Becoming an approved aged care provider

Governance arrangements

Amendments to the Aged Care Act have introduced specific responsibilities for certain approved providers in relation to their governance arrangements. These responsibilities are aimed at ensuring providers have the right leadership and culture, and that the organisation is transparent and accountable, all the while focusing on consumer wellbeing, safety, choice, and quality of life.

These responsibilities relate to the membership of governing bodies, the establishment of advisory bodies, and other related responsibilities (as set out in this document) which are intended to improve oversight and transparency and ensure that the focus of approved providers is on the best interests of consumers.

Both new applicants and existing approved providers must demonstrate that they understand these responsibilities.

For more detailed information, see the Provider responsibilities relating to governance – Guidance for approved providers on the Commission website.

What is an approved provider of aged care?

An approved provider is an organisation that has been approved by the Commission to deliver Australian Government subsidised home, residential or flexible care services to eligible older Australians.

An organisation which is formally approved by the Commission to provide aged care is eligible to receive a subsidy (a payment) from the Australian Government, for delivering identified types of care and services to aged care consumers in accordance with the Aged Care Act 1997 (Aged Care Act).

The different types of aged care and services that an organisation can be approved to deliver are:

• home care– refer to the consumer manual or provider manual for detailed information on this service
• residential aged care– facilities for older people who can no longer live at home
• flexible care– including multi-purpose services, innovative care, transition care and short-term restorative care.

Organisations wishing to provide one or more of the above types of aged care and services, but which are not approved as approved providers by the Commission, are ineligible to receive a Government subsidy for that purpose.

What does an approved provider do?

An approved provider is responsible for delivering identified types of care and services to aged care consumers.

Under the Aged Care Act, approved providers have a number of responsibilities including:

• being responsible for the care you deliver
• assisting care recipients to make decisions about quality care
• managing government subsidies
• managing care recipients’ fees and payments.

With respect to the quality and safety of the care provided to aged care consumers, an approved provider is required to comply with the Aged Care Quality Standards in the Aged Care Act.

What is the Commission’s role?

Under the Aged Care Quality and Safety Commission Act 2018 (Commission Act), the Commission is responsible for assessing and making decisions on applications from organisations seeking to become an approved provider.

The Commission is authorised to approve applications that meet all criteria from organisations wishing to provide:

• entry level support at home, and/or
• a higher level of support for older Australians who are able to keep living at home with assistance, and/or
• care options and accommodation for older Australians who are unable to live independently at home.

Applicants approved to offer care and services under the Aged Care Act, who are therefore approved providers, are eligible for an Australian Government subsidy.

Why do aged care providers need to be approved?

Aged care providers need to be approved in order to be eligible to receive an Australian Government subsidy to deliver aged care and services under the Aged Care Act.

The Australian Government subsidises approved providers to ensure that the care and services they offer are more affordable and accessible to eligible care recipients.

In order to be approved for the purposes of delivering Australian Government subsidised aged care and services, an organisation must satisfy a number of criteria which are explained below.

You must also continue to meet obligations under the Aged Care Act in order to retain your approval to provide Australian Government subsidised aged care. The Commission can revoke or suspend approval at any time if you breach requirements or are found to be non-compliant.

It is important to note that one of the grounds for the Commission revoking approved provider status is where an organisation’s application for approval contained misleading information. Other grounds include where the approved provider ceases to be a corporation, and where the approved provider ceases to be suitable for approval.

Where can I find out about current approved providers?

Anyone can go online and visit the My Aged Care website to search for an approved provider.

Who does not need to be approved?

An organisation does not need to be approved by the Commission to provide services for older Australians under:

• the Commonwealth Home Support Programme (CHSP)
• the National Aboriginal and Torres Strait Islander Flexible Aged Care Program.

However, organisations delivering aged care services under one of these programs (and receiving grant funding from the Australian Government for that purpose) must still comply with the Quality and Safety Commission Act, Rules and the Aged Care Act.

Eligibility to be an approved provider

You need to meet these requirements before you can be approved:

• comply with requirements set out in Part 7A of the Commission Act
• understand an approved providers’ responsibilities under the Aged Care Act
• deliver care that meets the associated Principles made under section 96-1 of the Aged Care Act, including the Aged Care Quality Standards.

