Care that meets older Australians exactly where they are.
AGS ACE Care coordinates rapid geriatric assessment, hospital ACE-unit liaison and in-home recovery support — so older patients avoid unnecessary admissions and regain independence sooner.
Regional Geriatric Consultation Liaison teams, referring GPs and hospital ACE units, so care stays coordinated from referral to recovery.
One coordinated journey, four stages
Referral & assessment
A GP, family member, hospital team or My Aged Care assessor refers the patient for a rapid geriatric evaluation covering mobility, cognition, medication and home safety.
Rapid admission pathway
If hospital care is needed, our liaison team fast-tracks entry into an ACE-model unit and briefs the ward on the patient's baseline function.
Coordinated ACE care
A dedicated plan protects mobility, cognition and independence throughout the stay, with daily review against the patient's goals.
Home recovery & follow-up
Community nurses and carers support recovery at home, with scheduled check-ins for the first 12 weeks post-discharge.
Specialised support at every stage of care
Rapid Geriatric Assessment
Fast-tracked evaluation that identifies the safest, least disruptive care pathway for each patient.
ACE Unit Coordination
Specialised care plans, based on the Acute Care of the Elderly model, that prevent functional decline in hospital.
In-Home Recovery Support
Nurses and carers help patients rebuild strength and independence after discharge, on their own terms.
Dignity first, always
Evidence-based
Our approach follows the Acute Care of the Elderly (ACE) model used across Australian hospital systems.
Family included
Carers and family are part of every care conversation, not informed after the fact.
One point of contact
A single coordinator follows each patient from referral through to home recovery.
Ways care can be funded
Home Care Packages
Government-subsidised packages (Levels 1–4) arranged through My Aged Care, based on assessed need.
DVA & veteran support
Coordination with Department of Veterans' Affairs entitlements for eligible veterans and war widows/widowers.
Private & self-funded
Direct, fee-for-service care for families who prefer to arrange support outside government programs.
Coordinated geriatric care, from assessment to recovery
Rapid Geriatric Assessment
Same-week evaluation of mobility, cognition and medical needs to determine the safest care pathway.
ACE Unit Care Coordination
Specialised inpatient-style care plans built to prevent functional and cognitive decline during a hospital stay.
Geriatric Consultation Liaison
Integrated support connecting GPs, hospitals and regional specialist teams so nothing falls through the cracks.
In-Home Recovery Support
Community nurses and carers help patients regain independence at home after a hospital stay.
Falls & Mobility Prevention
Home safety assessments and mobility programs designed to reduce fall risk and hospital readmission.
Family & Carer Support Line
A direct line for families to ask questions, share concerns and stay informed throughout care.
Discharge Planning Support
We work with hospital teams to plan a safe, well-resourced discharge before the patient leaves the ward.
Dementia & Cognitive Care Liaison
Specialist coordination for patients living with cognitive decline, delirium risk or dementia.
Every pathway includes
A dedicated care coordinator
One named coordinator stays with the patient and family from referral through to home recovery, so you're never re-explaining the situation to someone new.
A written, shared care plan
Goals, medications, mobility needs and follow-up dates are documented and shared with the patient, family and treating clinicians.
Regular family updates
Scheduled check-ins keep family and carers informed, with an open line for questions between updates.
Clear next steps at every stage
Before any transition — hospital to home, or assessment to care — you'll know exactly what happens next and who's responsible for it.
Understanding how care can be funded
Every family's situation is different. Here's a general guide to the main funding pathways in Australia — our coordination team can help you work out which applies.
My Aged Care & Home Care Packages
An ACAT/ACAS assessment through My Aged Care determines eligibility for a Home Care Package (Levels 1–4), which fund a mix of nursing, personal care, allied health and coordination support based on assessed need.
Commonwealth Home Support Programme
Entry-level support for older people who need a small amount of help to keep living independently at home, such as domestic assistance or transport.
DVA & veteran support
Eligible veterans, war widows and widowers may access care coordination through Department of Veterans' Affairs entitlements, including Veterans' Home Care.
