Practical support for safer transitions
NDIS Hospital Discharge Support

Accommodation and disability-support coordination for eligible participants who are preparing to leave hospital and need a safe, planned next step.

NDIS participant, hospital social worker and support coordinator planning a safe discharge

NDIS hospital discharge accommodation in Sydney

Eden Ability provides NDIS hospital discharge accommodation in Sydney and the Southern Highlands. Our homes include Mascot (SIL, SDA, MTA, STA and respite), Bossley Park (SIL with 24/7 support, MTA, STA and respite) and Mittagong (High Physical Support SDA, SIL, MTA and STA), plus homes in Bondi, Sydney CBD, Chatswood, Macquarie Park, Parramatta, Cronulla, Lidcombe and Blacktown. Hospital discharge teams can call 1300 228 856 to check a place for a patient who is medically ready to leave.

Where can I find NDIS hospital discharge accommodation in Sydney?

Eden Ability has homes across Sydney and the Southern Highlands, including Mascot, Bossley Park and Mittagong that take hospital discharge referrals. Depending on the person’s funding we can offer medium term accommodation (MTA), short term accommodation (STA), SIL or SDA.

Is there disability accommodation after hospital for NDIS participants?

Yes. NDIS participants who are ready for discharge but cannot go home yet can move into MTA while their long term home is arranged. Eden Ability offers MTA at all three of our homes.

What are the options for long stay patients with NDIS funding?

For long stay patients, the usual path is MTA first, then SIL or SDA once the long term plan is approved. Because Eden Ability offers MTA, SIL and SDA, the person can often stay with the same provider through each step.

Which Eden homes are near Prince of Wales, Fairfield, Liverpool and Bowral hospitals?

Our Mascot home is a short drive from Prince of Wales Hospital in Randwick. Bossley Park is close to Fairfield Hospital and Liverpool Hospital. Mittagong is a short drive from Bowral and District Hospital.

How does a hospital discharge team refer a patient to Eden Ability?

Call 1300 228 856 or use our referral page. Tell us the patient’s support needs, mobility, NDIS funding and planned discharge date, and we will confirm fit.

Refer a patient in one minute

For hospital discharge teams, social workers and support coordinators. Send the basics below and our team will call you back within one business day. Prefer to talk now? Call 1300 228 856.


    NDIS funding in place or requested



    Hospitals we take NDIS discharge referrals from

    Updated . Most of our referrals come from Prince of Wales Hospital, St George Hospital and Royal Prince Alfred Hospital. We take referrals from every public and private hospital in Sydney and the Southern Highlands. This is where our nearest homes are:

    HospitalNearest Eden Ability homes
    Prince of Wales Hospital, RandwickMascot, Bondi Junction
    St Vincent’s Hospital, DarlinghurstSydney CBD, Bondi Junction
    Royal Prince Alfred Hospital (RPA), CamperdownSydney CBD, Mascot
    St George Hospital, KogarahMascot, Cronulla
    Sutherland Hospital, CaringbahCronulla
    Royal North Shore Hospital, St LeonardsChatswood, Macquarie Park
    Concord HospitalMacquarie Park, Parramatta
    Westmead HospitalParramatta
    Liverpool HospitalBossley Park
    Fairfield HospitalBossley Park
    Blacktown and Nepean hospitalsParramatta, Bossley Park
    Campbelltown HospitalBossley Park
    Bowral and District HospitalMittagong (High Physical Support SDA)

    Why NDIS patients get stuck in hospital

    Some of the people we now support waited 6 to 12 months in hospital after they were medically ready to go home. The barrier is rarely their care needs. It is usually funding they do not understand, no long term home ready, or options that take away their privacy and choice.

    We make the pathway clear. Medium Term Accommodation (MTA) gets the person out of hospital quickly, usually for up to 90 days, while SIL and SDA funding is sorted. Most of our MTA clients choose to stay on with us long term, so they only move once.

    “My background is hospitality. A home should feel private, comfortable and built around the person, not the paperwork. Nobody should spend a year in hospital because the pathway out was unclear.”
    Sajjad Saidabadi, Director, Eden Ability (read the full article)

    Do you take referrals from St Vincent’s, Royal North Shore and Westmead?

    Yes. Eden Ability takes NDIS hospital discharge referrals from any hospital in Sydney, including St Vincent’s, Royal North Shore, Westmead, Concord, Liverpool, Campbelltown and Nepean, as well as Prince of Wales, St George and RPA. Use the one minute form above or call 1300 228 856.

    How long can a patient stay in Medium Term Accommodation?

    NDIS Medium Term Accommodation is usually funded for up to 90 days while a long term home is being set up. At Eden Ability many participants then stay on in the same home long term, with SIL and SDA funding, so there is no second move.

    What can we do for a long stay patient who is medically ready for discharge?

    Call us early, even if NDIS funding is not finalised. We review the person’s needs, check what their plan covers, hold a room where we can, and help the support coordinator request MTA, SIL or SDA so the patient can leave hospital sooner.

    From hospital to the right support setting

    A delayed or poorly coordinated discharge can create stress for participants, families and clinical teams. Eden Ability works with the participant and their support network to understand accommodation, accessibility and day-to-day support requirements before a transition is agreed.

    1

    Referral coordination

    One point of contact for participants, nominees, social workers, support coordinators and relevant clinicians.

    2

    Accommodation review

    We consider availability, accessibility, location, staffing and the intended longer-term housing pathway.

    3

    Transition planning

    Clear responsibilities, support information and move-in arrangements are agreed before discharge where possible.

    Who can contact us

    • NDIS participants and nominees
    • Hospital social workers and discharge planners
    • Support coordinators and recovery coaches
    • Allied health and clinical teams
    • Family members and informal supports, with participant consent

    Important information

    Eden Ability is not an emergency medical service and cannot replace clinical care, crisis accommodation or emergency response. If someone is in immediate danger or needs urgent medical assistance, call 000.

