Staffing for Small vs Large Aged Care Providers: What Changes
By Care Steps Australia
By Care Steps Australia | Last updated: 29 October 2026
Every residential aged care home must have at least one registered nurse onsite and on duty at all times, and must meet its own care minutes target, whatever its size. What changes is the margin for error and the funding attached. Homes with 50 or fewer residents can receive the 24/7 RN supplement, and a single staff absence hits a small roster harder.
Key Takeaways
- The 24/7 RN requirement and care minutes apply to every approved residential care home, small or large.
- The 24/7 RN supplement is only for homes averaging 50 or fewer residents a day. Homes averaging 30 or fewer can get a reduced-rate supplement while they build RN coverage.
- About a third of Australian residential aged care services are small (60 or fewer places), and their number fell 32% between 2017 and 2025.
- Small homes have fewer staff to cover each absence. Large homes and multi-site providers have more shifts, wings and targets to track at once.
- Short-term agency staff are most useful when they match the role in the gap: RN, EN or personal care worker.
Aged Care Staffing at a Glance: Small vs Large Homes
Size bands are from the Australian Institute of Health and Welfare (AIHW). Supplement rules are from the Department of Health, Disability and Ageing.
What Counts as a Small, Medium or Large Aged Care Provider?
AIHW groups residential care services by operational places: small services have 60 or fewer places, medium services 61 to 100, and large services 101 or more.
At 30 June 2025, according to AIHW GEN data on providers of aged care:
Provider size vs home size
A provider can run many homes. At 30 June 2025, 707 providers delivered residential care through 2,590 services with 224,493 operational places. Staffing rules are applied at each home, so a large provider with several small homes faces small-home staffing pressure in each of them.
Which Aged Care Staffing Rules Apply to Every Home?
Two rules apply to every approved residential care home, whatever its size.
24/7 RN requirement. At least one registered nurse must be onsite and on duty at all times at each approved residential care home. The requirement came from recommendation 86 of the Royal Commission into Aged Care Quality and Safety.
Care minutes. The care minutes requirement is based on a sector-wide average of 215 minutes of care per resident per day, including 44 minutes of direct RN care. Care minutes can come from registered nurses, enrolled nurses, and personal care workers or assistants in nursing. Each home's own target is calculated from the care needs of its residents, using the method in section 176-20 of the Aged Care Rules 2025.
The reporting calendar
What Changes for Small Aged Care Homes?
For small homes, the biggest difference is the 24/7 RN supplement. The Department's 24/7 RN supplement rules set size and coverage thresholds:
The supplement rate is also higher for homes with fewer average occupied bed days, and for homes in more remote Modified Monash (MM) areas.
Eligible rural and remote homes can apply for an exemption from the 24/7 RN requirement for up to 12 months at a time. Most homes in metropolitan Sydney are in MM1, so this exemption generally does not apply to them.
Worked example: how much RN cover can a small home lose?
This is an illustration based on the published rules, not a case study. In a 30-day month, a full 24/7 roster is 720 RN hours. The full-rate supplement needs an average of 21 hours a day, or 630 hours. A home can therefore fall up to 90 RN hours short in that month, about eleven 8-hour shifts, before it drops below the full-rate threshold.
Two points matter for a small home:
- The 24/7 requirement itself still applies to every hour. Any uncovered hour is a gap in the requirement, whatever happens to the supplement.
- With only a handful of RNs on the roster, one RN on extended leave can leave many shifts uncovered in the same month.
Where short-term staff help a small home most
- Covering an RN night shift when the regular nurse calls in sick
- Filling personal care shifts after a no-show
- Holding standards while a permanent vacancy is being filled
What Changes for Large Aged Care Homes and Multi-Home Providers?
Large homes usually do not qualify for the 24/7 RN supplement, because it only applies to homes averaging 50 or fewer residents a day, and a home with 101 or more places typically averages more. They still have to meet the 24/7 RN requirement and their care minutes target.
What grows with size is coordination:
- More targets to track. The care minutes target and the RN requirement apply at each home, so a multi-home provider tracks several targets at once.
- Funding linked to care minutes. From 1 April 2026, for non-specialised homes in metropolitan areas (MM1), some care funding is linked to the delivery of care minutes through the care minutes supplement.
- Public results. Care minutes performance for individual homes is published quarterly.
