Aged Care Act 2024
In-Home Nursing Services: What Families Need to Know
The landscape of in-home nursing in Australia is shifting quickly. New legislation, workforce pressures, aged care reforms and funding changes are all reshaping what families can expect when they arrange nursing care at home. Whether you are managing recovery after surgery, supporting an ageing parent, or coordinating care for someone living with a chronic condition, understanding what is changing matters enormously.
This article is written for patients, carers, family members and the health professionals who work alongside them. It is grounded in what is actually happening in the Australian healthcare system right now, not a generic overview of what in-home nursing looks like in theory.
What In-Home Nursing Services Actually Cover
In-home nursing services in Australia provide registered nurses and enrolled nurses who visit patients in their own homes to deliver clinical care. This includes wound management, medication administration and reviews, post-surgical monitoring, continence care, palliative nursing, chronic disease management, catheter care, IV therapy, and general health assessments.
For many Australians—particularly older people and those with complex or multiple conditions—receiving nursing care at home is not a luxury. It is the difference between remaining safely at home and being admitted to a hospital or residential aged care facility.
Nursing services at home are funded through several pathways in Australia, including Medicare, the Support at Home program (which replaced the Home Care Packages structure from 1 November 2025), the NDIS, the Department of Veterans’ Affairs, and private arrangements. Each funding stream has its own eligibility criteria, assessment processes and service scope, which is where families often run into difficulty.
The New Aged Care Act 2024 and What It Means for Home Nursing
One of the most significant recent developments affecting in-home nursing is the commencement of the new rights-based Aged Care Act 2024, which came into effect on 1 November 2025 [5]. The Act passed Parliament on 25 November 2024 and was a direct response to the findings of the Aged Care Royal Commission. The Aged Care Rules 2025 support its operation.
The new Act explicitly centres the rights of older people, including the right to safe and quality care, genuine choice and control over how and where that care is delivered, and accountability from providers [5]. For families arranging in-home nursing, this is meaningful because it provides a clearer legal basis to challenge inadequate care and demand better outcomes. Seven strengthened quality standards—covering clinical care, the environment, food and nutrition, and complaints—came into force simultaneously. Providers must register with the Aged Care Quality and Safety Commission and renew every three years.
From 1 November 2025, new aged care worker screening requirements also took effect. All aged care workers, subcontractors, and platform staff must hold either a valid police certificate (issued within three years) or an NDIS Worker Screening Clearance (valid five years). An expanded national Aged Care Worker Screening Check aligned with the NDIS model is expected to commence from mid-2026 [5].
However, the practical reality is more complicated. Persistent workforce shortages, variable quality, and limited integration between health, aged care and the NDIS continue to undermine what the legislation promises [8]. The therapists and nurses working across our network report the same thing regularly: the rights framework has improved, but wait times and staff availability gaps remain very real.
This creates what some researchers are calling a rights-resourcing gap [3]. Families may now have stronger legal standing to demand quality in-home nursing, but if qualified nurses are not available in their area, or if a provider’s roster is already stretched, those rights are difficult to exercise in practice.
Support at Home: What the Transition Actually Means for Families
From 1 November 2025, the Home Care Packages program was replaced by the new Support at Home program. This is the most significant aged care funding change in a generation, and the detail matters for families arranging in-home nursing.
The most important change for many families is this: clinical nursing services—including in-home wound care, medication management, post-surgical monitoring, continence nursing, and palliative care—are 100% government-funded under Support at Home with no participant co-contribution required, regardless of financial status [5]. This zero-contribution model for clinical care is new and directly relevant to any family that was previously managing nursing costs under a Home Care Package.
The program expands from four to eight ongoing funding classification levels, with annual budgets ranging from approximately $11,000 at the lowest level to $78,106 at the highest [5]. Classifications are determined through an aged care assessment using the new Integrated Assessment Tool (IAT), which replaced the previous ACAT model. The program is projected to support approximately 1.4 million Australians to remain at home by 2035, backed by a $4.3 billion government investment.
Means-tested co-contributions apply only to independence and everyday living services—not clinical nursing. Existing Home Care Package recipients as of 12 September 2024 are protected by a “no worse off” principle, meaning they will not pay more under the new scheme than they did under their previous arrangement. New entrants from 1 November 2025 are subject to the full means-testing model, which can require self-funded retirees to contribute up to 80% of the cost of non-clinical services, with a lifetime cap of approximately $130,000 on non-clinical out-of-pocket costs [5].
Support at Home also includes three short-term pathways that are fully government-funded and directly relevant to nursing needs:
- Restorative Care Pathway — up to 12 weeks of multidisciplinary allied health and nursing (16 weeks in regional areas), with funding of approximately $6,000–$12,000, for patients who need intensive short-term support to maintain or regain independence.
- End-of-Life Pathway — for people with a life expectancy of three months or less, up to $25,000 of additional support over 16 weeks to enable them to remain at home.
