Specific Care Pty Ltd and Aged Care Quality and Safety Commissioner
[2025] ARTA 1411
•18 August 2025
Specific Care Pty Ltd and Aged Care Quality and Safety Commissioner [2025] ARTA 1411 (18 August 2025)
Administrative Review Tribunal
Applicant/s: Specific Care Pty Ltd
Respondent: Aged Care Quality and Safety Commissioner
Tribunal Number: 2024/5914
Tribunal:General Member Darian-Smith
Place: Sydney
Date:18 August 2025
Corrigendum
Date of Corrigendum: 18 August 2025
Pursuant to section 114 of the Administrative Review Tribunal Act 2024, the following alteration is made to the decision:
1.The title ‘Solicitors for the Applicant’ on page 38 is to be replaced with ‘Solicitors for the Respondent’
..........................SGD.........................................
General Member Darian-Smith
Applicant/s: Specific Care Pty Ltd
Respondent: Aged Care Quality and Safety Commissioner
Tribunal Number: 2024/5914
Tribunal:General Member Darian-Smith
Place:Sydney
Date:18 August 2025
Decision:The Tribunal affirms the decision under review.
.............................SGD...........................................
General Member Darian-Smith
Catchwords
AGED CARE – refusal of application for registration as an approved provider of aged care – whether the Applicant has experience in providing aged care – whether the Applicant has demonstrated understanding of the responsibilities of a provider of the type of aged care (home care) for which approval is sought – whether the Applicant has systems or proposed systems sufficient to meet its responsibilities as a provider of aged care – Applicant’s record of financial management – whether the Applicant has systems or proposed systems to ensure sound financial management – where the Applicant has experience providing care under the NDIS scheme – where the Applicant has engaged an industry expert to assist with compliance with responsibilities of providing aged care – requirements not satisfied – decision under review affirmed
Legislation
Aged Care Act 1997 (Cth) ss. 2-1 – 3-5, 7-1, 9-2A, 10A-1 – 10A-2A, 11-3, 54-1 – 54-11, 55-1 – 62-2, 63-1 – 63-2, 87-1 – 88-3
Aged Care Quality and Safety Commission Act 2018 (Cth) ss. 5, 8 – 8C, 63B, 63C, 63D, 63E, 63N, 63T, 63U, 74K – 74N
Cases
AussieCare Foundation Pty Ltd and Aged Care Quality and Safety Commissioner [2023] AATA 2202
Better Disability Care Pty Ltd and Aged Care Quality and Safety Commissioner [2024] AATA 3593
Secondary Materials
Accountability Principles 2014 (Cth) ss. 53B – 53H
User Rights Principles 2014 (Cth) ss. 17 - 23
Quality of Care Principles 2014 (Cth) ss. 13, 15F – 15FC, 15L – 15NI, 18Aged Care Quality Standards Standards 2, 7, 8
Statement of Reasons
The Applicant (Specific Care) seeks a review of the decision made by a delegate of the Respondent (Commissioner) dated 6 August 2024 to confirm the original decision of a delegate of the Commissioner dated 16 June 2024 not to approve Specific Care to be an approved provider under subsection 63B(1) of the Aged Care Quality and SafetyCommission Act 2018 (Cth) (Commission Act) (the Reviewable Decision).
Specific Care has applied under section 63B of the Commission Act for the Commissioner’s approval to be an approved provider of home care, a type of aged care, under the Aged Care Act 1997 (Cth) (Aged Care Act).
The Commissioner’s position is that Specific Care has not demonstrated that it is “suitable” to provide aged care within the meaning of subsection 63D(3) of the Commission Act.
A person cannot be approved as a provider of aged care unless the Commissioner is satisfied as to the matters set out in subsection 63D(2) of the Commission Act, which are:
(a) the person is a corporation; and
(b) the person is suitable to provide aged care; and
(c) each individual who is one of the key personnel of the person is suitable to be involved in the provision of aged care.
The term “key personnel” is defined in section 8B of the Commission Act, which provides:
“8B Meaning of key personnel of a person or body
(1) Each of the following is one of the key personnel of a person or body (the entity) at a particular time:
(a) if the entity is not a State or Territory—a member of the group of persons who is responsible for the executive decisions of the entity at that time;
(b) if the entity is not a State or Territory—any other person who has authority or responsibility for, or significant influence over, planning, directing or controlling the activities of the entity at that time;
…
(d) if, at that time, the entity proposes to conduct an aged care service:
(i) any person who is likely to be responsible for the nursing services to be provided by the service and who holds a recognised qualification in nursing; and
(ii) any person who is likely to be responsible for the day-to-day operations of the service; whether or not the person is employed by the entity.”
The suitability of the key personnel of the person, who are to be involved in the provision of aged care is integrally bound up in the question of whether to approve a person as a provider of aged care. Subsection 63D(2) of the Commission Act provides:
“Approval as provider of aged care
(2) The Commissioner must not approve the person as a provider of aged care unless the Commissioner is satisfied that:
(a) the person is a corporation; and
(b) the person is suitable to provide aged care; and
(c) each individual who is one of the key personnel of the person is suitable to be involved in the provision of aged care.”
In deciding whether a person is “suitable” to provide aged care, the decision-maker, whether it be the Commissioner or the Tribunal, must consider the following matters contained in subsection 63D(3) of the Commission Act:
“(a) the person’s experience in providing, at any time, aged care or other relevant forms of care;
(b) the person’s demonstrated understanding of the person’s responsibilities as a provider of the type of aged care for which approval is sought;
(c) the systems that the person has, or proposes to have, in place to meet the person’s responsibilities as a provider of the type of aged care for which approval is sought;
(d) the person’s record of financial management and the methods that the person uses, or proposes to use, in order to ensure sound financial management;
(e) if, at any time, the person has been a provider of aged care or other relevant forms of care—the person’s conduct as such a provider and the person’s compliance with:
(i) the person’s responsibilities as a provider of that care; and
(ii) the person’s obligations arising from the receipt of any payments from the Commonwealth for providing that care;
(ea) whether the person has at any time been convicted of an indictable offence;
(eb) whether a civil penalty order against the person has been made at any time;
(f) any other matters specified in the rules.”
The issue for determination by the Tribunal is whether Specific Care is suitable to provide aged care within the meaning of subsection 63D(3) of the Commission Act. In particular, the Tribunal is to consider whether Specific Care has demonstrated:
(a) an understanding of its responsibilities as a provider of home care (s. 63D(3)(b));
(b) that the systems it has, or proposes to have, in place are sufficient to meet its responsibilities as a provider of home care (s. 63D(3)(c)) and
(c) that its record of financial management and the methods it uses, or proposes to use, ensures sound financial management (s. 63D(3)(d)).
The requirements set out in s. 63D(3)(a) and in 63D(3)(e) – 63D(3)(f) are not in dispute in this proceeding.
BACKGROUND TO APPLICATION FOR REVIEW
On 27 February 2024, Specific Care submitted an application to the Commissioner seeking approval to be an approved provider under subsection 63B(1) of the Commission Act.[1] (Application for Approval)
[1] T4, Joint Hearing Bundle (JHB) pages 59 – 169.
On 16 June 2024, a delegate of the Commissioner made the original decision not to approve Specific Care as an approved provider of aged care.[2]
[2] T8, JHB pages 378 – 407.
