The new Labor Government has wasted no time implementing its aged care law reform agenda, with one major Bill already passed and another in the works. In last week’s article we summarised the key reforms introduced via these Bills. Today we delve deeper into two of the most critical reforms, setting out what residential aged care providers need to know about:

• Registered Nurses required 24/7
• mandatory 200 minutes care time per resident.

Registered Nurses Required 24/7 – Expected to Commence 1 July 2023

The Requirement

From 1 July 2023, providers will have to ensure that “at least one registered nurse is on site, and on duty, at all times at the residential facility”.

In this context, “registered nurse” (RN) means:

• a person registered under a law of a State or Territory (other than the State of South Australia) as a general nurse, or
• a person registered under a law of the State of South Australia as a nurse.

Exemptions

Exemptions to this requirement will apply. Details are yet to be provided, but the Government has indicated that exemptions are likely to be available:

• for facilities that are co-located with a health service where registered and enrolled nurses are present
• for facilities in regional, rural and remote areas where the provider has been unable to recruit sufficient numbers of staff with the requisite skills.

Funding, Reporting and Enforcement

Details are yet to be finalised, but the Government has said that:

• funding arrangements to support providers to meet this requirement will be determined through the October 2022-23 Budget
• it is likely that additional reporting will be required by providers on 24/7 RN coverage, for example, reporting at the end of each month through a form on the My Aged Care Provider Portal on the periods that a facility did not have an onsite RN
• the Aged Care Quality and Safety Commission (Commission) will play a key role in the implementation of the new reform including by:
  • educating the care sector about how the new requirements will be regulated
  • identifying high risk services through analysis of data, including in combination with other regulatory intelligence
  • monitoring and enforcing service compliance with the requirements
  • managing increases in the volume of complaints about aged care staffing matters
• the reporting for care minutes and 24/7 RN care will be used to inform the new star ratings.

For more information, refer to the Explanatory Memorandum to the Aged Care Amendment (Implementing Care Reform) Bill 2022 (Cth).

Mandatory 200 Minutes Care Time per Resident – Expected to Commence from October 2023

The Requirement

As at 9 August 2022, this reform had not yet been made into law. However, the Government has committed to introducing:

• mandatory 200 minutes of care time per resident per day (including 40 RN minutes) from October 2023
• mandatory 215 minutes of care time per resident per day (including 44 RN minutes) from October 2024.

Funding and Implementation

Details are yet to be finalised, but the Government has said that:

• there will be a $5.4 billion funding boost (over the 2022-23 Budget forward estimates) to enable residential aged care providers to increase staffing levels to meet the new 200 care minute requirements (targets)
• the care time targets for each facility will be adjusted according the AN-ACC* casemix classification for each resident. In practice this means that facilities with higher needs residents will receive more funding while also being required to meet higher care minute targets.
• new quarterly reporting of direct care time and costs commences for the July-September period as part of the new Quarterly Financial report (QFR). Reporting will occur at a facility level. This reporting will allow the Department of Health and Ageing and the Commission to assess whether providers are meeting their care minutes requirements. For more information see the Department of Health and Aged Care website
• the reporting for care minutes and 24/7 RN care will be used to inform the new star ratings.

For more information, refer to the Explanatory Memorandum to the Aged Care Amendment (Implementing Care Reform) Bill 2022 (Cth).

*AN-ACC is the new aged care funding model that will replace ACFI from 1 October 2022.