Health And Aged Care Migration 2025: What HR Leaders Must Do Next

Workforce shortages are not easing in 2025. The rules are tighter, salary floors are higher, and monitoring is active. The opportunity is clear. If you run a clean pipeline and keep audit ready records, you can hire faster and protect your approvals.

What changed in 2025

• Skills in Demand 482 is the main temporary pathway, with Core, Specialist and Labour Agreement streams.
• Indexed income thresholds lift salary settings. Plan offers and budgets around CSIT and SSIT.
• Prohibited employer sanctions apply for serious breaches. The register is public.
• AHPRA English and registration steps for nurses need earlier planning.
• Award increases flow into market salary evidence. Align contracts, rosters and AMSR files.

Choose the right pathway

Registered nurses. Use SID 482 Core for most roles, step to ENS 186 for retention. If hiring multiple units, standardise position descriptions and AMSR across wards.

Personal care and support roles. Use the Aged Care Industry Labour Agreement. It covers aged or disabled carers, nursing support workers and personal care assistants. Expect LMT, sector concessions and strict file quality.

Allied health and clinical specialists. Test earnings against SSIT and CSIT. If salaries are close to thresholds, lock evidence early and avoid last minute rewrites.

Regional strategies. Where attraction is hard, compare 482 with 494 to secure a path to permanent residence, then decide based on time to fill and salary settings.

Build a decision ready nomination pack

• Role design that matches ANZSCO.
• Genuine need supported by rosters, client loads and bed numbers.
• Labour Market Testing with clear dates and screenshots.
• Salary evidence that meets CSIT or SSIT and aligns with award outcomes and internal parity.
• Employment contract that mirrors the nomination.
• AHPRA and English evidence where relevant.
• VEVO checks and onboarding plan.
• Notification log template for reportable changes.

Compliance you must not ignore

Genuineness.

The position must fit your structure and service demand. Avoid inflated titles or hybrid duties with no equivalent worker.

SAF levy.

Pay it at nomination. Do not pass it to the worker.

Record keeping.

Keep contracts, pay records, rosters, equivalent worker evidence, LMT, and change notifications for the full monitoring window.

Fair Work alignment.

If payroll and the nomination do not match, you create an audit trigger.

Change management.

Duty changes, hours reductions, location moves and leave without pay need assessment and, at times, notification.

Sanctions.

Repeated breaches risk cancellation and prohibited employer listing. This blocks access to new temporary visa hires.

Three common scenarios

1. Aged care facility adding 20 PCAs

Use the Aged Care Labour Agreement. Batch roles into clear streams with identical duties and pay. Map rosters to resident acuity. Keep LMT consistent across all positions. Build one AMSR methodology and reuse it.

2. Private hospital hiring theatre nurses and ICU nurses

Use SID 482 Core and a parallel ENS plan for high performers. Track AHPRA and English documents from day one. Use ward specific PDs but keep a standard salary and allowance framework.

3. Allied health practice recruiting a senior physio

Test earnings against SSIT. If earnings fall short of SSIT but meet CSIT and AMSR, use Core stream and document market data. If demand is stable, plan an ENS 186 step within the contract.

Timing benchmarks you can manage

• Specialist stream targets are short. Core stream is longer in practice for many employers. Assume best case targets for decision ready files and add a buffer.
• Labour Agreement setup or variations take more calendar time than a standard nomination. Start early if you plan a cohort hire.
• AHPRA steps can be the longest path item for nurses. Treat them as a separate workstream with weekly status checks.

Common refusal triggers and how to avoid them

• Duties do not match the nominated occupation. Fix position descriptions and rosters before you advertise.
• Weak AMSR evidence. Use award rates, enterprise agreements, and matched market data. Document the method.
• Contract misalignment. Update letters before you lodge. Do not assume a later variation will cure the problem.
• Incomplete LMT. Capture original ad text, dates and response summaries.
• Failure to notify changes. Use a shared log with owner, due date and proof of submission.

How Roam helps

We map your workforce plan to the right pathways, lift your documentation to audit ready standard, and build an operating rhythm that keeps you compliant. You get faster decisions, cleaner files, and fewer surprises. Read the regional hospital case study on our health and aged care page.

The content of this article is intended to provide a general guide to the subject matter. Specialist advice should be sought about your specific circumstances.