Financial reporting requirements cause fatigue in aged care

Reporting fatigue is one of the top concerns among aged care providers with a recently released Questions and Answers document highlighting a spate of challenges caused by financial reporting.

Key points

• The Department of Health and Aged Care released its responses to questions submitted during the July Aged Care Financial Reporting webinar
• Concerns over reporting requirements were common, with some providers forced to employ external consultants to prepare Quarterly Financial Reports (QFR)
• Others are struggling with the extra reporting linked to outbreak management expenses and the Aged Care Financial Report, plus constant changes to QFR requirements
• Respondents also touched on the issues with lifestyle workers not being included in care minute quotas despite providing direct care to residents

Reporting fatigue grows

Aged care’s reform journey has brought about necessary change, however, it’s clear many are struggling with the burden and fatigue of additional reporting requirements. 

Smaller providers are arguably finding it the hardest to manage, with one representative asking, “How is it fair that small facilities have to report in the same way as large corporates?”. 

Outbreak management expenses are another point of contention. Currently, the Aged Care Outbreak Management Supplement provides an annual amount of $941.35 to assist in the planning for and managing outbreaks linked to COVID-19 or other infectious diseases. 

The Department outlined that if a provider incurs costs exceeding the supplement amount, no additional funding will be provided. The reporting requirements are therefore essential to help understand the financial impact of infectious outbreaks. 

“Noting as well, that managing outbreaks and related expenses has long been part of a provider’s obligations under the Aged Care Quality Standards. Providers have been expected to manage outbreaks, including those caused by influenza, gastroenteritis, and other illnesses, for many years,” it added.

Yet some providers are feeling the pressure of reporting burden with one asking, “Do you realise how much impact the extra questions eg outbreak management are having on resourcing?”. 

Several questions also related to how much detail is required when reporting outbreak-related spending. Answers can be viewed here. 

Frustrations were also shared regarding the strict reporting deadlines for aged care providers and the seemingly vague deadlines for Government responses. To this, they said, “The department aims to respond to enquiries in a timely manner”. 

Quarterly challenges

Inconsistency with the QFR is challenging several providers, with requests for greater continuity in what is accepted by the Department each quarter being made.

“The data validation process associated with residential expenses and hours have remained consistent […]. The department began contacting providers for outlier values in relation to hourly wage rates and food and nutrition cost from Q2 (2023-24),” the Department said.

“Since this data, along with the residential direct care labour costs is published on My Aged Care and can influence the way providers are viewed by residents, it is vital the quarterly data undergo a thorough data quality assurance process.”

It added that the aim is to only introduce major changes in Quarter 1 of each reporting year. 

Two respondents shared that they have had to employ an external consultant to prepare their QFRs. This would be far from unusual, but it does highlight the need for (most likely) smaller providers to outsource their reporting due to limited internal resources. And while administration costs can be recovered, the Department reinforced that other costs to prepare the QFR cannot be separately recovered. 

Care minute concerns 

Ongoing discussions around the exclusion of lifestyle workers from care minute totals are only getting louder. 

Three respondents brought up the issue with one asking how lifestyle reporter time should be reported, another asking why they are not counted towards care minutes, and the other asking what action is going to be taken against providers inaccurately including care minutes. 

The Department said that lifestyle workers can only be counted in care minutes if they are a Registered Nurse (RN), Enrolled Nurse (EN) or personal care worker (PCW) or Assistant in Nursing (AIN). For the latter, they must be employed as a PCW or AIN under the relevant award or an equivalent role under an enterprise agreement. 

“This means a worker employed in a lifestyle role is not able to be counted towards care minutes, even where they are delivering direct care (and this direct care forms part of their position description),” it added.

It said this is in line with Recommendation 86 of the Royal Commission into Aged Care Quality and Safety which specified that minimum staff time should include RNs, ENs and PCWs. 

But as the Department later acknowledged in a different response, “The priority to explore staffing indicators for inclusion in the QI program responds to feedback on the potential reduction of enrolled nurses, allied health and lifestyle services following the introduction of 24/7 nursing requirements”. 

Feedback such as this could see a shift in their focus on lifestyle and allied health in the future, with the Star Ratings one area where a greater contribution could be made. 

The full range of questions and answers from the Department of Health can be viewed here.