of banning orders in relation to entities other than individuals—corrections on the Commissioner’s initiative
(2) This section applies if:
(a) the Commissioner becomes aware of a matter; and
(b) based on the matter, the Commissioner considers that information that is included in the register of banning orders in relation to an entity (other than an individual) requires a correction.
(3) The Commissioner must give a written notice to the entity:
(a) setting out the details of the matter and the proposed correction; and
(b) inviting the entity to give written comments on the matter and the proposed correction within the period specified in the notice.
(4) The period specified for the purposes of paragraph (3)(b) must not end earlier than 28 days after the day on which the notice is given.
(5) As soon as practicable after the earlier of:
(a) when the Commissioner receives comments from the entity; or
(b) the end of the period specified for the purposes of paragraph (3)(b);
the Commissioner must consider any comments given by the entity and:
(c) make the proposed correction; or
(d) make a different correction; or
(e) decide not to make a correction.
(6) The Commissioner must give the entity written notice of a correction or decision made under subsection (5).
507‑30 Publication of register of banning orders
(1) This section is made for the purposes of paragraph 507(6)(a) of the Act.
(2) The Commissioner may publish the register of banning orders, in whole or in part, on the Commission’s website.
Note: For the information that must be included in the register, see subsection 507(1) of the Act and section 507‑5 of this instrument.
Commissioner may decide not to publish part of register or particular information
(3) The Commissioner may decide not to publish a part of the register or particular information that is included in the register if the Commissioner is reasonably satisfied that it is not in the public interest to publish that part of the register or that information, taking into account all relevant matters including:
(a) the interests of individuals whose interests may be affected by publishing that part of the register or that information; and
(b) the interests of individuals who are accessing, have accessed, or may access, funded aged care services.
Part 3—Recoverable amounts
523‑5 Circumstances for waiver—settlements between Commonwealth and debtors—method for working out present value of unpaid amount
For the purposes of subsection 523(6) of the Act, the method for working out the present value of an unpaid amount mentioned in subsection 523(5) of the Act in relation to a recoverable amount is to use the following formula:
start formula start fraction annual repayment over interest end fraction times open square bracket 1 minus start fraction 1 over open round bracket 1 plus interest close round bracket superscript repayment period end fraction close square bracket end formula
annual repayment is the amount of the recoverable amount that the System Governor believes would be recovered under Division 2 of Part 13 of Chapter 6 of the Act in a year if subsection 523(4) of the Act did not apply in relation to the recoverable amount.
interest has the same meaning as in subsection 1237AAB(6) of the Social Security Act.
repayment period is the number of years needed to repay the unpaid amount if repayments equal to the annual repayment were made each year.
Chapter 13—Information management
534‑5 Simplified outline of this Chapter
This Chapter provides for matters relating to record keeping and information sharing under Chapter 7 of the Act.
Part 2 of this Chapter relates to retention of records by former registered providers under Part 3 of Chapter 7 of the Act.
Part 3 of this Chapter relates to information sharing under Part 4 of Chapter 7 of the Act, and deals with:
(a) certain information about funded aged care services that the System Governor must publish; and
(b) certain information about particular funded aged care services that the System Governor may publish; and
(c) certain information relating to funded aged care services delivered in a particular residential care home or home or community setting by a particular registered provider that the Commissioner may publish.
Part 2—Record‑keeping
543‑5 Retention of records by former registered provider
For the purposes of paragraph 543(1)(a) of the Act, every kind of registered provider is prescribed.
Part 3—Information sharing
Division 1—Publication by System Governor
Subdivision A—System Governor must publish information about funded aged care services generally
544‑5 Preliminary
(1) This Subdivision is made for the purposes of subsection 544(1) of the Act.
(2) Information published in accordance with this Subdivision must:
(a) be published on a portal or website maintained by the Department; and
(b) be published as soon as practicable after the information is given to the System Governor.
Note: See also subsection 544(3) of the Act, which relates to not publishing certain personal information.
