The Federal Government moved quickly this month to tighten the Higher Everyday Living Fee (HELF) rules, amending the Aged Care Rules to make clear that providers cannot begin charging existing residents for services they had previously received free of charge before November 2025.
Announcing the change, Aged Care Minister Sam Rae said the Government had been forced to act because some providers were “taking advantage” of older Australians. He reiterated that HELFs were always intended to cover optional lifestyle services, not services that had already formed part of a resident’s everyday care.
For aged care consultant Paul Sadler, the policy change itself is indisputable.
“The particular change is, in my view, a common sense one,” he said.
“The fact that you can’t start charging people for a service they received free… is actually sensible for existing residents.”
Where Sadler rejects the government’s narrative is in how providers arrived here in the first place.
Reform doesn’t arrive on a regular schedule
While the Government moved quickly to clarify HELF arrangements, Sadler contrasted that urgency with the prolonged uncertainty surrounding the aged care assessment algorithm, where promised changes have repeatedly slipped.
“The Government’s just refusing to go there,” he said.
“They’re not transparent with what they’re doing. They’re delayed even on the stuff they’ve said they were doing.”
But his conclusion is pragmatic rather than political.
“This time round it doesn’t cost the Government anything to do things quickly. It’ll cost the providers revenue.”
Whether leaders agree or disagree with that assessment, it highlights an operational reality. Regulatory priorities can shift rapidly, leaving providers to adjust at pace while other unresolved reforms continue in parallel.
The real reason providers introduced HELFs so broadly
Sadler is careful not to excuse providers who incorrectly applied HELFs to existing residents and says those charges should be corrected quickly.
However, he also resists accepting that the conversation is one about provider misconduct.
“I don’t see… profit grabbing,” he said, pointing instead to the financial realities of operating residential aged care.
“The real question should be… why do providers feel they have to do this?
“It’s because (…) funding of the system is inadequate.”
He reiterates that many providers were trying to solve the same problem – how to maintain services in an environment where resident expectations continue to rise faster than funding. Governance becomes significantly more difficult when financial sustainability and regulatory interpretation both have moving goalposts on the same playing field.
Don’t wait for the regulator to knock
For providers reviewing their own arrangements, Sadler’s advice is straightforward. He says to adopt Opal HealthCare’s approach.
If previous fee decisions no longer align with the clarified rules, review and change them now.
“If you’ve done something that was wrong, or could be perceived to be unfair to people, then correct it, repay promptly.”
He also recommends obtaining specialist financial, service model and legal advice before implementing or continuing HELF arrangements.
Rather than viewing reviews as admissions of failure, boards should instead integrate them as part of governing through an evolving reform environment. Waiting for an audit, complaint or investigation will ultimately narrow options available to providers wanting to moving forward.
Good governance still needs local judgement
One of Sadler’s more nuanced takes on the application of HELF is that compliance alone does not equal good governance.
During his time leading Presbyterian Aged Care, homes in Sydney’s eastern suburbs operated differently to those in Newcastle or regional New South Wales. The organisation’s mission remained constant, but local communities had different expectations, demographics and financial capacity.
The same principle applies to HELFs. Legal consistency is essential. Operational consistency reduces headaches. But identical service models across facilities are not always appropriate.
Providers still need to ask what residents in each community genuinely value, what aligns with the organisation’s purpose and what represents a reasonable everyday living expense.
Sadler goes further and offers a practical guide; if it is something a person would ordinarily expect to pay for while living independently, such as their own television or home Wi-Fi, it may be a reasonable place to begin the HELF conversation.
The critical element of implementation is ensuring residents know what they are choosing, what they are paying for and when those expectations are set.
The HELF changes are unlikely to be the last clarification providers face. In a sector where policy continues to evolve, good governance is becoming less about getting every decision right the first time, and more about recognising when new information requires yesterday’s decisions to be revisited.
