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Eligibility for funding

Approved Provider Information

General information regarding approved providers including: what is an approved provider; gaining approval as an approved provider; circumstances affecting suitability; key personnel; and approved forms and guidelines.

You may download this document in PDF format:

PDF printable version of Approved Provider Information (PDF 30 KB)

Download the approved forms and guidelines

Set out below is some detailed information on the processes involved in becoming an approved provider and the obligations of an approved provider under the Aged Care Act 1997 (the Act).

The information is not intended to be all that applicants should consider nor does it constitute legal advice. Applicants are also urged to obtain a copy of the Act and Aged Care Principles (the Principles), if they have not already done so. Copies of the Act and Principles may be obtained from CanPrint Information Services (1300 889 873) or on the Department’s website at: http://www.health.gov.au/internet/main/publishing.nsf/Content/ageing-legislat-aca1997-acaindex.htm

Overview

To receive Australian Government subsidies for providing aged care, an aged care service must be operated by an organisation that has been approved by the Australian Government (an “approved provider”) and has an allocation of “places” in respect of care recipients occupying those places in a service. If providing residential aged care the facility must also be accredited by the Aged Care Standards and Accreditation Agency (the Agency). Further information relating to this is located in the Accreditation Grant Principles 1999. You may also like to go to the Agency’s website located at http://www.accreditation.org.au for further details. For the approved provider to be eligible to receive a payment, the care recipient must be assessed by an Aged Care Assessment Team (ACAT) to be eligible to receive that type of care.

Approval as a provider of aged care under the Act

To gain approval as a provider of aged care under the Act, the applicant and its proposed key personnel, such as directors, board members and service managers must be assessed by the Department as suitable to provide aged care.

Approval as a provider of aged care under the Act can be for one or more types of care (residential, community, flexible), and for one or more specified aged care services. Once approved, the approved provider can provide care in any number of services (subject to any limitations imposed). Division 8 of the Act sets out the approval process requirements. State, territory and local government authorities are taken to be approved providers unless the approval has lapsed or been revoked (please refer to section 8-6 of the Act).

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Criteria for approval

The primary requirements to become an approved provider are:

• that the applicant is an incorporated body (section 8-1(1)(b) of the Act);
• that the applicant is suitable to provide aged care (section 8-1(1)(c) of the Act);
• that none of the applicant’s proposed key personnel is a disqualified individual (i.e. convicted of an indictable offence, insolvent or of unsound mind) (section 8-1(1)(d) and section 10A–1 of the Act); and
• the application is made on the approved form (section 8-2(2) of the Act).

The Department considers a range of issues when assessing suitability including an applicant’s:

• ability to provide care;
• record of financial management;
• ability to meet relevant standards for aged care; and
• commitment to the rights of aged care recipients.

The Department also considers the suitability and experience of the staff in management positions, known as key personnel, and the track record of the organisation and the key personnel in the provision of aged care or other similar activities.

An approval will commence to have effect only when the provider obtains an allocation of places in respect of a service, either through an allocation by the Department in the Aged Care Approvals Round (ACAR) or by transfer from another provider.

The approval lapses if it does not come into force in respect of an aged care service through which the person provides aged care within a period of 2 years. Once an approval has lapsed a new application for approval will need to be made; an allocation or transfer of places can only be made to an approved provider.

State, territory and local government authorities

State, territory and local government authorities are taken to be approved providers unless the approval has lapsed or been revoked (section 8-6 of the Act).

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Allocation of places

There are two ways that approved providers can acquire “places”:

• apply for places in an ACAR; or
• purchase places and apply to the Department for approval to transfer places from the vendor.

The Department is responsible for the allocation of aged care places. The planning system aims to ensure that all communities have a fair and equitable level of aged care services, including both residential and community aged care services. Aged care places are allocated annually through the highly competitive selection process, the ACAR, which takes into account the number of places made available, the identified needs of an aged care planning region and the relative merits of the proposals received. The ACAR is advertised in major newspapers and on the Department’s website. Information about the ACAR can be found at: http://www.health.gov.au/internet/main/publishing.nsf/Content/ageing-acar2009-index.htm

Key personnel

Key personnel are defined in section 8-3A of the Act as:

• people responsible for the executive decisions of the applicant (this includes directors and board members);
• people having authority or responsibility for (or significant influence over) planning, directing or controlling the activities of the applicant;
• any person responsible for nursing services provided, or to be provided, by the applicant, whether or not the person is employed by the applicant; and
• any person who is, or likely to be, responsible for the day-to-day operation of an aged care service conducted, or proposed to be conducted, by the applicant, whether or not the person is employed by the applicant.

Disqualified individual

An organisation must demonstrate, both at time of seeking to be approved to provide aged care and when approved, that they satisfy strict requirements set out in the legislative provisions under the Act. The Department considers the demonstrated experience and suitability of the organisation, and its proposed key personnel, including that none of the proposed key personnel is a disqualified individual.

