If it’s not already on your radar, the 2026 Registry of Senior Australians (ROSA) Outcome Monitoring System reports have been released, offering a revealing picture of quality and safety outcomes for older Australians, and valuable insights for providers across the country.
Among the findings, 42% of residential aged care residents were exposed to a high sedative load, while 38% presented to an emergency department during the reporting period. For Home Care Package recipients, emergency department presentations were even higher, at approximately 44%.
For South Australian providers, the reports offer a detailed picture of how their residents and clients are faring against state and national benchmarks, including several newly introduced indicators.
ROSA Director, Professor Maria Inacio explains that the program is about understanding how a provider’s cohort is doing, not assigning blame or credit to an organisation. Geography, service availability and many other factors influence outcomes, which is why the reports are intended as intelligence rather than a report card.
New indicators reflect a broader view of quality
This year’s reports introduce two new residential aged care indicators and three new home care indicators following a comprehensive literature review and consultation process by ROSA researchers and advisors.
“[During the] review of the literature around quality indicator programs, not just in aged care, but across most settings where older people receive care, we identified a lot of other measures that people felt were important to monitor for older people in general.”
Residential care now includes measures of functional decline using information collected through AN-ACC assessments, and continuity of primary care, which examines ongoing relationships with general practitioners.
Inacio says ROSA’s research has consistently identified continuity of primary care as one of the strongest factors associated with good outcomes, making it an important measure even when GP access is not entirely within a provider’s control.
Home care adds continuity of primary care, the proportion of people spending more than 30 days away from home in hospital, and the proportion who die at home.
“This measure [dying at home] was interesting because we have a few palliative care specialists in our advisory committee that felt that this would be really important because people don’t know this; but there’s also a lot of variation,” said Inacio.
“So every time you see a lot of variation in a measure like this, it’s an indication that there is an opportunity to actually improve or drive some changes.”
These additions reflect a growing focus on outcomes across the broader healthcare journey, including factors that extend beyond the direct control of aged care providers.
Trends add context to snapshots
For the first time in the ROSA Outcome Monitoring System reports, providers can view trend graphs for almost every indicator, allowing organisations to monitor changes in outcomes over multiple reporting periods.
This longer-term view is useful when interpreting outcomes that may be influenced by changes in resident needs, access to healthcare or service delivery. Rather than treating a single result as evidence of success or failure, leaders can investigate whether patterns are sustained and whether improvement initiatives are making a measurable difference.
However, a reporting lag does need to be considered. The 2026 reports examine outcomes from 2023–24, making them a valuable source of historical evidence rather than a real-time performance dashboard.
Inacio acknowledges that assembling linked administrative data takes time, with the research team only receiving the complete datasets in April 2026. By comparison, the National Quality Indicator Program collects information directly from providers each quarter, enabling more timely reporting.
Benchmarks are designed to support improvement
ROSA’s reports include “Achievable Benchmarks of Care”, drawing on the outcomes achieved by better-performing services. For the first time, these benchmarks are also available for home care providers.
The ROSA benchmarking model uses risk-adjusted measures to account for differences between care populations, recognising that providers do not all support people with the same needs or clinical complexity.
This gives providers a more meaningful basis for comparison and an achievable reference point when identifying opportunities for improvement.
However, not every measure requires a target. ROSA has deliberately avoided setting a benchmark for its new ‘died at home’ indicator, recognising that the outcome is influenced by individual circumstances and preferences.
For leaders, this means that an outcome that requires investigation does not necessarily indicate poor performance, and not every variation requires corrective action.
The reports complement existing quality reporting
The ROSA reports are independent of, but complementary to the National Quality Indicator Program and Star Ratings system. Rather than duplicating those systems, they provide another lens through which organisations can understand quality.
The main difference between the two is how the information is collected. ROSA draws on existing Medicare, pharmaceutical, hospital and aged care assessment datasets, allowing researchers to examine outcomes without requiring providers to submit additional information.
For example, medication dispensing and hospital admission records provide an independent source of evidence that providers can compare with their own clinical and operational reporting.
While the National Quality Indicator Program provides more timely reporting, ROSA offers a broader view of health outcomes across care settings, with individual-level data supporting risk-adjusted comparisons.
For providers, the opportunity is to bring these different sources together, investigate discrepancies and use the findings to inform clinical governance and quality improvement priorities, particularly where independently measured outcomes differ from internal reporting.
If you’re eligible, request your report
The scale of ROSA’s reporting is significant, with the 2026 reports covering 16,094 residential aged care residents and 24,746 Home Care Package recipients, representing approximately 73% and 79% of South Australia’s respective aged care populations. Older Australians become part of the ROSA dataset through an opt-out enrolment process when they undergo an aged care eligibility assessment, allowing researchers to link their existing health and aged care records.
This year, ROSA has produced 215 individual residential aged care facility reports and 117 home care service reports, available free to eligible South Australian providers.
For boards, the reports also include three-page governance summaries designed to support oversight of quality and safety without requiring directors to work through hundreds of pages of technical analysis.
Providers can use the findings to test their understanding of care outcomes, inform quality improvement priorities and strengthen governance discussions. They can also choose to share their individual results with residents and families, an approach encouraged by ROSA’s consumer advisory committee.
For eligible South Australian providers, the information is already available. It’s up to leaders now to examine what it reveals, ask questions where the findings differ from expectations and put that evidence to work.
