StewartBrown’s financial report for the 2021 financial year, which is based on surveys of 1,277 aged care homes and 53,559 home care packages from all around Australia, reveals a sector in continued decline, with real questions about sustainability.
“Homes in all locations, including metropolitan, regional and remote locations are making operating losses, which is unsustainable in the longer term,” the report states. Next year is also shaping up to be “challenging”, the report’s authors predict.
“Additional specific targeted funding and structural reform is required,” they said.
The average operating loss for all residential aged care homes was $8.43 per bed per day (pbd), excluding net COVID-19 funding support which is unlikely to continue. The result compares with an operating loss of $6.90 pbd during the 2020 financial year, meaning a deterioration of $1.53 pbd over the year.
In the 2021 financial year, the direct costs of providing everyday living services (excluding administration costs) exceeded the revenue by $9.78 pbd (compared to $9.20 pbd in 2020). However, with administration costs included – such as procurement, payroll, rosters, accounts, quality control, insurances, human resources and corporate costs – the loss increases to a worrying $22.29 pbd.
However, a portion of these funds will be required for the additional costs of showing the requirements of the supplement have been met: providers must show that the quality and nutritional component of their food is meeting expectations and is improving.
Metropolitan homes also received lower COVID-19 funding, and regional and remote homes benefited from the 30% viability supplement.
Metropolitan homes made an operating loss of $8.83 per bed day, compared to an operating loss of $8.00 per bed day for inner regional and $6.32 per bed day for rural and remote homes.
The growth in revenue did not keep pace with rising costs.
The government’s indexation increase of 1.1% was not enough to cover the 0.5% increase in the Superannuation Guarantee Scheme, wage award increases of between 1.75% and 3.5%, and an inflation rate of 3.8% for June year.
An increased compliance burden is also adding to providers’ costs, and are likely to continue to do so in 2022 due to the increased compliance burden of the Quality and Safety Standards, Serious Incident Response Scheme, COVID-19, ACFR reporting, and greater scrutiny of direct care staffing costs.
Medium-sized homes performed best. Homes with more than 100 beds recorded a loss of $10.35 pbd, compared with a loss of $6.01 for 80-100 bed homes and $8.47 for 60-80 bed homes. This may in part be due to the fact that larger homes tend to accept a greater range of residents, whereas smaller homes may focus on residents of a specific cohort.
The worst-performing homes are performing worse than ever, with the bottom 75% of homes (based on financial performance, a worrying 872 homes) recording an average loss of $18.38 per bed day, a deterioration of $1.19 per bed day compared to the previous year.
However, more is needed. The government has mandated a minimum of 200 minutes of direct care per resident per day, which will require an increase of 24.19 minutes of staffing per day from 2021 staffing levels – a 13.8% increase.
“To achieve this mandated level will require additional direct care staff to be employed,” the report states. “This will be a significant challenge for the sector, particularly in regional, rural and remote locations where registered nurse availability is at a premium.”
An average of $33.09 per resident per day is spent on food, food preparation and the serving of food, up from $32.00 in 2020.
The surveys found that 63% of providers operate their own kitchen, while 12% use contract food suppliers with their own on-site kitchen to prepare meals.
In the home care sector, operating results improved during the 2021 financial year, however, this was largely driven by reduced direct care staff costs and lower hours of care.
Revenue per client per day rose to $72.08 from $71.08 in 2020. The operating results per client per day increased to $6.05, up from $3.59 the previous year.
Unspent funds remain a significant problem in the home care sector, soaring to an average of $9,855 per consumer and a shocking $1.6 billion in total, representing funds tied up and unable to be used for care.
The large differences in funding between each package is “a major contributor to the exponential increase in unspent (unutilised) subsidy funding,” the report notes. The matter requires urgent reform, the report’s authors note.