Nursing targets forcing aged care beds to close, members warned

A confidential briefing from the Victorian Healthcare Association to its members warns the state’s rigid workforce rules are forcing beds to close.

​One in five public aged care beds are being forced to close under Victoria’s union-backed nurse-to-patient ratio requirements

One in five public aged-care beds is being forced to close under ­Victoria’s union-backed nurse-to-patient ratio rules, sparking warnings that Labor’s 24/7 nursing targets will trigger residential aged-care shutdowns when they come into force next month.

The bed closures come as figures from the Department of Health and Aged Care project a nursing shortfall of about 8100 in residential aged-care facilities between 2023-24, as the sector grapples with new reforms including 24/7 nurses and minimum care requirements.

A confidential briefing from the Victorian Healthcare Association to its members, obtained by The Australian, has warned the state’s rigid workforce rules – ­requiring at least one registered nurse per seven residents in the morning, eight in the afternoon and 15 at night – are further ­exacerbating critical nursing workforce shortages.

The staffing requirements were implemented in 2015 after significant lobbying from the Australian Nursing and Midwifery Federation, which argued staffing ratios eased workloads for nurses and ensured residents received better-quality care.

But the VHA has expressed concern that Victoria’s staffing requirements are inhibiting the ability of providers to service the public, with about 20 per cent of beds sitting vacant according to industry figures.

The VHA has warned that the workforce rules were not recommended by the Royal Commission into Aged Care Quality and Safety, and has called for the law to be amended to enable state-owned providers to hire personal care workers to alleviate critical workforce shortages and deliver high-quality care and residential aged care to older Australians.

The sector is concerned that the aged-care closures across the state are forcing elderly people into hospitals for non-acute conditions, clogging up the healthcare system and leading to shortages in acute beds designed for elective surgeries.

“This problem is currently closing around one in five publicly funded aged-care beds in Victoria at a time when other aged-care services are closing their doors nationally,” VHA chief executive Leigh Clarke said.

“We are deeply concerned about how this is impacting on people needing care in their own communities and the flow on ­effects for their families and other health services which often care for people waiting for residential aged care.”

According to Victorian industry figures, there are currently about 1200 empty beds out of 5300, with workforce shortages preventing providers from ­accepting new residents.

A Victorian government spokesman said no public sector aged-care beds had closed due to nurse-to-patient ratios and that the state government remained committed to the policy.

“We will always protect nurse-to-patient ratios – that’s why the Victorian budget 2023-24 invests $42m to help meet these ratios and ensure older Victorians get the best possible care,” the spokesman said.

Opposition health spokeswoman Anne Ruston said the Victorian aged-care closures were a “serious warning sign” of potential further stress to be put on the sector ahead of Labor’s 24/7 nursing targets set to take effect next month.

Senator Ruston said older Australians should not be forced out of their homes as a result of rigid workforce constraints, and that Labor governments were putting “politics and their union mates” ahead of care for the elderly.

‘This is a serious warning sign of potential further stress that Labor governments are prepared to put on the aged-care sector to appease their union mates,” Senator Ruston said.

“Implementing additional, mandated staffing requirements in the middle of a workforce crisis is irresponsible and will have significant detrimental consequences,” she said.

Aged Care Minister Anika Wells said facilities would not be forced to shut down if they could prove they had made genuine attempts to have a nurse onsite 24/7.

She told The Australian that the “vast majority” of providers would meet the 24/7 nursing target by July 1, and that the federal government would work with those unable to help them meet it “as soon as possible”.

“Come July 1 there will be many, many more nurses providing many, many more hours of care in nursing homes because of our 24/7 reforms,” Ms Wells said.

But The Australian last month revealed at least 23 aged-care homes had shut their doors since September last year, with a ­number of providers citing difficulty in attracting and retaining staff to meet the government’s targets.

The sector is scrambling to ­implement a suite of reforms including mandated minutes of care per resident, quality and safety standards and full-time nursing requirements, as it adjusts to a new funding model brought in last Oct­ober as recommended by the aged-care royal commission.

The overhaul comes as financial troubles plague the sector, with the latest figures from the Quarterly Financial Snapshot of the Aged Care Sector revealing 42 per cent of private providers are operating at losses.

One Victorian provider who spoke on the condition of anonymity said it was facing a $500,000 budget black hole which was projected to grow to $1m by the end of the year amid significant costs to rural and ­regional aged care.

The provider currently runs 69 beds in regional Victoria and has 24 people on its waiting list that it is unable to admit due to tough workforce requirements in the state.

Opposition immigration spokesman Dan Tehan, who represents the regional Victorian electorate of Wannon, said Victoria could no longer keep operating and urged the Victorian government to resolve the issue “as soon as possible”.

“We can’t keep operating with 20 per cent of our beds closed in our public aged-care sector in ­Victoria,” Mr Tehan said.

“That is 1200 people currently missing out on a bed with the number growing. This needs to be resolved as soon as possible.

“VHA is engaged in good faith with the Andrews government, they have to reciprocate on that good faith.”