Aged Care and Other Legislation Amendment Act 2025 (45 of 2025)

Schedule 1   Amendment of the Aged Care Act 2024

Part 1   Amendments commencing immediately after the commencement of the Aged Care Act 2024

Aged Care Act 2024

153   After Subdivision D of Division 4 of Part 2 of Chapter 4

Insert:

Division 4A - Amount of subsidy for residential care - individuals in prescribed classes

242A Eligibility for subsidy

(1) A registered provider is eligible for subsidyfor a funded aged care service delivered by the registered provider to an individual in a class of individuals prescribed by rules made for the purposes of section 227A through the service group residential care on a day if the System Governor is reasonably satisfied the requirements in subsections (2) to (4) are met.

General requirements

(2) The requirements are:

(a) the registered provider's registration is in effect and covers the funded aged care service; and

(b) the individual has an access approval that is in effect that covers the funded aged care service; and

(c) the individual has been allocated a place for the classification type for the service group under section 92; and

(d) the individual has a classification level in effect for the classification type ongoing or short-term for the service group; and

(e) either:

(i) the registered provider has given a start notification for delivering ongoing or short-term funded aged care services to the individual through the service group at an approved residential care home of the provider; or

(ii) circumstances prescribed by the rules apply; and

(f) the funded aged care service is not being delivered to the individual under a specialist aged care program; and

(g) the individual is not excluded (see subsection (5)).

Circumstances where registered provider not eligible

(3) Despite subsection (1), a registered provider is not eligible for subsidy for a day for the service group residential care for an individual if the System Governor is reasonably satisfied that:

(a) the registered provider ceased delivering funded aged care services through the service group to the individual in an approved residential care home on that day (and that day is a different day to the day the provider started delivering those services); and

(b) no other registered provider subsequently started delivering funded aged care services through the service group to the individual in another approved residential care home on that day.

(4) Despite subsection (1), a registered provider is not eligible for subsidy for a day for the service group residential care for an individual if the System Governor is reasonably satisfied that:

(a) the provider started delivering funded aged care services though the service group to the individual in an approved residential care home on the day; and

(b) the provider was not the first registered provider to start delivering funded aged care services through the service group to the individual in an approved residential care home on the day.

Excluded individuals

(5) For the purposes of paragraph (2)(g), an individual is excluded in relation to funded aged care services delivered to the individual by a registered provider through the service group residential care in an approved residential care home on a particular day if:

(a) the number of individuals to whom the registered provider delivered funded aged care services through that service group in that home during that day exceeds the total number of beds covered by the registered provider's registration for that home (as reduced by any offline beds for that home); and

(b) the individual is in the group of one or more individuals who comprise the excess based on working back from the most recent individual to enter the approved residential care home.

242B Amount of subsidy

The amount of subsidy a registered provider is eligible for under section 242A for an ongoing funded aged care service delivered to an individual in a class of individuals prescribed by rules made for the purposes of section 227A through the service group residential care on a day is the amount prescribed by the rules for that class of individuals.