The Australian National Aged Care Classification (AN-ACC) care funding model will replace the Aged Care Funding Instrument (ACFI) from 1 October 2022. This article explains the new care minute standards which are being introduced for residential aged care facilities as part of the AN-ACC funding model.
The Government is introducing mandatory care minute standards for residential aged care in response to the 2021 final report of the Royal Commission into Aged Care Quality and Safety (Royal Commission), which identified staffing levels as vital to the quality of the care residents receive.
The AN-ACC model will provide more equitable care funding to providers that better matches resident funding with the costs of delivering care enabling a more efficient, transparent and sustainable system. This will enable residential aged care providers to increase staffing levels to meet the new care minute requirements (targets).
What are the care minute requirements?
‘The most important policy measure for ensuring appropriate staffing levels is to adopt a regulatory requirement that establishes a minimum staffing level.’ The Royal Commission into Aged Care Quality and Safety Final Report, 2021 Ensuring every aged care service has a registered nurse on site 24 hours a day, 7 days a week by July 2023, and improving care by having more carers with more time to care are key components of the Government’s plan to improve aged care.
Consistent with the Royal Commission recommendations, from 1 October 2023, the initial care minute requirements will be set at a sector wide average of 200 minutes per day, including a minimum of 40 minutes of registered time. This will be based on care provided by registered nurses, enrolled nurses and personal care workers. Funding will be provided from 1 October 2022 (the commencement of AN-ACC) in recognition that it may take some time for providers to attract and retain staff.
The Government’s policy is that, from October 2024, the care minute requirements will increase to a sector wide average of 215 minutes per day, including a minimum of 44 minutes of registered nurse time.
What are casemix-adjusted care minutes?
Under the AN-ACC care funding model, each aged care resident will be assigned one of 13 AN-ACC classifications, based on an independent assessment to determine the variable funding component the provider will receive to meet the resident’s care needs. See What is AN-ACC and how will it work for more information about AN-ACC classifications.
Each AN-ACC class will have a specific care minute target that reflects the different care needs of residents in that class. This ensures the alignment of care minute targets with funding.
The targets for care minutes (initially 200 minute and 40 minute of registered nurse time) are an ‘average’ target across the sector. In practice, each residential aged care facility will have its own care minute target reflecting the AN-ACC casemix of residents in that facility.
For example, a facility with mainly higher needs residents will have a higher average care minute target than a facility with mainly lower needs residents.
How do I access my care minute targets?
Providers can expect to be able to access their quarterly care minute targets from August 2022, for each facility they operate from the My Aged Care Service Provider Portal
In the meantime, providers can access their residents’ AN-ACC classifications in the My Aged Care Service Provider Portal once their assessments have been completed and use this information to estimate the average care minute target for their facility. The average care minute target for each facility will be casemix-adjusted each quarter based on the total number of days each resident was in care and the specific care minute targets for each AN-ACC classification over the preceding three months.
See How do I calculate my care minutes targets for more information on the care minutes requirements for each AN-ACC class and guidance on how to estimate care minutes targets.
How will care minute performance be measured?
Since October 2021, providers have reported care staffing minutes per facility in their annual Aged Care Financial Report (ACFR). From 1 October 2022, reporting on care staffing minutes will move to quarterly reporting and will be included as part of the new Quarterly Financial Report (QFR). Data from QFRs will be used to determine each facility’s performance against their care minutes requirements.
The Aged Care Quality and Safety Commission will receive strengthened regulatory powers to enforce the care minutes standards and reporting requirements, as well as other new quality measures.
What care staff time is included in care minute calculations?
Consistent with the recommendations of the Royal Commission, the following types of care staff will be included in care minutes calculations:
registered nurses (registered with the Nursing and Midwifery Board of Australia)
enrolled nurses (registered with the Nursing and Midwifery Board of Australia)
personal care staff/ assistants in nursing.
‘Worked hours’ of registered nurse, enrolled nurse, and personal care worker staff will count towards care minutes. This excludes staff leave time and training.
Is resident care delivered by care management staff and staff in hybrid roles counted?
Where a registered nurse, enrolled nurse or personal care worker is employed in a hybrid role, for example providing both personal care and other activities such as catering and laundry, the portion of the worker’s time spent on personal care can count towards care minutes.
The portion of time that care management staff spend on care of residents can also be included in care minutes if they are a registered nurse, enrolled nurse or personnel care worker. For example:
managing the care of individual residents through tasks such as providing advice about or performing wound management, diabetes management, behavioural management, medication management, nutrition and hydration management, pressure care management and incontinence management.
identifying and documenting changes to a resident’s health status, care planning and liaising with residents and families, engaging with health providers including arranging appointments to ensure residents’ needs are met.
Care management staff activities that are administrative or not related directly to the care of individual residents, such as staff rostering, recruitment, and facility level planning and reporting, cannot be counted towards care minutes.
A residential aged care facility employs registered nurses, enrolled nurses and personal care workers. They also employ care management staff and aged care workers who work across the kitchen and laundry and also assist with resident personal care, depending on the requirements of the facility each day. Only the portion of time that care management staff and staff in hybrid roles spend on care of residents can be included in care minutes.
Only the care time entered in the QFR against the categories of registered nurses, enrolled nurses and personal care workers will count towards care minutes. However, they determine that care management staff spend, on average, one third of their time on resident care activities such as providing advice and supervision in relation to complex nursing requirements.
When completing the QFR, the facility apportions the worked time of care management staff, entering two thirds of their worked time in the care management staff category and the remaining third in the categories of registered nurse, enrolled nurse, or personal care worker, depending on the qualifications of care management staff.
They are also able to include the time spent on personal care by workers who undertake a variety of roles in the facility under the category of personal care.
Will there be sufficient funding to meet the new care minute standards?
1 October 2022, the Government will deliver a funding boost over three years (and then ongoing) to enable residential aged care providers to increase staffing levels to meet the new care minute standards.
Reporting on care minutes will be one of the measurable indicators used to inform a new star rating system on the My Aged Care website, that will be introduced from December 2022. Star ratings will further increase residential aged care accountability and help consumers to make more informed choices by providing meaningful information about the quality of services. See star ratings for residential aged care for more information.
Can care minute reporting be automated?
“The challenge for the aged care providers is how to capture and report the time spent with each resident without this becoming an administrative burden on their staff, taking them away from focusing on providing the best possible care for their residents”.
“In order to eliminate this burden, you can use a Care Minute Reporting System based on Real Time Location System (RTLS) technology. This system automatically captures every interaction between caregiver, registered nurses and resident with detailed real-time reporting and alerts to ensure each resident receives the right amount of care minutes.
More information and resources
Further information about the AN-ACC care funding model, including general information, is available on the residential aged care funding reform webpage.
See How to automate Care minute reporting for Australian Care Providers for more information, or book a call with us.
Source: What are Care Minutes?