Aged care: is a blunt instrument being sharpened?

Article published 26 June 2019

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THE Australian Government is considering a new system of working out the cost of nursing home care. It’s only about the cost of care, not about nursing home bonds or anything else.

How much does it cost to look after a nursing home resident given their health and needs?

The current system comes up with a figure, but nobody really knows what it is based on. That may seem strange, given that the Australian Government spends billions based on what that system calculates, but it’s a fact.

The current system doesn’t estimate how many staff hours go into providing care for a resident, for example, even though the industry reports that approximately 70 per cent of a nursing home’s cost are staffing costs.

However, the new system, the one the Government is thinking about, does make an estimate of staffing costs.

That’s progress, you might say. And it is, because this new system makes it possible to add up all the care staff hours for all the residents in a nursing home and out rolls: a staff-to-resident ratio for the whole nursing home.

All that’s needed now is to make that ratio mandatory and we have a mandatory staff-to-residents ratio.

It’s not a blunt instrument at all. The costing system calculates how much time a nursing home needs to spend on caring for residents at any point in time. It is then only reasonable to demand that that time be made available by the nursing home.

There is one, huge concern, though.

The new system is based on measurements of how much time staff spend on residents now, that is: under the old system. Under the old system, understaffing and underqualified staffing is rife. This means that basing the new system on the old system is going to produce an understaffed and underqualified care system.

Yes, this new system would be capable of delivering mandatory staff-to-resident ratios, but it would deliver inadequate mandatory staff-to-resident ratios.

While the idea to finally make a calculation of care costs (and subsidies) based on staff time spent is good, you don’t want to contaminate the new system with the well-publicised and significant failings of the old system.

But it seems that that is what is about to happen, unless the Government is compelled by evidence at the Royal Commission and ensuing recommendations by the Royal Commission to address the issue of understaffing.

For those who want to read up on the new system, check out the Department of Health’s pages on the Resource Utilisation and Classification Study (RUCS) as well as CPSA’s submission relating to the new system, which is called the Australian National Aged Care Classification (AN-ACC).

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