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Nursing Homes in Australia - High Level Residential Care

The Commonwealth Government regulates and partly funds the provision of residential care for frail older people who can no longer live independently in their own home. There are two levels of care and although they are officially called “low level residential care” and “high level residential care” they are still widely known and referred to as "hostels" and "nursing homes", respectively.

Before you can enter a hostel or nursing home you must be assessed and approved for care by an Aged Care Assessment Team (“ACAT”). ACATs are generally made up of local doctors, nurses, social workers and the like and they are usually located at hospitals, aged care centres or community centres. In appropriate circumstances they can see you in your own home or in hospital in order to make an assessment.

Care and Services

Residential care facilities must provide the following "Specified Care and Services":

  • accommodation services - to all residents irrespective of their level of care
  • low level care services - to all residents irrespective of their level of care
  • high level care services - to high level care residents only.

Accommodation services include:

  • administration, including resident documentation
  • basic accommodation related services, such as furnishings
  • bedding
  • general laundry, towels, washers, soap and toilet paper
  • cleaning services
  • maintenance of buildings and grounds
  • staff continuously on call to provide emergency assistance
  • meals, including special dietary requirements.

Low level care services are personal care type services. They include:

  • assistance with the activities of daily living such as bathing, toileting, eating, dressing, mobility and communication
  • certain treatments and procedures, including assistance with medication
  • recreational therapy and rehabilitation support
  • assistance in accessing health and therapy services
  • support for people who have difficulty understanding.

High level care services are nursing type services and additional personal care services. They include:

  • specialised furnishings and equipment items, such as those used to assist mobility, eg. walking frames, wheelchairs, lifting devices
  • basic medical and pharmaceutical supplies and equipment and aids to assist with toileting and continence management
  • nursing procedures
  • administration of medication
  • provision of therapy services
  • oxygen and oxygen equipment on a short term or episodic basis.

Continence aids must be provided free of charge only for high level care residents. Low level care residents who need continence aids may make arrangements with the hostel to provide them for an additional charge. Alternatively, residents may obtain their own supplies.

Veterans and war widow(er)s may be entitled to additional services through the Department of Veterans’ Affairs (link below).

Fees and Charges

When you move from your home to a residential care facility, your (changed) circumstances can affect your pension and the amount you pay for care. It is therefore a good idea to seek professional financial advice and it is wise to prepare in advance so that your affairs can be structured so as to obtain the best outcome. The free Financial Information Service (13 2300) may be a good place to start.

Most payments for Commonwealth Government funded residential care services are GST-free. GST is generally only payable to the extent that a payment relates to additional discretionary services, such as hairdressing, where the supplier is registered or is required to be registered for GST.

Depending on the nursing home and your personal and financial circumstances, you may be asked to pay:

  • a basic daily fee
  • an additional daily fee
  • an accommodation charge, or in some cases an accommodation bond
  • an extra service fee.

The following expenses may qualify for the medical expenses tax offset (ATO link below):

  • daily fee
  • additional daily fees
  • extra service fees
  • accommodation charges.

Quality Safeguards

A number of safeguards have been put in place to ensure that residents receive adequate quality of care and services.

Accreditation: Hostels and nursing homes must satisfy a set of Accreditation Standards in order to receive Government funding. The standards relate to matters such as health, personal care, lifestyle, safety and quality of buildings and surroundings, and management and organisational development. Once accredited, hostels and nursing homes are regularly monitored to ensure continued compliance. 

Aged Care Standards and Accreditation Agency: This independent agency manages the accreditation process, assists hostels and nursing homes to improve the quality of care and services, and refers transgressors to the Department of Health and Ageing for corrective action. You can contact the agency (see below) to find out how a particular facility is rated.

The Aged Care Complaints Resolution Scheme: This scheme allows residents to make complaints about issues that cannot be resolved with staff and management of the facility. It is operated by the Department of Health and Ageing and is overseen by an independent Commissioner for Complaints. Anyone can make a complaint about anything that may constitute a breach of the service providers responsibilities to past or present residents. Complaints can be kept confidential or anonymous. You can also complain to the responsible manager or the National Commissioner for Complaints if you are not satisfied with the operation of the scheme.

Advocacy Services: These services are provided free of charge to help people exercise their rights. Information, advice, support and representation can be provided to residents and their carers or other representatives on a confidential basis.

Community Visitors Scheme: This scheme facilitates regular friendly visits for isolated or lonely residents.

Internet Links

The Department of Health and Ageing has created the Aged Care Australia website, which is without doubt the most comprehensive source of information regarding aged care in Australia.

The Department of Veterans’ Affairs

Australian Taxation Office: Information about Medical Expenses Tax Offsets

Telephone Numbers

Aged Care Information Line:   1800 500 853    
Aged Care Standards and Accreditation Agency:
NSW / ACT:   (02) 9633 2099    
Victoria / Tasmania:   (03) 9897 4322    
Queensland:   (07) 3852 3100    
Western Australia:   (08) 9201 1344    
South Australia / Northern Territory:   (08) 8272 3766    
Aged Care Complaints Resolution Scheme:   1800 550 552    
Advocacy Services:
NSW   The Aged-Care Rights Service:   (02) 9281 3600 or 1800 424 079
Queensland   Aged and Disability Advocacy:   (07) 3637 6000 or 1800 818 338
Victoria   Residential Care Rights:   (03) 9602 3066 or 1800 133 312
Western Australia   Advocare:   (08) 9221 8599 or 1800 655 566
South Australia   Aged Rights Advocacy Service:   (08) 8232 5377 or 1800 802 030
Tasmania   Advocacy Tasmania Inc:   (03) 6224 2240 or 1800 005 131
Northern Territory   Darwin Community Legal Service:   (08) 8982 1111 or 1800 812 953
Northern Territory   Alice Springs Centacare:   (08) 8953 3177 or 1800 354 550

  Disability, Aged and Carers Advocacy Service:

  (02) 6242 5060
Commonwealth Carelink Centre:   1800 052 222    
Financial Information Service:   13 2300    

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