- AT-HM Scheme — separate funding (up to $15,000) for assistive technology and home modifications, sitting outside the quarterly service budget.
The 10% care management cap means that 10% of each participant’s quarterly budget is allocated to their provider’s care management. Unspent service funds can roll over each quarter up to $1,000 or 10% of the quarterly amount, whichever is higher. Government price caps across all Support at Home services are scheduled to apply from 1 July 2026.
From 1 October 2026, personal care services—showering, dressing, and continence management—will also be reclassified as clinical care and fully funded with no co-contribution, extending the zero-cost model beyond nursing into daily personal care [5].
The Commonwealth Home Support Programme (CHSP) continues separately until no earlier than 1 July 2027. The transition itself has caused some disruption for families settled in established arrangements, and the real-world waitlist remains significant: as of late 2025, more than 88,000 people were approved for home care but not yet receiving it, with a further 120,000+ awaiting assessment [5].
Workforce Pressures and What They Mean for Patients
The promise of “ageing in place” is genuine policy intent in Australia, but it runs up against workforce shortages that structural reform alone has not resolved. The Department of Health, Disability and Ageing’s own modelling forecasts a shortage of 17,551 FTE nurses in aged care by 2035 under its central scenario. CEDA modelling projects a direct aged care workforce shortfall of at least 110,000 workers within the next decade, potentially growing to 400,000 by 2050 without intervention [8]. Across all sectors, Australia faces a national nursing shortfall exceeding 70,000 FTE by 2035.
For families seeking in-home nursing, workforce shortages translate directly into delayed starts, limited availability in regional areas, and sometimes reliance on agency staff without ongoing familiarity with a patient’s needs. Over 60% of aged care providers report difficulties filling registered nurse roles. The government has committed $2.5 billion over five years toward increased aged care nurse wages, alongside Fair Work Commission rulings that delivered significant pay rises in 2024–25. Whether these measures will close the gap by 2035 is genuinely uncertain.
AHPRA introduced a streamlined registration pathway for internationally qualified registered nurses (IQRNs) in January 2025, reducing processing times from 9–12 months to 1–6 months for nurses from comparable jurisdictions including the UK, Ireland, USA, Canada, Singapore, and Spain. This is intended to partially address supply pressures in aged care and primary care, though it is a partial measure against a structural shortfall.
Burnout and non-clinical workload add further pressure. New regulatory and reporting requirements under the Aged Care Act 2024, combined with documentation demands of Support at Home, mean nurses are spending more time on compliance. For patients with complex needs, continuity matters enormously—and when rosters are unstable and staff turnover is high, that continuity is harder to guarantee.
Funding Pathways and the Navigation Challenge
One of the most common frustrations families raise is not being sure who is responsible for funding what. Consider a common scenario: an older person is discharged from hospital after a hip replacement. They may need wound nursing through a Medicare-funded post-acute service, ongoing nursing support through Support at Home, and assistance with daily living that could sit with either aged care funding or the NDIS depending on their age, diagnosis and circumstances. Getting those streams coordinated—without duplication or gaps—often falls to the family member or carer rather than a funded coordinator.
The funding silos between health, aged care and disability remain largely intact despite years of policy discussion about seamless care [8]. Families describe the experience as one agency pointing to another, with the patient waiting in the middle.
Fee Transparency: A Shift in the Right Direction
For families using private in-home nursing arrangements or combining Medicare with private services, the 2026 Health Legislation Amendment bill is worth understanding. The bill introduces a transparency-by-default model that uses existing Medicare claims data to publish specialist fee ranges, expected out-of-pocket costs after Medicare and insurance, and whether providers use gap cover [1].
This is a meaningful shift away from the previous voluntary model, where the Medicare Cost Finder had low participation and gave families little reliable information before committing to a service. Under the new model, data is drawn from actual claims rather than self-reporting, and there is a legal requirement to update published information when prices drop significantly [1].
That said, transparency does not mean affordability. Seeing clearly what a service costs does not help a family if there is no lower-cost alternative locally. In regional and remote areas especially, the choice of in-home nursing providers may be limited regardless of what fee information is available.
Telehealth and In-Home Nursing: A Partial Answer
Telehealth has become a standard part of the Australian healthcare model, and it does offer some genuine benefits for patients receiving in-home nursing. Remote monitoring, nurse-led telehealth consultations, and virtual case conferences between GPs, specialists and community nurses can reduce the need for physical appointments and help coordinate care more efficiently [7].
But telehealth has limits in nursing specifically. Wound assessment, medication administration, catheter care and physical observation cannot be done remotely. In-home nursing is inherently hands-on, and telehealth supplements rather than replaces it. There are also ongoing concerns about digital access for older people and those in rural areas, where connectivity and digital literacy gaps mean the benefits of virtual care do not reach everyone equally [8].
