Mar 10, 2023

24/7 nurse mandate concerns escalate as date creeps closer

Concerns that more aged care homes will become at risk of closing down when 24/7 nursing requirements are mandated in July are growing among industry stakeholders.

These concerns are especially prevalent among providers in rural and regional areas where Registered Nurses (RN) are even more scarce than in metropolitan Australia.

From July 1, all aged care homes must have at least one RN on duty at all times but aged care providers fear more reprimanding from the Aged Care Quality and Safety Commission as they struggle to obtain enough nurses to meet the mandated requirements.

The 11-bed Allambi Elderly Peoples Home in Dimboola, western Victoria, closed last November, claiming the mandate has made it unviable to operate.

But the Aged Care Amendment (Implementing Care Reform) Bill 2022 outlines that providers will be able to get an exemption from the requirement if they are unable to meet the new regulation and for homes with fewer than 30 residents in regional areas.

Wheatfields Residential Care’s 53-bed complex in Freeling, north of Adelaide, is not eligible for an exemption and is concerned it could face sanctions from the Commission if it can’t employ RNs to work around the clock.

This week, Wheatfields’ Chief Executive, Michelle Schupelius, told The Advertiser that the Government’s “one size fits all model” showed a “lack of recognition” for Enrolled Nurses who also provide clinical care in aged care homes.

“In our region alone, it is estimated that over 50 Registered Nurses will need to be employed to meet this legislation. This is in a small radius of 30 kilometres in a regional area,” she said.

“There is also competition with several aged care facilities with acute care facilities seeking Registered Nurses.”

Aged care homes with fewer than 61 residents can receive monthly financial supplements from the federal government to help employ extra nurses based on the number of residents a facility has and its location.

But Aged and Community Care Providers Association’s (ACCPA) Chief Executive Officer, Tom Symondson, confirmed to ABC News yesterday that more and more providers were concerned about meeting the mandate deadline, stating the world is experiencing a dire shortage of RNs.

“I’d love to think that … by the deadline in July and also in October … that we could have every single worker that we needed,” he said. 

“I don’t think it’s realistic to say that we will. I just don’t think that’s likely.

“It’s a very stressful time for us in the aged care sector.”

A Spokesman for the Commission told The Advertiser that a provider failing to meet the 24/7 nursing requirements was not enough on its own for the Quality and Safety Commission to close its facility.

“The Commission is unlikely to consider escalated compliance action in relation to the 24/7 RN responsibility where a provider is making a genuine ongoing effort to fulfil this responsibility and has an ongoing history of delivering safe care,” the Spokesman said.

“However if we received complaints about care arrangements at that service and/or other intelligence was available that raised concerns about its care, then the Commission would engage directly with the service to assess what was happening and make an informed decision about whether compliance and enforcement action was warranted.”

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  1. “The exemption framework is therefore an appropriate and proportionate limitation on the right to health as it recognises the difficulties approved providers of residential facilities in rural, regional and remote areas may face in accessing sufficient staff of registered nurses to consistently meet the 24/7 RN responsibility while also ensuring that the clinical care needs care recipients in a residential facility are still being met even where an approved provider is unable to meet the 24/7 RN responsibility in respect of particular residential facility.”

    I am very concerned about this sentence on exemptions and understand it to mean that if there are no RNs then that’s OK — facilities don’t need to worry about important things like assessing residents, giving meds, looking for side effects, handling falls, head injuries # femurs, UTIs, fitting, pressure ulcers, skin tears etc. etc.…………… I could go on & on.

    How can clinical care needs be met if there is no RN?? How are Schedule 8 drugs going to be properly checked and given? Who is giving insulin and checking BSLs?
    I am furious………just lots of excuses not to hire.

    If the thousands of unjabbed nurses who were terminated, across the country, 18 months ago, were re-instated part of the problem may be rectified.

  2. I have no qualms with reporting concerns and issues associated with the new reforms however please desist from using alarmist statements then following with what can and does actually happen.
    Have you ALL the details of why Allambi decided to close its doors- think you will find it considerably more than what you have reported.

    1. An eleven bed facility, a fifty bed or even eighty place facility would struggle to survive financially. These little homes have no economy of scale and require just too much labour and cost to stay open. They should close, they have to close because no one can fund this.

  3. The problem with mandating at least one RN, the larger for profit facilities will have one RN, as most already do but this is for 160 residents, this is where it is grossly inadequate. Until ratios are mandated in private nursing homes care for our most vulnerable people will still be nowhere near the standard it should be. What is needed is more care staff on the floor doing the basic work like getting our aged to the toilet when they need to go, and taking time assisting with feeding, showering, and importantly cleaning teeth; this is what is needed. The RN does not have time to help with the basic care needs, by mandating an RN on duty is not going to improve the residents daily living standards. Throwing money at private nursing homes very rarely filters down to where its needed, providing care.


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