Transition Care Programme

The Transition Care Programme helps older people recover after a hospital stay by providing short-term care for up to 12 weeks. Read about the program, care provided, and why it’s important.

About transition care

Transition care provides short-term care for older people to help them recover after a hospital stay, including:

  • social work
  • nursing support
  • personal care
  • allied health care.

Care can last up to 12 weeks and take place in a person’s home, an aged care home or both.

If you’re an older person, read about who is eligible and how to apply on My Aged Care.

Why it's important

We know that many older people want to stay in their own home as they age.

Transition care helps older people to:

  • recover after a hospital stay
  • regain functionality or mobility
  • remain independent in their homes
  • delay their entry into an aged care home for as long as possible
  • avoid the need for long-term care
  • finalise ongoing care arrangements.

Eligibility

To be eligible an older person must:

  • be a patient in a public or private hospital (including Hospital in the Home programs)
  • be ready to be discharged
  • potentially benefit from accessing a short period of restorative care services.

Upon discharge from hospital, the person must enter transition care within:

  • 24 hours if they are entering transition care in a residential setting
  • 48 hours if they are receiving transition care in their home.

How to become a transition care provider

You can apply to become a transition care service provider by contacting your state or territory government health department.

Delivering transition care services

You must deliver services in line with the Transition Care Programme guidelines.

The guidelines outline:

  • how you must deliver services
  • your responsibilities
  • the aged care principles that govern the program.

Extending transition care

You can ask to extend care for up to 42 days (6 weeks) through the My Aged Care Service and Support Portal. You can only do this once and must ask along with the care recipient or their representative within the first 12 weeks of transition care.

Breaks from care

Older people can have up to 7 break days during their transition care period, which they can take individually or consecutively.

Break days count towards the total care period and are included in the older person’s contribution fees.

People in care can use breaks for hospital admissions or social purposes, but not for respite care or to extend the length of the care period.

Funding

We fund transition care through flexible care subsidies to Transition Care Programme providers.

The state and territory governments contribute through:

  • in-kind contributions
  • direct funding to service providers.

If people in care can afford to contribute to their cost of care, providers can ask them for fees.

Read more about the subsidy amount in the Schedule of Subsidies and Supplements for Aged Care.

The Transition Care subsidy rate will increase from 1 January 2025 for some Transition Care Programme workers.

Find out more about better and fairer wages for aged care workers.

Time-limited places

From 1 July 2023 to 30 June 2025, we created 265 new time-limited places across Australia. View the Ministerial Determination creating these places under subsection 12-3(1) of the Aged Care Act 1997.

Who we work with

We develop program policy and allocate transition care places to state and territory governments.

State and territory governments are responsible for:

  • day-to-day management of the program
  • delivering the program
  • choosing the best way to meet local service needs and individual care needs.

Program review

A 2019 review of the program found that it:

  • has supported the early discharge of older people from hospital
  • can help delay their entry into residential care.

Contact

Transition care contact

Email us if you have questions about the Transition Care Programme.
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