ACAT replacement
Aged Care Assessment Home Visits: What Families Need to Know in 2026
Most older Australians and their families first encounter the formal aged care system not through careful planning, but through a crisis. A fall. An unexpected hospitalisation. A phone call from a neighbour who noticed something was wrong. By the time a home visit assessment is booked, families are often exhausted, anxious and focused on logistics rather than outcomes. What they frequently don’t realise is that the assessment itself — and how well they prepare for it — can significantly shape the level of government-funded support their loved one is approved to receive.
This matters enormously in the current policy environment. The Aged Care Act 2024 commenced on 1 November 2025, fundamentally shifting the legal framing around aged care in Australia [1]. Older people now have explicit rights to participate in decisions about their care, to receive safe and high-quality services, and to be protected from abuse and neglect. But rights without informed participation are hollow. Understanding what the home visit assessment actually involves, what assessors are looking for, and what families can do to ensure the assessment reflects reality is now more important than ever.
What Is an Aged Care Assessment and Who Conducts It Now
From 9 December 2024, the old Aged Care Assessment Team (ACAT) and Regional Assessment Service (RAS) workforces were unified into a single national Single Assessment System (SAS) [2]. Assessments now use a standardised national tool called the Integrated Assessment Tool (IAT), which replaced the previous National Aged Care Screening and Assessment Form from 1 July 2024. The term “ACAT assessment” is still widely used colloquially, and you may hear it from GPs, hospital teams and community services — but the organisation and process conducting your assessment has changed. If you started your journey before December 2024, you may still be engaging with the same assessment organisation, now operating within the new unified system.
The home visit component exists for a specific reason: it gives assessors the opportunity to observe the older person in their actual environment, not in a clinical setting where presentation can be misleading. A person who appears capable and composed in a GP’s waiting room may struggle significantly to manage stairs, prepare meals or recall medication schedules at home. This ecological validity is the whole point of the visit, and it is why preparation at the home level matters so much operationally.
Referrals for assessment can come from GPs, hospital discharge teams, community health workers, or family members. The process is coordinated through My Aged Care (1800 200 422), and a Triage Delegate will typically contact you within two weeks of the referral being accepted to confirm your needs and book the right assessment type. Waiting times vary considerably depending on region. In metropolitan areas, waits are typically a few weeks. In rural and regional settings, the wait can stretch considerably longer due to workforce shortages that remain a persistent challenge across the Australian aged care system [3].
What Assessors Are Actually Evaluating During the Home Visit
Assessors are not simply ticking a checklist. They are building a picture of functional capacity across multiple domains: cognition, physical mobility, continence, nutrition, medication management, social connection, safety in the home environment, and the capacity of informal carers to sustain their current level of support. Each of these domains can influence the type and level of care funding recommended.
The distinction between what a person can do in theory and what they actually do in daily life is central to the assessment. Families often coach their loved one — sometimes without realising it — in ways that inadvertently understate the level of support needed. A well-meaning “Mum always manages fine when I’m there” can obscure what happens on the four days a week when no one is there.
The assessor will typically ask questions directly of the older person, separately if possible, to gain an independent picture. They will also speak with carers and family members. They may ask to see the bathroom, kitchen and bedroom — not to intrude, but because environmental hazards and adaptive equipment tell a detailed story about daily function.
What is often missed is that assessors are also assessing carer burden and sustainability. If a spouse or adult child is providing an unsustainable level of informal care, that is relevant to the recommendation. The comprehensiveness of Australia’s aged care literature consistently identifies carer burnout and care coordination failure as major contributors to poor outcomes, particularly for older people with dementia or complex comorbidities [3].
The IAT Algorithm: What Families Should Know
The Integrated Assessment Tool (IAT) uses a rules-based algorithm to determine Support at Home funding classifications from the structured data assessors enter. This is a material change from the previous system, and families preparing for an assessment in 2025 or 2026 should understand how it works in practice.
By 30 March 2026, there were 834 formal review requests for IAT classification decisions — more than double the number received in the program’s first weeks. A Senate inquiry in April 2026 heard evidence that assessment delegates are prohibited by legislation from overriding the algorithm’s classification, and that qualitative clinical notes entered by assessors during the visit are not fed into the algorithm’s funding determination — only structured data inputs are used [2]. The Commonwealth Ombudsman has launched an investigation into the IAT’s operation. The Australian Human Rights Commission has endorsed the review.
What this means practically for families is significant: a skilled assessor’s nuanced clinical observations may influence their structured data entries, but cannot override the algorithm. If you have an OT report, GP letter, or allied health assessment that documents functional limitations in specific, structured terms, providing this to the assessor before or during the visit gives the algorithm more to work with than qualitative narrative alone. Documented, measurable functional data is more likely to be captured in the structured fields than descriptive accounts of daily difficulty.