On 25 June 2024, Specific Care requested, under section 74K of the Commission Act, that the Commissioner reconsider the original decision.[3]
[3] T9, JHB pages 408 – 647.
On 6 August 2024, the Reviewable Decision was made and on 22 August 2024, under section 74N of the Commission Act, Specific Care filed its application for review (Application for Review).[4]
[4] T1, JHB pages 1 – 11.
Specific Care has filed, and seeks to rely upon a Statement of Facts, Issues and Contentions dated 27 November 2024 (Applicant’s SFIC)[5] and a Response to the Respondent’s Claims dated 16 January 2025 (Applicant’s Response)[6]. The Commissioner has filed, and seeks to rely upon, a Statement of Facts, Issues and Contentions dated 20 December 2024 (Respondent’s SFIC).[7]
[5] JHB2, JHB pages 653 – 736.
[6] JHB4, JHB pages 755 – 764.
[7] JHB3, JHB pages 737 – 754.
On 8 July 2025, at the conclusion of the hearing, the Tribunal made directions as follows:
”1. The Applicant is to provide to the Tribunal and give to the Respondent the relevant information which would be provided when making an application for approval to be an approved provider of home care under the Aged Care Act 1997 (Cth) concerning the proposed 7th key personnel, Ms Alma Adato (Ms Adato), on or before 21 July 2025.
2. The Respondent is to provide to the Tribunal and give to the Applicant a schedule of matters which it identifies as “Day 1 Gap Matters”, on or before 25 July 2025. The Schedule should identify areas where a gap in the information provided by the Applicant exists, a brief description of what is needed to fill that gap and the relevant Joint Tender Bundle page(s) referencing the gap.”
On 11 July 2025, Specific Care filed the relevant information concerning Ms Alma Adato in compliance with Direction 1.
On 25 July 2025, the Commissioner filed a document entitled “Respondent’s Table of “Day 1 Gap Matters”” (Respondent’s Gap Schedule).
LEGISLATIVE FRAMEWORK
The requirement that persons who seek to receive government subsidies for providing aged care services must be an “approved provider” is set out in Chapter 3 of the Aged Care Act. Subsidies are paid under Chapter 3 and certain approvals are required before the Commonwealth can pay a subsidy to an approved provider of aged care.[8]
[8] Aged Care Act Divisions 3-1, 3-2.
Subsection 2-1(1) of the Aged Care Act sets out its objects, which are:
“(1) The objects of this Act are as follows:
(a) to provide for funding of *aged care that takes account of:
(i) the quality of the care; and
(ii) the *type of care and level of care provided; and
(iii) the need to ensure access to care that is affordable by, and appropriate to the needs of, people who require it; and
(iv) appropriate outcomes for recipients of the care; and
(v) accountability of the providers of the care for the funding and for the outcomes for recipients;
(b) to promote a high quality of care and accommodation for the recipients of *aged care services that meets the needs of individuals;
(c) to protect the health and well-being of the recipients of aged care services;
(d) to ensure that aged care services are targeted towards the people with the greatest needs for those services…”
Section 7(1) of the Aged Care Act states the requirement for approval as a provider of aged care services:
“Payments of *subsidy cannot be made to a person for providing *aged care unless:
(a) the person is an approved provider; and
(aa) the approval of the person is in effect; and
(b) the approval of the person is in respect of the type of aged care provided, at the time it is provided; and
(c) the approval of the person is in respect of the *aged care service through which the aged care is provided, at the time it is provided.
Note: For the approval of providers of aged care, see Part 7A of the [Commission Act].”
The responsibilities of approved providers are set out in Chapter 4 of the Aged Care Act and relate to the quality of the care they provide (Part 4.1), the user rights for recipients of the care provided ((Part 4.2) and accountability for the care which is provided and the suitability of the key personnel of the approved provider (Part 4.3).
As to the responsibilities of an approved provider for the quality of the care they provide, subsection 54-1(1) of the Aged Care Act, states them as being:
“(a) to provide such care and services as are specified in the Quality of Care Principles in respect of aged care of the type in question;
(b) to maintain an adequate number of appropriately skilled staff to ensure that the care needs of the recipients are met;
(ba) if section 54-1A applies to the provider—to comply with subsection 54-1A(2);
(c) to provide care and services of a quality that is consistent with any rights and responsibilities of care recipients that are specified in the User Rights Principles for the purposes of paragraphs 56-1(m), 56-2(k) or 56-3(l);
(d) to comply with the Aged Care Quality Standards made under section 54-2;
(e) to manage incidents and take reasonable steps to prevent incidents, including through:
(i) implementing and maintaining an incident management system that complies with the Quality of Care Principles; and
(ii) complying with any other requirements for managing or preventing incidents specified in the Quality of Care Principles;
(f) if the provider provides aged care of a kind specified in the Quality of Care Principles to care recipients—to ensure a *restrictive practice in relation to those recipients is only used in the circumstances set out in those Principles;
(g) to comply with the provisions of the *Code of Conduct that apply to the approved provider;
(ga) to take reasonable steps to ensure the *aged care workers, and the *governing persons, of the approved provider comply with the provisions of the Code of Conduct that apply to them;
(h) such other responsibilities as are specified in the Quality of Care Principles.”
Subsection 54-2(1) of the Aged Care Act provides the Quality of Care Principles 2014 (Cth) (Quality of Care Principles) can set out Aged Care Quality Standards in Schedule 2. Subsection 13(5) of the Quality of Care Principles provides that an approved provider must provide care and services in compliance with the Aged Care Quality standards in Schedule 2.
Part 4.3 of the Aged Care Act sets out the provisions dealing with the accountability responsibilities of approved aged care providers. Section 63-1 of the Aged Care Act relevantly provides:
“63-1 Responsibilities of approved providers
(1) The responsibilities of an approved provider in relation to accountability for the *aged care provided by the approved provider through an *aged care service are as follows:
(a) to comply with Part 6.3 in relation to keeping and retaining records relating to the service
…
(c) to comply with Division 9 in relation to notifying and providing information[9]…”
[9] For example, in relation to the obligation under section 9-2A of the Aged Care Act to notify the Commissioner of changes to key personnel or changes in suitability matters relating to an individual who is key personnel.
The Commission Act establishes the Commission and establishes a regulatory framework, including the office of the Commissioner, to support the objects of the Commission Act, set out in section 5, which are to:
“(a) protect and enhance the safety, health, well-being and quality of life of aged care consumers; and
(b) promote aged care consumers’ confidence and trust in the provision of aged care services and Commonwealth-funded aged care services;
(c) promote engagement with aged care consumers about the quality of care and services provided by:
(i) approved providers of aged care services; and
(ii) service providers of Commonwealth-funded aged care services.”
SPECIFIC CARE’S KEY PERSONNEL
Specific Care is a registered proprietary company limited by shares, which was registered on 18 November 2020.[10]
[10] JHB1, JHB page 175.
At the time of the Application for Approval, Specific Care had two directors, Anthony Hrdalo (Mr Hrdalo) and Corazon Jasa (Ms Jasa).[11]
[11] JHB1, JHB page 197.
