Mirus reveals a major care minute milestone is surpassed despite falling RN minutes

Mirus’ November Industry Analysis Data release has revealed the industry has surpassed an important milestone: the sector-wide care minute average of 200 minutes per resident per day. This has been achieved thanks to an almost 5% increase in care minutes in the month of October, although stagnating Registered Nurse minutes mean there’s still work to be done.

One of the things that the Government is working on with regards to policy making in the sector is creating a multipronged strategy to assist in filling out large voids. There are conversations with relevant immigration departments in place that focus on bringing in more visa categories to allow smoother transition for overseas workers.

One of the other policy restructures also includes wiping out the HECS debt from nurses who spend time in regional communities, this can help in more than one way but most importantly it will help in attracting more RNs to work in these regional and rural communities. 

“Providers are looking at several ways to help fill these RN vacancies and get them out to regional centres across Australia. But they also need to have enough RNs available to fill these shifts,” says Robert Covino, Partner and Co-founder of Mirus.

“So until regulations around meeting RN target minutes as well as their direct care time allowances doesn’t change, we will continue to see providers just using more of Enrolled Nursing.”

Care minutes are trending up

In October, Mirus reported that aged care providers were less than one minute away from reaching the required sector-wide 200 care minute benchmark. Now, the sector has surged past with a 4.74% increase taking the direct care minute average to 209.14 minutes per resident per day. 

• Allied health minutes experienced the largest percentage change, decreasing by almost 55% to just 4.11 minutes per resident per day
• Diversional therapy minutes increased by 5% to 6.31, slightly offsetting the loss of allied health minutes
• Non care minutes, including hospitality, remain strong after a 3.98% increase elevated them to almost 48 minutes

This is a positive sign, suggesting that most organisations have acclimatised to the casemix adjusted requirements that came into effect on October 1. The October 2024 sector-wide target of 215 minutes per resident per day seems all the more achievable with 11 months to establish it as the baseline.

However, it’s not all good news for the sector. After growing by almost 8% last month, RN minutes have plateaued with a slight drop to 33.74 minutes per day. These minutes are calculated through time and attendance records. 

It’s no secret that the industry has struggled with these RN minutes for a while now. What we also know is that, while there are groups that won’t be meeting their RN minutes, they are instead meeting their allocation of total direct time, and that’s what gets the facility their 3 star level, based on Government’s current directives, which isn’t meant to change until April 2024.

“The reason we raised this issue right now is because there are a lot of groups who have the extra resources that sit in those non clinical leadership roles rostered in their home that gives them that over achieving rates, although their RN time may be just below the required time,” says Robert.

As highlighted by Mirus Australia Industry Lead Robert Covino in October, there is a chance that many providers are underreporting their RN data. Ongoing workforce shortages and limited access to RNs will also likely be blamed as providers continue to work hard and meet their RN requirements. 

With RN minutes steady, the contribution of ENs and AINs steered the increase. Their combined total, which does not have a daily target like RNs, changed by 5.83% to 175.40 minutes per day. This data will likely strengthen the conversation around recognising EN contributions in care minute totals as their input grows and the push to recruit RNs stalls.

The care time received by an average resident right now, aligning to both system’s of funding, is closest to a category 9, which pays $250 a day to the provider. This requires 202 minutes of direct care time and 46 minutes of RN time. 

Key figures hold steady 

It appears the aged care sector is holding steady across the board in terms of occupancy levels, claiming activity and the Average Daily Subsidy (ADS). Mirus data shows most key figures have experienced little change between September and October which is a good sign for stability. 

• ADS, which represents the mean entitlement of subsidy for all residents, encompassing respite but excluding defaults, has further strengthened with a 23 cent increase to $255.16. This indicates there is consistent improvement in claiming activity rates by all cohorts. 
• Occupancy levels experienced a 0.16% change, rising to 88.79%. With 1500 fewer new permanent admissions it will be interesting to see if occupancy levels decrease or remain unchanged over the coming months.

“AN-ACC is a very different mechanism and that is something that providers need to consider because otherwise it will just continue to see ADS go up and providers will then be constantly trying to find staff to keep up with their pushing of the ADS. So that’s the next thing we’re definitely advocating with a lot of our clients to really reconsider because if the staff aren’t there, you just can’t take the funding. That’s really the message from the regulator,” adds Robert.