A Commonwealth Ombudsman investigation has revealed that the government's aged care tool has led to unfair outcomes and undermined public confidence and safety.
The Department of Health, Disability and Ageing uses a Single Assessment System (SAS) which includes the Integrated Assessment Tool (IAT) introduced on 1 November 2025. The legislatively prescribed tool is used for home care assessments and is automated to determine the level of aged care services an older individual requires.
However, the Ombudsman found that the IAT lacks safeguards and capacity to override incorrect assessments.
"Currently, under the law, automated decisions made by the IAT's algorithm cannot be overridden and changed, even if they are clinically inappropriate," Commonwealth Ombudsman Iain Anderson said on Monday.
"The IAT and its associated decision-making framework do not merely have the potential to undermine public confidence — rather, a reasonable person would, in my view, lack confidence that the system is in fact fair and consistent."
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Around 1.1 million older Australians access aged care services through the home support system.
The SAS has attracted several complaints, particularly about contracted assessment providers using the IAT and its algorithm, the ombudsman said.
Complaints about the SAS detailed poor communication, long wait times, slow review processes, insufficient assessors, and assessors lacking appropriate training and qualifications.
Complaints about the IAT detailed the underassessment of care needs, inability to change automated decisions and limited clinical expertise and algorithmic transparency.
The Ombudsman found no publicly available information on how the IAT determines an outcome — which is "inconsistent with the intentions of the Robodebt Royal Commission recommendations about transparency of government automated decision-making".
Anderson said he believed the department "did not and may still not, understand key components of the legal framework it created".
He said it also did not "understand what legal framework it was meant to create".
The investigation also revealed that the department has been stating assessments automated by IAT could be changed — which is untrue.
"Up until the introduction of the legislation in October 2025, the Department had been incorrectly advising assessment providers and the public that automated IAT outcomes could be changed," he said.
The Ombudsman also found that the SAS assessment provider performance has been "falling short" of KPIs.
It also found the department has taken a "limited role" in checking training requirements and compliance of assessors using the IAT, and that there are no safeguards protecting the "integrity of the online training".
The Ombudsman investigation made 10 recommendations to the department, including amending the legislation to allow overrides of automated IAT decisions and conducting a comprehensive review of both the legislation related to the needs assessment process and the business rules underpinning the algorithm.
It also recommended that any changes be "preceded by meaningful consultation with the public" and that the Australian National Audit Office consider a performance audit of the department's use of public resources.
The Department of Health, Disability and Ageing has accepted relevant recommendations. SBS News has contacted it for comment.
In September, The Guardian reported that department staff had warned the Aged Care Minister Sam Rae and Health Minister Mark Butler about removing the IAT's human override function — three days before it was rolled out.
At the time, Motor Neurone Disease Australia CEO Clare Sullivan said the organisations had been "raising serious concerns".
"For months, MND Australia has been raising serious concerns about a system where an algorithm can determine the level of care someone receives without an assessor being able to intervene when the outcome is clearly inappropriate," she said.
"People living with MND do not have the luxury of waiting indefinitely for answers."
She said there needed to be a "clear pathway for experienced assessors to apply clinical judgement when the system gets it wrong".
At the time, the National Aboriginal and Torres Strait Islander Ageing and Aged Care Council said it had "consistently raised" that the issues with the IAT were "simply not implementation issues" and rather reflect a "failure in national system design".
"Recognising the failures in the IAT is one thing. The real test is what the government does about it," CEO and Warramunga woman Kim Whiteley said.
"The answer cannot simply be another tool built on the same system assumptions. What comes next must deliver assessments that uphold dignity and respect, are culturally safe and appropriate and genuinely understand the person and their circumstances."
