# 2026 Australian Source Brief — Star Ratings and Quality Regulation | Field | Detail | | ------------------ | --------------------------------------------------------------------------------------------------- | | **Type** | Australian source brief — mandatory star ratings, quality regulation framework, implications for NZ | | **Status** | Reference | | **Date** | June 2026 | | **Classification** | Neutral business/campaign intelligence | --- ## Why This Matters for NZ Australia's mandatory **star ratings system** for aged care facilities represents the most significant public transparency reform in residential aged care globally. Since December 2023, every Australian residential aged care facility receives a publicly reported 1-5 star rating based on compliance, quality measures, staffing, and resident experience. This replaces a system that, like NZ's current approach, relied on complex audit reports that were difficult for the public to interpret. NZ currently has **no equivalent public ratings system**. The primary transparency mechanism is the HealthCERT audit report database, which publishes technical compliance reports with certification periods (1-4 years) that serve as a rough quality proxy. Consumer advocacy groups, the Aged Care Commissioner, and media investigations have all called for greater transparency. Understanding Australia's star ratings system — its design, implementation, strengths, and weaknesses — is essential for NZ policy makers, advocates, and providers considering similar reforms. --- ## Key NZ-Relevant Data and Findings ### Australia's Star Ratings System — Overview | Feature | Detail | | --------------------- | ------------------------------------------------------------------------------------------------------ | | **Introduced** | December 2023 (mandatory for all residential facilities) | | **Governing body** | Aged Care Quality and Safety Commission (ACQSC) | | **Scope** | All ~2,700 residential aged care facilities in Australia | | **Rating scale** | 1 star (significantly below standard) to 5 stars (excellent) | | **Update frequency** | Quarterly (updated as new data becomes available) | | **Public display** | Star rating displayed on facility profile pages on the Aged Care Quality and Safety Commission website | | **Legislative basis** | Aged Care Act 2024; Aged Care Quality and Safety Commission Rules | | **Penalties** | Facilities rated 1-2 stars face increased regulatory oversight; sanctions possible | Source: Aged Care Quality and Safety Commission, _Star Ratings Explained_ (2024) — https://www.agedcarequality.gov.au/star-ratings. ### How Star Ratings Are Calculated Each facility receives an **overall star rating** calculated from four sub-domains: | Sub-domain | Weight | Data Source | NZ Equivalent | | ----------------------- | ------ | --------------------------------------------------------------------------------------------------------------------- | -------------------------------------------------------- | | **Compliance rating** | ~33% | Performance against Aged Care Quality Standards from site audits | HealthCERT audit compliance ratings (CI, FA, PA, UA) | | **Quality measures** | ~33% | 6 clinical indicators: pressure injuries, falls, medication management, physical restraint, weight loss, incontinence | No equivalent public reporting (some internal reporting) | | **Staffing minutes** | ~22% | Average care minutes per resident per day (RN, EN, PCW) — verified by payroll data | No public staffing data by facility | | **Resident experience** | ~12% | Resident experience survey results (collected annually from a sample of residents) | No systematic resident experience survey in NZ | Source: Aged Care Quality and Safety Commission, _Star Ratings Technical Specification_ (2024). ### Star Rating Distribution (as of mid-2024) | Rating | Meaning | % of Facilities (mid-2024) | | ------ | ---------------------------- | -------------------------- | | ★★★★★ | Excellent | ~3% | | ★★★★☆ | Good | ~24% | | ★★★☆☆ | Acceptable | ~41% | | ★★☆☆☆ | Needs improvement | ~23% | | ★☆☆☆☆ | Significantly below standard | ~9% | Source: Aged Care Quality and Safety Commission, _Star Ratings Quarterly Report_, Q2 2024. **Note:** The distribution shows that ~32% of Australian facilities are rated 1 or 2 stars — a significant proportion that demonstrates the system's ability to identify poor performance. ### ⚠️ Star Ratings Redesign (October/November 2025 — Reflected in May 2026) Two significant changes were made to the Star Ratings system under the new Aged Care Act 2024, effective from late 2025 and visible in the May 2026 quarterly update. #### Compliance Rating — Redesigned (from 1 November 2025) The Compliance rating was redesigned