544‑10 Pricing information
If a registered provider gives a report to the System Governor under section 166 of the Act, in accordance with section 166‑1005 of this instrument (relating to prices of services), the System Governor must publish the information in that report.
544‑15 Approved residential care home—income and expenditure
(1) The System Governor must publish information about the following matters in relation to an approved residential care home of a registered provider:
(a) the provider’s income in relation to the approved residential care home in a financial year for the provider;
(b) expenditure by the provider on the following matters in relation to the approved residential care home in the financial year:
(i) the delivery of funded aged care services, including labour costs;
(ii) catering;
(iii) maintenance;
(iv) cleaning and laundry;
(v) administration;
(c) the provider’s profit or loss in relation to the approved residential care home in the financial year.
(2) To avoid doubt, the requirements in subsection (1) do not apply in respect of the delivery of funded aged care services delivered only under the NATSIFACP or the MPSP.
544‑20 Approved residential care home—other information
(1) The System Governor must publish information about the following matters in relation to an approved residential care home of a registered provider registered in the provider registration category residential care:
(a) information given to the System Governor in accordance with paragraph 166‑810(1)(a) (relating to kinds of feedback and complaints);
(b) information given to the System Governor in accordance with paragraph 166‑810(1)(b) (relating to improvements made by the provider);
(c) information given to the System Governor in accordance with paragraph 166‑810(1)(c) (relating to initiatives to support a diverse and inclusive environment);
(d) subject to subsection (3)—information given to the System Governor in accordance with paragraph 166‑810(1)(d) (relating to the representation of different demographic groups in the membership of the governing body);
(e) information relating to the total number of individuals accessing funded aged care services in the approved residential care home;
(f) information relating to the occupancy rate of total available beds in the approved residential care home;
(g) information relating to the number of individuals who commenced accessing funded aged care services in the approved residential care home;
(h) information relating to the number of individuals who ceased accessing funded aged care services in the approved residential care home.
(2) To avoid doubt, the requirements in subsection (1) do not apply in respect of the delivery of funded aged care services delivered only under the NATSIFACP or the MPSP.
(3) The System Governor must not publish information in accordance with paragraph (1)(d) relating to the demographic group of a member of a governing body of a registered provider unless that member has consented to the publishing of that information.
544‑25 Nursing and transition care
(1) The System Governor must publish information about the following matters in relation to a registered provider registered in the provider registration category nursing and transition care:
(a) information given to the System Governor in accordance with paragraph 166‑810(1)(a) (relating to kinds of feedback and complaints);
(b) information given to the System Governor in accordance with paragraph 166‑810(1)(b) (relating to improvements made by the provider);
(c) information given to the System Governor in accordance with paragraph 166‑810(1)(c) (relating to initiatives to support a diverse and inclusive environment);
(d) subject to subsection (2)—information given to the System Governor in accordance with paragraph 166‑810(1)(d) (relating to the representation of different demographic groups in the membership of the governing body);
(e) information relating to the total number of individuals to whom the provider delivers funded aged care services under the TCP.
(2) The System Governor must not publish information in accordance with paragraph (1)(d) relating to the demographic group of a member of a governing body of a registered provider unless that member has consented to the publishing of that information.
(3) To avoid doubt, the requirements in subsection (1) do not apply in respect of the delivery of funded aged care services delivered only under the NATSIFACP or the MPSP.
(4) To avoid doubt, the requirements in paragraphs (1)(c) and (d) do not apply in respect of the delivery of funded aged care services delivered only under the TCP.
544‑30 Approved residential care home—direct care responsibilities
(1) The System Governor must publish information about the following matters in relation to an approved residential care home of a registered provider:
(a) information relating to the required combined staff average number of care minutes per individual per day in respect of the approved residential care home for the quarter worked out under subsection 176‑20(1);
(b) information relating to the required registered nurse average number of care minutes per individual per day in respect of the approved residential care home for the quarter worked out under subsection 176‑20(2);
(c) information relating to the average number of care minutes delivered in the approved residential care home by direct care staff members of the registered provider per mainstream counted individual per day during the quarter;
(d) information relating to the average number of care minutes delivered in the approved residential care home by enrolled nurse staff members of the registered provider per mainstream counted individual per day during the quarter;
(e) information relating to the average number of care minutes delivered in the approved residential care home by registered nurse staff members of the registered provider per mainstream counted individual per day during the quarter.
