The escalation ladder: what to do when a complaint goes nowhere
Most aged care problems — missing statements, surprise charges, cancelled shifts, unreturned calls — are solved at the first rung. But families often stall there for months because nobody told them the ladder has more rungs, or that climbing them is free, safe, and sometimes faster than waiting. Here is the order that works.
Rung 1: the provider, in writing
Put the concern in an email — not a phone call — with what happened, what you want done, and a reasonable, firm deadline (14 days is fair). One paragraph is enough; you are documenting, not negotiating. Most providers resolve most written complaints, and if this one doesn’t, the email becomes the record every later rung will ask for. The statements guide shows this method applied to the most common complaint of all.
Rung 2: an advocate in your corner — OPAN, 1800 700 600
The Older Persons Advocacy Network provides free, independent advocates who take up stuck cases with providers and with My Aged Care on your behalf. Advocacy is not a formal complaint — it is someone who knows the system pressing your case inside it. For many families this rung resolves things without going further, and an advocate can also help you prepare the next rung properly. And if English is not your family’s first language, the Translating and Interpreting Service (131 450) provides free interpreters for this and every other call on this page — the system is required to speak your language, not the other way around.
Rung 3: the Complaints Commissioner — 1800 951 822
The Aged Care Quality and Safety Commission takes complaints about any government-subsidised aged care service — care quality, invoicing accuracy, statement failures, pricing. Three things families often don’t know: it is free; you can complain openly, confidentially or anonymously; and you do not have to have raised it with the provider first (though having Rung 1 in writing makes the case stronger). In May 2026 the government announced new consumer protections under which the Commission is to be empowered to order providers to refund overcharging and to act against providers failing to issue monthly statements — so this rung is getting sharper teeth.
The Commission publishes its own timeframes, in the Complaints Commissioner’s guidelines. They are worth having beside you, because they tell you when to chase:
| Step | Timeframe in the guidelines |
|---|---|
| Written acknowledgement of your complaint | Within 3 business days |
| Written outcome (the “complaint determination”) | Within 90 days, in most cases |
| If more time is needed | Up to 120 days, and you are to be told the reasons |
| Beyond 120 days | Further 30-day extensions, in exceptional circumstances or if you agree |
Two choices at this rung change what the Commission can do for you. Confidential is usually better than anonymous. Confidential means the Commission knows who you are but keeps your identity from the provider. Anonymous means nobody can contact you, so you get no acknowledgement and no updates, and the guidelines say the Commission’s actions are limited to those that do not need to know who you are. And do not sit on a complaint: the Commission can close one where the events happened more than a year before you complained and are no longer happening.
Before Rung 4: ask the Commission to reconsider
If the Commission decides to take no further action, or ends its resolution process, and you disagree, you can ask for that decision to be reconsidered. The request must reach the Commission within 42 days of receiving the complaint determination, can be made by phone or in writing, and must include your reasons. The guidelines say the request is acknowledged within 14 days, the decision is looked at again by someone who was not involved in the original, and you are given a written decision with reasons within 60 days. Use this step before going to the Ombudsman; an advocate at Rung 2 can help you write it.
Rung 4: the Commonwealth Ombudsman — 1300 362 072
If you are unhappy with how the Commission itself handled your complaint — not the provider, the process — the Commonwealth Ombudsman reviews the actions of government agencies, including the Commission. The same applies to My Aged Care and the Department: once you have followed their complaint process and are still not satisfied, the Ombudsman is the next step. This rung is rarely needed, but knowing it exists changes how the earlier rungs treat you.
When the problem is My Aged Care or the assessment, not the provider
The ladder above is for complaints about a provider. A lost referral, an assessment that never gets booked, or a classification you think is wrong are different problems, and the Complaints Commissioner is not where they go. My Aged Care’s own complaints page sets out three separate doors. Picking the right one saves weeks.
| Your problem | Start here | If that does not fix it |
|---|---|---|
| The service you got from My Aged Care (wrong information, a record that cannot be found, calls going nowhere) | My Aged Care, 1800 200 422 | Email myagedcaresupport@health.gov.au with your complaint reference number |
| How or when the assessment was done (a long wait, how it was carried out) | The assessment organisation’s own complaint process | My Aged Care, 1800 200 422 |
| You disagree with the outcome in your Notice of Decision | Internal review by the Department, within 28 days | Administrative Review Tribunal |
A complaint about My Aged Care’s service. Phone is the quicker option. If the issue is not resolved on the call, you are given a complaint reference number: write it down and quote it every time. You can also post the complaint to My Aged Care Complaints, PO Box 1237, Runaway Bay QLD 4216, and should get a call within 10 to 14 business days of it being received. If you are not satisfied with the response, email the details and the reference number to myagedcaresupport@health.gov.au.
Concerns about the assessment itself. Assessments are carried out by assessment organisations, and each has its own complaint process. Their contact details are in the Notice of Decision letter. If you have no letter yet because the assessment has not happened, ask My Aged Care which organisation your referral was sent to. If the assessment organisation does not resolve it, the next step is My Aged Care on 1800 200 422.
Disagreeing with the outcome. This is not a complaint, it is a review, and it has a deadline. You can ask the Department of Health, Disability and Ageing for an internal review within 28 days of receiving the Notice of Decision. It is free, and you can send new information with it. Use the Request for an Internal Review of a Decision form, or write to the System Governor: Review of Decisions Section, Regulatory Systems, Safeguards and Reviews Branch, Department of Health, Disability and Ageing, GPO Box 9848, Adelaide SA 5001. If you disagree with the internal review, you can ask the Administrative Review Tribunal for an external review. There is a charge for that, and the Tribunal cannot look at it until the internal review is done.
One distinction matters here. An internal review is for a decision you think was wrong when it was made. If the decision was fair at the time but needs have changed since, the route is a Support Plan Review, requested through My Aged Care or an Aged Care Specialist Officer, or by the provider with your consent (Support at Home Program Manual, section 7.6).
If you have followed the right door and are still not satisfied with the outcome or with how it was handled, the Commonwealth Ombudsman (Rung 4) is the last step for these too. And if the wait itself is putting someone at risk, say so plainly on the call: the CHSP Manual (section 5.3) allows My Aged Care or the assessment organisation to refer a person for urgent services before the assessment is finished, where there is a significant risk of harm. It is their decision, case by case.
Two more doors outside the ladder
- Wrong contribution rate, or a means problem (the rate letter looks wrong, grandfathered protections not being applied, a change in circumstances not processed): the provider cannot fix this — rates are set by Services Australia: aged care line, 1800 227 475. Ask in writing where you can (myGov messages create a record), and if you disagree with a decision, use the words “I would like a formal review of this decision” — review rights are built in.
- Concerns about elder abuse: call the free national helpline 1800 ELDERHelp (1800 353 374) — it operates independently of the complaint process above.
One principle across every rung: keep receiving care while you complain. A dispute about paperwork or pricing is the provider’s problem to fix — it should never shrink anyone’s support while it is being fixed.
Complaint about costs? Know what the numbers should be first — the estimator computes them from the official schedules.
Estimate the costsRelated: your provider owes you a statement every month · how to compare provider prices