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For eight months, a common question we have heard from providers about the Higher Everyday Living Fee is: where exactly is the line between standard services and chargeable extras?
This month, the Aged Care Quality and Safety Commissioner answered it.
What the Commissioner said
In a radio interview on ABC Radio National on 13 July, Commissioner Liz Hefren-Webb set out the Commission's expectations in plain terms. HELF belongs to the genuinely premium end of everyday living. Her examples were the kind of services a resident actively chooses because they want more than the standard: an elevated dining experience, a drink with dinner, entertainment and lifestyle programs beyond what every home must already provide.
She was equally direct on the question providers have been asking all year. The boundary, in her view, is not ambiguous. The Residential Care Service List defines the standard every resident is entitled to, and anything on it cannot be repackaged as an extra. Meals are the sharpest example. Providing food that meets residents' nutritional needs and preferences is a baseline obligation under the Standards, so charging for it under a HELF agreement is off the table.
The interview followed the Commission's announcement earlier in July that it is investigating several providers over HELF practices inconsistent with the rules. The publicly cited examples share a common thread: taking something residents already had, or were already entitled to, and attaching a price to it. Televisions stripped from vacant rooms so incoming residents could be charged for installation. Basic services withdrawn, then offered back at a fee. Plans to bill residents for concerts that volunteers were performing for free.
Where breaches are found, the Commission has flagged strong regulatory action, including requiring providers to reinstate withdrawn services and refund fees charged incorrectly.
The wider context matters
The Commissioner's comments landed in a charged environment. National media attention, including a 60 Minutes segment, has focused on a Federal Court class action against one large private operator over additional service bundles charged in previous years. It is worth being precise about what that case is and is not. The conduct at issue occurred under the previous Aged Care Act, before HELF existed, and the Commissioner made that distinction on air. One of the specific protections HELF introduced is that no resident can be required to sign a HELF agreement in order to secure a place.
That distinction is important, but the sector should not take too much comfort from it. Consumer advocates continue to raise concerns about bundled charges and pricing transparency. Public trust in additional fees is low, and scrutiny will only increase. Every provider's HELF model is now effectively operating in public view.
This is the clarity the sector was waiting for.
When we polled the sector during our HELF as a Competitive Advantage webinar in March, the results told a clear story. Across 321 responses from 150 organisations, just over half had not yet implemented a HELF model. Only 8 per cent were confident their room prices fully recovered capital and operating costs, and half were unsure. When we asked how providers manage opt-outs operationally, 32 per cent told us the issue had not yet been addressed. And when we asked about the biggest concern with HELF packages, operational complexity dominated, cited by half of all respondents.
At the time, the most common reason we heard for holding back was uncertainty about where the boundaries sat. That reason no longer holds. The Commissioner has confirmed the Service List is the reference point, named the practices the Commission considers unacceptable, and signalled the regulatory consequences of getting it wrong.
There is another point worth making. The consumer research we shared in that webinar, drawing on choice modelling across thousands of Australians, found genuine willingness to pay for exactly the services the Commissioner has now described as legitimate HELF territory: premium and restaurant-style dining, alcohol or premium beverages with meals, outings and excursions, and wellness and entertainment programs. The demand for genuine extras is real. The Commissioner has not narrowed the opportunity. She has defined it.
Building a HELF model that stands up
The approach we set out in March holds up well against the Commissioner's comments, and it starts before you write a single package.
Start with the compliance test. Every service in a HELF agreement must sit genuinely above the Residential Care Service List, and residents must be able to use what they are paying for. HELF cannot be a condition of entry, cannot be presented as mandatory, and agreements should reflect what an individual resident has freely chosen. If a reasonable person would consider a service part of quality aged care, it does not belong in a HELF agreement.
Know your segment before you price. Our analysis of accommodation economics shows why a one-size HELF model fails. The surplus available on accommodation varies dramatically by room price segment, and HELF plays a different role in an economy home than it does in a premium one. HELF strategy and capital strategy need to be aligned, not developed in isolation.
Test packages with consumers, not committees. The choice modelling we presented showed that consumer preferences shift between shoppers and residents, and between wealth groups, in ways that are not intuitive from inside the organisation. Develop two or three clear tiers, test them with a limited group, and refine before rolling out.
Build the operational protocols early. Establish when and how HELF is discussed with residents and families, standardise opt-out and variation procedures, and plan communications for both adoptees and non-adoptees. Half the sector told us operational complexity was their biggest concern. The Commission's investigation activity has turned that concern into an obligation.
HELF is still the right lever, used well
None of this changes the underlying economics. With limited margin available on care, everyday living remains one of the few levers providers have to support viability, and HELF was designed to give residents genuine choice about services above the standard. The Commissioner is not arguing against HELF. She is arguing against using it badly.
The opportunity now is the same one we described in March, sharpened by regulatory clarity. Providers who build HELF models around genuine value, priced transparently and delivered consistently, will earn both the revenue and the trust. Providers who treat it as a repackaging exercise will find the regulator, the media and the market waiting.
But here is the uncomfortable truth our webinar poll surfaced: HELF is the second question, and most providers have not yet answered the first. Only 8 per cent of organisations could tell us their room prices fully recover capital and operating costs. Half did not know. If you cannot see whether your accommodation is profitable, you cannot know what role HELF needs to play, how to price it, or whether you are asking extras to quietly subsidise a pricing problem that belongs somewhere else. That is precisely the pattern the Commissioner is now investigating.
So start with accommodation. Understand your room pricing against your market, your cost recovery by room type, and where your surplus actually comes from. We produce accommodation pricing reports tailored to your organisation, benchmarking your room types and prices against your competitors, and we work with providers every day on the economics that sit underneath. Get that foundation right, and your HELF model becomes what it was designed to be: genuine extras, honestly priced, on top of accommodation that pays for itself. Talk to us.