Private & self-funded care
Families who prefer not to wait for a government assessment, or who need care sooner, can arrange fee-for-service support directly with us.
How to refer a patient or family member
Get in touch
Call us, or send a referral through the contact form with a short summary of the situation.
Initial conversation
A coordinator calls back within one business day to understand needs and urgency.
Funding check
We help confirm which funding pathway applies, and assist with My Aged Care steps if needed.
Care begins
A named coordinator is assigned and the care pathway starts.
Guides for families and carers
Practical information to help you understand the care pathway. Ask our team if you'd like the full guide on any topic.
Understanding Home Care Package levels
What Levels 1 through 4 actually cover, how assessment works, and how long it typically takes to receive a package.
Ask us about this →Preventing falls at home
A practical home-safety checklist covering lighting, rugs, bathroom grab rails and footwear.
Ask us about this →Preparing for a hospital discharge
Questions to ask the ward team, and what to have ready at home before your family member returns.
Ask us about this →Built around the ACE model of elder care
AGS ACE Care (ABN 29 173 090 551) supports older Australians through the Acute Care of the Elderly (ACE) approach — the same framework used by hospital geriatric units to protect independence, reduce avoidable admissions and shorten recovery time.
We work alongside regional Geriatric Consultation Liaison teams, referring GPs and hospital ACE units, and we extend that same coordinated care into the home once a patient is discharged.
Who we work with
Geriatricians, care coordinators, community nurses and allied health professionals.
Our approach
Evidence-based, family-inclusive care that treats independence as the goal, not an afterthought.
Service area
South Australia, with pathways coordinated through regional hospital and community networks.
Why we built AGS ACE Care
Too many older patients spend longer in hospital than they need to — not because of their medical condition, but because assessment, admission and discharge aren't coordinated. AGS ACE Care exists to close that gap: one team following the patient from referral, through an ACE-model hospital stay if one is needed, and into a supported recovery at home.
How we hold ourselves accountable
We align our care planning with the Aged Care Quality Standards, and every care pathway includes a documented plan, a named coordinator and a clear process for raising concerns. If you're ever unhappy with our service, you can escalate to the Aged Care Quality and Safety Commission at any time.
Who coordinates your care
Clinical Lead
Oversees the ACE care model and reviews complex cases alongside treating geriatricians.
Care Coordinator
Your single point of contact — manages the day-to-day plan from referral to home recovery.
Family Liaison
Keeps family and carers updated, and is the first call for any questions along the way.
Common questions
What is the ACE model of care?
Acute Care of the Elderly (ACE) is a hospital unit framework focused on preventing functional decline in older patients through coordinated, patient-centred care and rapid admission pathways.
How is care funded?
Through a My Aged Care Home Care Package, the Commonwealth Home Support Programme, DVA entitlements, or privately. See our funding page for details, or ask us to help work out what applies to you.
How long does an assessment take?
We aim to complete an initial geriatric assessment within one week of referral, sooner if the situation is urgent.
What areas do you service?
We currently coordinate care across South Australia, working through regional hospital and community networks.
What does it cost?
Cost depends on your funding pathway — government-subsidised packages cover most or all costs for eligible patients, while private care is fee-for-service. We'll always be upfront about costs before care begins.
What if I have a complaint?
Contact your care coordinator directly, or reach out via our contact form. If it's not resolved to your satisfaction, you can escalate to the Aged Care Quality and Safety Commission.
Do I need a GP referral?
A referral helps us coordinate faster, but families can also contact us directly to start an assessment.
Do you provide care at home or only in hospital?
Both. We coordinate hospital-based ACE care when needed and continue support at home through recovery.
Will I receive text messages from you?
Only if you choose to opt in. You can agree to receive SMS updates when registering or contacting us, and you can opt out at any time — see our Privacy Policy.
How do I refer a patient or family member?
Use the contact form or call us directly — our coordination team will follow up within one business day.
Let's talk about care
Phone
1300 000 000
care@agsace.org
Service area
South Australia
Hours
Mon–Fri, 8am–6pm ACST. Family line available 24/7.
