We are barely a month into 2023 and it is already shaping up to be another hectic year for aged care providers. Here are five major upcoming reforms to flag now so that you can prepare early and be ready.

Overview of the Five Major Reforms

• Registered Nurses required 24/7 from 1 July 2023.
• Mandatory 200 minutes of care time per resident per day (including 40 RN minutes) from October 2023.
• Revised Aged Care Quality Standards commencing sometime in 2023.
• New governance requirements commencing 1 December 2023.
• Potential wage increase for aged care workers – Fair Work Commission to decide next steps on 28 February 2023.

24/7 Registered Nurses

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 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.

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. The reporting for care minutes and 24/7 RN care will be used to inform the new star ratings.

Key Dates

The requirement is expected to commence 1 July 2023.

More Information

• Mandatory Care Minutes and 24/7 RNs in Aged Care: What You Need to Know
• Explanatory Memorandum to the Aged Care Amendment (Implementing Care Reform) Bill 2022 (Cth).

Mandatory Care Minutes

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.

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.

Key Dates

Mandatory 200 minutes care time expected to commence October 2023, increasing to mandatory 215 minutes from October 2024.

More Information

• Mandatory Care Minutes and 24/7 RNs in Aged Care: What You Need to Know
• Explanatory Memorandum to the Aged Care Amendment (Implementing Care Reform) Bill 2022 (Cth).

Revised Aged Care Quality Standards

The Aged Care Quality and Safety Commission (Commission) is planning to revise the Aged Care Quality Standards. The proposed changes will reduce the number of Standards from eight to seven, and consolidate some areas covered by each of the Standards. There will be new expectation statements for each of the Standards which will replace the consumer outcome statements in the current Standards.

The proposed revised quality Standards will be:

• Standard 1: The Person
• Standard 2: The Organisation
• Standard 3: The Care and Services
• Standard 4: The Environment
• Standard 5: Clinical Care
• Standard 6: Food and Nutrition
• Standard 7: The Residential Community

Key Dates

As of 17 January 2023, there is no official start date for the new Standards. It is expected that there will be a transition period to allow providers to familiarise themselves with the new Standards and to implement any systems and practices to allow them to comply. Further consultation will commence in early 2023 on guidance material for providers and older people, as well as the implementation of the revised Standards and transition periods.

More Information

• Revised Aged Care Quality Standards are Coming: Stay Up to Date with The Proposed Changes
• Review of the Aged Care Quality Standards
• Consultation Paper – Summary Aged Care Quality Standards Review

New Governance Requirements

In August 2022, the Government passed legislation that imposed new requirements with respect to aged care governance. While all new aged providers must meet these requirements immediately, existing aged care providers do not have to meet the requirements until December 2023 (“existing provider” means a provider who was approved before December 2022). There are three new requirements:

Membership of the Governing Body

Providers will need to ensure that:

• a majority of the members of the governing body are independent non-executive members
• at least one member of the governing body has experience in the provision of clinical care.

These requirements do not apply to small aged care homes (with fewer than five board members and fewer than 40 residents) or to Aboriginal Community Controlled Organisations.

Consumer Advisory Body

The new reforms also require providers to give their care recipients and the care recipients’ representatives the opportunity to form a consumer advisory body. Providers must provide this opportunity at least every 12 months and keep a record of each offer. The consumer advisory body would be able to give the provider feedback on the quality of its service and the care provided. If such a body is established, the governing body of the provider is obliged to consider the body’s feedback when making decisions about the quality of care and inform the body of this consideration. If a consumer advisory body is formed, records must be kept about its composition.

Constitutions of Providers

There are also new requirements related to aged care providers who are a wholly-owned subsidiary of another body corporate that is not an aged care provider. To ensure that the interests of consumers are always placed first and foremost, a provider cannot allow their constitution to authorise a director of the provider to act in the best interests of the holding company.

Key Dates

These requirements apply from 1 December 2023 for existing providers. For providers who are approved after 1 December 2022, the requirements apply immediately.

More Information

• Aged Care Quality and Safety Commission: Strengthening Provider Governance
• New Governance Responsibilities for Aged Care Providers Commence 1 December 2022
  
  

Potential Wage Increase for Aged Care Workers

In April 2022, the Health Care Services Union (Union) and the Australian Nursing and Midwifery Federation (Federation) brought a case before the Fair Work Commission (FWC), seeking to vary several awards to increase pay for aged care workers by 25 per cent.

On 4 November 2022, the FWC released a Summary of Decision. Under the heading “An Interim Increase”, the decision states that a 15 per cent wage increase for direct care workers in the Aged Care and SCHADS Awards and nurses working in aged care who fall under the Nurses Award, was “Plainly justified by work value reasons”. The FWC also noted that this ruling would not conclude their consideration for a 25 per cent increase for employees, specifically those in administrative, kitchen, cleaning, and other support roles. The FWC further stated “Nor are we suggesting the 15 per cent interim increase necessarily exhausts the extent of the increase justified by work value reasons in respect of direct care workers.”

Key Dates

The case is not yet resolved. The parties are discussing the issues and must report back to the FWC on 28 February 2023. The FWC will then decide on the next steps.

More Information

• Fair Work Commission: Work value case – Aged Care Industry
• Wage Increase for Residential Aged Care Workers: Update November 2022