How the Aged Care Act 2024 Changes the Stakes
The shift from the Aged Care Act 1997 to the new rights-based framework that commenced 1 November 2025 is not simply administrative. It changes the legal basis on which older Australians and their families can engage with, and challenge, care decisions [1].
Under this framework, older people have an explicit right to participate in decisions about their care, including assessment decisions. This means that families who feel an assessment did not accurately reflect their loved one’s needs now have a clearer legal basis to request reconsideration or escalate concerns. Seven strengthened quality standards took effect simultaneously, and providers are accountable to the Aged Care Quality and Safety Commission for ensuring care meets assessed needs.
However, there is a significant tension between what the new Act promises and what the system can realistically deliver right now. Australia’s aged care sector is still grappling with workforce shortages, quality variation across providers, and the ongoing challenge of integrating aged care with primary and acute health services [3]. Raising the floor of entitlement is meaningful. But the infrastructure to meet that entitlement — especially in regional and remote communities — is still catching up.
Preparing for the Visit: What Actually Makes a Difference
Preparation is not about gaming the system. It is about ensuring the assessment reflects reality accurately — and given how the IAT algorithm works, ensuring that reality is captured in structured, documentable terms where possible.
Keep a one to two week diary before the assessment. Note the times the older person needed help, what they struggled with, any incidents, and how long informal support tasks take each day. This gives concrete, time-stamped evidence rather than impressionistic recollections under pressure.
Have relevant medical records and specialist letters available. Diagnosis letters, recent discharge summaries, GP management plans and any specialist reports (particularly neurology, geriatrics or cardiology) give assessors important clinical context. Do not assume the assessor will have already accessed these through My Aged Care.
If an allied health professional has recently visited at home, request a brief report. An OT or physiotherapist who has observed the person in their home can produce a structured clinical report addressing functional limitations that maps well to the IAT’s structured data fields. This is one of the most practical ways to influence classification outcomes under the current algorithm-based system.
Be present, but give the older person space to speak independently. Assessors need to hear directly from the person being assessed. Family members who answer every question on behalf of their loved one can inadvertently complicate the assessment.
Describe what a bad day looks like, not just an average one. Functional capacity fluctuates. If there are days when your parent cannot get out of bed, cannot remember whether they have eaten, or becomes confused or distressed, those days are directly relevant to the classification outcome.
Mention carer limits honestly. If the current informal care arrangement is unsustainable, say so clearly. Acknowledging the real limits of informal support is not abandonment. It is accurate information.
When the Assessment Happens After a Hospitalisation
A significant proportion of assessments happen in hospital before discharge, not at home. Hospital environments present older people in a way that may not reflect home capacity at all. A person assessed in a hospital bed, with access to call buttons, nursing staff and structured meals, may appear far more functional than they will be once they return to an empty house.
If an in-hospital assessment leads to a recommendation that feels insufficient, families have the right under the Aged Care Act 2024 to request a reconsideration [1]. In some cases, requesting a follow-up home visit once the person has returned and settled will yield a more accurate picture. Hospital-based assessors are working under considerable time pressure due to discharge planning targets, which can affect thoroughness.
What Happens After the Assessment: Support at Home
The assessment results in a written support plan and approval for specific care types. The critical change for families to understand is that Home Care Packages no longer exist. From 1 November 2025, they have been replaced by the Support at Home program, which uses eight ongoing funding classification levels with annual budgets ranging from approximately $11,000 at the lowest level to $78,106 at the highest [1].
Under Support at Home, clinical care — including nursing, occupational therapy, physiotherapy, and speech pathology — is classified as clinical care, meaning it is fully government-funded with no participant co-contribution required. This is one of the most important changes from the previous Home Care Package model, and one of the least widely understood.
There is also a critical financial eligibility distinction that families should understand before or during the assessment process. Older people who were approved for or receiving a Home Care Package on or before 12 September 2024 are protected under the ‘No Worse Off’ principle, meaning they will not pay higher contributions under Support at Home than they would have under the old system. Those who applied after 12 September 2024 are subject to the new means-tested contribution rules, which apply differently across the Clinical, Independence, and Everyday Living service categories. If you are unsure which group applies to you, clarify this with My Aged Care or a financial information service before committing to a provider arrangement.
Wait times remain a real challenge. As of December 2025, more than 130,000 older Australians were approved for Support at Home but not yet receiving services at their assessed level — a figure that underscores how important it is to start the assessment process early rather than waiting for a crisis [1]. Families should plan for this gap and explore interim support options — including private mobile allied health — while waiting.
