A major new study has raised genuine concerns about the shift toward for-profit ownership in Australia’s aged care sector, finding it may come with real consequences for residents’ health outcomes.

What the study found

The research, published in the British Medical Journal’s BMJ Open, examined emergency department presentations and unplanned hospital admissions among more than 200,000 long-term aged care residents across Australia, drawing on the Registry of Senior Australians national cohort between 2013 and 2018.

Of the 205,079 residents studied, 8,961 (4.4 per cent) lived in government-owned facilities, 105,144 (51.3 per cent) lived in not-for-profit homes, and 90,974 (44.4 per cent) lived in for-profit homes.

The results were notable: residents in government-owned aged care homes experienced fewer hospital-related events overall, with the gap most pronounced in Australia’s inner-regional areas. Residents in government-owned homes also had a lower risk of emergency department presentation than those in not-for-profit homes, and similar patterns held for unplanned hospitalisations and total days spent in hospital, across multiple regions.

Why this matters right now

The findings land at a genuinely significant moment for the sector, as ownership patterns across Australian aged care continue to shift. Several large providers have acquired homes previously run by not-for-profit organisations, and the overall number of providers fell from 663 in 2023 to 642 in 2024, a sign of real consolidation taking place across the industry.

Flinders University lead author Dr Miia Rahja said the study compared different nursing home ownership models while also examining the role geographic location plays in resident outcomes, a factor she said hasn’t always been given enough attention in this kind of research.

Senior author Professor Maria Inacio, who heads the Registry of Senior Australians Research Centre (ROSA) and the Flinders Ageing Alliance, said ongoing monitoring of aged care ownership is essential, given the real, measurable impact it can have on residents. She noted the findings align closely with what the Royal Commission into Aged Care Quality and Safety already identified regarding the influence ownership structures have on care quality and outcomes.

Professor Inacio also pointed to prior research showing for-profit providers are less likely to comply with sector requirements such as mandatory care minutes, the minimum amount of direct care time residents are legally entitled to each day.

Dr Rahja said the findings reinforce the need for genuine financial, quality and social accountability monitoring as aged care ownership continues to consolidate, given how significantly it can shape the outcomes residents actually experience.

What this means for families

For Australians currently navigating aged care decisions for themselves or a loved one, this research offers a genuinely useful, evidence-based reminder that ownership structure is a factor worth asking about directly when comparing facilities, alongside more commonly considered factors like location, cost and star ratings. It’s a reasonable, fair question to raise with any facility you’re considering: who actually owns and operates this home, and what does that mean for the care being provided?

This article reports on research published in BMJ Open and is general in nature. It isn’t personalised advice — if you’re navigating an aged care decision, it’s worth discussing your specific circumstances with an aged care financial adviser or My Aged Care.

IMPORTANT LEGAL INFO This article is of a general nature and FYI only, because it doesn’t take into account your personal health requirements or existing medical conditions. That means it’s not personalised health advice and shouldn’t be relied upon as if it is. Before making a health-related decision, you should work out if the info is appropriate for your situation and get professional medical advice.