24/7 Registered Nurses (RNs) in Aged Care: How to Apply for an Exemption
From 1 July 2023, residential aged care providers will have to ensure that “at least one registered nurse is on site, and on duty, at all times at the residential facility” (24/7 RN requirement). Applications are now open to apply for an exemption to this requirement. Here’s what you need to know about eligibility for the exemption and how to apply.
Overview of the 24/7 RN Requirement
From 1 July 2023, residential aged care providers will have to ensure that “at least one registered nurse is on site, and on duty, at all times at the residential facility”.
For the purposes of the 24/7 RN requirement, a “registered nurse” is a person who is registered under the Health Practitioner Regulation National Law in the nursing profession as a registered nurse (RN). This means that enrolled nurses do not meet the requirement.
An RN is considered “on site” when they are physically present at the residential facility.
An RN is considered “on duty” if they are working and can respond in person to the clinical care needs of consumers at the facility when they need it.
Some residential aged care providers may be eligible to apply for an exemption from the 24/7 RN requirement.
Am I Eligible for the Exemption?
Residential aged care providers may be eligible for an exemption from the 24/7 RN requirement for up to 12 months from 1 July 2023 (i.e. until 30 June 2024) if:
their facility has 30 or fewer operational places; and
they have taken reasonable steps, by having alternative clinical care arrangements in place, to ensure that the clinical care needs of their care recipients will be met during the exemption period.
The MMM is a measure of remoteness and population size used to define whether a location is a city, regional, rural, remote, or very remote. Locations are categorised from MMM 1 – MMM 7, where MMM 1 is a major city and MMM 7 a very remote location. Only facilities located in small rural towns or remote areas will be eligible for the exemption.
Facilities with more than 30 operational places or that do not have alternative clinical care arrangements in place will not be eligible for the exemption.
If an exemption is not granted, providers must ensure that they meet the 24/7 RN requirement for each facility through which care is provided to residents from 1 July 2023.
How to Apply
Applications for exemptions opened on 3 April 2023. Eligible providers can apply for an exemption from the 24/7 RN requirement using this online form.
The form requires providers to fill out their details to prove their eligibility for the exemption, including whether they have taken reasonable steps to ensure that the clinical care needs of their residents will be met during the period that the exemption will be in force.
Providers should apply as soon as possible to ensure that their exemption will be granted before 1 July 2023.
Exemption periods begin from when the exemption is granted.
The Department of Health and Aged Care (Department) states that it will inform providers of the outcome of their application in writing in a timely manner.
A “residential facility” is “a building or complex of buildings (inclusive of their immediate surrounds) used for the specific purpose of providing residential aged care”.
A residential facility will usually consist of one residential care service. However, this is not always the case.
For the purposes of the 24/7 RN requirement:
Single facilities with one or more services (i.e. co-located services) are only required to have at least one RN on site and on duty across their services.
Where services are delivered at multiple physical locations (i.e. split services) that do not meet the definition above, at least one RN is required to be on site and on duty at each separate site.
What Is an “Operational Place”?
An “operational place” is a place allocated in respect of a residential care service through which residential care is provided.
This does not include provisionally allocated places, offline places and any places for which a residential care subsidy is not payable.
What Are “Alternative Care Arrangements”?
Where providers do not have an RN on site and on duty 24/7, they must take appropriate steps to ensure that the care needs of consumers are met.
These steps will vary depending on the specific circumstances of the facility and the needs of consumers.
In most cases, providers will need to employ a range of strategies (such as on-call arrangements or requiring support staff to obtain additional qualifications) in tandem to adequately make up for the absence of an RN.
Do I Still Have to Comply with My Other Obligations?
Yes. Being granted an exemption from the 24/7 RN Requirement does not affect any of your other obligations, including your obligations to meet the mandatory care minutes responsibility from 1 October 2023 and your reporting arrangements in respect of the 24/7 RN requirement.
Does the 24/7 RN Requirement Apply to Flexible Care Services?
No. The requirement does not apply to flexible care services like multi-purpose services.
Am I Still Eligible for the 24/7 RN Supplement?
Providers that are granted an exemption from the 24/7 RN requirement will not be eligible to receive the 24/7 RN supplement for the exempt residential facility. However, eligible providers can opt out of the exemption at any time to receive the supplement to help meet the cost of providing 24/7 RN care.
What Happens if I Do Not Comply with the 24/7 RN Requirement?
Where providers are found to be non-complaint with the 24/7 RN requirement, the Aged Care Quality and Safety Commission (ACQSC) may take administrative or enforceable compliance actions.
The ACQSC will consider the attempt that the provider is making to meet their obligations along with the risk posed to consumers when deciding what specific actions to take.
In cases where exempted providers are not appropriately applying alternative clinical care arrangements, their exemption may be revoked.
What Happens After My Exemption Expires?
The current exemption period lasts until 30 June 2024. It is still unclear if the exemption period will be extended past this date.
What Should I Do if My Circumstances Change?
If you are granted an exemption but your circumstances change (for example, the number of operational places at your facility increases to more than 30 places), you must contact the Department in writing.