• Select the relevant change(s) being notified and ensure the relevant Section(s) is completed for each selection
• A change to your suitability to be a registered provider is not limited to things that negatively affect your suitability. A change also includes things that improve your suitability to deliver funded aged care services. 
   

• Provide date on which a responsible person of the provider first became aware of the change in circumstances
• Describe the circumstances or event(s) through which you became aware of the change
   

In answering these questions, consider the following: 

• Identify who made the finding

• Detail the circumstances surrounding the non-compliance, including type of non-compliance and the relevant legislation
• Detail the impact of the non-compliance issue and any enforcement action (by whom and reasoning) on your organisation, and on the delivery of aged care services

Detail actions taken to remedy non-compliance, review ongoing compliance and manage risk of repeated non-compliance

For question 3.4, ‘obligations’ also refers to your conditions of registration as a registered provider. In this question, detail the steps you are taking, or plan to take, to meet your obligations and conditions of registration as a registered provider. 

You may use this form to capture separate findings of non-compliance that occur on the same date. However, if there are separate findings of non-compliance occurring on different dates, please complete a new smart form for each finding. 

You must disclose whether an NDIS banning order issued by the NDIS Quality and Safeguards Commission, has ever been made against you.

You must make this disclosure even if the order is no longer in force.

This information is relevant to your suitability to deliver funded aged care services.

If you need to explain a banning order or NDIS banning order, your explanation should include:

• when the order was made

• the period of effect of the order (including if it is indefinite) 

• what the order applies to (e.g., only specified NDIS activities) 

• the reasons for the order (e.g., explanation of the incident(s))

• relevant legislative references (e.g., to the National Disability Insurance Scheme Act 2013)

• any other relevant information, such as persons involved and their role, including if any compliance or enforcement actions were also taken (and by whom) against the person as an individual

If the banning order or NDIS banning order is no longer in force, also provide detail on: 

• when this occurred

• the reasons why it is no longer in force

• any relevant actions taken by you (e.g., to address previous non-compliance)

• any processes you have in place to monitor and ensure ongoing compliance with your legal obligations (e.g., to the National Disability Insurance Scheme Act 2013).

• Provide the reason that a suspension was issued, including relevant sections of the National Disability Insurance Scheme Act 2013

• Detail the circumstances that led to the suspension

• Detail the impact of suspension on care services being provided, including on continuity of care

• If the suspension is still in place: 

  • Identify actions to be implemented or currently being taken to remedy reasons for suspension

• If the suspension has since been lifted:

  • Identify the date and reason for the suspension being lifted

  • Detail the actions taken to address reasons for suspension

• Detail the processes in place to review ongoing compliance with the NDIS Act and manage risk of future suspension

If your NDIS registration has ever been revoked, you must provide detail on the following: 

• the date of effect of revocation
• the reasons for the revocation (e.g. explanation of the incident(s))
• the impact of the revocation on care services being provided, including on continuity of care
• relevant legislative references (e.g. to the National Disability Insurance Scheme Act 2013)
• a description of the impact that the revocation had on care services being provided, including matters related to the continuity of care 

If the revocation is still in place, identify actions to be implemented, or currently being taken, to remedy reasons for revocation. 

If the revocation has since been lifted: 

• the date of effect of revocation
• detail the actions taken to address the revocation

Detail the processes that are in place to review ongoing compliance with the National Disability Insurance Scheme Act 2013 and manage risk of future revocation.

• Describe the circumstances or event(s) through which you became aware of the change

• Providers are required, as set out in Part 6 of the Aged Care Rules 2025, to take reasonable measures to require each responsible person to notify them if any of the following applies to the responsible person:

  • an NDIS exclusion decision is in force

  • an NDIS clearance decision is suspended

  • certain convictions.

• Select the relevant change(s) being notified and ensure question 3.2 is completed for each selection

• For Question 3.2, provide details of the change of circumstance, including: 

  • Date of the change

  • Circumstances surrounding the change

  • If any enforcement action was taken against the individual, the reasons for the enforcement, including reference to relevant legislation 

• If ‘no’ to Question 3.3, take time to consider the suitability matters in relation to the individual

• For Question 3.5:

  • If the individual will cease to be a responsible person of your organisation, complete Question 4.1, and the ‘Removing a Person as a Responsible Person’ smart form

  • If the individual will continue to be a responsible person, detail any actions taken, or proposed to be taken, in relation to the individual. This may include any adjustments or limitations to their position in your organisation, or in the delivery of aged care services.

