Aged Care Operating Excellence 2026
Written by:
Mathew Tolley
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Written by:
Trace Insights
Publish Date:
May 2026
Topic Tag:
Workforce Planning & Scheduling

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Operating Excellence in Australian Aged Care: A 2026 Guide for Providers

The Australian aged care sector is operating under sustained pressure. Care minute obligations, 24/7 registered nurse coverage, the Strengthened Aged Care Quality Standards, the Support at Home transition, and Fair Work Commission wage increases have collectively reshaped the operating environment. Funding has increased in headline terms. Cost pressure has increased more. The space between the two is where every provider's operating model now lives.

The providers who thrive in this environment are not the ones with the most polished compliance documentation. They are the ones with the tightest operating discipline: workforce models that meet care minute targets without agency dependency, rostering capability that delivers continuity of carer and predictable cost, scheduling that translates care minute obligations into shift-level reality, and the operational rhythm that surfaces problems early enough to fix them. Operating excellence in aged care is no longer a strategic option. It is the difference between sustainable margin and structural margin compression.

This guide is the practitioner's framework for operating excellence in Australian aged care in 2026. It covers the workforce model, the rostering and scheduling discipline, the agency cost issue most providers struggle with, the Support at Home operating implications, the data and technology capability required to run a modern aged care operation, and the leadership rhythms that hold it together.

The operating environment in 2026

The pressure picture is consistent across the sector. The sector-wide care minute targets of 215 minutes of direct care per resident per day, including 44 minutes of direct registered nurse care, have been in place since 1 October 2024. The 24/7 RN coverage requirement has been in place since July 2023, with the Australian Nursing and Midwifery Journal reporting in early 2026 that around 88 per cent of homes are meeting their RN care minute requirements.

Funding has stepped up. The AN-ACC price increased from $282.44 to $295.64 per National Weighted Activity Unit on 1 October 2025. The hotelling supplement increased from $15.60 to $22.15 per resident per day on 20 September 2025. The Support at Home program with eight funding levels up to $78,106 per year replaced Home Care Packages from 1 November 2025.

The cost picture has stepped up further. Fair Work Commission Stage 3 award wage increases for aged care workers and a separate nurse award increase took effect on 1 October 2025, with the Department of Health identifying $6.25 and $1.88 per resident per day respectively as the funding attributable to those wage increases inside the AN-ACC price. Ageing Australia's December 2025 pre-budget submission noted that while headline AN-ACC funding rose 4.67 per cent, provider-modelled actual funding increases sit in the 1.7 to 2.9 per cent range once underlying cost movements are netted off.

The operating implication is straightforward. Providers cannot rely on funding indexation to absorb operational drift. The operating model has to be tighter than it was in 2023. Workforce productivity, care minute delivery efficiency, agency reduction, occupancy management, asset utilisation, procurement leverage, and overhead discipline all matter more.

The good news is that the levers are available. The providers who pull them outperform the providers who do not.

The workforce model: the central operating lever

Workforce is the largest cost line, the primary regulatory exposure, and the dominant determinant of care quality. The workforce model is therefore the central operating model lever in aged care.

A modern aged care workforce model has six components.

Workforce demand modelling. The starting point is a precise, role-by-role, shift-by-shift, site-by-site view of the workforce demand that the operating model needs to deliver. Care minute obligations, resident acuity, service mix, geographic distribution, and seasonal variability all shape the demand profile. Most providers we work with have a less granular demand view than they need. The gap shows up in chronic over-rostering in some areas, chronic under-rostering in others, and persistent reliance on agency to absorb the variance.

Workforce supply analysis. Against the demand profile, the supply analysis covers permanent workforce by role and shift, contracted hours, voluntary overtime, casual pool depth, and agency dependency. The gap between demand and supply is what drives cost and risk. The supply analysis identifies where the gap is structural (insufficient permanent headcount) versus operational (sufficient headcount but poor deployment).

Workforce mix design. Permanent versus casual, full-time versus part-time, generalist versus specialist, on-site versus floating, regular versus relief. The right mix varies by site, service mix, and labour market. The wrong mix shows up as fixed cost rigidity, agency reliance, or care continuity problems. Designing the mix deliberately, rather than letting it accumulate by default, is one of the highest-return decisions a provider can make.

Recruitment and retention. The aged care labour market is tight, particularly for registered nurses and personal care workers in regional and outer-metropolitan locations. Recruitment strategy, employer brand, career pathway design, retention drivers, and the targeted use of overseas-trained worker pipelines all sit inside the workforce model. Retention is the most under-managed lever. A provider that reduces unwanted turnover by 20 per cent typically captures more margin improvement than a provider that runs a recruitment campaign.

