Regional and remote residential aged care services are considering whether they can remain open in the face of an extreme shortage of registered nurses.
This comes as the sector prepares for the federal government’s requirement for 24-7 RNs in residential aged care, which comes into effect from July 1 (with mandatory care minutes from October 1).
While no-one disputes the value more nurses and care minutes bring to improving care outcomes, the focus on these new requirements has overshadowed the realities of RN workforce constraints faced by regional and remote aged care providers.
Struggling to meet even current workforce requirements, these mostly not-for-profit providers must also contend with an inflexible regulatory environment, putting their mission and sustainability at significant risk.
Aged care providers in regional and remote areas face immense difficulty attracting RNs, despite offering lucrative salary packages that can double what they would be offered in metro areas.
They must rely on ludicrously expensive fly-in, fly-out or drive-in, drive-out agency staff (who don’t know the residents or systems) and lesser qualified enrolled nurses (who simply can’t replace an RN’s scope of practice).
In the end, this affects their compliance and financial sustainability.
Aged Care Minister Anika Wells recently argued that providers should feel optimistic about the sector’s prospects and assured them that no facility would be closed for not meeting the care minute and registered nurse targets.
However, this call for optimism misses the point.
The reality is that regional and remote aged care providers are barely managing to meet current quality standards relating to workforce due to RN workforce constraints.
What’s more, when the Aged Care Quality & Safety Commission assesses these struggling providers, no concessions are made to account for such constraints.
Ms Wells might say that no home will be closed if they don’t meet the targets, but these providers will be penalised by the regulator in other ways (sanctions and forced exits) for failings not of their making.
Yes, commonsense changes must be made to the RN targets and mandatory care minute requirements to avoid unfairly punishing providers doing everything they can to meet the targets.
This will allow them to concentrate on their primary objective of caring for their residents.
The Aged Care & Community Providers Association has proposed some very sensible amendments to the legislation in this respect.
I would also argue that the government should revisit the use of the Modified Monash Model to assess remoteness and therefore funding/available exemptions.
The current model does not accurately reflect the realities many regional and remote services operate in.
This is particularly the case in Western Australia, where even towns with relatively large populations are isolated by distance from the rest of the state.
However, ultimately, the government’s focus must be on the broader issue of addressing the RN workforce shortages in regional and remote areas.
Among other things, this needs to include requiring the Aged Care Quality & Safety Commission actively consider the context within which an aged care service operates, including any constraints not of its making.
Further, the government should create a specific visa category for skilled migrants willing to work in aged care in regional and remote areas.
This would help alleviate the workforce shortage by tapping into a pool of skilled and dedicated professionals who could contribute significantly to the aged care sector.
The unspoken crisis faced by regional and remote aged care providers must be acknowledged and addressed to prevent the gradual retreat of not-for-profit providers from these areas.
By recognising the workforce shortages and regulatory challenges, providing targeted support, creating a specific visa for skilled migrants, and revisiting the Modified Monash Model, we can ensure that aged care providers continue to fulfil their mission and that elderly Australians in regional and remote areas receive the care they deserve.
Only through a comprehensive and tailored approach can we truly address the ongoing workforce and regulatory crisis affecting regional and remote aged care.
- Amber Crosthwaite is a commercial lawyer specialising in seniors living, aged care and disability
