Meeting the 24/7 Registered Nurse rule: What smaller and rural Tasmanian providers can do

Every residential aged care home in Australia must now have a registered nurse on site and on duty twenty-four hours a day, seven days a week, unless it has been granted an exemption. For a ninety bed metropolitan home this is a budgeting exercise. For a twenty-eight bed home in the north west, it can be the difference between viability and closure.

The obligation did not soften when the new Aged Care Act framework took effect in late 2025. If anything, the expectation around clinical coverage has hardened. Smaller and rural Tasmanian providers need a clear-eyed view of both the rule and the realistic ways around the staffing maths.

The rule, precisely

The requirement is an RN onsite and on duty at all times. To help fund it, the Government pays a 24/7 RN supplement, intended to support the cost of employing the additional registered nurses the rule demands. For most homes the supplement softens the cost but does not remove the core challenge, which is finding the nurses at all in a thin Tasmanian labour market.

The rural exemption, and its limits

A genuinely rural or remote home can apply for an exemption. The eligibility is specific: the home must sit in a Modified Monash MM5, MM6 or MM7 area, have no more than thirty operational places on the day of the decision, and satisfy the Department that residents’ clinical care needs will still be met. Exemptions are granted for up to twelve months at a time.

Here is the catch that surprises operators. If you hold an exemption for a home at any point in a month, you do not receive the 24/7 RN supplement for that month. The exemption removes the obligation and the funding together. It buys breathing room, not a sustainable model.

What actually works

The providers who will still be standing in three years are not the ones leaning on exemptions. They are the ones using the time an exemption buys to build supply. A few approaches are working in practice.

• Grow your own registered nurses by sponsoring enrolled nurses through the two year EN to RN pathway.
• Use the funded Transition to Practice program to attract and retain new graduate RNs.
• Roster registered nurses across a fortnight so night coverage is sustainable rather than dependent on one or two people.
• Partner with nearby small homes on shared or floating RN arrangements where geography allows.
• Work with a recruitment partner who genuinely understands rural Tasmanian supply rather than one quoting mainland availability.

The common thread is supply, not scheduling tricks. A home that treats the registered nurse shortage as a monthly emergency will be in the same position next year. A home that treats it as a workforce-building project, growing enrolled nurses into registered nurses, retaining the graduates it trains, and rostering for sustainability, slowly stops depending on luck and locums.

The agency trap

When coverage gets desperate, agency registered nurses fill the gap, and at three in the morning in a rural home they are sometimes the only option. But agency cover at a premium is the most expensive way to meet the rule, and it does nothing to build a workforce you can rely on. Every dollar spent on a locum is a dollar not spent sponsoring an enrolled nurse through their conversion, or making your own roster liveable enough to keep the nurses you have. Used briefly, agency is a bridge. Relied upon, it is a slow leak.

An exemption gives a small rural home twelve months, not a future. The operators who survive are the ones spending that year building their own registered nurse pipeline.

If you are mapping how to cover the 24/7 obligation without relying on agency premiums or an exemption that strips your funding, that is a workforce planning problem more than a hiring one, and it is the kind of problem we help Tasmanian operators solve.