Capability development. The Strengthened Aged Care Quality Standards include explicit expectations of clinical leadership, with registered nurses taking on broader oversight and mentoring responsibilities. Capability development cannot be left to ad hoc training programmes. The workforce model has to include the capability development rhythm that produces the leadership depth the regulatory environment expects.

Performance and engagement. Workforce engagement is the input that drives retention and quality. Performance management is what surfaces underperformance early. Neither replaces the other. Most providers run one or the other reasonably well. Few run both.

The integrated workforce model is what allows a provider to meet care minute targets, control agency cost, deliver continuity of carer, and protect margin simultaneously. Without it, the provider is solving the same problems repeatedly through tactical interventions.

Rostering and scheduling: where the workforce model becomes real

The workforce model lives or dies in the rostering and scheduling layer. Rostering produces the planned shift coverage. Scheduling handles the daily reality of variation. Both together determine whether the care minute target is hit on a given day, whether the RN cover is in place at 3am, and whether agency is filling a gap that should have been filled by the permanent workforce.

Most rostering and scheduling failures we see are not technology failures. They are process and discipline failures.

Rostering done badly looks like: rosters built three weeks out, then reworked twice before they are published. Permanent staff with stable shift patterns that no longer reflect resident acuity. Casual pool members allocated by who shouted loudest, not by skill and fairness. Shift swaps and overtime absorbed without governance. Roster compliance audited at month end, not at the point of breach.

Rostering done well looks like: rosters built from the workforce demand model, published with enough lead time to allow life planning, locked at a defined point with structured exception handling. Permanent shift patterns reviewed quarterly against acuity. Casual pool managed by skill match, fairness, and continuity of carer principles. Overtime and swaps governed through structured approval. Compliance visible in real time, not at audit.

The same pattern applies to scheduling. The gap between a roster as published and the workforce that turns up on the day is where care minute breaches and agency cost typically occur. Modern scheduling capability includes real-time shift coverage visibility, structured replacement protocols, decision-rights frameworks for site leaders, and the automation that allows replacement decisions to be made quickly enough to prevent agency calls.

For most providers, lifting rostering and scheduling maturity is the single highest-return operational improvement available. It does not require capital investment. It requires structured intervention into how the rostering and scheduling functions actually operate.

For more on the workforce planning, rostering and scheduling discipline across aged care and adjacent sectors, our Workforce Planning and Scheduling practice covers the operating layer in depth.

Agency cost: the persistent operating issue

Agency cost is the most consistent operational issue we see in Australian aged care. The cost differential between permanent and agency workers is significant. The continuity of carer impact is material. The compliance risk associated with high agency use is real. Yet agency dependency persists across most providers, often at materially higher levels than the operating model needs.

Agency dependency is rarely a deliberate decision. It is the accumulation of small failures across recruitment, retention, rostering, casual pool management, and scheduling. Breaking out of it requires structured intervention rather than tactical cost cuts.

The agency reduction pattern that works in our experience covers four steps. Quantify the current agency cost by site, role, shift type, and cause (vacancy, unplanned absence, peak demand). Identify the proportion of agency use that reflects structural workforce gaps versus operational inefficiency. Build the permanent workforce in the areas where structural gaps exist and lift the rostering and scheduling discipline in the areas where operational inefficiency is the cause. Track the agency reduction outcome at site level monthly, not as an aggregated KPI.

In our experience, providers that approach agency reduction structurally typically see meaningful reductions over six to twelve months. Providers that approach it tactically (through procurement renegotiation alone, or through one-off recruitment drives) see modest short-term improvement that erodes within the year.

Support at Home operating implications

The Support at Home program changed the home care operating model from 1 November 2025. For providers operating in home care, the operating excellence agenda includes five home-care-specific considerations.

Travel time and geographic clustering. Home care economics live and die on travel efficiency. Geographic clustering of clients, route optimisation, and the trade-off between client preference for specific carers and travel efficiency are central operating decisions. Providers without active travel time management leak margin every day.

Continuity of carer. Client preference for continuity of carer is a quality dimension and a retention dimension simultaneously. Scheduling for continuity is harder than scheduling for availability, and most legacy home care scheduling approaches optimise for the wrong variable.

Skill-to-task matching. Support at Home covers a wider range of service types than Home Care Packages. Matching the right skill to the right task, while managing cost, requires scheduling discipline that many providers have not historically needed.

Pricing transparency and competitive positioning. Support at Home requires providers to publish standard prices for certain services. This creates a more transparent competitive environment than home care has previously operated in. The operating model must include the pricing decision-making capability to position competitively, and the cost model to know whether published prices recover delivery cost.

