Chronic shortages of aged residential care workers in the South Island has left shifts without a registered nurse on site.
A report to the Community and Public Health Advisory Committee shows 83 shifts across five hospital-level facilities were without a registered nurse in October.
While that number was less than previous months, it says any shift without a nurse is a concern.
The aged-care sector has been experiencing a chronic workforce shortage for some time, largely due to Covid-19 border restrictions.
The report warned that the effect of staffing shortages was beginning to be reflected in regular audits of aged-care residences.
Planning, Funding and Population/Public Health acting executive director Rory Dowding said in the report that the situation continued to worsen.
"Facilities that have had excellent audits historically are receiving multiple findings of moderate (bordering on high) risk," he said.
The shortage is also worsening the sector's ongoing bed availability issues, with 31 people across the Southern District Heath Board currently on waiting list.
While there are opportunities for growth, such as the 300 monthly spaces in managed isolation and quarantine for heallcare workers, the report shares concern that would not be enough.
It is not yet known how many aged care workers, including nurses, have been stood down since the Covid-19 vaccine mandate was enforced, but Dowding said the sector was anticipating to lose some staff.
He said the current working environment was delicate.
"The sector is concerned about the effect the settlement of the New Zealand Nurses Organisation/DHB employment collective agreement will have on their already fragile workforce."
Southern District Health Board will consider the report on Monday.