Private Health Insurance and In-Home Nursing
For patients with private health insurance, in-home nursing may be covered as part of hospital-in-the-home or post-acute care arrangements, depending on the policy. The 2026 legislation requires insurers to seek ministerial approval not just for premium increases, but for new products and changes that reduce coverage or value [1]. This is intended to address so-called junk insurance products that leave patients underinsured when they actually need to use their cover.
If you are relying on private health insurance to cover in-home nursing, reviewing what your policy actually includes before you need it is important. Contacting your insurer directly and asking specifically about home nursing coverage, any limits on visits or duration, and what gap costs apply remains the most reliable approach.
What to Look for in an In-Home Nursing Provider
Clinical qualifications and registration. All registered nurses in Australia must be registered with AHPRA. Ask specifically about the qualifications of the nurse who will be attending, not just the organisation they work for.
Continuity. Ask whether you will have the same nurse or a consistent small team, particularly for ongoing or complex care. This matters clinically as well as practically.
Communication with your GP and other providers. A good in-home nursing service communicates with your treating team. Ask how they document and share care information.
Availability and response times. Particularly for wound care or medication management where timing matters, understand what the service can reliably deliver.
Experience with your specific condition. Palliative care nursing, paediatric nursing at home, and complex wound management all require specific experience. General availability is not the same as relevant expertise.
Frequently Asked Questions
What is in-home nursing in Australia?
In-home nursing refers to clinical nursing care delivered in a patient’s own home by a registered or enrolled nurse. Services include wound care, medication management, post-surgical monitoring, palliative care, continence care and chronic disease support.
How is in-home nursing funded in Australia?
Funding pathways include Medicare (for some post-acute and chronic disease services), the Support at Home program (for eligible older Australians), the NDIS (for eligible people with disability), DVA (for veterans), and private health insurance or out-of-pocket arrangements. Under Support at Home, clinical nursing is 100% government-funded with no co-payment required.
Is in-home nursing free under Support at Home?
Yes, for clinical services. From 1 November 2025, clinical nursing services under Support at Home—including wound care, continence nursing, medication management, and palliative care—are fully government-funded with no participant contribution required, regardless of financial status. Means-tested contributions only apply to independence and everyday living services, not clinical nursing.
Has the new Aged Care Act changed in-home nursing rights?
Yes. The Aged Care Act 2024, which commenced on 1 November 2025, strengthens older people’s legal rights to quality care and choice, with seven strengthened quality standards and a legally enforceable Statement of Rights. However, workforce shortages and provider availability in some areas mean these rights are not always easy to exercise in practice.
What is the Support at Home program?
Support at Home replaced the Home Care Packages program from 1 November 2025. It uses eight funding classification levels (up to $78,106 per year), funds clinical nursing at zero out-of-pocket cost, and includes short-term Restorative Care and End-of-Life Pathways. A “no worse off” principle protects existing Home Care Package recipients.
Can private health insurance cover in-home nursing?
Some private health insurance policies cover in-home nursing as part of hospital-in-the-home or post-acute care. Coverage varies significantly between policies. New legislation from 2026 requires insurers to seek approval for coverage reductions, which should improve policy reliability over time.
How do I find a qualified in-home nurse in my area?
You can ask your GP or care coordinator for a referral, contact your aged care provider or Support at Home case manager, or use a platform like Home Visit Network that matches patients with qualified mobile healthcare professionals, including nurses, in their local area.
What if there are no in-home nursing services available near me?
Workforce shortages are a real problem in regional and rural Australia. If you cannot access local nursing services, speak with your GP about what Medicare-funded options exist, whether your Support at Home plan allows you to source a provider from a broader area, and whether any telehealth nursing or remote monitoring options can bridge the gap while you wait.
References
- Health Legislation Amendment (Improving Choice and Transparency for Private Health Consumers) Bill 2026. Fee transparency-by-default model using Medicare claims data. health.gov.au
- The modern regulator. 10 reforms reshaping Australian health regulation. themodernregulator.com
- Croakey. Rolling wrap of health sector reactions to the 2026–27 Federal Budget. croakey.org
- Australian Government Department of Health, Disability and Ageing. Aged Care Act 2024 — commenced 1 November 2025. Support at Home program including 8 classification levels (up to $78,106), clinical care zero participant contribution, short-term Restorative Care and End-of-Life Pathways, worker screening requirements, “no worse off” principle, personal care reclassification from 1 October 2026. health.gov.au; My Aged Care. myagedcare.gov.au
- Royal Australasian College of Physicians. Healthcare Reform. racp.edu.au
- Dyer SM, et al. Comprehensive analysis of Australia’s aged care system to inform policy development. BMC Health Services Research. 2025. PMC12021627. Workforce shortfall: 17,551 FTE nurse deficit in aged care by 2035 (DoH modelling); CEDA projection of 110,000 aged care worker shortfall by 2035, up to 400,000 by 2050. pmc.ncbi.nlm.nih.gov
