Care minute compliance: No easy feat ahead of October deadline

It has been a big year for the aged care sector. On July 1, 24/7 Registered Nursing coverage came into effect, and on the same day direct care staff – and a select few other aged care workers – received 15% wage increases. The next big milestone is the mandatory care minute responsibility for residential aged care providers, beginning October 1.

Key points

• Aged care providers will have their own case-mix adjusted care minute targets, based on resident AN-ACC classification percentages. 
• As a result, care minute requirements could be higher or lower than the sector-wide average of 200 minutes of care per resident each day, depending on the number of high-care or low-care residents within a facility. 
• RN quotas will also be impacted based on adjusted targets, with 40 minutes being the sector-wide average.

Workforce shortages, a highly competitive nursing market and a limited number of applicants willing to relocate are all to blame as some providers struggle to meet care minute requirements, particularly regional and rural operators. 

Even a 12-month exemption from the 24/7 RN requirement may not be enough to help as recruitment challenges are likely to continue for some time. And now, with Government mandates in place, it means providers can be penalised for not meeting rigid expectations even if alternative workforce options are not available.

So where does that leave the sector? Russell Egan, CEO of Superior Care Group, said there are positive signs as interest in working in the sector grows, but providers aren’t necessarily finding the talent to fill the most critical RN gaps. 

“Up until very recently, workforce [demand] has been impossible to satisfy. But since the implementation of the pay increase on July 1, and from the May Budget announcement, I have noticed the market increase particularly in relation to personal care worker interest. They’re not all high-quality candidates, but I’ve noticed the number of applicants for positions has markedly increased,” Mr Egan explained.

“In relation to Registered Nurses, the situation has not improved. There are not enough Registered Nurses and the mandates will not be met, particularly from regional and remote providers. [The Government] passing a law and saying ‘you are breaking that law unless you get an exemption’ is just a terrible way to treat providers who are trying their best.”

RN coverage not what it seems

Despite being concerned about the sector’s ability to meet nursing and care minute requirements, Government statistics have shown that 86% of Australia’s aged care facilities have an RN onsite 24/7 with almost round-the-clock coverage. Great news, right?

There are some caveats. The figures used by the Government exclude split service facilities and facilities with an approved or pending 24/7 RN exemption. Based on 2022 provider statistics, 183 facilities were not included in the Government’s August 24/7 RN update – although some have closed down since the 2022 data was collected.  

But by combining the number of facilities excluded entirely, facilities that did not report results, and those that were more than two hours away from meeting 24/7 RN coverage, up to 450 aged care facilities are struggling to meet Government nursing mandates. 

In some ways, the Government is doing what it can to help providers meet the requirements: the 15% aged care pay rise, 12-month exemptions and increased international recruitment opportunities are a step in the right direction.

However, by setting lofty targets with short timeframes, not all providers have had an opportunity to really establish the required workforce. Mr Egan said his own internal modelling shows they are struggling to consistently meet the care minute requirements despite marked improvement. 

“Stone by stone, the Government is placing pressure on providers to do things for which they’re not being paid or what is not factored into the funding situation,” Mr Egan said.

“At the outset, we’re not into a mandatory minutes regime yet, we’re still working towards it, although we’re being funded as if it is in effect. You’re ramping up a workforce that up until two or three months ago, the candidates weren’t there to get the higher minutes. But it’s not sufficient to cover all of us moving up to public hospital rates of pay [which is] the mainstream market you have to compete with.”

Mr Egan has urged the Government to do more than just provide exemptions. He wants to see mandates revisited and revised until more compelling evidence is found that suggests the aged care workforce can actually meet requirements. Until then, he said the rules must not be mandatory for the sake of the sector.