Note: See also Subdivision A of Division 2 of Part 6 of Chapter 5 to this instrument (Delivery of direct care—mainstream providers).
(2) To avoid doubt, the requirements in subsection (1) do not apply in respect of the delivery of funded aged care services delivered only under the NATSIFACP or the MPSP.
(3) The System Governor must publish the information mentioned in paragraphs (1)(a) and (b) as soon as practicable on or after the calculation day for the relevant quarter.
Subdivision B—Information that System Governor may publish about particular funded aged care services
545‑20 Additional matters that the System Governor may publish
For funded aged care services delivered in a particular residential care home or home or community setting, the matters are the following:
(a) any information included in a report referred to in section 166‑855 of this instrument (relating to reporting requirements relating to registered nurses);
(b) if the provider has been granted an exemption from section 175 of the Act (relating to registered nurses) in relation to the residential care home:
(i) the steps the provider has taken to ensure that the clinical care needs of the care recipients residing in the residential care home will be met during the period for which the exemption is in force; and
(ii) confirmation that the System Governor is satisfied that those steps are reasonable;
(c) any information included in a report referred to in section 166‑10, 166‑15, 166‑20 or 166‑25 of this instrument (relating to service staff and individuals who have received certain vaccinations);
(d) any information included in any of the following:
(i) an aged care financial report referred to in section 166‑310 of this instrument;
(ii) a response to a request for further information given under subsection 166‑310(8) of this instrument (relating to an aged care financial report);
(iii) a financial support statement referred to in section 166‑315 of this instrument;
(iv) a response to a request for further information given under subsection 166‑315(8) of this instrument (relating to a financial support statement);
(v) a care minutes performance statement referred to in section 166‑335 of this instrument;
(vi) an audit referred to in subsection 166‑335(6) of this instrument of a care minutes performance statement;
(vii) a quarterly financial report referred to in section 166‑340 of this instrument;
(viii) a response to a request for further information given under subsection 166‑340(11) of this instrument (relating to a quarterly financial report);
(ix) a general purpose financial report referred to in section 166‑345 of this instrument;
(x) a response to a request for further information given under subsection 166‑345(10) of this instrument (relating to a general purpose financial report);
(xi) an audit referred to in section 166‑350 of this instrument of a general purpose financial report;
(xii) an annual prudential compliance statement referred to in section 166‑360 of this instrument;
(xiii) an audit referred to in section 166‑385 of this instrument of an annual prudential compliance statement;
(xiv) a report referred to in section 166‑805 of this instrument (relating to governing body statements);
(xv) a report referred to in section 166‑810 of this instrument (relating to provider operations reporting);
(e) any information included in an annual wellness and reablement report referred to in section 166‑615 of this instrument (relating to CHSP reporting);
(f) the grade assigned to a provider in a final assessment report referred to in section 110‑30 of this instrument (relating to an entity’s conformance with the Aged Care Quality Standards);
(g) any information included in an audit referred to in section 110‑38 of this instrument (relating to an entity’s conformance with the Aged Care Quality Standards);
(h) any information relating to a compliance notice given under section 481 or 482 of the Act, including:
(i) the date the compliance notice was sent to the provider;
(ii) brief details of the non‑compliance or possible non‑compliance;
(iii) action that the provider must take, or refrain from taking, to address the non‑compliance or possible non‑compliance;
(iv) the period within which the provider must take, or refrain from taking, the action to address the non‑compliance or possible non‑compliance;
(v) whether the System Governor or the Commissioner (as applicable) is satisfied that the provider has complied with the compliance notice;
(vi) whether the compliance notice is varied or revoked;
(i) any information included in an annual activity report referred to in section 166‑725 of this instrument (relating to MPSP reporting);
(j) any information included in an annual statement of financial compliance and income and expenditure referred to in section 166‑730 of this instrument (relating to MPSP reporting);
(k) any information included in a service demographics report referred to in section 166‑735 of this instrument (relating to MPSP reporting).
