Under the Higher Everyday Living Fees program aged care providers can charge residents for services that might have previously been provided at no extra cost.
Families and advocates say the fees are creating confusion and inequality in nursing homes.
Advocates are calling for changes to require providers to supply services such as in-room TVs, phones and wi-fi at no extra cost.
Thousands of people living in Bupa aged care homes will not receive cooked breakfasts unless they sign up for a $42-a-day meal package under a contentious new fee schedule rolling out across the sector.
The Higher Everyday Living Fees (HELF) program, introduced as part of the government's "once in a generation" changes, means residents will need to sign up to Bupa's "Enhanced Dining Experience" at a cost of $15,330 per year.
That entitles them to two hot breakfasts a week, a daily, extra-hot meal option at lunch, a dessert at lunch and a beer, wine or soft drink with lunch and dinner.
Bupa, which has more than 5,000 aged care residents, confirmed that those who do not pay the $42 daily fee will receive a continental breakfast only.
It said it would "provide additional cooked protein options for residents if recommended by a dietitian, irrespective of whether the resident has opted for our enhanced dining options".