• If ‘no’, this is the end of the form 

• If ‘yes’, complete the ‘Removing a responsible person’ form 

• The Occupation Standard Classification for Australia (OSCA) establishes definitions for job classifications based on skill level and specialisations required for specific occupations. Classifications are broken down into major, sub-major, minor and unit groups, and occupations. For each occupation, OSCA provides a statement describing the nature, main activities and skill level. For question 2.1.2, provide an explanatory response in section 8.1 with reference to the OSCA guidance 

• For Question 2.1.2, job role should be consistent with OSCA occupation definitions

• Questions 2.2.1 to 2.2.6 only need to be answered if you selected ‘a registered nurse responsible for the management of the nursing services’ for question 2.1.4

• Provide Ahpra registration details for each responsible person

• If ‘no’ to all options in Question 2.2.5, no additional information is required 

• Otherwise, if ‘yes’ to any option in Question 2.2.5, provide an explanatory response explaining what the registration is subject to

• In the context of Question 2.2.6, ‘state’ refers to any conditions the registration has been subject to (e.g. conditions, undertakings or reprimands)

• Include the following details where relevant, which you should have been made aware of in determining suitability of the person to become a responsible person:

  • Qualification or certificate details, including:

    • Qualification or certificate title and educational facility

    • Date obtained (or date started if still studying) 

  • Registration details
  • Membership details
  • Licence details

• Detail the person’s experience in, or relevant to, providing aged care or similar services against the relevant service types you are currently registered to provide or are looking to be registered for. This may include the delivery of care under the CHSP, NDIS, sub-contractor or private fee for service care. 

  • In explaining the e person’s prior experience, include where relevant, their employer’s name and address, period of employment and role description (including relevance to providing aged care)

  • Multiple relevant prior experience may be included in the response

  • Experience and performance should be of the person, not of a parent company or franchise organisation to which they belong. 

     

If you are unable to respond to these questions, reconsider your nomination of this person as a responsible person.

You must disclose if a banning order issued by us, or an NDIS banning order issued by the NDIS Quality and Safeguards Commission has ever been made against you. 

You must make this disclosure even if the order is no longer in force. 

This information is relevant to your suitability to be a responsible person of a registered provider. 

If you need to explain a banning order or NDIS banning order, your explanation should include: 

• when the order was made
• the period of effect of the order (including if it is indefinite)
• what the order applies to (e.g. specified NDIS activities)
• the reasons for the order (e.g. explanation of the incident(s))
• relevant legislative references (e.g. to the National Disability Insurance Scheme Act 2013)
• any other relevant information 

If the banning order or NDIS banning order is no longer in force, also provide detail on: 

• when this occurred
• the reasons why it is no longer in force
• any relevant actions taken by you (e.g. to address previous non-compliance)
• any processes you have in place to monitor and ensure ongoing compliance with your legal obligations (e.g. to the National Disability Insurance Scheme Act 2013)

• If ‘yes’ to Question 4.3:

• Identify when the civil penalty order was made, and the civil penalty imposed

• Identify on what grounds the civil penalty order was issued

• Detail actions taken to remedy misconduct

• Detail the processes in place to review ongoing compliance with legislation

• For Question 4, listed bodies refers to those listed in section 13(1)(g) of the Aged Care Act 2024:

  • a Department of the Commonwealth or of a State or Territory;

  • the Australian Securities and Investments Commission;

  • the Australian Charities and Not‑for‑profits Commission;

  • the Australian Competition and Consumer Commission;

  • the Australian Prudential Regulation Authority;

  • the Australian Crime Commission;

  • AUSTRAC (within the meaning of the Anti‑Money Laundering and Counter‑Terrorism Financing Act 2006);

  • the Australian Health Practitioner Regulation Agency;

  • another body established for a public purpose by or under a law of the Commonwealth;

  • a State or Territory authority (including, but not limited to, a body that is equivalent to a body mentioned in subparagraphs (ii) to (viii));

  • a local government authority;

  • a body responsible for maintaining standards of conduct in a profession that is involved in the delivery of funded aged care services;

• If ‘yes’ to Question 4.5:

  • Identify what the negative finding or enforcement action was

  • Identify on what grounds the negative finding was made, or enforcement action issued

  • Detail actions taken to remedy previous misconduct

  • Detail the processes in place to review ongoing compliance with legislation

• If ‘yes’ to Question 4.7:

• Identify what the finding or judgement was about

• Identify on what grounds the finding or judgement was made

• Detail actions taken to remedy misconduct

• Detail the processes in place to review ongoing compliance with legislation

• If ‘yes’ to Question 4.9:

• Identify on what grounds the administrative, civil, or criminal proceedings have been initiated

• Identify the expected decision date for the final finding or judgment

• Detail the processes in place to review ongoing compliance with legislation

• If ‘yes’ to Question 4.11:

  • Identify the date and period of disqualification, noting it may be a current or previous disqualification

  • Identify on what grounds the person is or was disqualified from management

• If the disqualification is no longer in place:

  • Detail why the disqualification is no longer in place (e.g. lapsed, revoked)

  • Detail actions taken to remedy previous misconduct leading to disqualification

  • Detail the processes in place to review ongoing compliance with legislation

• If ‘no’ to any question from 4.1 to 4.12, you do not need to complete this question. Continue to Section 5. 