The Application for Approval named 6 key personnel and their respective roles at Specific Care: Mr Hrdalo – Chief Executive Officer, Ms Jasa – Operations Manager, Frank Beretin (Mr Beretin)– Chief Financial Officer, America Linga (Ms Linga) – Nurse/Risk Manager, Ralph Cequena (Mr Cequena) – Systems Manager, Krisina Biniahan (Ms Biniahan) – Administration Manager.
Specific Care’s evidence at the hearing was that a seventh person, Ms Adato, was also a key personnel of Specific Care. The Applicant provided the relevant information concerning Ms Adato in response to the Tribunal’s direction made at the hearing (see paragraph [14] above). The Commissioner raised a concern with the Tribunal that this informing at the hearing was the first time Ms Adato’s involvement as key personnel of Specific Care had been notified to the Commissioner.
At the hearing, Specific Care called evidence from three of the key personnel, Mr Hrdalo, Ms Jasa and Ms Biniahan, each of whom were cross examined.
Mr Hrdalo has a Bachelor of Engineering degree, obtained from the University of Wollongong in 2002. The Application for Approval lists the following work experience for Mr Hrdalo said to be relevant to the provision of aged care:
(a) 2009: Caltex Refineries (NSW) Pty Ltd: Senior Project Manager.
(b) 2009 - 2011: Thiess John Holland JV: Senior Project Manager.
(c) 2011 - 2013: Commodore Cement Industries L.L.C.: Project Director. And
(d) 2013 - current: Specific Engineering Pty Ltd: Project Director/Senior Project Manager/Consultant.[12]
[12] JHB1, JHB page 85.
Mr Hrdalo has been the Chief Executive Officer of Specific Care since November 2020, and states that “his role will continue to manage the overall service (all different divisions) and provide the future strategic direction.”
The description of Mr Hrdalo’s role and how it is relevant to providing aged care is described as follows:
“As the CEO of an NDIS provider, Mr Hrdalo has experience running a small to medium organisation. Anthony oversees the operations of the business to ensure efficient and effective service delivery. He ensures the company meets all applicable laws, regulations and licensing requirements and stays informed and up to date about changes in the industry. Mr Hrdalo also works in partnership with Ms Jasa to develop and implement operational policies, procedures and guidelines.
Mr Hrdalo also oversees the finances of the business in collaboration with the Chief Financial Officer, to establish financial goals and objectives and manages the organisations budget and financial performance.
Mr Hrdalo sets the strategic direction of Specific Care as well as other businesses. His involvement in the NDIS service has given him the skills to be involved in delivering aged care.”
Ms Jasa has a Bachelor of Nutrition and Dietetics degree obtained from the University of the Baguio, Philippines in 1986 and a Graduate Certificate in Migration Law and Practice obtained from Australian National University in 2010. The Application for Approval lists the following work experience for Ms Jasa said to be relevant to the provision of aged care:
(a) 1988-1989: Texas Instruments Cafeteria: Supervisor of food service staff.
(b) 1990-2019: Department of Immigration and Home Affairs/ Immigration Review Tribunal: Visa and Citizenship Decision maker/ Assisting Tribunal members in case preparation. And
(c) 2010 – present: CJ Migration: Principal Migration Agent.[13]
[13] JHB1, JHB pages 88 – 89.
The Application for Approval states that Ms Jasa’s duties as General Manager of Specific Care is to manage: “risk, compliance, audits, registration, continuous improvement and complaints. Therefore, ensuring all systems comply with the requirements of the business model, this includes the manual, policies and procedures are maintained, ensuring compliance to standards and legislation, and coordinating and/ or assist with carrying out audits. She will also handle the complaints process.”
The description of Ms Jasa’s role and how it is relevant to providing aged care is described as follows:
“Ms Jasa’s role is to oversee the day-to-day operations of the head office. She collaborates with the management team to determine staffing requirements, equipment needs and resource allocation for service provision. Ms Jasa also works in partnership with the company CEO to ensure quality assurance is met and policies and procedures are in place and up to date. In conjunction with Ms Linga conducts audits on the services.
Ms Jasa’s experience managing Specific Care as a NDIS provider has equipped with the knowledge and skills to manage an Aged Care Provider. She demonstrates she can meet legislative requirements and quality standards as outline[d] by the NDIS Quality and Safeguard Commission and will use this knowledge to apply the same quality of care as a home care provider as set out by the Aged Care Quality and Standard Commission.”[14]
[14] JHB1, JHB page 87.
Mr Beretin has a Bachelor of Commerce (Accounting & Finance) obtained from the University of Western Sydney in 1993 and has been a Fellow of Certified Practicing Accountants since 2008. The Application for Approval lists the following work experience for Mr Beretin said to be relevant to the provision of aged care:
(a) 2003 – 2006: Cleanaway: Financial Controller.
(b) 2006 – 2008: T&S Warehousing and Logistics Group: Chief Financial Officer (CFO).
(c) 2010 – 2014: Commercial Metals: CFO. And
(d) 2014 – 2019: Plumbers Supply Cooperative: CFO. Mr Beretin has been the CFO for the Specific Care companies since Specific Care commenced in 2020.[15]
[15] JHB1, JHB page 91.
The Application for Approval states that Mr Beretin’s duties as CFO of Specific Care are to “oversee the financial management of Specific Care and its related entities to make sure the financial systems comply with the requirements of the business model including the Aged Care Act.”
The description of Mr Beretin’s role and how it is relevant to providing aged care is described under the headings, Financial Management, Financial Strategy and Planning, Financial Reporting and Budgeting and Forecasting. The description further states that the “role makes sure that the claiming of subsidies and operating within the requirements of the Improved Payment Arrangements are followed that apply to aged care.”[16]
[16] JHB 1, JHB page 91.
Ms Linga has a Bachelor of Science in Nursing obtained from Nueva Ecija College in the Philippines in 2006 and a Bachelor of Nursing Graduate Entry from Western Sydney University Hawkesbury in 2016. The Application for Approval lists the following work experience for Ms Linga said to be relevant to the provision of aged care: 2008 – present: BUPA Willoughby: Registered Nurse.[17] Ms Linga has worked at Specific Care in the role Nurse/Risk Manager since 2022, on a casual basis.
[17] JHB 1, JHB page 96.
The Application for Approval states that Ms Linga’s duties as Nurse/Risk Manager of Specific Care are to “provide monitoring and oversight of clinical care services, as well as provide training and support to clinical and support staff. She will undertake clinical audits and direct supervision of the Nursing staff.” Her duties also include overseeing risk management, providing advocacy to clients and develop and implement individual care plans.
The description of Ms Linga’s role and how it is relevant to providing aged care is described under the headings: Clinical Staff Management, Client Advocacy, Quality Assurance, Risk Management and Documentation and Record Keeping.[18]
[18] JHB1, JHB page 95.
Mr Cequena has a Bachelor of Arts degree obtained from Far Eastern University in the Philippines in 2003 and is currently studying for a Diploma of Leadership and Management at Pacific College of Technology. He joined Specific Care in 2023 in the role of Systems Manager to manage the staff and IT systems. The Application for Approval lists the following work experience for Mr Cequena said to be relevant to the provision of aged care:
(a) 2012 – 2015: Concentrix, Philippines: HR Manager. And
(b) 2015 – 2022: Citibank, Philippines: HR Manager.[19]
[19] JHB1, JHB pages 239 – 240.
