This study aimed to identify risk factors in medication management in Australian residential aged care (RAC) homes. Only 18 out of 3,607 RAC homes failed aged care accreditation standard in medication management between 7th March 2011 and 25th March 2015. Text data mining methods were used to analyse the reasons for failure. This led to the identification of 21 risk indicators for an RAC home to fail in medication management. These indicators were further grouped into ten themes. They are overall medication management, medication assessment, ordering, dispensing, storage, stock and disposal, administration, incident report, monitoring, staff and resident satisfaction. The top three risk factors are: “ineffective monitoring process” (18 homes), “noncompliance with professional standards and guidelines” (15 homes), and “resident dissatisfaction with overall medication management” (10 homes).