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Privacy Policy
Last updated: 16 August 2026 · AGS ACE Care, ABN 29 173 090 551
1. Overview
AGS ACE Care ("we", "us", "our") respects your privacy and handles personal information in accordance with the Privacy Act 1988 (Cth) and the Australian Privacy Principles (APPs). This policy explains what we collect, why, and the choices you have — including around SMS communications.
2. Information we collect
- Contact details: name, email address and phone number, provided through our registration and contact forms.
- Account details: information you provide when creating an account.
- Correspondence: messages you send us and records of our communications with you.
3. How we use your information
We use your information to respond to enquiries, coordinate care-related communication, manage your account, and — only where you have opted in — to send SMS updates and promotional messages.
4. SMS & Marketing Communications
We only send marketing or promotional SMS messages to people who have actively opted in via a checkbox on our Registration or Contact forms. We do not add phone numbers to our messaging list without consent.
- By checking the SMS consent box, you agree to receive recurring automated marketing and informational text messages from AGS ACE Care at the mobile number provided.
- Message frequency varies. Message and data rates may apply, depending on your mobile carrier and plan.
- Consent to receive marketing SMS is never a condition of using our services or creating an account.
- You may opt out at any time by replying STOP to any message, or by contacting us at care@agsace.org. Reply HELP for assistance.
- We do not sell or share your mobile number with third parties for their own marketing purposes.
- Carriers are not liable for delayed or undelivered messages.
This program is operated in accordance with the Spam Act 2003 (Cth), which requires consent, clear sender identification and a working unsubscribe mechanism for commercial electronic messages.
5. Data storage & security
We take reasonable technical and organisational steps to protect personal information from misuse, loss and unauthorised access.
6. Your rights
You may request access to, or correction of, the personal information we hold about you, and you may withdraw SMS consent at any time. Contact us using the details below.
7. Cookies
Our website may use minimal cookies necessary for basic site functionality. We do not use cookies for third-party advertising.
8. Changes to this policy
We may update this policy from time to time. The "last updated" date above reflects the most recent version.
9. Contact us
AGS ACE Care · ABN 29 173 090 551 · care@agsace.org · 1300 000 000
Terms and Conditions
Last updated: 16 August 2026 · AGS ACE Care, ABN 29 173 090 551
1. Acceptance of terms
By using this website or registering an account, you agree to these Terms and Conditions and our Privacy Policy.
2. About our services
AGS ACE Care provides geriatric care coordination, ACE-model care planning, and related support services. Information on this site is general in nature and does not replace individual clinical advice.
3. SMS Marketing Program Terms
This section applies specifically to anyone who opts in to SMS communications via a consent checkbox on our Registration or Contact forms.
- By opting in, you agree to receive recurring, automated marketing and informational SMS messages from AGS ACE Care at the phone number you provide.
- Opting in is entirely optional and is never required in order to register, contact us, or receive our services.
- Message frequency varies based on your interactions with us. Message and data rates may apply.
- You can withdraw consent and stop messages at any time by replying STOP. Reply HELP for support, or contact us directly.
- Mobile carriers are not responsible for delayed or undelivered messages.
- Full details on how we collect, use and protect your phone number are set out in our Privacy Policy.
4. Registration & accounts
You are responsible for maintaining the confidentiality of your account credentials and for all activity under your account. Provide accurate information when registering.
5. Acceptable use
You agree not to misuse this website, attempt unauthorised access to our systems, or submit false or misleading information.
6. Limitation of liability
To the extent permitted by law, AGS ACE Care is not liable for indirect or consequential loss arising from use of this website. Nothing in these terms excludes rights that cannot be excluded under Australian Consumer Law.
7. Governing law
These terms are governed by the laws of South Australia, Australia.
8. Changes to these terms
We may update these terms from time to time. Continued use of the site after changes means you accept the updated terms.
9. Contact us
AGS ACE Care · ABN 29 173 090 551 · care@agsace.org · 1300 000 000