Last-minute changes and reactive scheduling. Home care operations live with frequent client-initiated changes: a hospital admission, a family visit, a change of circumstance. The scheduling operating model must absorb these without cascading through the rest of the day's service delivery.

The providers who execute Support at Home well are the ones treating it as a different operating model from Home Care Packages, not as a re-badged version of the old program.

Data, technology and the operational rhythm

Operating excellence in aged care requires data and technology capability that most providers have built up incrementally rather than designed deliberately. Care management systems, workforce management platforms, rostering and scheduling tools, time and attendance systems, payroll, and clinical documentation typically sit on a patchwork of platforms acquired over a decade.

The capability that the modern operating model requires covers four areas.

Workforce data integrity. Care minute reporting, the Care Minutes Performance Statement (now requiring external audit in the 2025-26 Aged Care Financial Report), AN-ACC reporting, and Strengthened Quality Standards evidence all rely on data flowing from rostering and time and attendance through to reporting. Data integrity at the source is what makes the reporting layer defensible.

Real-time operational visibility. Site leaders need real-time visibility of shift coverage, care minute delivery against target, agency usage, and exception events. The reporting horizon that worked five years ago (weekly or monthly) does not work under the current operating environment.

Decision support analytics. Demand modelling, scenario testing, workforce mix analysis, and agency reduction tracking all require analytical capability that goes beyond standard system reporting. Most providers we work with benefit from a focused investment in decision support analytics layered over their existing operational systems.

Integration discipline. The biggest data and technology constraint we see is integration. Disconnected systems produce reconciliation work, duplicate data entry, and reporting gaps that absorb leadership attention that should be spent on care delivery. Integration is rarely glamorous but it is consistently high-value.

For more on technology selection and the integration layer underneath the operating model, our Technology practice covers the selection and implementation discipline in depth.

The leadership operating rhythm

Operating excellence does not survive without a leadership operating rhythm. The rhythm is the set of recurring forums, reviews, and decisions that hold the operating model together at site, regional, and executive level.

The rhythm we see in providers who run well covers four levels.

Daily. At site level, the shift handover, the day's care minute position, the day's agency usage, the day's exception events. Site leaders own this rhythm.

Weekly. At regional or cluster level, the weekly operational review covering care minute performance, agency cost trajectory, recruitment pipeline, and exception trends. Regional leaders own this rhythm.

Monthly. At executive level, the monthly performance review covering financial position, workforce metrics, quality and clinical outcomes, regulatory engagement, and the issues that have emerged from the site and regional rhythms. Executive leaders own this rhythm.

Quarterly. Operating model review covering the strategic operating model decisions: portfolio, workforce mix, capability investment, technology, procurement. Board and executive leaders own this rhythm.

The leadership rhythm is not the operating model, but the operating model does not deliver without it. Providers that run the rhythm consistently outperform providers that do not.

Sector-wide failure patterns

In our experience advising Australian aged care providers, five operating failure patterns recur. All of them are avoidable.

Jumping to solutions before understanding the problem. The most common pattern. A new rostering system, a recruitment drive, an agency preferred supplier panel, a workforce restructure. All deployed before the team has understood the actual shape of the operating problem at site level. The result is investment without operating improvement.

Treating compliance and operating excellence as the same thing. Compliance documentation passes audit. Operating excellence delivers care and protects margin. The two are related but not identical. Providers that focus only on compliance often pass audits while their operating model deteriorates underneath.

Underweighting the change management. New workforce models, new rostering disciplines, and new technology platforms all require structured change management. The change effort is consistently underweighted relative to the technical effort. Adoption then fails, and the investment does not deliver.

Centralising decisions that should sit at site level. Aged care operating excellence is local. Site leaders need decision rights on rostering, scheduling, and exception handling. Centralising those decisions in regional or head office structures slows the response and increases agency cost.

Failing to measure what matters. Most providers measure the things that are easy to measure (cost lines, turnover percentages) rather than the things that drive performance (care minute delivery by shift, agency cost by cause, continuity of carer by client). The measurement frame shapes the management response. The wrong frame produces the wrong response.

The common thread is that operating excellence in aged care is a discipline, not an outcome. The providers who build the discipline outperform the providers who treat it as a series of interventions.

How Trace Consultants can help

Trace Consultants advises Australian aged care providers on operating excellence across workforce planning, rostering, scheduling, agency reduction, and the broader operating model. Our positioning is deliberate: senior-led, partner-anchored, vendor-agnostic, with practical operating experience across residential, home care, and broader health supply chain.

Workforce planning, rostering and scheduling. Our Workforce Planning and Scheduling practice supports the demand modelling, workforce supply analysis, rostering design, agency reduction, and scheduling discipline that determine whether care minute targets are met sustainably and whether agency cost is controlled.