• If ‘yes’ to any question from 4.1 to 4.12, provide an explanation for each adverse finding or enforcement action. That is, if you answered ‘yes’ to more than one question, suitability needs to be explained for each question. Your explanation should detail the person’s suitability to provide safe, reliable, and high-quality care and services. 

• If ‘yes’ to Question 5.1, provide details of the bankruptcy, administration or insolvency.

If ‘yes’ to Question 5.1, provide details of the bankruptcy, administration or insolvency.

• Provide details on how you plan on managing the risk associated with the person, as a result of their NDIS clearance decision
• Outline and describe the risk management plan that will be in place for this person, including a description on the strategies that will be used for how the person will be supervised
• For question 6.3.3, if the person has been banned from being in a risk assessed role, outline and describe the reasons for why this has occurred 
   

• Provide a response to questions 6.4.1 to 6.4.5 to support verification of their Nationally Coordinated Criminal History Check.
• Detail the actions the responsible person has undertaken since any previous disclosable court outcomes, that shows they may now be suitable for a responsible person role 
   

• Provide a response detailing any suspensions, exclusions or conditions 

• Describe any roles or responsibilities currently held at other organisations, including any directorships with other organisations.

• Provide any additional details about the person that were not addressed by the above questions, such as if the person has been disqualified under the Corporations (Aboriginal and Torres Strait Islander) Act 2006
• Skip this question if there is no additional information you would like to provide

For question 2.5: detail the reason the individual ceased to be a responsible person of your organisation, and where relevant, summarise any change in the responsible person’s suitability. If there is a change to the responsibility person’s suitability, elaborate on that change in the ‘Change to suitability of a responsible person’ form.

Specify if the responsible person being removed was in charge of an approved residential care home. If so, also specify which approved residential care home.

For question 2.6: detail how this role is being filled, including through: 

• A permanent redistribution of the individual’s previous tasks or responsibilities, including if they were in charge of an approved residential care home

• A temporary redistribution of the individual’s previous tasks or responsibilities, including if they were in charge of an approved residential care home, and plans to attain a replacement for the role

If you are adding a new responsible person to your organisation, complete an “adding a person as a responsible person” form. 

• If ‘no’, this is the end of the form
• If ‘yes’, complete the ‘Change to suitability of a responsible person’ form 

• Detail the reason and circumstances for the change, including any internal or external factors

• Detail the impact of this change on your delivery of care and services

• Your change may relate to an insolvency event, which may involve:

  • a CGT event G3 in respect of your shares or financial instrument

  • the making of an order that you will be wound up in insolvency

  • the passing of a special resolution that you will be wound up voluntarily

  • the passing of a resolution by your creditors that you will be wound up

  • the making of a sequestration order against your estate

  • the acceptance of a debtor’s petition against you by an Official Receiver

  • the making of an insolvency event declaration in relation to you

• Outline what services the new entity will be providing, to support your management or governance function (e.g. clinical support, financial advice) 

• Detail the reason and circumstances for the change, including any internal or external factors

• Detail the impact of this change on your delivery of care and services

• Detail the reason and circumstances for the change, including any internal or external factors

• List each incoming and outgoing member, and the impact of this change on the organisational structure 

• Outline the steps that you are going to take as a registered provider, to ensure ongoing compliance with the governing body membership requirements outlined in section 157 of the Aged Care Act 2024

• For question 5.4, ‘obligations’ refers to all key obligations that a registered provider must comply with, including conditions on their registration. For further information, see section 103 of the Aged Care Act 2024

• If you are no longer in compliance with the governing body membership requirements outlined in section 157 of the Aged Care Act 2024, please apply for a Governing Body Determination. For further information, please see the Determinations webpage

• Include a detailed description of adverse changes to your financial capacity, the impact on your business operations. This may include:

  • any immediate financial status issues and longer-term sustainability issues
  • any impact on your ability to meet your (evaluated) minimum liquidity amount. Complete Section 3: Change to liquidity, if your (evaluated) minimum liquidity amount is impacted
  • any impact on your ability to refund your refundable deposits to residents.

• Explain how this change will affect how you deliver current care and services. This should include: 

  • A description on how this change will impact your systems, practices and procedures, and your plan to minimise the impact
  • A description of how you plan to ensure ongoing and long-term financial viability
  • If you are intending on delivering services in Category 6, your answers should cover liquidity, record and disclosure management

• Provide details in relation to your current liquidity and the predicted change to your liquidity, including if your ability to meet your (evaluated) minimum liquidity amount is impacted.

• Outline the reasons for the drop, or predicted drop in liquidity. This may include 

  • Circumstances of your liquidity arrangements, including any financial or contractual arrangements
  • Any changes to any related third-party transactions that impact your liquidity
• Outline the processes to be implemented and/or planned actions currently being taken to return to your (evaluated) minimum liquidity amount.