- More shifts per day. More wings mean more shifts that can fall through on the same day.
Where short-term staff help a large home most
- Several personal care gaps on the same day
- Covering a wing during staff transitions
- Keeping standards steady when permanent staff are on planned leave
How Does Staffing Affect a Home's Star Rating?
My Aged Care shows each home's staffing performance in the Staffing section of its profile in the Find a provider tool. Performance against the care minutes targets informs the Staffing rating, which is part of the Government's Star Ratings for aged care homes. Families compare homes on this, so staffing gaps are visible, not just internal.
Small vs Large: How Short-Term Cover Decisions Differ
For unplanned gaps, see our guide to handling last-minute aged care staff shortages.
Which Role Fills Which Gap? RN, EN or PCW/AIN
Match the agency worker to the role that is missing. My Aged Care describes the roles this way:
Only an RN can fill an RN gap for the 24/7 requirement.
What to Check Before Using an Aged Care Staffing Agency
Whatever your size, check these before the first shift:
- Police checks for every worker
- Working With Children Check where needed
- Current qualifications for the role
- Insurance
- NDIS Worker Screening if the worker also covers disability shifts
- Response time for urgent gaps
- How workers are oriented to your home
Our article on pre-vetted carers and nurses explains what each screening step covers.
Do the Same Staffing Rules Apply to Home Care Providers?
Care minutes and the 24/7 RN requirement are rules for residential care homes. Home care providers deliver visits in clients' homes, so their staffing pressure is about covering visits when a worker is unavailable, rather than meeting a per-home RN or care minutes target.
How Care Steps Supports Small and Large Aged Care Providers in Sydney South-West
Care Steps Australia supplies short-term, casual, ad-hoc and temporary workers, for shifts, days or weeks, from our own qualified workforce. We support residential aged care, home-based care services and NDIS providers across Sydney's south-west, and we aim for same-day or next-shift response for urgent needs, depending on availability and location. Every worker holds current qualifications and has completed police checks, NDIS Worker Screening and relevant training.
We do not do permanent recruitment. If you are weighing a large national agency against a local one, our comparison of big staffing agencies vs local specialists sets out the trade-offs. See our workforce solution for aged care providers for how shift cover works.
Need Short-Term Aged Care Staff in Sydney South-West?
Tell us the shift, the role and your location, and we will confirm availability. Contact us or call (02) 8201 3100.
Care Steps Australia 48 Lancaster Avenue, Punchbowl NSW 2196 Phone: (02) 8201 3100 Email: info@carestepsaustralia.com.au Find us on Google Maps: https://maps.app.goo.gl/ZsJQgwvKcMMUVb1MA
In Short
Small and large aged care homes follow the same core staffing rules: an RN onsite 24/7 and a care minutes target set for each home. What changes with size is the 24/7 RN supplement, which only homes averaging 50 or fewer residents can receive, and how quickly one absence turns into an uncovered shift. Small homes need fast RN and care cover; large homes need cover for several gaps at once. For short-term aged care staffing in Sydney South-West, call Care Steps Australia on (02) 8201 3100.
Sources checked 29 October 2026: Department of Health, Disability and Ageing, 24/7 registered nurse requirement, 24/7 registered nurse supplement for residential aged care, and Care minutes in residential aged care; My Aged Care, Nursing and personal care in aged care homes; AIHW GEN, Providers of aged care (updated 29 May 2026); Care Steps Australia Workforce Solution page.
FAQ
No. Australia sets care minutes targets for each home and requires an RN onsite 24/7, rather than a fixed number of staff per resident. Each home's target reflects the care needs of its residents.
Partly. My Aged Care says up to 10% of the RN care minutes target may be provided by enrolled nurses. The rest must come from registered nurses.
Yes. The Department says the care minutes requirement applies to all permanent care and respite care residents in a home, with exceptions for residents on long-term leave.
The Department shares care minutes and 24/7 RN reporting data with the Aged Care Quality and Safety Commission, which may take action to address non-compliance
No. The Department says eligible homes do not need to apply. Services Australia pays the supplement monthly, in line with other residential aged care subsidies and supplements.
Yes. The Department publishes a 24/7 RN coverage tool, an Excel file that helps providers identify gaps in RN coverage for a reported month. It is not an approved reporting form, and using it is optional.
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