Exclusive: Many aged care residents in Australia are charged for services they can’t use or understand, prompting an investigation from the regulator
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Jeff Gilling was surprised when he looked at the contract for the aged care home his mother, Dorothy, was about to enter.
Contained within it was a $52 daily fee for Foxtel, outings, newspapers and a choice of wines.
“She was in advanced stages of dementia, and so couldn’t even turn on the TV, let alone choose a channel or enjoy what she was watching,” Gilling says.
When he was told the additional service fee “wasn’t optional”, he signed.
“She was being charged for services that she simply couldn’t use or enjoy. But the contract gets put in front of you, and your priority is to get your parent out of hospital and into better care, or out of the home into safe care, and so there’s a lot of emotion.”
Gilling later researched his mother’s rights, then took the fight to the aged care facility in Sydney’s north-west where his mother lived – and managed to get almost $37,000 refunded.
Yet his shock mirrors that of others around Australia, who have either been charged or had loved ones charged fees from aged care providers for services they can’t use or understand.
The national regulator, the Aged Care Quality and Safety Commission, received 199 complaints about aged care fees, funds and service charges to residents in the first half of 2026 alone, launching an investigation into several providers charging allegedly illegal additional fees.
The commission says there are “several providers where we have concerns about misuse” of fees.
Of the 199 complaints that included a concern around “fees and charges” or “funding for services relating to ageing” at residential facilities, 121 relate to for-profit providers; 75 to not-for-profit providers, and three were about government providers.
The regulator’s commissioner, Liz Hefren-Webb, told Guardian Australia that “these investigations are ongoing”.
“Because of this, we won’t provide further details at this time,” she said.
She said a number of providers had already voluntarily reviewed and changed their practices.
The for-profit provider Arcare is meanwhile facing a class action alleging Arcare illegally charged residents fees for services including high teas, hot meals and exercise classes, even in cases where residents physically could not use those services, for example due to health issues.
The federal court action also alleges Arcare charged additional fees to residents for basic services it is legally obliged to provide, such as a nutritious choice of meals.
An Arcare spokesperson said that as the matter was before the court “it would not be appropriate to comment on the allegations or the legal proceedings”.
Damian Scattini, a partner at Quinn Emanuel Urquhart & Sullivan, which is acting for the class action applicants, said the law firm was “actively investigating other operators”.
‘It is unconscionable’
According to aged care legislation, providers can only charge fees for additional care and services where a resident agrees to it, is able to access and benefit from the services, and has the capacity to make use of them.
When Gilling discovered this, he emailed the managers at his mother’s home, Estia Health’s Epping aged care facility, in 2019. “It is unconscionable – and I believe unlawful – for you to be charging this fee in respect of a resident with dementia who does not have the cognisant ability to choose the services or to benefit from them,” he wrote.
After a review by the regional manager, Gilling was reimbursed $26,741 in February 2021, to cover 537 days charged during the time his mother was in a dementia support unit.
In October 2021, a further refund of $10,088 was approved, after Gilling successfully argued the fees should never have been applied, from the first day his mother entered the facility.
Gilling said not all families would be aware that the charges are unlawful, or have the ability to fight them.
“You really do need to kind of gather up your fortitude and arm yourself with stamina and confidence, because it is a bit of a battle, and you’re really the David to their Goliath,” he said.
An Estia Health spokesperson said when a resident or family raised a concern about fees, it was reviewed.
“Where we find a charge was not right, we correct it, and refund what should not have been charged,” she said. “Residents and their authorised representative can request a review of additional services, or opt out of them, at any time.
“Caring for older Australians, including those living with dementia, is a privilege and we take our obligations to them seriously”.
Concerns about ‘two-tier’ system
In an attempt to rein in unlawful charging for basic services, the government in November introduced the Higher Everyday Living Fee (Helf), allowing residents to be charged for premium services and lifestyle additions that go above and beyond the mandatory standard of care.
Hefren-Webb said she is concerned that in response some unnamed providers had reduced standards – such as choice and availability of meals – “in ways that encourage or pressure residents to purchase premium options”.
“The Aged Care Quality Standards are clear that residents must have access to a high-quality standard meal service that is nutritious, appealing and responsive to their preferences,” she said.
“Providers cannot use Helf arrangements to reduce the quality, quantity, choice or nutritional adequacy of the standard meal service that must be available to all residents.”
The commission’s investigation is focusing on Helf fees specifically.
Dr Sarah Russell, the director of the advocacy group Aged Care Matters, said a “worrying aspect of Helf” was that providers can choose the cost and the type of inclusions.
“For example, an aged care home in NSW included entertainment as an extra service, despite the fact that this entertainment was provided by a volunteer,” she said.
She said Helf had embedded additional service fees as the norm, creating a “two-tier” system: “Those who can afford the additional services, and those who can’t.”
Do you know more? melissa.davey@theguardian.com