The assessment of your application considers the following:

• you must be a corporation
• each individual who is one of the key personnel of the person must be suitable to be involved in the provision of aged care
• your experience providing aged care or other relevant forms of care
• what you understand about approved provider responsibilities
• that you have, or will have, systems in place to meet your responsibilities
• that you have, or will have, sound financial management records and practices
• your compliance with financial obligations and other responsibilities as a care provider, if you already are one.
• Whether an individual who is one of the key personnel of the person has at any time been convicted of an indictable offence or if a civil penalty order against an individual has been made at any time

Government organisations

State, territory or local government organisation do not need to be approved by the Commission to deliver aged care services. Instead, these organisations complete a Government notification form to create a record that will enable the payment of subsidies to your organisation.

Although Government organisations are not assessed by the Commission for suitability, they are still required to meet the regulatory responsibilities of an approved provider.

What you need to know before you apply

Please read the information below before you apply to become an approved provider of aged care. It is expected that you have, and are able to demonstrate, a clear understanding of approved provider requirements and obligations.

Read the guidance

It is extremely important that you read the Aged Care Approved Provider Applicant Guide. It will help you and your staff complete the form accurately and will provide guidance on what you’re required to do as an approved provider.

Did you use the services of a consultant?

You are responsible for the information in your application form and its attachments. Please review and ensure you understand the information your consultant has given you. If your application contains inaccurate details, it may not be approved.

This is why it’s important that you take the time to read our website and publications to ensure you know your responsibilities and what is required under the legislation.

Your organisation must be incorporated

If you are not an incorporated organisation, or if you’re a sole trader, you cannot be approved and your application will be invalid.

Demonstrating you can provide services in accordance with the Aged Care Act

You must tell us, in sufficient detail, about your understanding of the responsibilities of an approved provider. This means that you must know what is expected under Division 54, Division 56 and Division 63 of the Aged Care Act, as well as the Aged Care Principles and Quality Standards.

Carry out police and insolvency checks for each of your key personnel

This is mandatory. You must provide one of the following documents with your application:

• National Police Certificate (NPC) — from a police agency, or
• National Criminal History Check (NCHC) — from an Australian Criminal Intelligence Commission-accredited agency, or
• NDIS Worker Screening Check

The date on each NPC or NCHC must be within 90 days of submitting your application. The police certificate guidelines for aged care providers provides more information about national police certificates.

Depending on the circumstances of your key personnel, a statutory declaration is required for each person when:

• all former or current names are not shown on the NPC, NCHC and NDIS Worker Screening Check, and or
• they were a citizen or permanent resident of a country other than Australia after turning 16 years old.

The declaration should state whether the person has committed an indictable offence that is:

• against a law of the Commonwealth or a state or territory, and/or
• against the law of a foreign country that corresponds to an offence against a law of the Commonwealth or a state or territory.

You are also required to provide a copy of an insolvency check undertaken in relation to each key personnel to confirm that they are not, or have every been, insolvent under administration.

Always use the correct and most current application form

We update our application forms from time to time to ensure they include the latest information and legislative requirements.

Please only complete the current application form on our website we cannot process your application.

You must pay an application fee to have your application assessed

Section 23 of the Commission Act allows the Commission to charge fees for performing regulatory services including assessing and processing applications for approved providers. These fees are detailed on our Approved provider application fees page.

Submit your completed application form to obtain an invoice

When you lodge your completed approved provider application, we will undertake a validity check and identify the care and services you are seeking approval to provide.

If your application is valid, an invoice will be sent to you for the relevant application fee. This process may take 10 days.

Once the payment of the application fee has been received by the Commission, we will confirm this with you and advise that your application will proceed to initial assessment.

How to pay your application fee

Payment terms will be detailed on your invoice, which will be issued by the Commission once your application has been deemed valid. Your application fee is payable to the Commission via electronic funds transfer using the following bank details:

 

Account name	ACQSC Departmental External Revenue
BSB	062000
Account number	17177204
Reference	[insert the reference number that was sent to you by the Commission]
Remittance advice	Send the remittance advice to approvedproviderapplications@agedcarequality.gov.au to confirm payment has been made.

Application fees waiver

Application fees may be waived if you are seeking approval to provide residential, home or flexible aged care and services under the following 3 conditions:

• you intend to provide all, or at least 85% of care and services, to care recipients located in Modified Monash Model areas 6 and/or 7 – regions which are remote or very remote, and
• you can provide strong evidence of the above intention, and
• you give us detailed information about the services you intend to provide in these remote or very remote areas in the Application fee waiver request form, which we will cross check with the information you provide in your application form.

