Aged Care forms
On this page
- Aged Care Funding Instrument (ACFI) form
- Registration for Aged Care Online Claiming
- Aged Care approved provider statement
- Banking details for the direct deposit of payments
- Application for eligible oxygen treatment and/or enteral feeding supplement
- Appointment of a nominee
- Resident Entry Record (RER)
- Authorised signatory form
Note: Forms are available as a web fillable PDF. All forms will still need to be printed to include an original signature and returned by post.
Aged Care Funding Instrument (ACFI) form
This form replaces the Resident Classification Scale (RCS) form.
Registration for Aged Care Online Claiming
The Registration for Aged Care Online Claiming forms are used to register to participate in Aged Care Online Claiming. For more information about choosing an online claiming channel go to Aged Care Online Claiming.
- Registration for Aged Care Online Claiming using File Upload or Business to Business (B2B) [PDF, 605Kb]
- Registration for Aged Care Online Claiming using Web Forms [PDF, 444Kb]
If you are already registered for Aged Care Online Claiming, key personnel can complete the Change of nominated user’s details form to register, amend access or deactivate users to the Aged Care Online Claiming website.
Note: If you are only deactivating users from the Aged Care Online Claiming website, key personnel can send an email to Medicare Australia Aged Care
with the user’s name, A or RA number and deactivation date.
Aged Care approved provider statement
The Aged Care approved provider statement is signed by key personnel of an approved provider to advise that appropriate business and security controls are in place. It ensures all aged care forms, claims and other relevant documentation to claim payments of subsidy under the Aged Care Act 1997 are appropriately authorised.
The 2011 provider statement is due to Medicare Australia by 30 June 2011.
Note: If your organisation operates more than one aged care service you can complete one statement, attaching a list of services. Each page must be signed by the key personnel.
Banking details for the direct deposit of payments
The banking details form is for approved providers to formally notify Medicare Australia of the banking details for:
- Australian Government-funded residential aged care services
- Community Aged Care Package (CACP) services
- Extended Aged Care at Home (EACH) services, and
- Transition care services
This form can be used to either add banking details for a new service or change the details for an existing service.
The form should be completed and signed by the approved provider (for a sole provider) or two key personnel (for a service administered by a board on behalf of the approved provider).
Note: Authorised signatories can only sign this form if they are key personnel.
When you have completed the form, make a copy for your records and send the original to Medicare Australia.
Application for eligible oxygen treatment and/or enteral feeding supplement
Approval for higher-level funding for oxygen treatment is generally for a six-month period. This is because costs often fluctuate considerably for most residents' individual oxygen needs. Residential aged care services must advise Medicare Australia of any changes that result in a variation of the amount being claimed and also any changes affecting payment of the benefit to the service.
Appointment of a nominee
This form is for residents in Australian Government-funded residential aged care services who wish to authorise another person to deal with the Department of Health and Ageing (DoHA) on their behalf. This form is also to be used for residents who are mentally impaired and are therefore unable to administer their own affairs.
If a resident is in a residential aged care service, they can authorise another person (a 'nominee') to act of their behalf with DoHA. The nominee may receive information from DoHA about their care costs and may give DoHA information about their income and assets. If it’s decided not to appoint a nominee, DoHA will contact the resident directly about these matters. You may vary or cancel the appointment of a nominee at any time by writing to DoHA
For more information, contact the Aged and Community Care Information line on 1800 500 853*.
Resident Entry Record (RER)
- RER for permanent care form [PDF, 1.5Mb]
- Guide for aged care providers: RER for permanent care [PDF, 143Kb]
- Completed RER contact sheet (where to send your completed RER form) [PDF, 80Kb]
- Questions and answers about the RER form [PDF, 123Kb]
- Guide to pensioner cards [PDF, 337Kb]
Authorised signatory form
From 1 September 2007 the Annual Aged Care Approved Provider Statement replaced this form.
Some documents on this page may require the free Adobe PDF reader.
Last updated: 21 March, 2011