With aged care homes facing "extreme pressure" from the Omicron wave, one has resorted to testing only some of its staff due to large shortfalls in government-supplied rapid antigen tests.
The NSW provider said workers, visitors and contractors had checked in thousands of times into one of its homes in the past month.
But testing all of them was difficult when the government had supplied enough RATs to cover one-third of those entries.
Faced with paying $25,000 a week to make up the RAT shortfall, the aged care home is instead only testing people who aren't wearing full personal protective equipment including N95 masks and face shields.
"The risk of them passing COVID to a resident is extremely low due to all the coverings," one of the provider's managers, who requested anonymity, told AAP.
"If they are symptomatic, they don't come to work."
Wholesale rapid antigen tests are currently selling for $11 to $15 while PPE costs have also risen up to 95 per cent.
"If you don't have funds in the bank, you will be forced to close at some point," the aged care manager said.
Industry body Leading Age Services Australia says providers around the country were struggling with PPE and RAT supplies, the cost of disease prevention measures and then the cost of trying to stop an outbreak.
That was on top of ongoing worker fatigue and frustration, and trying to find replacement staff to fill shifts.
"Many providers are reporting a real sense of crisis on the frontline," LASA chief executive Sean Rooney told AAP on Friday.
"What we're left with is a system under extreme pressure, relying on a small number of really dedicated people."
While the government says three million rapid antigen tests are being delivered to aged care facilities next week, adding to seven million already sent, Mr Rooney said supply remained unstable, insecure and inadequate.
He pointed to an instance of a home with 80 residents and 140 staff being given 50 tests by federal authorities.
"What are 50 tests going to do? That would be gone in a morning and you still haven't covered every resident," Mr Rooney said.
Aged care providers and unions last week made a united call for guaranteed PPE and RAT supply, defence force personnel to provide emergency support and assistance to nursing homes and for improved payments for exhausted frontline staff.
Conversations with the government were ongoing "but it's urgent and we can't wait", Mr Rooney said.
"Every day we're seeing more infections and sadly, in aged care homes, we've seen rising numbers of fatalities."
About one-third of the COVID-19 deaths in Australia in 2022 have occurred in residential aged care, with 200 deaths in NSW facilities alone.
More than half of all NSW aged care homes and 1200 nationwide are battling outbreaks, according to data released last week.
Aged Care Minister Greg Hunt and Aged Care Services Minister Richard Colbeck referred questions to the federal health department.
A department spokeswoman acknowledged it had been a difficult time for residents and families, amid an unprecedented rise in outbreaks at facilities driven by community cases.
"The strongest predictor of cases in aged care are high case numbers in the community - through staff exposures in the community, residents leaving the facility and visitors entering," she said.
The government was prioritising the distribution of PPE and RATs to residential aged care facilities with a COVID-19 outbreak or exposure, she said, processing orders based on urgency.
Facilities facing an outbreak can also source their own commercial supply and claim the cost of RATs.
"Aged care providers can seek reimbursement of eligible costs associated with managing the outbreak, including RAT kits through the Aged Care Support Program Extension Grant," she said.
Vaccine providers are also being asked to prioritise homes with outbreaks, to deliver third-dose boosters.
Australian Associated Press
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