The Application for Approval states that Mr Cequena’s duties as Systems Manager are to provide the “Human Resources Function as well as managing the IT Systems and coordinate and manage the training for staff.”
The description of Mr Cequena’s role and how it is relevant to providing aged care is described under the headings Human Resources Management (under subheadings Recruitment and Selection, Employee Relations, Performance Management and Training and Development) and Information Management.[20]
[20] JHB1, JHB page 238.
Ms Biniahan has a Certificate 4 in Administration (Legal Services) and a Certificate 3 in Business Administration (Medical) both obtained from South Western Sydney Institute in 2016 and a Diploma in Early Learning and Care obtained from Kirana College in 2018. The Application for Approval lists the following work experience for Ms Biniahan said to be relevant to the provision of aged care:
(a) 2018 – 2021: Gowrie Early Learning Centre: Child Care Assistant. And
(b) 2017 – current: CJ Migration: Administration Assistant.[21]
[21] JHB1, JHB pages 230 – 231.
The Application for Approval states that Ms Biniahan’s duties as Administration Manager are to “manage the day-to-day administration and to roster the staff on for shifts for clinical, care and other services.”
The description of Ms Biniahan’s role and how it is relevant to providing aged care is described as:
“Assist in the completion of client documentation. Assist in the gathering of required documentation for third party support organisations.
Assist in managing client records, ensuring accuracy, completeness and confidentiality.
Maintain effective communication with other departments and stakeholders involved in client care.
Build relationships with community organisations, healthcare providers, and other stakeholders to enhance collaboration and support for clients. Participate in community events and promote the organisation’s services.
Coordinate schedules for staff and ensure adequate staffing to meet client needs. Assist payroll and monitor staff attendance.
Maintain accurate and organised records of client information and ensure compliance with privacy laws and maintain confidentiality of client records.”[22]
[22] JHB1, JHB page 229.
Ms Adato has a Certificate III in Aged Care obtained in 2010 from Nurses Around the Clock, a Bachelor of Business (Accounting) obtained in 2017 from Kings Own Institute, and a Master of Professional Accounting obtained in 2020 from Wentworth Institute. The Application for Approval information provided states Ms Adato’s work experience from 2011 – 2025 as an Accounts and Technical Manager at Country Fresh Mushroom Pty Ltd, as being relevant to providing aged care.
Ms Adato joined Specific Care in August 2024. The description of Ms Adato’s role and how it is relevant to providing childcare is described as follows:
“The role of Accounts Receivable and Payable in Specific Care, an NDIS-registered organisation, is to manage the flow of money coming in and going out to support the smooth delivery of services. Accounts receivable involves preparing and sending invoices to the NDIS, plan managers, or private clients, and ensuring payments are received on time. This ensures the organisation has the necessary funds to continue delivering care and support services.
Accounts payable involves processing payments to support workers, contractors, and suppliers, as well as reimbursing staff for expenses. This ensures that services are delivered without interruption and that staff and providers are paid correctly and on time.
This financial management is highly relevant to providing aged care, as it helps to maintain consistent service delivery, supports compliance with NDIS and aged care funding guidelines, and ensures clients receive the care they need without delays due to payment issues.”
In 2023, to support the work which needed to be done by the key personnel in relation to the Application for Approval, Specific Care engaged Mark Sheldon-Stemm (Mr Sheldon-Stemm), a well regarded and qualified consultant who has been involved in the aged care industry for almost 30 years. Mr Sheldon-Stemm has developed a proprietary software/compliance tool in the nature of an operational manual supported by a series of policies and procedures, known as the MyCDC system, which has been used with considerable success by a number of aged home care providers.
SPECIFIC CARE’S SUBMISSIONS
The Applicant’s SFIC sets out a few general points in support of the Application for Review, including that Specific Care:
(a) has been operating as a NDIS provider for more that two years, during which time they have serviced clients who have similar care needs as prospective clients under their Home Care Packages program.[23] The majority of services provided under NDIS would also be provided under the Aged Care Home Packages which Specific Care would provide if successful in gaining the Commissioner’s approval to be a provider of aged home care services.[24]
(b) intends to “operate a small, personalised service for the local community of around 25 – 30 clients” along similar lines to its operations with its NDIS program.[25]
(c) has the necessary key personnel, business plan, policies and procedures which will enable it to meet the requirements of the Aged Care Act and the Commission Act.[26]
(d) has been informed in the process of seeking to become an approved provider of home care by procuring the consultancy services of Research Analytics, whose principal is Mr Sheldon-Stemm. The expert consultancy services purchased have included the provision of expert industry advice to Specific Care, access to template policies, procedures and systems, including the My CDC system, and representation before the Tribunal in the present proceedings.[27] And
(e) is in an analogous position to the applicant in AussieCare Foundation Pty Ltd and Aged Care Quality and Safety Commissioner[28] (AussieCare), in which AussieCare Foundation was held to have been able to overcome the Commissioner’s concerns under subsection 63D(3) of the Commission Act because of: “… the fact that the Applicant has been a satisfactory NDIS care provider and had the benefit of the assistance of Mr Sheldon-Stemm and his MyCDC system.”[29]
[23] Applicant’s SFIC, [1.3.1].
[24] Applicant’s SFIC, [1.4].
[25] Applicant’s SFIC, [1.3.4].
[26]Applicant’s SFIC, [1.3.3].
[27] Applicant’s SFIC, [1.3.5] – [1.3.6].
[28] [2023] AATA 2202.
[29] [2023] AATA 2202, [177]; Applicant’s SFIC [1.5] – [1.8], [2].
Specific Care submits in respect of the Reviewable Decision that it: “… raises points that either do not relate to the application or [are] trying to find fault in areas where we can demonstrate that we understand home care, and we would operate the service. As a NDIS provider we are already subject to most of these requirements and therefore are confident we can demonstrate we can operate a home care service in accordance with the legislation.”[30]
[30] Applicant’s SFIC, [2].
In the Applicant’s Response, Specific Care makes the following substantive points:
(a) It has the systems, processes and personnel in place to meet the legislative requirements for the provision of home care services under the Aged Care Act.[31]
(b) By reason of it having provided care to people with disability under the National Disability Insurance Scheme Act2013 (Cth) since 2020, it is already providing services which are identical or at least very much like the home care services it would provide under the Aged Care Act.[32]
(c) The Commissioner deems the Key Personnel of Specific Care to be suitable to provide home care under the Aged Care Act.[33]
(d) An industry expert has been engaged by Specific Care and has provided advice on systems, policies and procedures.[34]
[31] Applicant’s Response, [1.1] – [1.6].
[32] Applicant’s Response, [1.2] – [1.3].
[33] Applicant’s Response, [1.4].
[34] Applicant’s Response, [1.5] – [1.6].
Specific Care refutes the Commissioner’s contention that it is not suitably familiar with the Policy Manual prepared by Mr Sheldon-Stemm, pointing to the fact that most home care providers rely on external consultants for their policies, procedures and advice. It further states that: “Once approved we will customise these [policies and procedures] further with the finer details required to operate…”[35]
[35] Applicant’s Response, JHB4, JHB page 756.
COMMISSIONER’S SUBMISSIONS
The Commissioner’s case, set out in the Respondent’s SFIC and supplemented by some of the evidence given by the Specific Care witnesses in their answers to cross examination, focussed on a detailed analysis of whether Specific Care had met the requirements of subsections 63D(3)(b), (c) and (d) of the Commission Act.
