The well publicised problems Kaitaia rest home Switzer Residential Care is having retaining immigrant staff is just the tip of a large and growing iceberg according to New Zealand Aged Care Association chief executive Simon Wallace.

Nursing shortages were reaching crisis point, he said, as record numbers left residential care facilities for DHBs, in anticipation of better pay and conditions, compounding critical shortages that were exacerbated by a hardening of immigration policies.

Registered nurse vacancies in the sector had now record levels of around 500 of almost 5000 positions.

"Effectively we're down by nearly 10 per cent in nursing staff, the skilled employees we desperately need to provide safe and quality care for our most vulnerable older citizens," Mr Wallace said. "And we expect this number to escalate in the next six to 12 months, given an additional 500 nurses are likely to be recruited into DHBs.

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"Where will these nurses come from? Not the graduate pool. They'll move from the aged care sector, and already are.

"Potentially we're looking at being down by up to 1000 nurses in a very short space of time. That's unsustainable."

He was aware of some of NZACA members who were considering closing facilities, because they were unable to staff them to provide safe, quality care. That situation was going to worsen.

The flight of nurses to DHBs was magnifying the recruitment and retention problems arising from 2016 immigration policy changes, which had shifted registered nurses (aged care) from the long-term shortage skills list to the immediate skills shortage list.

"This change has lowered the morale of our aged care nurses, making it even harder for providers to recruit and retain them," Mr Wallace said.

"Our latest data show that 38 per cent of our members are facing increased difficulty recruiting internationally qualified nurses on visas since the policy change. And 65 per cent are facing increased difficulty in recruiting New Zealand citizens and resident registered nurses.

"Annual turnover for registered nurses in the sector has risen from 26 per cent in February 2017 to nearly 38 per cent as of July. This spells a crisis for the ability of our providers to deliver safe, quality care for our older citizens, with potential closure of units and facilities putting pressure on the DHBs. Where else will these residents go?"

The NZACA was in discussions with DHBs and the Health Ministry to find a solution, and was seeking their support in lobbying the government and Immigration NZ to return registered nurses to the long-term shortage skills list.