Note: See also subsection 545(2) of the Act, which relates to not publishing certain personal information.
Division 2—Publication by Commissioner
546‑5 Purpose of this Division
For the purposes of paragraph 546(1)(l) of the Act, this Division prescribes matters, about which the Commissioner may publish information, relating to funded aged care services delivered in a particular residential care home or home or community setting by a particular registered provider.
546‑10 Matters included in or related to final assessment reports for approved residential care homes
For funded aged care services delivered in a particular residential care home, the matters are matters included in or related to the final assessment report of a home assessment of the home, including, but not limited to, the following:
(a) the report’s findings;
(b) information considered in reaching those findings;
(c) the grade assigned for conformance with the Aged Care Quality Standards for the registered provider’s delivery of funded aged care services in the approved residential care home.
546‑15 Matters included in or related to final audit reports
For funded aged care services delivered in a particular residential care home or home or community setting, the matters are matters included in or related to a final audit report of an entity’s ability to conform with the Aged Care Quality Standards, including, but not limited to, the following:
(a) the name of the entity to which the final audit report relates;
(b) the date of completion of the final audit report;
(c) a summary of the outcome of the audit including the grade assigned for conformance with the Aged Care Quality Standards (as outlined in the audit methodology);
(d) to the extent that the audit relates to services delivered in a particular approved residential care home:
(i) the name of the approved residential care home; and
(ii) the date of completion of the home assessment conducted in accordance with subsection 110‑26(2); and
(iii) a summary of the outcome of the home assessment, including the grade assigned (as outlined in the audit methodology) for conformance with any of the Aged Care Quality Standards assessed at the approved residential care home.
Note: Home assessment outcomes about an approved residential care home in which funded aged care services are delivered by a registered provider may be published before the completion of the final audit report (see section 546‑10).
Chapter 14—Miscellaneous
555‑5 Simplified outline of this Chapter
This Chapter provides for the reconsideration and review of certain decisions made by the Commissioner, System Governor and the Pricing Authority under this instrument.
It also provides for application fees and fees for services provided by the System Governor, Commissioner and Complaints Commissioner.
Part 2—Reconsideration and review of decisions
556‑5 Decisions by the Commissioner
The following table prescribes decisions and entities for the purposes of table item 31 in subsection 556(1) of the Act.
Decisions by the Commissioner
Item Column 1 Decision Column 2 Entity
1 A decision under subsection 507‑20(3) of this instrument to not make a requested correction to information that is included in the register of banning orders in relation to an entity The entity
2 A decision under subsection 507‑25(5) of this instrument not to make a proposed correction, or to make a different correction, to information that is included in the register of banning orders in relation to an entity The entity
557‑5 Decisions by the System Governor
The following table prescribes decisions and entities for the purposes of table item 44 in section 557 of the Act.
