Australian aged care services have undergone a series of substantial reforms in recent years under the rubric of the Aged Care Reform Strategy. Overall, there has been a progressive refinement of the targeting of available services on those most in need, defined in terms of both disability levels and financial resources. A key component of this process have been the progressive reduction of nursing home bed provision ratios, accompanied by increases in the resources being directed toward hostel type accommodation and community based services. This paper aims to provide a more sophisticated understanding of the impacts of these changing patterns of residential care. A decomposition analysis suggests that the proportion of aged persons in nursing homes has decreased substantially in Australia over the period under study, and that those decreases have been most marked amongst women. These findings raise policy questions about the appropriateness of current and future levels of provision.