Two upcoming financial changes are directly relevant to families making decisions now. From 1 July 2026, government price caps set by the Independent Health and Aged Care Pricing Authority (IHACPA) will apply to all Support at Home services for the first time. Until that date, providers set their own prices. This means families organising support in the weeks before July 2026 should compare provider pricing now, while the market is still unregulated, as the cap may change what is available from some providers. From 1 October 2026, personal care services — showering, dressing and continence management — will be reclassified as clinical care under Support at Home and fully government-funded with no co-contribution required, extending the zero-cost model beyond nursing and allied health into daily personal care [1]. For families budgeting for ongoing in-home support, this is a significant reduction in future out-of-pocket costs.
If a family disagrees with the classification outcome, they can request a review through My Aged Care under the new rights-based framework. For residential aged care, the aged care assessment approval is necessary before permanent placement, and the choice of provider, funding model and room type involves additional complexity, including the Aged Care Act 2024’s strengthened protections around financial transparency and dignity of care.
The Role of Allied Health Professionals in Supporting Assessment Outcomes
Occupational therapists, physiotherapists, speech pathologists and social workers often interact with older people at exactly the point in their health trajectory where an aged care assessment becomes relevant. Mobile allied health professionals are frequently the first clinicians to observe genuine functional difficulty in the home environment, often before a formal referral has even been made.
For GPs, care coordinators and discharge planners: if a patient has been visited at home by an allied health professional in the weeks before an assessment, a brief structured report from that clinician — specifically addressing observed functional limitations in the home environment in measurable terms — can meaningfully support the assessment process. Given how the IAT algorithm processes structured data, this kind of pre-assessment documentation has become more operationally important than under the previous system.
Frequently Asked Questions
What is an aged care assessment home visit?
An aged care assessment home visit is conducted by the Single Assessment System workforce using the Integrated Assessment Tool (IAT). It evaluates an older person’s care needs to determine eligibility for government-funded aged care services including the Support at Home program and residential aged care. The visit takes place in the person’s home to observe functional capacity in their actual environment. The term “ACAT assessment” is still widely used colloquially, but the ACAT workforce was replaced by the Single Assessment System from 9 December 2024.
Who can request an aged care assessment?
Referrals can be made by GPs, hospital teams, allied health professionals or family members. The process is coordinated through My Aged Care (1800 200 422). The older person themselves can also self-refer. A Triage Delegate will usually contact you within two weeks of the referral being accepted.
How do I prepare for an aged care assessment home visit?
Keep a diary of daily assistance needs in the weeks before the visit, gather relevant medical documentation, and request a structured report from any allied health professional who has recently visited at home. Be honest about carer capacity and describe what difficult days actually look like. Given that the IAT uses a rules-based algorithm, structured clinical documentation from a GP or OT maps better to the assessment tool than verbal description alone.
Can I dispute the outcome of an aged care assessment?
Yes. Under the Aged Care Act 2024 that commenced 1 November 2025, older Australians have the right to participate in care decisions and to request a review of assessment outcomes [1]. Contact My Aged Care to initiate a reconsideration. Note that as of April 2026, the Commonwealth Ombudsman has also launched an investigation into the IAT algorithm’s operation following a high volume of review requests.
What replaced Home Care Packages?
The Support at Home program, which launched 1 November 2025, replaced Home Care Packages entirely. Support at Home uses eight funding classification levels (up to $78,106 per year) rather than the previous four HCP levels. Clinical services including nursing and allied health are fully government-funded under Support at Home with no participant co-contribution.
How long does it take to receive support after an assessment?
Approval can happen relatively quickly, but access to services at your assessed level may involve waiting periods. As of December 2025, more than 130,000 older Australians were approved but waiting for services at their assessed level. Families should plan for this gap and explore interim options while waiting, including the Commonwealth Home Support Programme (CHSP), which remains separately funded and available through My Aged Care until at least July 2027, as well as private mobile allied health.
References
- Australian Government Department of Health, Disability and Ageing. Aged Care Act 2024 — commenced 1 November 2025. Support at Home program: 8 classification levels (up to $78,106); clinical care zero participant contribution; personal care reclassified as clinical care from 1 October 2026. health.gov.au; My Aged Care. myagedcare.gov.au
- Australian Government Department of Health, Disability and Ageing. Single Assessment System — replaced ACAT and RAS from 9 December 2024. Integrated Assessment Tool (IAT) in use from 1 July 2024. IAT controversy: 834+ review requests by March 2026; Senate inquiry April 2026; Commonwealth Ombudsman investigation launched. health.gov.au
- Dyer SM, et al. Comprehensive analysis of Australia’s aged care system to inform policy development. BMC Health Services Research. 2025. PMC12021627. Workforce shortages and care coordination failure identified as central systemic challenges. pmc.ncbi.nlm.nih.gov; KPMG. Aged Care Sector Analysis 2026. ~96,700 approved for Support at Home but not yet receiving services at assessed level. May 2026.
