The royal commission into aged care has heard two Southern Cross Care facilities placed budget outcomes ahead of residents' care.

At an aged care facility on Tasmania's northwest coast, Brian Harvey would often sit in pain for 90 minutes on a portable toilet waiting for staff to help him.

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The 84-year-old former public servant died in August from prostate cancer but not before shedding light on his final months at Yaraandoo Hostel.

"I asked the commissioners how would they feel if they were left alone on a mobile toilet, unable to stand up and get off?" he wrote in an April submission to the royal commission into aged care.

"I've been left like that for a long time on so many occasions I've lost count.
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"When neglected like that, I feel I have been dehumanised, left as a carcass in an aged care abattoir ready to be processed like a slab of meat in a sausage processing factory."

Monday's royal commission hearing in Hobart was told Yaraandoo, which is operated by Southern Cross Care, put budget outcomes ahead of people and cut staff hours for financial reasons without assessing the impact on residents.

Mr Harvey's widow Ellie Valler said after-hours and weekend workers weren't aware of his medication requirements and his palliative care plan wasn't adhered to.

"He had an agonising death which, on the information available to me, was avoidable," Ms Valler said.

"Brian, was a very caring and loving individual (but) he couldn't bear to be touched so I couldn't hold him in my arms. I couldn't comfort him."

An audit into Yaraandoo found staff hours were cut by 14 hours a day in August last year.

Former facility manager Patrick Anderson said he was told upon starting the job in October 2017 that Yaraandoo was losing $30,000-40,000 a month.

He said he was told by higher managers that subsequent staffing cuts were a matter of "financial sustainability".

"It would mean not imminently but at some point closing the doors if it wasn't rectified," Mr Anderson said, adding there was no analysis undertaken as to the impacts of cuts on resident care.

"I was being reassured by these senior experienced people that this was appropriate."

Yaraandoo was last year sanctioned by the Australian Aged Care Quality Agency for not meeting 18 of 44 expected quality outcomes.

Clinical care coordinator Tammy Marshall said reduced staff hours had led to increased stress for workers.

"Well, there was certainly a vision to save on costs," she said.

"But I feel that that vision wasn't looked upon as to the effect it would have on the facility."

Counsel assisting the commission Paul Bolster said Southern Cross Care facilities had been given a break-even financial directive, which placed budget outcomes ahead of care.

Yaraandoo is one of two Southern Cross Care facilities, along with Glenara Lakes, being probed by the royal commission across a five-day hearing.

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