to incorporate **graded assessment** against the **strengthened Aged Care Quality Standards**, responding to a Royal Commission recommendation. **How it's calculated:** Based on the **lowest** rating across two dimensions: | Star Rating | Regulatory decision\* | Graded assessment | | ------------------------------------------- | -------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- | --------------------------------------------------------------------------------------------------------------------------------- | | **1 star** (significant improvement needed) | Civil penalties, compensation order, compliance notice (significant failure/systemic), criminal prosecution, enforcement of undertaking, injunction, notice of requirement to agree, revocation/suspension of registration | **Major non-conformance** with one or more strengthened Quality Standards | | **2 stars** (improvement needed) | Acceptance of enforceable undertaking, Commission-initiated conditions on registration, compliance notice (information suggesting non-compliance) | **Minor non-conformance** with one or more strengthened Quality Standards | | **3 stars** (acceptable) | – | Major or minor non-conformance **resolved post-audit** | | **4 stars** (good) | – | **Conformance** with all applicable strengthened Quality Standards | | **5 stars** (excellent) | – | Conformance plus **exceeding grade** (awarded by Commission after separate process; removed if a regulatory decision is received) | _\*Regulatory decision must relate to delivery of funded aged care services at that home._ **Transition rules:** Before a home is assessed under the new standards, the Compliance rating is determined by presence of any regulatory decisions, time since a regulatory decision, and period of ownership. #### Staffing Rating — Updated (from 1 October 2025, reflected in May 2026 quarterly update) Homes must now meet **both** legislated care minutes targets to receive 3 or more stars: - **Total care minutes** (RN, EN, PCW, AIN) - **Registered nurse (RN) care minutes** (EN time can count for up to 10% of the RN target) **Staffing Rating Matrix:** | RN minutes (incl. up to 10% EN) | Total care minutes — Well below (<90%) | Below (90–<100%) | Meets (100–<105%) | Above (105–<110%) | Well above (≥110%) | | :------------------------------ | :------------------------------------: | :--------------: | :---------------: | :---------------: | :----------------: | | **Well below (<90%)** | ★☆☆☆☆ | ★☆☆☆☆ | ★★☆☆☆ | ★★☆☆☆ | ★★☆☆☆ | | **Below (90–<100%)** | ★☆☆☆☆ | ★☆☆☆☆ | ★★☆☆☆ | ★★☆☆☆ | ★★☆☆☆ | | **Meets (100–<105%)** | ★★☆☆☆ | ★★☆☆☆ | ★★★☆☆ | ★★★☆☆ | ★★★★☆ | | **Above (105–<110%)** | ★★☆☆☆ | ★★☆☆☆ | ★★★☆☆ | ★★★★☆ | ★★★★★ | | **Well above (≥110%)** | ★★☆☆☆ | ★★☆☆☆ | ★★★★☆ | ★★★★★ | ★★★★★ | **Key change:** Previously, the Staffing rating was more lenient — homes could achieve 3+ stars by meeting only one target. The dual-threshold requirement is significantly more stringent. **Sources:** - https://www.health.gov.au/our-work/star-ratings-for-residential-aged-care/changes (accessed 9 Jun 2026) - https://www.health.gov.au/news/changes-to-staffing-rating-for-aged-care-star-ratings (accessed 9 Jun 2026) ### Key Differences: Australian Star Ratings vs NZ Certification | Feature | Australian Star Ratings | NZ Certification System | | ------------------------ | ----------------------------------------------------- | ------------------------------------------------------------------------ | | **Format** | 1-5 stars (consumer-friendly) | 1-4 year certification period (technical) | | **Public accessibility** | Prominent on regulator website | Buried in HealthCERT database; requires technical knowledge to interpret | | **Components** | Compliance + quality + staffing + resident experience | Compliance only (audit outcome) | | **Update frequency** | Quarterly | At audit (1-4 year cycle) | | **Comparability** | Standardised across all facilities nationally | Regional differences in audit interpretation | | **Enforcement link** | Direct (low ratings trigger regulatory action) | Indirect (short certification triggers monitoring) | | **Consumer awareness** | High — widely covered in media | Low — most consumers unaware of database | | **Provider incentives** | Strong — reputation directly affected | Weak — certification period is not widely understood | Sources: ACQSC, _Star Ratings_; HealthCERT, _Understanding Rest Home Audit Reports_. --- ## NZ Audit vs Australian Star Ratings — Detailed Comparison ### What NZ Currently Provides NZ's transparency framework consists of: 1. **HealthCERT audit reports** — published for each facility, but: - Technical language (CI, FA, PA, UA ratings) - No summary rating or star equivalent - Difficult to