Decisions by the System Governor
Item Column 1 Decision Column 2 Entity
1 A decision under subsection 166‑335(7) of this instrument to approve a person to audit a registered provider’s care minutes performance statement The registered provider
2 A decision under subsection 166‑350(2) of this instrument to approve a person to audit a registered provider’s general purpose financial report The registered provider
3 A decision under subsection 166‑355(3) of this instrument to determine a period of 12 months, other than the financial year, to be a registered provider’s reporting period The registered provider
4 A decision under subsection 166‑385(2) of this instrument to approve a person to audit a registered provider’s annual prudential compliance statement The registered provider
5 A decision under subsection 175‑25(1) of this instrument to refuse to grant an exemption from subsection 175(1) of the Act to a registered provider in relation to a residential care home The registered provider
6 A decision under subsection 175‑50(1) of this instrument to revoke a registered provider’s exemption from subsection 175(1) of the Act in relation to a residential care home The registered provider
7 A decision under paragraph 197‑10(1)(a) of this instrument to determine an individual’s fortnightly total income amount, fortnightly total essential expenses or fortnightly remaining income amount Each of the following:(a) the individual;(b) the registered provider delivering funded aged care services to the individual
8 A decision under paragraph 197‑10(1)(b) of this instrument to determine the day a determination made under subsection 197‑10(1) takes effect Each of the following:(a) the individual;(b) the registered provider delivering funded aged care services to the individual
9 A decision under paragraph 197‑10(1)(c) of this instrument to determine the period for which a determination made under subsection 197‑10(1) is in effect Each of the following:(a) the individual;(b) the registered provider delivering funded aged care services to the individual
10 A decision under subsection 197‑20(1) of this instrument to vary or revoke a home or community fee reduction supplement determination Each of the following:(a) the individual;(b) the registered provider delivering funded aged care services to the individual
11 A decision under subsection 211‑20(5) of this instrument on an application by a registered provider to determine an amount for an individual who has the classification level AT High for the classification type short‑term for the service group assistive technology Each of the following:(a) the individual;(b) the registered provider
12 A decision to refuse to make a determination under subsection 230‑30(1) of this instrument that an approved residential care home is a significantly refurbished home The registered provider
13 A decision to refuse to make a determination under subsection 230‑35(1) of this instrument that an approved residential care home of a registered provider is a significantly refurbished home The registered provider
14 A decision under paragraph 230‑35(5)(a) of this instrument that the System Governor is not satisfied, as referred to in paragraph 230‑35(1)(b), that an approved residential care home of a registered provider meets the requirements in paragraphs 230‑35(3)(a) to (h) The registered provider
15 A decision under paragraph 231‑17(1)(a) of this instrument to determine an individual’s daily total essential expenses, daily remaining income amount, unreduced daily amount of the resident contribution and reduced daily amount of the resident contribution Each of the following:(a) the individual;(b) the registered provider delivering funded aged care services to the individual
16 A decision under paragraph 231‑17(1)(b) of this instrument to determine the day a determination made under subsection 231‑17(1) takes effect Each of the following:(a) the individual;(b) the registered provider delivering funded aged care services to the individual
17 A decision under paragraph 231‑17(1)(c) of this instrument to determine the period for which a determination made under subsection 231‑17(1) is in effect Each of the following:(a) the individual;(b) the registered provider delivering funded aged care services to the individual
18 A decision under subsection 231‑19(1) of this instrument to vary or revoke a residential care fee reduction supplement determination Each of the following:(a) the individual;(b) the registered provider delivering funded aged care services to the individual
19 A decision under subsection 246A‑5(2) of this instrument to determine that a judgment or settlement is to be treated as having taken into account the future costs of delivering funded aged care services to an individual, and the part of the compensation under the judgment or settlement that is to be treated as relating to those future costs The individual
20 A decision under subsection 246A‑5(3) of this instrument to determine the part of the compensation that is to be treated as relating to the future costs of delivering funded aged care services to an individual The individual
21 A decision under paragraph 263‑10(3)(b) of this instrument not to approve the proposed transfer of a service delivery branch of a registered provider to another registered provider Each registered provider
558‑5 Decisions by the Pricing Authority
The following table prescribes decisions and entities for the purposes of the table item 2 in section 558 of the Act.
Decisions by the Pricing Authority
Item Column 1Decision Column 2Entity
1 A decision under subsection 290‑30(4) that the Pricing Authority is not satisfied of the matters referred to in paragraph 290‑30(3)(b) in relation to information given by a registered provider The registered provider
Part 3—Application fees and fees for services provided by the System Governor, Commissioner and Complaints Commissioner
597‑5 Fees—exemptions—fees that must accompany application or request made to System Governor, Commissioner or Complaints Commissioner
(1) For the purposes of subparagraph 597(d)(i) of the Act, the circumstances specified in column 2 of an item of the following table are prescribed for the fee specified in column 1 of the item.