    Accommodation and supports depend on suitability, vacancy, participant consent, funding and the information available to the referral team.

    View the discharge checklist

    Information we need for an initial review

    Current situation

    Hospital, expected discharge date, current risks and why the present setting cannot continue.

    Disability support

    Daily living assistance, mobility, communication, behaviours, overnight support and equipment needs.

    Funding and housing

    Relevant NDIS funding, support coordination contacts and the planned medium- or long-term housing pathway.

    For social workers and hospital discharge teams

    What a hospital team needs to confirm before discharge

    A safe referral is more than finding a room. These are the practical details we review with the participant, hospital team, support coordinator and treating clinicians.

    Discharge readiness and timing

    Expected discharge date, current admission status and whether the participant is medically ready to leave hospital.

    NDIS and funding pathway

    Current NDIS plan, home-and-living status, support coordination contacts and any plan reassessment underway.

    Property accessibility

    Mobility, transfers, bathroom access, bedroom needs, assistive technology and environmental requirements.

    Support capability

    Required staffing ratios, active or inactive overnight support, behaviours of concern and specialist competencies.

    Clinical and equipment handover

    Medication, wound care, continence, mealtime management, equipment delivery, training and follow-up appointments.

    Consent and continuity

    Participant consent, decision-maker details, discharge summary, risk plans and the contacts responsible after discharge.

    Hospital discharge support in Sydney and the Eastern Suburbs

    Our team is based in Mascot and can discuss referrals from hospitals across Sydney, including participants returning to Bondi, Randwick, Maroubra, Mascot and nearby Eastern Suburbs communities.

    Official guidance: NDIS guide to your hospital stay and NDIS medium-term accommodation information.

    How the referral moves forward

    Initial contact

    Call, email or send an enquiry with the participant’s consent and essential referral details.

    Multidisciplinary review

    We clarify support, accommodation, clinical and transition information with the relevant people.

    Agreed next step

    If we have a suitable option, the team develops a practical transition plan and confirms responsibilities.

    For discharge planners and social workers

    Discharge accommodation near your hospital

    When a patient is medically ready to leave hospital but cannot go home yet, our homes can be the supported next step while longer term housing is arranged. Call 1300 228 856 with the target discharge date and we will check current availability.

    Bossley Park, Western Sydney

    SIL with 24/7 support, Medium Term Accommodation (MTA), Short Term Accommodation (STA) and respite. Near Fairfield Hospital and Liverpool Hospital.

    Mittagong, Southern Highlands

    High Physical Support SDA, SIL, Medium Term Accommodation (MTA) and Short Term Accommodation (STA). Near Bowral and District Hospital.

    Mascot, Eastern Suburbs

    SIL, SDA, Medium Term Accommodation (MTA), Short Term Accommodation (STA) and respite. Within easy reach of Prince of Wales, St Vincent’s, Royal Prince Alfred and St George hospitals.

    Questions hospital and social-work teams ask

    Do you have discharge accommodation near Liverpool, Fairfield or Bowral hospitals?

    Yes. Our Bossley Park home is near Fairfield and Liverpool hospitals and offers SIL with 24/7 support, MTA, STA and respite. Our Mittagong home is near Bowral and District Hospital and offers High Physical Support SDA, SIL, MTA and STA. Our Mascot home is within easy reach of Prince of Wales, St Vincent’s, Royal Prince Alfred and St George hospitals and offers SIL, SDA, MTA, STA and respite. Call 1300 228 856 to check current vacancies.

    Can a hospital social worker or discharge planner refer to Eden Ability?

    Yes. Hospital teams, support coordinators, participants, nominees and families can make an initial enquiry. Participant consent and the appropriate information-sharing arrangements must be confirmed before sensitive documents are provided.

    Can Eden Ability review an urgent hospital discharge referral?

    We can review urgent enquiries, but acceptance depends on participant consent, sufficient clinical and functional information, a suitable vacancy, accessibility, staffing, funding and a safe handover. Contact us early and state the target discharge date.

    Does a participant need a confirmed long-term home before hospital discharge MTA can be considered?

    Current NDIS information says a participant being discharged from hospital may have MTA added if they are eligible for SDA, SIL, ILO or home modifications, and they do not need a confirmed long-term home. The NDIA makes funding decisions and Eden Ability must separately confirm a suitable property and support arrangement.

    What does NDIS Medium-Term Accommodation pay for?

    Current NDIS guidance describes MTA as accommodation funding for up to 90 days. It does not include food, utilities or personal care supports; approved disability supports are funded separately through the participant’s plan.

    What information is needed for an initial discharge review?

    Useful information includes consent, current NDIS plan and contacts, discharge date, functional and accessibility needs, daily and overnight supports, equipment, medications and health-support plans, risks, behaviour support where relevant, and the intended longer-term pathway.

    Can the participant be discharged before equipment and supports are ready?

    A discharge should proceed only when the receiving environment, essential equipment, disability supports, medications, handover and escalation contacts are properly coordinated. Eden Ability will identify outstanding items rather than represent an incomplete arrangement as ready.

    Can clinicians send reports directly?

    Yes, with appropriate participant consent and secure information sharing. Contact our team before sending sensitive documents so we can confirm the correct recipient and process.

    What happens if there is no suitable vacancy?

    We will explain that clearly. The support coordinator, hospital liaison officer and discharge team can continue considering other accommodation, home-and-living and community options instead of relying on an unsuitable placement.

    Need to discuss a discharge pathway?

    Call 1300 228 856 or visit Shop G2/669 Gardeners Rd, Mascot NSW 2020.