Objectives:Australia’s ongoing aged care reforms have re-focused service
provisions from a provider-driven policy approach to a consumer-directed care focus and
redirected residential care subsidies. This study aimed (i) to identify the experiences
and perceptions of people involved in the governance of residential care facilities about
their management of changes due to new accreditation requirements and funding mechanisms,
and (ii) to describe their strategic responses to aged care reform changes.Methods:A qualitative description design used interviews exploring
perspectives of Board Chairs, Board Directors, and Chief Executive Officers of two
NSW-based residential care organizations. Thematic analysis was conducted of interview
transcripts.Results:Four key themes emerged from the data: (1) Business
strategies and challenges under reform conditions including the need for business
diversification and new approaches, (2) costs incurred by the reforms such as compliance
with accreditation requirements, (3) workforce demands: for example maintaining staffing
levels and training needs, and (4) expectations about maintaining quality of care.Discussion:Changes were necessary in business models for facilities to
remain sustainable, meet staffing needs, and continue to provide services in a complex,
changing fiscal environment. These included generating revenue streams other than
government subsidies, better clarity about government support and establishing
partnerships.