The contentions set out in the Respondent’s SFIC address in turn the requirements of subsections 63D(3)(b), (c) and (d), which are:
(a) Has the Applicant demonstrated an understanding of its responsibilities as a provider of home care: s 63D(3)(b) of the Commission Act: Respondent’s SFIC, paragraphs [33] – [50].
(b) Has the Applicant demonstrated that that the systems it has, or proposes to have, in place are sufficient to meet its responsibilities as a provider of home care: s 63D(3)(c) of the Commission Act: Respondent’s SFIC, paragraphs [51] – [54]. And
(c) Has the Applicant demonstrated that its record of financial management, and the methods it uses, or proposes to use, ensures sound financial management: s 63D(3)(d) of the Commission Act: Respondent’s SFIC, paragraph [55].
The Commissioner’s conclusions as to each of the three requirements are then set out under topic headings in the Respondent’s SFIC and the Respondent’s Gap Schedule, drawing together those matters which the Commissioner says that Specific Care had failed to demonstrate it could deliver, and which it would have to deliver, on day one after it was granted approval to be a provider of aged home care services.
The Commissioner contends that the Application for Approval is defective by reason of Specific Care having failed to demonstrate, in the information provided by it, an understanding of its responsibilities under Part 4.1 of the Aged Care Act-Quality of Care for the purposes of subsection 63D(3)(b) of the Commission Act.
Examples of this failure which are referred to in the Respondent’s SFIC include:
(a) Specific Care’s “Policies and Procedures – CDC – Home Care” dated January 2024 (Policy Manual) was prepared externally by Mr Sheldon-Stemm. The contents of the Policy Manual are not well enough known or understood by the key personnel of Specific Care.[36]
(b) Information provided in the Application for Approval is not reflected in the Policy Manual and/or in Specific Care’s operational manual “My CDC Operational Manual Consumer Directed Care (CDC)- Home Care (Operational Manual).[37]
(c) The appropriate assessment of, and delivery of services to, people with dementia, sufficient information about specific processes and methods for assessing and delivering services to people with special needs under section 11-3 of the Aged Care Act, details around specific initiatives to ensure support workers have an adequate understanding and training are all areas which are not adequately covered in the Policy or Operational Manuals.[38]
(d) The significant reliance placed by Specific Care on the MyCDC system developed by Mr Sheldon-Stemm in circumstances where Specific Care’s key personnel had insufficient familiarity with, and competence in implementing, its operational processes. There was no evidence that Mr Sheldon-Stemm would have a significant ongoing involvement in Specific Care, and in any event not in the capacity of key personnel.[39]
(e) Whilst Specific Care placed reliance upon the Tribunal’s decision in Aussie Care[40] as an example of the successful implementation of the MyCDC system, the Commissioner in turn placed reliance on the Tribunal’s decision in Better Disability Care Pty Ltd and Aged Care Quality and Safety Commissioner[41] (Better Disability), as an example of an applicant who intended to use the MyCDC system not being approved.[42]
[36] Respondent’s SFIC, [36] – [37].
[37] Respondent’s SFIC, [38].
[38] Respondent’s SFIC, [39 (a), (c), (e)].
[39] Respondent’s SFIC, [40].
[40] [2023] AATA 2202.
[41] [2024] AATA 3593.
[42] Respondent’s SFIC, [41] – [42].
Similar contentions are made by the Commissioner in respect of Specific Care having failed to demonstrate an understanding of its responsibilities under Part 4.2 of the Aged Care Act-User Rights for the purposes of subsection 63D(3)(b) of the Commission Act and the User Rights Principles 2014 (User Rights Principles).
Examples of this failure which are referred to in the Respondent’s SFIC include:
(a) The Application for Approval failed to sufficiently refer to the relevant legislative provisions, the sections of its Policy or Operational Manuals, or to provide practical examples in relation to user rights. The Commissioner noted that references to sections 56-2, 56-4, 56-5, 61-1 and 61-2 of the Aged Care Act and sections 19AA, 19AD, 19AE, 19AF, 19B, 19C and 19D of the User Rights Principles were lacking.[43]
(b) The Application for Approval did not demonstrate a sufficient understanding of Specific Care’s responsibilities to provide information to care recipients, as they are set out in Division 3 of the User Rights Principles, including accounting for the principles in sections 20,21, 21A and 21B.[44]
(c) Again, the reliance placed by Specific Care on the MyCDC system, was not sufficient of itself to satisfy the user rights obligations in the absence of also being able to demonstrate a thorough understanding of, and capacity to deliver, that system.[45]
[43] Respondent’s SFIC, [44 (a)].
[44] Respondent’s SFIC, [44 (b)(i) – (iv)].
[45] Respondent’s SFIC, [45].
Further contentions are made by the Commissioner in respect of Specific Care having failed to demonstrate an understanding of its responsibilities under Part 4.3 of the Aged Care Act-Accountability for the purposes of subsection 63D(3)(b) of the Commission Act.
The Commissioner refers to four examples of Specific Care’s failure to demonstrate, in the Application for Approval and subsequent submissions (collectively the Responses), an understanding of the relevant accountability principles:
(a) The Responses do not demonstrate a sound understanding of the provision of an undertaking or agreement to certain matters in the event of non-compliance, as required by sections 63T and 63U of the Commission Act (in turn relevant to Specific Care demonstrating an understanding of subsections 63(1)(k) and (l) of the Aged Care Act).[46]
(b) The Responses do not demonstrate a sound understanding of the responsibilities for governing and advisory bodies under section 63-1D of the Aged Care Act, especially in the context of Specific Care’s ability to comply with its statutory obligations as it grows its client base.[47]
(c) The Responses do not demonstrate a sound understanding of its responsibilities in respect of giving information relating to reporting periods under section 63-1G of the Aged Care Act.[48]
(d) The Responses do not demonstrate a sound understanding of its responsibilities concerning the suitability of its key personnel under section 63-1A of the Aged Care Act.[49]
[46] Respondent’s SFIC, [46].
[47] Respondent’s SFIC, [47 (a)].
[48] Respondent’s SFIC, [48].
[49] Respondent’s SFIC, [49].
The Commissioner submits that the cumulative outcome of Specific Care’s inability to demonstrate a sound knowledge of its responsibilities in Parts 4.1, 4.2 and 4.3 of the Aged Care Act if it became an approved provider, means that it cannot satisfy subsection 63D(3)(b) of the Commission Act.[50]
[50] Respondent’s SFIC, [50].
The Respondent’s SFIC refers to several examples of Specific Care’s failure to demonstrate that the systems it has in place or is proposing to have in place on day one of its post-approval operations, will be sufficient to meet its responsibilities for the purposes of subsection 63D(3)(c) of the Commission Act. The main examples given were:
(a) The Response does not demonstrate that Specific Care has effective organisational governance systems in place which would satisfy Standard 8 of the Aged Care Quality Standards. The Commissioner referred again to Specific Care’s repeated reliance on the successful implementation of the MyCDC system and “Turnpoint Care” system (Turnpoint) by other providers as evidence that its own governance systems will be both adequate and compliant. The Application for Approval ask for an explanation as to how and why the external systems it had imported to Specific Care would make its policies and management system compliant. The Commissioner submits that the necessary explanation was not provided.[51]
(b) The practical description of the Serious Incident Response Scheme (SIRS) given in the Application for Approval was not sufficient because the necessary discussion and analysis of the information taken from the Policy Manual was lacking. The key element missing was practical examples of how Specific Care’s SIRS obligations would be implemented in the daily operation of the business.[52]
(c) The Application for Approval did not provide real insight into how Turnpoint would work in practice for Specific Care in meeting the delivery requirements in the Burwood region, where it would be operating. More generally, there was no cross-referencing of Turnpoint with the Operational or Policy Manuals to show how Turnpoint was being integrated with daily operations.[53]
[51] Respondent’s SFIC, [52 (a) and (b)].
