Nursing home crisis as facilities forced to close
No homes to go to: Ageing population may struggle to find beds
IRELAND’S ageing population will struggle to access nursing home beds in the near future, with the closure of 11 homes so far this year, a representative group has warned.
The nursing home shortage is growing with 40 closures of homes since 2018, with the number of beds falling to just over 31,000.
An estimated 45,000 beds will be needed by 2031, warns Nursing Homes Ireland (NHI) in their annual national survey released yesterday.
The number of people aged over 65 has grown by 139,100 – an increase of 22% in just six years – to over 680,000 people.
The group say that the sector faces further challenges with the cost-of-living crisis ‘tipping businesses over the edge’, while the Fair Deal scheme is ‘making it impossible for many homes in lower-rate locations to survive’.
Many respondents to their survey said they do not believe the Fair Deal rate covers the operational costs of the home.
The county with the lowest Fair Deal payment as of May this year is Donegal, where the average weekly rate of €955 is €280 less than for residents in Co. Dublin – which has the highest average weekly rate at €1,235.
The Fair Deal scheme is a financial support mechanism that helps pay for the cost of staying in a nursing home, which is managed by the HSE.
Under the scheme’s terms, residents in nursing homes will pay a certain amount towards their care with the HSE paying the rest. The funding covers care in private nursing homes, voluntary nursing homes and public nursing homes.
Chief executive of NHI, Tadhg Daly, told the Irish Daily Mail: ‘Ultimately there’s been years of significant underfunding for nursing home care. What we’ve seen as a result is a significant number of closures in the last few years, with 29 nursing homes closing between 2018 and 2021 and already this year we are aware of 11 further closures.
‘Now, we’re seeing a significant number of homes having to make that heart-breaking and traumatic decision to close their business, and that means there are many residents who have to find alternative nursing homes.
‘It’s deeply traumatic, first of all for the residents and their families. Some of them have lived there for a number of years, and may have to move to another nursing home, but it may not be in their local area. It’s very upsetting.
‘What you have on the one hand is an ageing population,’ he said, and ‘on the other we have a contraction and reduction in the capacity to care for that population. It’s linked to the Fair Deal funding scheme. There’s been years of significant underfunding.
‘The cost-of-living crisis is tipping businesses over the edge. Now we’re into over-inflation – inflation doesn’t even capture what’s happening in the sector with food, energy and consumer use. Energy alone... The nursing home sector is a big user of energy with heating and lighting. Inflation has literally tipped people over the edge with a number already having closed and others contemplating their future.’
He added: ‘Not all people will be able to find homes in their area. They may have to travel to other nursing homes, or may indeed be stuck in hospitals as a result of not having care in the community.
‘It’s never a decision that’s made lightly. The vast majority of owners would have invested heavily, and been in the business for 15, 20, maybe 30 years.’
The NHI’s report, which was compiled by BDO Ireland, also revealed that while planning applications were up 25% nationally compared with 2020, Connacht and Ulster – where some of the lowest Fair Deal rates exist – recorded a decrease of 40%.
Permissions granted were down 31% nationally compared with 2020 and this decrease was seen in all regions with the exception of Leinster. Dublin recorded a spike in activity which was up 307% in 2021 since 2020 figures.
Meanwhile, taking into account Fair Deal incomes only, respondents in the Dublin North region received the highest average turnover per bed at €63,955, with respondents in the midwest region reporting the lowest average turnover per bed at €50,392.
Brian McEnery, head of advisory at BDO Ireland, said: ‘Smaller homes, particularly in regional areas, are struggling to meet existing regulatory demands and rising costs under the constraints of the prevailing Fair Deal scheme.
‘This is a worrying trend, not least for the more sparsely populated area where these nursing homes are integral in the community but are not sustainable. These areas have low Fair Deal rates, and this combined with rising costs is putting at risk the survival of these smaller homes, with others inevitably set to close.
‘The differential between the highest and lowest rate is significant for home operators with the current rising cost environment.’
‘Traumatic decision to close’
‘They may have to travel to a home’