Operating model design. We work with provider leadership teams to design the integrated operating model across care delivery, workforce, financial, and technology dimensions. The deliverable is a coherent operating model the provider can execute, not a slide pack.

Procurement and supplier strategy. Our Procurement practice supports category strategy across agency, food services, consumables, clinical supplies, and supplier rationalisation.

Technology selection and implementation. Workforce management platforms, care management systems, rostering and scheduling tools, and data integration capability are in scope of our Technology practice.

Programme delivery and change management. Where the operating excellence agenda is delivered as a transformation programme, our Project and Change Management practice supports the delivery and adoption.

Sector depth. Our work across the Health and Aged Care sector brings the operational substrate to make the recommendations practical and the delivery credible.

Explore our Health and Aged Care sector services →

Speak to an expert at Trace →

Where to begin

If you are an aged care provider scoping the operating excellence agenda, start with three questions. What is the current state of your workforce model against your care minute obligations, by home, by shift, by role, and where are the gaps? What is your agency cost line by site and by cause, and what proportion is structural versus operational? What is the rostering and scheduling discipline at site level, and where does it break down?

If those three questions surface material gaps, the next step is a structured operating excellence review.

Frequently asked questions

What does operating excellence mean in aged care? The integrated discipline of workforce planning, rostering, scheduling, agency management, procurement, technology, and leadership rhythm that allows a provider to meet care quality and regulatory obligations sustainably while protecting margin. It is a discipline, not a one-off intervention.

Why does workforce model design matter so much in aged care? Workforce is the largest cost line, the primary regulatory exposure (through care minute obligations and 24/7 RN coverage), and the dominant determinant of care quality. The workforce model is therefore the central operating model lever. A weak workforce model shows up as agency dependency, care minute breaches, retention issues, and margin compression.

What is the typical agency cost issue in aged care? Many providers run agency cost lines materially higher than the operating model needs, driven by the accumulation of small failures across recruitment, retention, rostering, casual pool management, and scheduling. Structured intervention typically produces meaningful agency reduction over six to twelve months. Tactical cost cuts typically do not.

How do you reduce agency cost without compromising care? Quantify the current agency cost by site, role, shift type, and cause. Identify what is structural (insufficient permanent workforce) versus operational (sufficient workforce, poor deployment). Build permanent capacity where the gap is structural. Lift rostering and scheduling discipline where the gap is operational. Track the reduction at site level, not as an aggregated KPI.

What is the difference between rostering and scheduling? Rostering produces the planned shift coverage. Scheduling handles the daily reality of variation from that plan. Both are needed. Most rostering and scheduling failures are process and discipline failures, not technology failures.

How do care minute obligations affect the operating model? The 215-minute and 44-minute RN targets need to be delivered on a sector-wide average basis but the operating model must deliver them at home level, across the reporting period, with the data integrity to defend the Care Minutes Performance Statement in the Aged Care Financial Report. From the October to December 2025 quarter onwards, MM1 metropolitan non-specialised homes have a portion of funding linked to care minutes performance from April 2026.

What does Support at Home change about the home care operating model? Pricing transparency, eight funding levels rather than four, a wider service mix, and a more transparent competitive environment. The home care operating model needs to manage travel time, geographic clustering, continuity of carer, skill-to-task matching, and reactive scheduling discipline.

How long does it take to lift operating excellence in aged care? Material operating improvements typically take six to eighteen months depending on scope. Rostering and scheduling discipline can lift in three to six months with structured intervention. Workforce mix redesign and agency reduction typically takes six to twelve months. Broader operating model transformation typically takes twelve to eighteen months.

What is the most common operating failure pattern in aged care? Jumping to solutions before understanding the problem. A new rostering system, a recruitment campaign, or an agency procurement renegotiation deployed before the underlying operating issue has been diagnosed. The result is investment without operating improvement. Diagnosis first, intervention second.

Where should a provider start? With an honest current state of the workforce model against care minute obligations, the agency cost line by site and cause, and the rostering and scheduling discipline at site level. The starting point is operational reality, not a target operating model designed in the abstract.

Operating excellence in aged care is not glamorous. It is the daily discipline of workforce model, rostering, scheduling, agency management, and leadership rhythm that determines whether a provider runs sustainably under sustained operating pressure. The providers who build the discipline outperform. The providers who treat operating excellence as a series of interventions do not.

If you are scoping the operating excellence agenda for 2026, the work starts at site level.

Explore our Health and Aged Care sector services →

Speak to an expert at Trace →

Related reading: Health and Aged Care · Workforce Planning and Scheduling · Procurement · Technology · Project and Change Management · Insights

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We help organisations transform ideas into measurable results with strategies that work in the real world. Let’s talk about how we can solve your most complex supply chain challenges.

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