compare facilities - Not designed for consumer use 2. **Certification period** (1, 2, 3, or 4 years) — a rough quality proxy: - 4 years = strong performance - 3 years = satisfactory - 2 years = concerns - 1 year = serious concerns - But this is not explained to consumers, and the range is narrow (only 4 levels vs Australia's 5 stars) 3. **No public reporting on**: - Staffing levels per facility - Clinical quality indicators (falls, pressure injuries, etc.) - Resident experience surveys - Complaint data by facility ### What Australia Provides That NZ Doesn't | Data Point | Australia | NZ | | ------------------------------------- | ------------------------------------ | ------------------------------- | | Facility-level star rating | Public on regulator website | Not available | | Staffing minutes per resident per day | Public by facility | Not collected/published | | Clinical quality indicators | 6 measures by facility | Limited internal reporting | | Resident experience scores | Annual survey, published | No systematic survey | | Comparison tool | Search and compare facilities online | No equivalent | | Trend data | Rating history available | Limited (only past audit dates) | | Enforcement actions linked to rating | Direct and transparent | Indirect and opaque | Sources: ACQSC, _Star Ratings_; HealthCERT, _Rest Home Audit Reports_; Consumer NZ, _Submissions on Aged Care Transparency_. --- ## Political Relevance ### Australian Political Context - Star ratings were a **direct recommendation of the Royal Commission** into Aged Care Quality and Safety (2021) - The system was **fast-tracked** — the Commission called for it by 2024, and it was delivered in December 2023 - **Provider pushback** was significant — some industry groups argued star ratings were overly simplistic and punitive - **Consumer groups** have broadly supported the system, though some argue it doesn't go far enough - **The system is still evolving** — the resident experience component (currently 12% weight) is expected to increase as survey data matures - **The 2024 Act** strengthens the link between ratings and enforcement actions ### Implications for NZ Politics - **The 2026 election** is a likely moment for parties to commit to public quality transparency - **Consumer NZ** and **Age Concern** have called for a NZ star ratings system - **Aged Care Commissioner Carolyn Cooper** (2024 report) recommended better public information on facility quality - **Media investigations** (Newshub, RNZ, NZ Herald) have highlighted quality variations that a ratings system would make transparent - **Provider resistance** is expected in NZ as it was in Australia, but the Australian precedent strengthens the case ### Likely NZ Party Positions | Party | Likely Stance on Star Ratings | | ----------------- | ------------------------------------------------------------------------------------ | | **National** | Cautious — may support "quality information" improvements but not a full star system | | **Labour** | Supportive — has previously committed to greater aged care transparency | | **NZ First** | Supportive if focused on rural and regional facilities | | **ACT** | Likely opposed — regulation cost concerns | | **Green** | Strongly supportive — consumer rights and transparency focus | | **Te Pāti Māori** | Supportive — equity concerns; wants Māori providers rated fairly | --- ## Business Implications ### For Aged Care Providers - **If NZ adopts star ratings**, providers would need to invest in: - **Data collection systems** for clinical quality indicators - **Staffing data reporting** (time and attendance systems) - **Resident experience surveys** - **Quality improvement programmes** linked to ratings - **Providers with strong quality systems** would benefit from positive ratings — creating a market advantage - **Small providers** (<50 beds) may struggle with data collection requirements — Australia's experience suggests a phased approach is needed ### For Corporate Providers (Bupa, Ryman, Summerset, Metlifecare, Oceania) - **Australian operations** already subject to star ratings — providers have experience to draw on - **Brand reputation** becomes more directly tied to quality ratings — competitive positioning changes - **Capability advantage** — providers with sophisticated quality management systems will differentiate - **Investment in quality** becomes a competitive necessity rather than optional ### For Investors - **Star ratings create transparency** that market analysts value — differentiation between providers becomes measurable - **Low-rated facilities** face financial pressure (lower occupancy, regulatory action) — investment risk more visible - **High-rated facilities** may command premium valuations - **NZ-listed providers** (Ryman, Summerset, Oceania, Arvida) would need to adapt if NZ adopts the system ### For Workforce - **Staffing minutes transparency** would directly expose understaffing — a major issue in NZ aged care - **Ratings-linked pay** could emerge as providers compete for staff in a tight labour market - **Worker recruitment** could benefit from transparent quality information — staff want to work at rated facilities --- ## Campaign Relevance ### Key Messages 1. **"Australia has a star rating for every aged care home. NZ families have no way to compare quality"** — the transparency gap 2. **"Australia publishes how many minutes of care each resident receives. NZ doesn't track this publicly"** — the staffing gap 3. **"Australia asks residents about their experience and publishes the results. NZ doesn't run a systematic resident survey"** — the voice gap 4. **"32% of Australian facilities are rated below 3 stars — that's the kind of information NZ families deserve"** — the accountability gap 5. **"Australia's Royal Commission demanded star ratings. NZ's Aged Care Commissioner has called for better transparency"** — the reform momentum ### Campaign Strategy | Phase | Action | Target | | ----------- | --------------------------- | ------------------------------ | | **Phase 1** | Research and benchmarking | Health NZ, Ministry of Health | | **Phase 2** | Provider quality data audit | Identify data gaps | | **Phase 3** | Consumer awareness campaign | General public, older people | | **Phase 4** | Legislative advocacy | MPs, Select Committee | | **Phase 5** | Piloting a NZ ratings model | Selected DHB/Health NZ regions | ### How Australia's Experience Should Shape NZ's Approach | Lesson from Australia | Application for NZ | | ---------------------------------- | --------------------------------------------------------------------------- | | Start simple, add complexity later | Begin with compliance-based rating, add clinical measures and staffing data | | Phase implementation | Pilot in selected regions before national rollout | | Resident voice must be central | NZ should prioritise resident experience surveys from day one | | Small provider support needed | Provide data collection tools and training for small facilities | | Ratings must link to enforcement | Transparency without action is performative | | Industry resistance will come | Build public and consumer support first | | Independent oversight is essential | NZ's regulator (HealthCERT or a new body) must be seen as impartial | --- ## Source List ### Australian Government Sources 1. Aged Care Quality and Safety Commission (ACQSC), _Star Ratings_ — https://www.agedcarequality.gov.au/star-ratings 2. ACQSC, _Star Ratings Technical Specification 2024_ — https://www.agedcarequality.gov.au 3. ACQSC, _Star Ratings Quarterly Reports_ (Q2 2024) — https://www.agedcarequality.gov.au 4. Royal Commission into Aged Care Quality and Safety (2021), _Final Report: Care, Dignity and Respect_ — https://agedcare.royalcommission.gov.au 5. Australian Government, _Aged Care Act 2024_ — https://www.legislation.gov.au 6. Australian Government Department of Health and Aged Care, _Aged Care Quality Standards_ — https://www.health.gov.au 7. Australian Institute of Health and Welfare (AIHW), _Aged Care Data_ — https://www.gen-agedcaredata.gov.au 8. Productivity Commission (Australia), _Report on Government Services 2024_ — https://www.pc.gov.au/ongoing/report-on-government-services ### NZ Government and Official Sources 9. HealthCERT, _Rest Home Audit Reports Database_ — https://www.health.govt.nz/regulation-legislation/certification-of-health-care-services 10. Ministry of Health, _Understanding Rest Home Audit Reports_ — https://www.health.govt.nz 11. HDC (2024), _Amplifying the Voices of Older People_ — recommendations on transparency and quality information — https://www.hdc.org.nz 12. Health NZ (2024), _The Health of Older People and Aged Care in New Zealand_ — https://www.health.govt.nz 13. Sapere Research Group / Health NZ (2024), _Aged Care Service Model and Funding Review_ — https://www.healthnz.govt.nz 14. NZNO (2025), _Care in Crisis_ — https://www.nzno.org.nz 15. E tū / CICTAR (2025), _Transparency and Corporate Tax in ARC Funding_ — https://etu.nz 16. Consumer NZ, _Submissions on Aged Care Act and Quality Transparency_ — https://www.consumer.org.nz 17. NZIER (2022), _Assessing the Equity Issues Facing Aged Residential Care Over the Coming Decade_ — https://img.scoop.co.nz 18. Office for Seniors, _Better Later Life Strategy_ — https://www.officeforseniors.govt.nz --- _Part of the NZ Seniors Knowledge Base — Aged Residential Care layer_ _Location: `02 Aged Residential Care/`_ _Last updated: June 2026_