For providers grappling with care minute targets, the holiday season delivered a sobering message.
Between December 10 and 24, the ACQSC issued an unprecedented 23 enforceable undertakings (EUs) to aged care providers. Of these, 22 cited consistent failure to meet care minute targets—a sharp escalation from the mere 3 issued in 2023. While the Commission’s rhetoric just over a year ago in December 2023 assured providers they wouldn’t face punishment for missing targets if they acted in good faith and avoided risking resident safety, the recent flurry of EUs confirms a significant shift.
Interestingly, no Western Australian providers were included among the 12 operators that entered enforceable undertakings. Further, all but one of the providers involved were for-profit operators, reigniting sector discussions around the different tax treatment for ‘for-profit’ and ‘not-for-profit’ providers.
The Commission’s focus has been sharpest on services with care minute gaps of 30 minutes or more and those falling short of the 24/7 RN requirement by 15 minutes or more. Providers whose care spending appears low relative to their funding have also come under increased supervision, including site visits to monitor risks to care quality.
One can also expect that, the Commission will be scrutinising how boards use their care minute data as well as sector benchmarks to inform their clinical government decision-making and continuous improvement agendas (particularly once the strengthened Aged Care Quality Standards commence).
So, why are care minutes still proving elusive for some? Metro providers, in particular, have drawn criticism for failing to meet targets. Many argue this is less about intent and more about the operational realities of urban environments. Workforce shortages, compounded by high turnover and cost-of-living pressures, create bottlenecks that are hard to overcome. Metro providers also face added scrutiny due to comparisons with neighbouring services that may not face the same challenges, further amplifying the pressure.
The Commission reports some progress—services with large care minute shortfalls have dropped from 319 in June 2024 to 149, and fully compliant services have increased from 805 to 1,042. These figures highlight a significant effort by providers to achieve compliance under difficult conditions.
While an EU doesn’t immediately spell disaster, it does place a provider on a precarious footing. A breach can result in legal and financial penalties, further destabilising operations. Compliance is now non-negotiable, yet increasingly challenging to achieve. Providers under scrutiny can expect case management, site visits, and, where needed, enforceable undertakings or non-compliance notices. The Commission has also warned of investigations for breach of the Aged Care Code of Conduct for “providers intentionally avoiding compliance,” which could attract court-ordered penalties of up to 250 penalty units per contravention.
With an election looming, it is hard not to notice Minister Anika Wells’ directive to the ACQSC emphasising stricter oversight of 24/7 nursing and mandatory care minutes comes when, historically, governments have leaned on "tough on compliance" narratives when seeking voter trust.
The government has also announced significant funding changes. From October 2025, AN-ACC funding for non-specialized metropolitan services (MM1) will be reduced by up to $31.64 per resident per day for providers failing to meet care minute targets. Compounding this, the federal government has introduced new policies to shift residential aged care payments into arrears starting July 2026, effectively removing $2.5 billion from the sector. These changes will challenge providers already grappling with tight margins and rising operational costs.
The appointment of Liz Hefren-Webb as the Commission’s new head adds a layer of unpredictability.
Whatever the drivers, providers must adopt proactive strategies to address care minute targets while securing their cashflow and financial footing. Providers should also be carefully integrating care minute data analysis into their clinical governance frameworks in preparation for the increased focus on clinical governance come 1 July 2025.
For legal guidance or general discussion, contact Amber Crosthwaite at 9288 6931 or amber.crosthwaite@lavan.com.au.
