The royal commission says transparency and accountability should be embedded in the new aged care system.

The aged care royal commission has put forward recommendations to make providers more accountable for the expenditure of taxpayer funds.

It says residential care providers get about $11.7 billion in federal government care subsidies.

“However, there is no specific requirement on residential aged care providers to spend any portion of the money they receive on care,” it points out.

It recommends that all residential care providers should report, on a quarterly basis, the “total direct care staffing hours” provided each day at each facility they conduct.

Reports should specify the different employment categories, including personal care workers/AiNs, enrolled nurses, registered nurses and allied health care professionals engaged in direct care provision.

The commission wants the government regulator to assess the reports against minimum staffing     requirements and take action if providers don’t meet standards.

The commission also wants greater transparency by home care providers.

At present, they are paid subsidies for each month in advance, regardless of the services actually provided.

“This means the Australian Government is wholly reliant on approved providers for accurate financial reporting and reconciliation of funds,” the commission points out.

“This arrangement has several undesirable effects, including the accumulation of ‘unspent funds’ and a lack of clarity regarding what services are delivered.”

To increase “efficiency, transparency and accountability” the commission recommends that home care providers be paid from home care packages after services have been delivered or after “liability to deliver them has been incurred”.

Providers cry poor – but no transparency

Owners of some rural and regional aged care facilities recently told an NSW Upper House inquiry they will “go out of business” if they are required to have a registered nurse on site 24/7.

Inquiry chairperson Courtney Houssos asked Charles Sturt University Associate Professor Maree Bernoth, an NSWNMA member, to respond to the claim.

Professor Bernoth asked, “How do we know that, when there is no transparency required of aged care facilities?”

“Except for those in Queensland, I believe these facilities do not have to share with us their financials. We do not know how much they are spending on staff.

“We do not know how much they are spending on equipment. We do not know where our taxpayer money is being used.

“That lack of transparency … means that the aged care facilities cannot claim that they are going out of business. We need to see where their money is being spent, and then maybe we can make some comment, but until then we cannot.

“Secondly, if that is so, why do we have so many aged care facilities in rural areas that are doing very well? There are quite a few aged care facilities that have registered nurses and are doing very well.”