Circumstances for the exemption of fees for certain applications or requests
Item Column 1 Fee Column 2 Circumstances
1 the application fee prescribed in section 104‑5 of this instrument for an application made by an entity under section 104 of the Act to be registered as a registered provider the circumstances are that on the day the application is made any of the following apply:(a) the entity intends to be registered as a registered provider delivering funded aged care services under the MPSP or TCP;(b) the entity intends that 85% of the individuals that the entity is to deliver funded aged care services to will be located in an area with a 2023 MM category known as MM 6 or MM 7;(c) the entity is known as an Aboriginal Community Controlled Organisation
2 the application fee prescribed in section 107‑5 of this instrument for an application made by a registered provider under section 107 of the Act to renew the provider’s registration the circumstances are that on the day the Commissioner invites the registered provider under section 106 of the Act to renew the provider’s registration any of the following apply:(a) the registered provider is delivering funded aged care services under the MPSP or TCP;(b) all of the individuals the entity is delivering funded aged care services to are located in an area with a 2023 MM category known as MM5, MM 6 or MM 7;(c) the Commissioner considers, based on the information held by the Commissioner as at that day, that the provider is in the smallest 10% of all registered providers based on the number of individuals to whom funded aged care services are delivered by the provider
3 the application fee prescribed in section 111‑5 of this instrument for an application made by an entity under section 111 of the Act to approve a residential care home in relation to the entity the circumstances are that on the day the application is made any of the following apply:(a) the entity is, or intends to be, registered as a registered provider delivering funded aged care services under the MPSP or TCP;(b) the entity is, or intends to be, registered as a registered provider and 85% of the individuals the entity is delivering, or intends to deliver, funded aged care services to, are, or will be, located in an area with a 2023 MM category known as MM 6 or MM 7;(c) the entity is known as an Aboriginal Community Controlled Organisation
4 the application fee prescribed in section 124‑5 of this instrument for an application made by a registered provider under section 124 of the Act to vary the provider’s registration the circumstances are that on the day the application is made any of the following apply:(a) the entity is a registered provider delivering funded aged care services under the MPSP or TCP;(b) 85% of the individuals the entity is delivering, or intends to deliver, funded aged care services to, are, or will be, located in an area with a 2023 MM category known as MM 6 or MM 7;(c) the registered provider is known as an Aboriginal Community Controlled Organisation
5 the application fee prescribed in section 124‑10 of this instrument for an application made by a registered provider under section 124 of the Act to vary the provider’s registration the circumstances are that on the day the application is made any of the following apply:(a) the registered provider is delivering funded aged care services under the MPSP or TCP;(b) 85% of the individuals the registered provider is delivering funded aged care services to are located in an area with a 2023 MM category known as MM 6 or MM 7;(c) the registered provider is known as an Aboriginal Community Controlled Organisation
597‑10 Fees—refunds—fees that must accompany application or request made to System Governor, Commissioner or Complaints Commissioner
(1) For the purposes of subparagraph 597(d)(ii) of the Act, the circumstances specified in subsections (2) and (3) are prescribed for a fee for an application specified in subsection (5).
Circumstances for full refund
(2) The circumstances in which a fee specified in subsection (5) may be refunded in whole in relation to an application and an entity are that:
(a) either or both of the following apply:
(i) the entity makes the application in a form other than the approved form; or
(ii) the entity fails to include information in the application that is required under the Act to be included; and
(b) the entity pays the applicable fee in relation to the application.
Circumstances for partial refund
(3) The circumstance in which a fee specified in subsection (5) may be refunded in part in relation to an application and an entity is that both of the following apply:
(a) the entity makes the application;
(b) the entity pays an amount which exceeds the applicable fee in relation to the application.
(4) If subsection (3) applies in relation to an application and an entity, the amount by which the amount referred to in paragraph (3)(b) exceeds the applicable fee may be refunded.
Fees for which circumstances apply
(5) For the purposes of subsections (2) and (3), the fees are the following:
(a) for an application made under section 104 of the Act—the application fee prescribed in section 104‑5 of this instrument;
(b) for an application made under section 107 of the Act—the application fee prescribed in section 107‑5 of this instrument;
(c) for an application made under section 111 of the Act—the application fee prescribed in section 111‑5 of this instrument;
(d) for an application made under section 124 of the Act—the application fee prescribed in section 124‑5 of this instrument;
(e) for an application made under section 124 of the Act—the application fee prescribed in section 124‑10 of this instrument.
