The impact of facility ownership on nurses' and care workers' perceptions of missed care in Australian residential aged care

The Australian government has reduced restrictions on ownership of residential aged care facilities (RACF) as part of aged care reform enabling the growth of private-for-profit ownership. This study explores the impact of private-for-profit ownership through comparison of perceptions of the volume of missed care in government, private-not-profit and for-profit RACF in Australia. Data were collected through development and administration of a MISSCARE survey to 3,206 nurses and personal care workers (PCW) working in RACF and hospitals providing aged care services. Employees working within government owned facilities reported levels of missed care that are significantly lower than privately owned facilities on six activities: moving patients who cannot walk; assisting residents' toileting within 5 min of request; assisting resident mouth care; assessing skin integrity; answering call bells within 5 min and wound care. Staffing levels were identified as the most common reason for missed care across all settings. Of the 27 factors identified as causing missed care, government employees reported significantly lower scores for 16 items. Further research is needed on the impact of facility ownership upon capacity of nurses and personal care workers to deliver care.