An aged care advocate wants the federal government to support facilities in rural and remote areas to have registered nurses, rather than giving them an exemption to the requirement.
Labor's aged care reforms includes a requirement for there to be a registered nurse (RN) on-site at aged care facilities at all times, but there will be exemptions for rural facilities that are unable find staff.
Charles Sturt University academic Maree Bernoth acknowledged the regional workforce shortages but said the government was taking an "easy" option.
"Our older people in rural areas deserve the same standards of care as everywhere else," Dr Bernoth said.
"We shouldn't be looking for a lesser standard or a lesser qualification of people working with our rural older people than is available in metropolitan areas."
A Senate committee is considering the proposed legislation for 24-7 registered nursing in aged care and will report back at the end of August.
Paul Sadler from the Aged and Community Care Association said exemptions were necessary, particularly for facilities in rural and regional areas.
"In particular we don't want the process of making it mandatory to have a registered nurse 24-7 mean at the end of the day that small aged care homes in country towns have to close because they fail to do that," Mr Sadler said.
RNs 'like hen's teeth'
At Hillston in south western NSW, the community-run aged care facility has first-hand experience of the challenges in recruiting a registered nurse.
Board member John McKeon said the first registered nurse for the 18-bed facility was employed last year after but finding her somewhere to live was also a problem.
"It's very hard to get accommodation for people, especially out of town people," Mr McKeon said.
"The manager we have now has to live in a caravan park which is far from satisfactory.
"It's almost double the cost to have a nurse on your staff as it is a standard care worker, if we need to have more than one nurse it's going to cost a lot more money and we would struggle without government assistance."
It is a similar story at Coleambally, also in southern NSW, where the not-for-profit aged care home provides 18 beds for full-time residents and one for respite service.
Manager Karen Hodgson said she was lucky to have two part-time registered nurses.
"Registered nurses are just like hen's teeth, they're just not out there, they're certainly not in our community but they are not even the wider community," she said.
Concern for the future
Ms Hodgson said there had been no detail about how the proposed exemptions to the aged care reforms would be applied.
"We just want to keep providing the excellent care that we do but I worry about these 19 people; what's going to happen to them," she said.
"We run here so that the elderly in our community can stay here, so that they don't have to go to the nearest town, which is 50 minutes away ... My concern is where do they go if we shut our doors?"
Dr Bernoth said long-term strategies were needed to tackle the underlying problem of workforce shortages.
"In our smaller centres we need to think about reliability and certainty of employment, accommodation once they're there, and a career pathway for them," Dr Bernoth said.
"I would suggest we think of a another model … where a team of registered nurses might be able to move around a number of smaller facilities."
The Department of Health and Aged Care says it will consult with unions and experts to see what registered nurse exemptions are needed.
It says it also has plans to bolster the nursing workforce, including extra university training places, and making a submission to the Fair Work Commission for increased pay for aged care workers.
There are also plans to increase the supply of registered nurses through the Pacific Australia Labour Mobility Scheme, it added.