[52] Respondent’s SFIC, [53 (a)].
[53] Respondent’s SFIC, [54].
The main submission made by the Commissioner in relation to the financial management requirements to be demonstrated by Specific Care under subsection 63D(3)(d) of the Commission Act, was that insufficient information had been provided in the Application for Approval to establish that the necessary policies and procedures needed to ensure sound financial management were in place. Specific Care’s responses to questions concerning financial management policies and procedures tended to be generic.[54] Relevant pages concerning financial management were said to be missing from the Policy Manual. Further, Specific Care’s” Financial Management Policy and Procedure” lacked the necessary detail about which Key Personnel were responsible for the various financial management actions.[55]
[54] Respondent’s SFIC, [55 (a)].
[55] Respondent’s SFIC, [55 (b)].
CROSS EXAMINATION OF SPECIFIC CARE WITNESSES
As a general observation, the oral evidence provided by the Specific Care witnesses who were called as witnesses did not serve to substantiate many of the statements, both as to the level of knowledge of the witnesses as to the legislative requirements and as to the appropriate operational implementation of home care services to be provided under the Aged Care Act, made in the Application for Approval or in the Applicant’s SFIC or Response.
Ms Rasa was the first witness called by Specific Care. The areas of concern to the Commissioner about which she was stated to be giving evidence, were in relation to the Policy Manual, Tailored Systems and Turnpoint.
The following points arose from Ms Jasa’s cross examination:
(a) Ms Jasa was unfamiliar with the onboarding process and was unable to answer adequately questions which probed the details of onboarding as it was described in the Application for Approval and in the Operational Manual.
(b) Ms Jasa’s evidence was that no Onboarding Questionnaire currently existed despite an Onboarding Questionnaire being referred to in the Application for Approval.[56]
(c) Ms Jasa acknowledged that she had not completed dementia-specific training and could not identify any written policy in place, or proposed, which support workers could refer to for guidance as to what to do if a client appeared to be suffering from cognitive decline.
(d) Ms Jasa’s evidence did not demonstrate a real understanding of the various categories of “people with special needs” for the purposes of section 11-3 of the Aged Care Act.
(e) Ms Jasa conceded that the assessment tools to be used when carrying out clinical assessments for clients had not yet been developed when the Policy Manual referred to Specific Care as having a set of assessment tools for use in carrying out clinical assessments.[57]
(f) Ms Jasa also conceded, in answering questions about carrying out clinical audits in the context of Quality Standard 8, that the audit tools referred to in the Policy Manual were yet to be developed.[58]
(g) Ms Jasa’s evidence was that as part of her General Manager role, she was responsible for training. She was questioned about the list of training in the Policy Manual but was unable to provide clarity as what training would be mandatory and who would receive what training.[59]
(h) Ms Jasa conceded that Specific Care did not currently have a policy or procedure addressing elder abuse. She was unclear in her evidence about the roles and responsibilities of the key personnel in managing serious accidents/incidents in implementing the procedure referred to in the Policy Manual under “Accidents/Incidents involving clients”.[60]
[56] JHB1, JHB page 122.
[57] JHB1, JHB page 561.
[58] JHB1, JHB page 562.
[59] JHB1, JHB page 603.
[60] JHB1, JHB page 547.
Mr Hrdalo was the second witness called by Specific Care. The areas of concern to the Commissioner about which he was stated to be giving evidence, were in relation to the Policy Manual, Support Staff Training, Care Management (Support Plan), New and Continuing Clients (Charter of Rights), Standard 8, Financial Policies and Procedures, Policy and Procedure on Dementia, Feedback, Legislative Requirements for Key Personnel, Serious Incident Report Scheme (SIRS), Special Needs Clients and Governing Bodies.
The following points arose from Mr Hrdalo’s cross examination:
(a) Mr Hrdalo’s evidence showed a lack of understanding of the categories of “people with special needs” for the purposes of section 11-3 of the Aged Care Act. His evidence was that all clients have “special needs.”
(b) Mr Hrdalo’s evidence proceeded on the assumption that the procedures previously implemented by Specific Care and in use with respect to its NDIS clients would be applicable to the services to be provided by it with respect to aged home care. His evidence showed a lack of awareness of the areas where simply copying existing practices from the NDIS context into aged care would not be sufficient. Examples of this were:
(i) the Operational Manual incorrectly identified care management under subsection 13.1(1)(a) of the Quality of Care Principles as being optional when it was mandatory. Mr Hrdalo explained this anomaly as having arisen because the development of care management plans is optional for NDIS clients. And
(ii) Mr Hrdalo could not comment on the obligation to review fees under section 19AF of the User Rights Principles. He was unable to explain how aged care clients would be assisted to understand their individual budgets and said the budgeting process (and including the budget formats used for NDIS clients) would need further consideration and adaptation for aged home care if Specific Care gained approval.
(c) Mr Hrdalo’s evidence disclosed a lack of awareness of the statutory definition of key personnel and the specific “suitability matters” set out in section 8C of the Commission Act, to be assessed for each of the individuals named as key personnel. He accepted that the Policy Manual did not set out a process for managing compliance with the “suitability matters.”
(d) Mr Hrdalo identified during his evidence an additional key personnel, Ms Adato, for the first time from the Commissioner’s perspective, and conceded that the necessary paperwork which should have accompanied her appointment had not been lodged with the Commissioner.[61]
(e) Mr Hrdalo did not appear to understand what the open disclosure policy meant or what the detail of the implementation of an open disclosure policy would involve.[62]
(f) Mr Hrdalo’s evidence concerning the Organisational Chart for the Specific Group of companies was unclear on aspects of the governance arrangements between the companies in the group, and whether for example Ms Rasa was a member of the Audit and Finance Committee.[63]
(g) Mr Hrdalo’s evidence about items in Specific Care’s 2023 Income Statement, for example why only $60 was shown for expenditure on staff training[64] and in relation to whether the Financial Statements had been independently audited, raised doubts for the Tribunal about the adequacy of the systems in place for financial management.
[61] JHB1, JHB page 506.
[62] JHB1, JHB page 565.
[63] JHB1, JHB page 179.
[64] JHB1, JHB page 297.
Ms Biniahan was the third and final witness called by Specific Care. The areas of concern to the Commissioner about which she was stated to be giving evidence, were in relation to the Policy Manual, Support Staff Training, Care Management (Support Plan), New and Continuing Clients (Charter of Rights), Policy and Procedure on Dementia, Feedback, SIRS, Special Needs Clients, Tailored Systems and Turnpoint.
