Feb 12, 2025

The impossible equation: Why aged care minutes don’t add up

The impossible equation: Why aged care minutes don’t add up

Australia’s aged care sector is under immense pressure to meet government-mandated care-minute targets, introduced as part of reforms following the Royal Commission into Aged Care Quality and Safety.

The targets, set at 215 minutes of care per resident per day — including 44 minutes of direct care from a registered nurse (RN) — aim to improve the quality of care for elderly Australians.

However, when we break down the numbers against real-world staffing ratios, shift structures, and operational demands, it becomes clear that these benchmarks are unrealistic — if not impossible — to achieve.

The numbers don’t add up

Our calculations, based on a 100-bed aged care home operating under common staffing ratios, highlight a critical discrepancy between what is mandated and what is physically possible:

  • Actual Care Minutes possible per resident per day:
    • Personal Carers: 75–80 minutes per resident per day (vs. the required 171 minutes)
    • Registered Nurses (RNs): 18–20 minutes per resident per day (vs. the required 44 minutes)

This means that providers are being held to a standard that requires over 50% more time than can realistically be delivered under current conditions.

Why meeting this standard is physically impossible

A range of operational and workforce challenges make it clear why achieving the mandated care minutes is an uphill battle for providers. These challenges stem from fundamental issues in staffing availability, shift structures, and regulatory burdens, all of which contribute to a growing shortfall in meeting compliance requirements.

  1. Staffing ratios are already stretched
    • A typical aged care home operates with 1 carer per 10 residents in the morning, 1 per 13 in the afternoon, and 1 per 30 overnight. RNs are even scarcer, with 1 RN per 50 residents during the day and 1 per 100 at night.
    • These ratios mean that even if carers and RNs worked at full capacity, they do not have enough hours in the day to meet the mandated minutes. 
  2. Breaks, handover & documentation reduce direct care time
    • Staff are entitled to one hour of breaks per shift (30-minute meal break + additional short break).
    • Each shift starts with a 30-minute handover and ends with 30–45 minutes of documentation to comply with reporting requirements.
    • This reduces the actual time available for direct care to approximately 6 hours per shift per worker. 
  3. Night Shifts Leave Huge Gaps
    • Night duty operates with a 1:30 carer-to-resident ratio and 1 RN per 100 residents.
    • Under these conditions, a night-shift carer has 12 minutes per resident, per shift—nowhere near the required standard. 
  4. Recruitment and workforce shortages are a crisis
    • The government’s mandated care minutes assume that the workforce is readily available to increase staffing levels. It isn’t.

The sector is already struggling with workforce shortages, meaning increasing headcount to meet mandated care minutes is unrealistic without major workforce investment.

HelloCare spoke with an industry veteran who highlighted this issue, stating, “When you factor in all the necessary breaks, the handovers, the documentation… it’s just not physically possible to meet the numbers without compromising the quality of care.”

For smaller facilities, such as those with 50 beds, the situation is even more complex. While these facilities may exceed RN care-minute requirements due to having 24/7 RN coverage, this often leads to overstaffing based on government measures, resulting in poor financial outcomes.

A questionable benchmark

Given these constraints, how are providers expected to meet these targets? It is no surprise that providers are struggling to meet reporting requirements, given that the mandate itself is mathematically impossible.

In fact, the real question is: How have only a handful of providers been found non-compliant, when in reality, these requirements exceed what is physically possible by more than 50%?

Instead of imposing unattainable benchmarks, policymakers must engage with providers to develop practical solutions that reflect the realities of aged care operations. Until then, the sector will continue to grapple with a compliance expectation that is out of reach.

The Department of Health and Aged Care was approached for comment on the suitability of these benchmarks. However, they failed to directly address the question of whether the targets are realistic or achievable for a large number of providers.

Instead, the department emphasized its risk-based assurance reviews to verify self-reported data, sidestepping the core issue of systemic feasibility.


Disclaimer:
The information provided in this article is based on industry research, operational data, and publicly available workforce statistics. The challenges and calculations presented are general in nature and may vary depending on individual facility circumstances, noting that even when the ratios are increased/decreased marginally the care minutes are still unattainable. 

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  1. They need to reduce RN minutes and factor in some of these minutes to be EN’s. They are missing a whole sector of EN nurses especially when struggling for RN’s.

  2. I have worked and still work in aged care for over 30 years. For all these years my residents have received excellent care without care minutes being calculated. We do not have staff to residents ratios. I have over my time worked in homes ranging from 50 beds to 150 beds In big cities and small regional towns. With 1 RN on a floor of 40 plus residents. BUT back then there was not as much paperwork to be completed we did our progress notes. Made our care plans and kept them up to date. Wound care documentation.
    But now there is so much more we have to do. Such AN-ACC documentation has to be just right or you do not get the right funding for the care you are giving. Behaviour support plans for those with severe behaviours have to be correct to match the restrictive practices (that we have to remember to ensure they are signed and revised
    every 3 months ) dignity of risk forms if a resident chooses to use their walking aid, or eat the modified diet they have been assessed in.
    Dietician annual reviews for the meals there new regulations that the nurses have to ensure they residents are receiving the care with their meals.
    All the benchmarking we have to keep under to ensure compliance. Quality standards. SIRS reporting Etc just to name a few which takes the RN away from the resident

    I am now a care manager and all these new rules
    and regulations have made what was an enjoyable job that you felt privileged to be working in so stressful not just for the management but for the nursing staff aswell. I used to have time to go out in the floor to help and sit and talk to the residents etc not now my job is desk bound. I still do go and talk with the residents and help my overworked staff but to my own detriment as I work long hours and sometimes weekends at home to ensure everything is compliant.

    I know there were and maybe still are some bad homes out there but please I wish the government would get off our backs because before long there will not be an aged care home for our beautiful elderly residents to go into and that would include some of these politicians who have put all these regulations in place.

    I agree there has to be a standard of care but this is now ridiculous

  3. The Department of Health’s own modelling in 2024 showed the shortage of RNs in aged care is 9,900 FTE in aged care and 27,000 FTE overall. The modelling goes on to show that this shortage will only worsen out to 2035. Setting unmeetable but nice-sounding targets means Governments get to pass blame to providers instead of explaining to taxpayers that good quality care is possible with lower care minutes. We will never have the labour to meet the targets and need to focus our efforts on providing the best quality care with available labour – that’s not possible when providers are scrambling to try to comply with impossible targets.

  4. You have to wonder who The idiots were who came up with these minutes. If You have Residents who require 2 Carers to change/bathe Them, that in itself takes time. Then there are meal times where You have to stop what You are doing to ensure Residents are fed……
    Come into the real world and see for yourself what is required on Carers and R.N’S.

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