Endnotes
The endnotes provide information about this compilation and the compiled law.
The following endnotes are included in every compilation:
Abbreviation key—Endnote 2
The abbreviation key sets out abbreviations that may be used in the endnotes.
Legislation history and amendment history—Endnotes 3 and 4
Amending laws are annotated in the legislation history and amendment history.
The legislation history in endnote 3 provides information about each law that has amended (or will amend) the compiled law. The information includes commencement details for amending laws and details of any application, saving or transitional provisions that are not included in this compilation.
The amendment history in endnote 4 provides information about amendments at the provision (generally section or equivalent) level. It also includes information about any provision of the compiled law that has been repealed in accordance with a provision of the law.
Editorial changes
The Legislation Act 2003 authorises First Parliamentary Counsel to make editorial and presentational changes to a compiled law in preparing a compilation of the law for registration. The changes must not change the effect of the law. Editorial changes take effect from the compilation registration date.
If the compilation includes editorial changes, the endnotes include a brief outline of the changes in general terms. Full details of any changes can be obtained from the Office of Parliamentary Counsel.
Misdescribed amendments
A misdescribed amendment is an amendment that does not accurately describe how an amendment is to be made. If, despite the misdescription, the amendment can be given effect as intended, then the misdescribed amendment can be incorporated through an editorial change made under section 15V of the Legislation Act 2003.
If a misdescribed amendment cannot be given effect as intended, the amendment is not incorporated and “(md not incorp)” is added to the amendment history.
ad = added or inserted
orig = original
am = amended
p = page(s)
amdt = amendment
para = paragraph(s)/subparagraph(s)
C[x] = Compilation No. x
/sub‑subparagraph(s)
ch = Chapter(s)
pres = present
cl = clause(s)
prev = previous
cont. = continued
(prev…) = previously
def = definition(s)
pt = Part(s)
Dict = Dictionary
r = regulation(s)/Court rule(s)
disallowed = disallowed by Parliament
reloc = relocated
div = Division(s)
renum = renumbered
ed = editorial change
rep = repealed
exp = expires/expired or ceases/ceased to have
rs = repealed and substituted
effect
s = section(s)/subsection(s)
gaz = gazette
/rule(s)/subrule(s)/order(s)/suborder(s)
LA = Legislation Act 2003
sch = Schedule(s)
LIA = Legislative Instruments Act 2003
SLI = Select Legislative Instrument
(md) = misdescribed amendment can be given
SR = Statutory Rules
effect
sub ch = Sub‑Chapter(s)
(md not incorp) = misdescribed amendment
sub div = Subdivision(s)
cannot be given effect
sub pt = Subpart(s)
mod = modified/modification
underlining = whole or part not
No. = Number(s)
commenced or to be commenced
Ord = Ordinance
Name
Registration
Commencement
Application, saving and transitional provisions
Aged Care Rules 2025
24 Sept 2025 (F2025L01173)
1 Nov 2025 (s 2‑5(1) item 1)
Aged Care Amendment (Care Minutes) Rules 2025
12 Dec 2025 (F2025L01555)
13 Dec 2025 (s 2(1) item 1)
—
Aged Care Legislation Amendment (2026 Measures No. 1) Rules 2026
2 Feb 2026 (F2026L00074)
sch 3: 3 Feb 2026 (s 2(1) item 1)
—
Aged Care Legislation Amendment (March Indexation and Other Measures) Rules 2026
19 Mar 2026 (F2026L00292)<br>
sch 1 (items 1‑60): 20 Mar 2026 (s 2(1) item 2) sch 2: 23 Mar 2026 (s 2(1) item 3) sch 3: 1 Apr 2026 (s 2(1) item 4) sch 4: 1 July 2026 (s 2(1) item 5) sch 5: 1 Oct 2026 (s 2(1) item 6)
—
Provision affected
How affected
Chapter 1
Part 1
s 2‑5..............