The following points arose from Ms Biniahan’s cross examination:
(a) Ms Biniahan was not familiar with the detailed onboarding process set out in the Operational Manual[65], and in points of detail her understanding was different to that of Ms Jasa.
(b) Ms Biniahan had not completed dementia-specific training and could not clearly identify the skills required to enable a support worker under her supervision to be matched to a client with dementia.
(c) In common with Ms Jasa and Mr Hrdalo, Ms Biniahan’s evidence displayed an insufficient understanding about the categories of “people with special needs” as set out in section 11-3 of the Aged Care Act. When combined with the lack of checklists and other guidance materials, it was apparent that instructing support workers under her supervision as to the specific requirements of “people with special needs” would be difficult.
(d) Ms Biniahan’s evidence in respect of ongoing assessment and planning for the purpose of meeting Quality Standard 2 was that each aged care client’s progress notes would be checked daily but not all clients would receive services daily. This evidence raised doubts as to how Specific Care would practically fulfill its ongoing assessment obligations.
(e) Ms Biniahan also lacked familiarity with the detail of Advance Care Planning for clients, which is an important component of Quality Standard 2.
(f) Whilst Ms Biniahan indicated a willingness to undertake whatever specific aged care training was appropriate to support her role as Care Manager, she acknowledged in her evidence that she had not yet considered and identified what that training would be comprised of.
(g) In common with Ms Jasa’s evidence concerning whether there was an understood list of mandatory training for support workers and key personnel, there was a lack of consistency between them as to what training was to be compulsory, whether that training would be provided internally or externally, what the consequences of non-compliance with the mandated training program would be and how training would be managed during the probation period of support workers, and thereafter.
(h) Ms Biniahan’s evidence was to the effect that she did not see her present role (in the NDIS context) materially changing if Specific Care gained approval to provide aged home care services which served to indicate her lack of awareness of the regulatory and other differences in the service delivery requirements between the NDIS and aged care sectors.
[65] JHB1, JHB pages 440 – 450.
CONSIDERATION
This proceeding shares some common features with the Tribunal’s decision in Aussie Care, which Specific Care contends is supportive on its facts to its situation, and with the Tribunal’s decision in Better Disability, which the Commissioner contends is the more relevant decision for present purposes. The common features are that the applicant in each of Aussie Care and Better Disability was an existing provider of NDIS services and had engaged the consultancy services of Mr Sheldon-Stemm (and purchased the MyCDC system) to assist it with its application for approval as a provider of aged home care services.
The findings in Aussie Care which Specific Care says are relevant for present purposes are that key personnel were found to have “had NDIS experience and qualifications”, “the systems, processes and care provided under NDIS are similar and , in many cases, the same as that provided in aged care” and “the experience of the key personnel was supported by the policies, procedures and systems to be used called MyCDC.”[66] The key elements of the Aussie Care decision, and their application in this proceeding, are considered in the following paragraphs.
[66] Applicant’s SFIC, [1.7], JHB page 654.
Deputy President Sosso accepted that “prima facie, the Applicant has demonstrated experience in the provision of disability care services, and the services provided are of a type that would be similar to the aged home care services that would be provided.”[67] I accept, that as a prima facie proposition, the same can be said of Specific Care in this case.
[67] [2023] AATA 2202, [58].
The Tribunal in Aussie Care said in relation to defects in the information provided by the applicant in the application for approval, that “to engage in an exercise of finding minor errors and omissions, and then to conclude that an applicant has not met the requirements of s 63D(3), would be incorrect.”[68] As will be clear from the earlier references to the Respondent’s submissions and to the cross examination of Specific Care’s key personnel, the Tribunal is satisfied that the multiple errors and omissions in the Application for Approval are not confined to minor or harmless errors or omissions.
[68] [2023] AATA 2202, [80].
Identification by the decision maker of the errors and omissions in an applicant’s documentation needs to be placed in its correct context. That context was explained in Aussie Care in the following terms:
“It is the case that legislative and regulatory requirements for the provision of aged care are complex and complicated. The associated Principles which form part of the regulatory framework are comprehensive and detailed. Further, this is an evolving area of the law, with frequent, and sometimes opaque changes to the regulatory framework…
Clearly, the overarching regulatory framework in this area is designed to ensure that vulnerable consumers are given the care they require and are not subject to inappropriate and negligent care. The regulatory burden is set at a high level to ensure that those vulnerable consumers at most risk are not placed in the care of an applicant whose staff are not appropriately trained and who are not aware of their legal responsibilities as providers of aged care.”[69]
[69] [2023] AATA 2202, [94] – [95].
The Tribunal in Aussie Care observed that the Commissioner had been correct in pointing out the errors and omissions in the documentation, explaining:
“Whilst care must be taken not to “cherry pick” relatively harmless omissions and errors in the documentation and then default to a finding that the person therefore lacks demonstrated understanding of their responsibilities, nonetheless where multiple errors and omissions are identified, this could result in a negative finding to the question posed by s 63D(3)(b).
Further, and but for the presence of two key factors, the Tribunal accepted that “it would be open for the Tribunal to reach the same conclusion as the Commissioner.”[70]
[70] [2023] AATA 2202, [96].
The two factors identified by Deputy President Sosso were, first, that the applicant had been providing home care to persons with a disability under the NDIS regime for some years,[71] and, second, that the applicant had retained the services of Mr Sheldon-Stemm and had the benefit of using the MyCDC system.[72]
[71] [2023] AATA 2202, [97].
[72] [2023] AATA 2202, [103].
With respect to the applicant being an NDIS provider, the Tribunal said:
“The Tribunal agrees with Mr Dube [the Commissioner’s advocate] that the fact that a person is an NDIS provider is not, of itself, determinative of whether that person meets the various requirements mandated by s 63D(3). If that was the case, then the relevant aged care legislation or subordinate legislation would require a decision maker to automatically approve an NDIS provider to be an aged care provider. A decision maker must independently consider each of the requirements of s 63D(3). However, when undertaking that exercise, the fact that an applicant is an approved NDIS provider is a relevant consideration. Further, if such an applicant has a long history of compliance with the regulatory responsibilities mandated by the NDIS, then it may be a highly relevant consideration.”[73]
[73] [2023] AATA 2202, [100].
With respect to the applicant’s reliance on the expertise of Mr Sheldon-Stemm, the Tribunal said:
“Mr Dube is correct in highlighting that the requirements of s 63D(3)(a) cannot be delegated to an external person or organisation. The requirement of demonstrated understanding of the person’s responsibilities as a provider of aged care, is directed to an applicant and their key personnel. If a person lacked the requisite understanding required by s 63D(3)(b), but instead relied on an external consultant for such understanding, then that applicant would not meet the requirements of s 63D(3)(b).”[74]
[74] [2023] AATA 2202, [106].
Deputy President Sosso, in determining the subsection 63D(3)(b) question in the applicant’s favour, concluded that Aussie Care through its key personnel, did have the requisite understanding and that Mr Sheldon-Stemm’s involvement made that understanding both improved and more robust, but did not replace it.[75]
[75] [2023] AATA 2202, [107].