The applicant is required to provide evidence that none of the proposed key personnel has been convicted of an indictable offence, which would make them a disqualified individual. Each state and territory has different types of offences considered to be indictable offences, however, these may include more serious offences, such as murder, manslaughter, and aggravated assault. Other examples may include the intentional and unlawful administration of drugs or poisons; and committing fraudulent or dishonest activities.

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Circumstances which affect suitability

For any approval given after 1 January 2009, the Secretary may specify a particular circumstance which materially affects the approved provider’s suitability, so that the approved provider is required to seek the Secretary’s agreement before that circumstance changes. An example of this is an ongoing relationship to provide care through a management company. It has become the business practice of a number of approved providers to engage another company to manage the delivery of care services such as a management company. If an applicant for approval as a provider of aged care under the Act is entirely reliant on a management company to demonstrate that it has skills and experience in aged care, any changes to the use of that management company could have significant impacts on its capacity to provide aged care. The Department would specify the steps to be taken by the applicant to notify the Department and obtain agreement before there is any change to that circumstance.

This is one of the approved provider’s responsibilities under section 63-1C of the Act and failure to comply may result in sanctions being imposed under Part 4.4 of the Act.

How long does it take?

Applications for approval to provide aged care can be made at any time on the approved form. Section 8-5 of the Act sets out that the Department has 90 days in which to assess an application. A further 90 days may apply if the Department is required to request further information from the applicant in support of the application.

Review rights

If your application for approval as a provider of aged care is rejected, you may, under section 85-8 of the Act, request the Secretary to reconsider the decision by submitting a notice in writing within 28 days of receiving this advice. Such a request should set out the reasons for making the request.

The Secretary must then reconsider the decision, and confirm, vary, or set the decision aside and substitute a new decision. If the Secretary does not give notice of a decision within 90 days after receiving the request, the Secretary is taken to have confirmed the decision. If you wish to appeal against a decision after review by the Secretary, you may make an application to the Administrative Appeals Tribunal (AAT) for further review.

You may apply again for approval to provide aged care at any time.

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Responsibilities of approved providers

Once approved, Chapter 4 of the Act sets out the requirements for approved providers and their key personnel including:

• obligations of being an approved provider;
• certification of residential care services;
• quality of care;
• user rights;
• accountability;
• prudential requirements; and
• record keeping.

In addition, approved providers are required to notify the Department of any changes which may affect their suitability to provide aged care, as well as any changes to their key personnel within 28 days after the change occurs. Failure to comply may result in sanctions being imposed under Chapter 4.4 of the Act.

Download the approved forms and guidelines

Application Form

The Application for Approval to Provide Aged Care is available for download in PDF format only. Two versions of the application form are available – a static PDF that can be printed and completed by hand or an interactive PDF that is fillable and savable on your computer using the latest version of Adobe Reader. Please select your preferred version of the PDF from the two options below:

Application for Approval to Provide Aged Care (Static) (PDF 398 KB)
Application for Approval to Provide Aged Care (Interactive) (PDF 1580 KB)

Guidelines

The Guidelines for Applicants Seeking Approval to Provide Aged Care are available in PDF format and are supplied to assist the applicant and its proposed key personnel in completing the application form.

Guidelines for Applicants Seeking Approval to Provide Aged Care (PDF 209 KB)

Notification of Changes to Key Personnel forms

The Notification of Changes to Key Personnel forms are available in PDF or word format:

To Add a new key personnel (PDF 67 KB)
To Add a new key personnel (Word 557 KB)

To Cease a key personnel (PDF 45 KB)
To Cease a key personnel (Word 458 KB)

To Change a key personnel (PDF 33 KB)
To Change a key personnel (Word 443 KB)

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National criminal history record checks

The applicant and each of its proposed key personnel must provide an original national criminal history record check with their application. Each national criminal history record check report must be dated no more than 90 days before the date the application is received by the Department.

Further information about national criminal history record checks can be obtained from the Australian Federal Police at http://www.afp.gov.au/business/national_police_checks.html or CrimTrac at http://www.crimtrac.gov.au/criminal_history_checks/index.html.

Further advice

Applicants seeking to provide care through a residential aged care service are advised to refer to the Residential Care Manual at: http://health.gov.au/internet/main/publishing.nsf/Content/ageing-manuals-rcm-rcmindx1.htm

You may also wish to seek advice from the following industry bodies:

• Aged Care Association Australia (ACAA) – a national industry association for providers of residential and community aged care services.

• Aged and Community Services Australia (ACSA) – an industry peak body representing not for profit church, charitable and community organisations that provide residential and community care services to older Australians.

Contact us

Send applications for approval to provide aged care to:

Approved Provider Section
Prudential and Approved Provider Regulation Branch
Office of Aged Care Quality and Compliance
Department of Health and Ageing
MDP 454
GPO BOX 9848
CANBERRA ACT 2601

Questions and queries relating to approval as a provider, including how to become an approved provider may be sent to the following e-mail address: ApprovedProviderProgram@health.gov.au
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