Read more information about the Modified Monash Model (MMM).

To satisfy conditions regarding MMM areas 6 and 7:

• If you are seeking approval to provide home care and/or flexible care in a home care setting, you are required to provide evidence of as many of the following as possible:
  • the rental or ownership of an administrative or business location within the relevant MMM area
  • a recruitment strategy for staff within the relevant MMM area
  • advertising or promotion of services within the relevant MMM area
  • MoUs with communities or community groups from within the relevant MMM area
  • representation on the applicant’s board or advisory body of people from the relevant MMM area
  • involvement of key personnel from the MMM area
  • a history of relevant service provision in the relevant MMM area
  • evidence of demographic studies or service demand studies within the relevant MMM area
  • corporate documents stating organisation goals and target locations/populations within the relevant MMM area
  • references from members of target communities within the MMM area.
• If you are seeking approval to provide residential care services and/or flexible care in a residential care setting, you are required to provide evidence as stated above as well as evidence of your facility’s location within MMM 6 and/or 7 areas. A waiver is not available to organisations whose application proposes provision of these services both within MMM 6/7 areas and outside these areas.

If you believe you meet these conditions, please complete an Application fee waiver request form and submit it with your application form.

Apply to be an approved provider of aged care

Important information

When completing your application, you are responsible for ensuring you have properly understood the responsibilities of an approved provider, and for providing the requested information to allow a proper assessment of your organisation. If you don’t do this, your application may not be approved.

Your application must also be valid and meet the requirements of section 63B of the Commission Act, otherwise it will be returned to you.

If you submit an application form, and then make changes to your organisation or your plans, and those changes affect the accuracy of any of the information you provided, you must let us know. You can do this by emailing us at approvedproviderapplications@agedcarequality.gov.au

Choosing the right application form

Please make sure you use the correct application form. There are 3 different forms available to apply for approval, and the one you select will depend on what you are seeking.

Option 1: If you are a provider of aged care who is not yet approved

Use this form if you are an organisation that is not currently approved to provide any type of care either under the Commission Act or the Aged Care Act. This includes organisations funded to deliver the Commonwealth Home Support Programme (CHSP).

If this applies to you, you must complete the new applicant form if you wish to become an approved provider.

Option 2: If you are an existing approved provider who wants to add or change service types

Use this form if you are an approved provider who wants to provide another care type – for example, if you provide residential aged care and want to provide home care, you would use this form. 

If this applies to you, you must complete the existing approved provider form. This form lets you demonstrate your ability to provide another type of care.

Option 3: If you are a government organisation

Because state, territory and local government authorities are taken to be approved to provide aged care services, the process is different.

If you are a government organisation, the Commission does not assess you for suitability. However, there is a registration process you must complete. This is required to create a departmental record so the Australian Government can pay subsidies to you.

If this applies to you, you must complete the government organisation form.

Additional key personnel form

This is an addendum to the application forms. You only need to complete the additional key personnel form if you have more than 4 key personnel to identify. This form must be submitted with your application form.

The assessment process

We follow a four-stage assessment process when determining whether you will be approved as a provider. These steps are outlined below:

1. Validity check

Go to the section on this page titled ‘Submit your completed application form to obtain an invoice’ for information about paying the application fee.

If you have applied for a fee waiver, the completeness check will not commence until after a decision is made on your fee waiver application.

For your application to be considered ‘valid’, it must meet the requirements of section 63B(2) of the Commission Act. It must be:

• made in writing
• made using the form approved by the Commissioner
• accompanied by any documents or information specified by the Commissioner
• accompanied by any fee specified by the Commissioner.

To determine these matters, a validity check is undertaken. We will confirm receipt of the application fee and check the information provided in the form and the documents that you have attached. Applications that do not pass this check will be returned to you. You will be informed in writing and you will not receive a refund of the application fee. This process may take up to 10 business days.

If your application passes this stage, you will be advised in writing.

2. Initial assessment

The initial assessment is a more thorough check of your application to identify, for example, whether all documents identified by you or specified on the application form are attached.

We check your organisation’s records held with the Australian Securities and Investment Commission (ASIC), and the ASIC records of all your key personnel including company Directors and Board members. If you provide care under another Australian Government subsidised scheme, your record of compliance is also checked with the relevant agency.

The initial assessment step enables the Commission to identify whether information is missing or unclear, and if further information is required to allow your application to progress.