Turning to the subsection 63D(3)(c) question concerning whether the applicant had the systems or proposed systems to meet its responsibilities as a provider of aged care, the involvement of Mr Sheldon-Stemm and his MyCDC system is again highly relevant. The Tribunal explained:
“Importantly, Mr Dube concedes that the MyCDC is a system that can meet a person’s responsibilities pursuant to s 63D(3)(c). The issue in contention, therefore, is not a fundamental one as to the suitability or quality of the MyCDC system, it is more directed to the manner in which it has been adopted (or is proposed to be utilised) by the Applicant.”[76]
[76] [2023] AATA 2202, [121].
Holding that point about the manner in which the MyCDC system has been adopted (or is proposed to be utilised) by the applicant, consideration needs also to be given to the Better Disability decision, upon which the Commissioner relies.
In Better Disability, Member Maryniak also considered whether the capabilities of the applicant though its key personnel satisfied subsections 63D(3)(b), (c) and (d) of the Commission Act. Findings were made by the Tribunal that the key personnel of Better Disability, and therefore the applicant itself, had not demonstrated a sufficient understanding of the responsibilities necessary to be a provider of the type of aged care for which approval had been sought.[77]
[77] [2024] AATA 3593, [16].
As was the case in Aussie Care, significant reliance was placed by the applicant, both in making its application for approval and in presenting its case in the Tribunal, on Mr Sheldon-Stemm.
The significance of Mr Sheldon-Stemm’s involvement was explained by Member Maryniak in the following terms:
“It is apparent from an analysis of the testimony that substantial reliance was placed upon Mr Sheldon-Stemm, who testified that he was engaged as a contractor or consultant on behalf of the Applicant. He was contracted to assist with at least the finalisation of the Applicant’s initial Application, and most likely had input into the creation and provision of the key documents relied upon by the Applicant in support of its application…”[78]
“Whilst the use of a consultant of itself is not fatal, the extent of his involvement and contribution here, as established on the evidence, has highlighted important deficiencies in the knowledge and experience of the key personnel of the Applicant, and hence the Applicant. The initial application document itself was a mosaic of templates cut and pasted in, with input from Mr Sheldon-Stemm. It is also clear from the evidence that the provenance of the Business Plan and many of the foundation documents to the application was not that of either of the key personnel of the Applicant.”[79]
[78] [2024] AATA 3593, [17].
[79] [2024] AATA 3593, [18].
In short, the quality and degree of Mr Sheldon-Stemm’s involvement with Better Disability, served to bring into sharp focus the shortcomings of the applicant and its key personnel. A further difficulty for Better Disability arose from the evidence as to the future involvement of Mr Sheldon-Stemm, in respect of which the Tribunal said:
“… the Tribunal finds that Mr Sheldon-Stemm’s role has been limited to his retainer in assisting the Applicant with the application process up to and including the Tribunal hearing. There is no evidence as to planned future involvement which, in any event, would only be on a task oriented contracted basis and not, relevantly, as one of the key personnel of the Applicant.”[80]
[80] [2024] AATA 3593, [27].
The Tribunal in Better Disability accordingly rejected the applicant’s submission that its application was similar on its facts to that in Aussie Care.[81]
[81] [2024] AATA 3593, [28].
I am of the view that neither the Aussie Care decision nor the Better Disability decision is precisely aligned to this case. The position of Specific Care’s key personnel, and therefore of Specific Care itself, is not as strong as the applicant’s position was in Aussie Care, nor is it as weak as the applicant’s position was in Better Disability.
The Tribunal makes the following further observations, based on the evidence and authorities which are before it:
(a) It is common ground in this dispute that an approved provider of aged care services must both demonstrate a sound understanding of its responsibilities under the Aged Care Act and the Commission Act for the delivery of those services and be able, as a practical matter, to deliver those services from day one after the approval has been granted. The practical requirement that an approved provider of aged care services be ready from day one after approval is at odds with Mr Hrdalo’s evidence that Specific Care would need 3 months “to get up to speed” and that services could be provided by 1 November 2025.
(b) Specific Care’s key personnel appear, prima facie, to have relevant skills and experience, including in the provision of NDIS services, to be able to demonstrate their suitability to deliver aged home care services.
(c) However, the multiple material errors and omissions in the Application for Review which have been identified in the evidence (which the Tribunal accepts have for the most part been made out by the Commissioner), in combination with the points which emerged from the cross examination of Ms Rasa, Mr Hrdalo and Biniahan (summarised in paragraphs [69], [71] and [73] above), shows the Tribunal that there remains some serious work to be done before Specific Care can meet the requirements of section 63D(3) of the Commission Act.
(d) The retainer of Mr Sheldon-Stemm and the purchase of the MyCDC system are clearly positive steps taken by Specific Care to support the Application for Approval, but as Aussie Care and Better Disability make clear, the Tribunal is to direct its enquiries beyond the suitability or quality of the MyCDC system to look at the manner in which it has been adopted by Specific Care through its key personnel. That is particularly so, where the ongoing involvement of Mr Sheldon-Stemm appears likely on the evidence to be on a limited task oriented contracted basis.
(e) The successful adoption of the MyCDC system and the acquiring of the necessary understanding of the legislative requirements for the provision of aged home care services by the key personnel of Specific Care remains a work-in -progress.
(f) The Tribunal is not satisfied that the three key personnel of Specific Care who gave evidence currently possess, either individually or collectively, a sufficient understanding of Specific Care’s responsibilities as a provider of aged home care. This finding includes a finding that the key personnel have not demonstrated a sufficient understanding of the differences between the provision of services in the NDIS sector and the aged care sector.
(g) In addition to being satisfied that Specific Care cannot presently satisfy subsection 63D(3)(b) of the Commission Act, the Tribunal accepts that Specific Care has failed to demonstrate that the systems it has in place, or proposes to have in place on day one, will be sufficient to meet its responsibilities under subsection 63D(3)(c). The Tribunal refers to the examples set out in paragraph [65] above and to the Respondent’s Gap Schedule. And
(h) The Tribunal is also not satisfied, in the absence of sufficient information, including the lack of evidence from either Mr Beretin and/or Specific Care’s external accountants/auditors, that the requirements of subsection 63D(3)(d) as to Specific Care being able to demonstrate sound financial management have been met.
CONCLUSION AND DECISION
In summary, the Tribunal is not satisfied that Specific Care is suitable, at the time of this decision, to provide aged home care within the meaning of subsections 63D(3)(b), (c) and (d) of the Commission Act.
The Commissioner has provided Specific Care with the Respondent’s Gap Schedule, which maps out with some granularity the gaps in Specific Care’s Day 1 operational capability, were it be approved as a provider of aged home care services. The Respondent’s Gap Schedule sets out the short-term action points to be addressed by the key personnel of Specific Care to fill the identified gaps.
The Tribunal does not want this decision to stand in the way of Specific Care, through its key personnel, making a fresh application to the Commissioner at some future time. It follows from these Reasons that a future application, if made, would occur after the matters raised by the Respondent’s Gap Schedule have been addressed and the necessary additional work done to improve Specific Care’s understanding to the point of it being able to demonstrate to the Commissioner that the legislative requirements for becoming an aged care service provider can be met.
The Tribunal affirms the Reviewable Decision.
Date of Hearing: 7, 8 July 2025
Date of Decision: 18 August 2025
Representative for the Applicant: Mr M Sheldon-Stemm
Counsel for the Respondent: Ms T Waterhouse
Solicitors for the Applicant: Ms C Campbell (HWL Ebsworth Lawyers)
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