rep LA s 48D
s 5‑5..............
am F2026L00292 (sch 2)
s 7‑20.............
am F2026L00292
Chapter 2
Part 3
Division 2
s 80‑15............
am F2026L00292
Subdivision BA
Subdivision BA............
ad F2026L00074
s 80‑47............
ad F2026L00074
s 80‑49............
ad F2026L00074
Part 5
Division 1
s 92A‑5............
rs F2026L00074
s 92A‑10...........
rs F2026L00074
Chapter 4
Part 4
s 148‑70...........
am F2026L00292
Division 4
s 149‑35...........
am F2026L00292
Part 5
s 150A‑15..........
am F2026L00292
s 150A‑25..........
am F2026L00292
Part 6
s 153‑10...........
rs F2026L00292
s 153‑15...........
rep F2026L00292
Part 7
s 155‑60...........
am F2026L00292
Chapter 5
s 166-20.................
rep F2026L00292
s 166‑145..........
am F2026L00292
s 166‑165..........
am F2026L00292
s 166‑170..........
am F2026L00292
Subdivision E
s 166‑310..........
am F2026L00292
Subdivision L
s 166‑850..........
am F2026L00292
Subdivision N
s 166‑1005.........
am F2026L00292
Part 6
s 175‑5............
rs F2026L00292
s 175‑10...........
am F2026L00292
s 175‑15...........
am F2026L00292
s 175‑20...........
am F2026L00292
s 175‑25...........
am F2026L00292
s 175‑30...........
am F2026L00292
s 175‑50...........
am F2026L00292
s 175‑55...........
am F2026L00292
Division 2
s 176‑20...........
am F2025L01555
Chapter 7
s 194‑5............
am F2026L00292
s 196‑25...........
am F2026L00292
s 196‑30...........
am F2026L00292
Part 7
s 230‑15...........
am F2026L00292
s 231‑17...........
am F2026L00292
s 231‑35...........
am F2026L00292
s 242B‑10..........
am F2026L00292
s 242B‑40..........
am F2026L00292
Division 4
Subdivision A heading........
ad F2026L00292
s 243A‑5...........
ad F2026L00292
s 243A‑10..........
ad F2026L00292
s 243A‑15..........
ad F2026L00292
s 243A‑20..........
ad F2026L00292
s 243A‑25..........
ad F2026L00292
s 243A‑40..........
ad F2026L00292
s 243A‑45..........
ad F2026L00292
s 243A‑50..........
ad F2026L00292
Part 9
s 247‑15...........
am F2026L00292
Part 10
Division 1A
Division 1A...............
ad F2026L00292
s 256‑5............
ad F2026L00292
Part 11
s 265‑5............
rs F2026L00292
Chapter 8
s 279‑5............
am F2026L00292
s 280‑10...........
am F2026L00292
Division 2A
s 285A‑13..........
am F2026L00292
s 285A‑14..........
am F2026L00292
Chapter 9
s 287‑103A.........
rs F2026L00292
Division 5
s 287‑155..........
am F2026L00292
Part 3
s 290‑25...........
am F2026L00292
Division 6
s 302‑15...........
am F2026L00292
Division 7
s 311‑5............
am F2026L00292
s 313‑5............
rs F2026L00292
s 313‑10...........
rs F2026L00292
Chapter 10
s 314‑10...........
am F2026L00292
s 314‑15...........
am F2026L00292
s 314‑55...........
am F2026L00292
s 314‑65...........
am F2026L00292
s 314‑75...........
rs F2026L00292
s 314A‑5...........
am F2026L00292
s 319‑5............
am F2026L00292
ed C3
Subdivision H
s 330‑5............
am F2026L00292
Subdivision K
s 337‑5............
am F2026L00292
Chapter 11
s 343A‑5...........
am F2026L00292
Endnote 5—Editorial changes
In preparing this compilation for registration, the following kinds of editorial change(s) were made under the Legislation Act 2003.
Paragraph 319‑5(7)(b)
Kind of editorial change
Give effect to the misdescribed amendment as intended