Your application may be determined to be invalid at this step, or we may send you a Request for Information which is a notice under section 63C of the Commission Act. Additional fees will apply.

A Request for Information will tell you what information you need to provide so that your application can progress to assessment. Generally, this might include additional information about your key personnel, or where a financial document is incomplete and the missing pages are necessary to understand your financial position.

Important details to note

Your responses and documents must be easy to understand and you should include sufficient information to allow us to assess your suitability, including how you will operate your service on a day-to-day basis. There is a fee payable for each Request for Information notice sent to you.

If you do not provide the requested information within 28 days, your application will be withdrawn. You will not receive a refund of any of the fees you have paid.

Alternatively, we may decide that a decision can be made based on the evidence provided by you prior to this step. Therefore, a Request for Information will not be required.

The initial assessment process may take up to 10 business days to complete.

3. Formal assessment

Once your application passes the initial assessment step, you will be informed by email. The 90-day timeframe for deciding your application, as established under section 63D of the Commission Act, starts at this point.

The next step is a full assessment of your application against the suitability matters established under section 63D of the Commission Act.

A senior assessor will review your application and draft a recommendation to the Delegate.

If the senior assessor identifies that further information is needed to allow a proper assessment of your suitability and to finalise the recommendation to the Delegate, a Request for Information will be issued to you and you will be required to pay an additional fee.

A Request for Information will seek to clarify information you have provided in the application and it will specify the information that is needed and why it is necessary for assessing your suitability. If you do not give us the requested information in 28 days, or you have not requested an extension of time, your application will be withdrawn and you will have to reapply. You will not receive a refund of any of the fees you have paid.

The legislated timeframe stops at this point and will start again when the requested information is received.

4. Decision and finalisation

The Delegate will consider the recommendation provided by the senior assessor, discuss it with the senior assessor as necessary, and decide the outcome of your application. In accordance with section 63E of the Commission Act, a written decision is sent to you within 14 days after the decision is made. 

If the decision is a non-approval, a statement of reasons is provided to you. It will let you know why your application was not approved and it will tell you what your review rights are.

Getting a decision

You will be notified of your application outcome within 90 days from the time you receive an email from the Commission advising that your application has passed the initial assessment step.

If we request more information during the formal assessment stage, we will make a decision within 90 days after receiving your response.

If you’re approved

We will send a notice of approval which will tell you the next steps you need to take in the process.

If you’re not approved

You have 2 options if we don’t approve your application:

• reapply
• request a reconsideration.

Reapplying

If you reapply, you must complete a new application form. You should reflect on the reasons you weren’t approved as set out in your written notice. It is strongly recommended that you address these reasons and add any new information that shows why you believe you meet the eligibility criteria.

You will also need to pay an application fee.

Requesting a reconsideration

You can request a reconsideration of a non-approval decision under Part 8B of the Commission Act.

To request a reconsideration of a non-approval decision, you must submit a written request within 14 days of receiving the written decision notice. 

Applications for reconsideration are to be submitted to reconsideration@agedcarequality.gov.au. In the subject line, please add ‘Director Reviews and Reconsiderations – request for reconsideration under s74K of the Commission Act’.

In acting on a request for reconsideration, the Commission will identify a Delegate to undertake this work who is different from the person who made the initial decision.

If you choose to email us, your email must:

• tell us why you’re making the request
• address specific areas we identified as reasons for non-approval
• add any evidence you would like to be considered.

The possible outcomes of reconsideration are:

• we confirm the decision, or
• we vary the decision, or
• we set the decision aside and substitute a new decision.

If we don’t respond within 90 days, the original decision is confirmed.

If the original decision is confirmed, you may seek a review by the Administrative Appeals Tribunal.

Administrative Appeals Tribunal

You can appeal a reconsideration decision made by the Commissioner by submitting an application to the Administrative Appeals Tribunal.

To make an application to the Administrative Appeals Tribunal for review of the decision you must:

• apply in writing
• apply within 28 days of receiving the decision
• pay the application fee.

For further information, please visit the Administrative Appeals Tribunal’s website or call 1800 228 333.

Contact

We encourage you to read the information on this webpage before contacting us as it provides you with all the details you need to make an application.

If you need further support please email approvedproviderapplications@agedcarequality.gov.au.

If you would like to make an enquiry, provide feedback, order a publication, or lodge a concern or complaint, please contact us.