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26 Sept 2022

Government needs to act on regulator warning about closure of smaller nursing homes

Leitrim public asked to honour outstanding care in local nursing homes

File photo

Nursing Homes Ireland (NHI) has called on the Government to act urgently in addressing the regulator HIQA’s concerns regarding the closure of small nursing homes.

HIQA this week expressed concern regarding the closure of smaller nursing homes, which are citing financing and resourcing as reasons for closure. HIQA stated the loss of smaller nursing homes should be considered in the context of a loss of a particular model of care. HIQA stated the loss of the model will have implications for older person care, with nursing homes being removed from particular communities, resulting in people having to travel further to avail of care and issues arising with regard to visitor access, GP and pharmaceutical care.

Tadhg Daly, NHI CEO said: “There’s an immediate and a longer-term issue at play here. The current cost environment is intensively acute for all nursing homes. Smaller nursing homes are finding it extremely difficult and, for some, impossible to cope. Some have said it is just not viable to operate a nursing home and have closed their doors. We have engaged with the Minister for Older People Mary Butler and her officials on the extremity of the cost pressures and the emergency presenting for nursing home care over a period of months. The Minister has acknowledged the cost environment now presenting for nursing homes is unprecedented. However, it is disappointing, despite the months of engagement, no measure has been brought forward by the Government to alleviate the pressures upon nursing homes. There is requirement for an immediate intervention by the State through rollout of a mechanism that will support nursing homes, which are around-the-clock operators, in alleviating pressures emanating from the likes of energy and food costs. We are talking about the extraordinary inflationary environment and its consequences on care of the older person.”

14 private and voluntary nursing homes with 411 registered beds (average 30) have closed their doors the past two years. A further three will be closing their doors in the weeks ahead.  

Fees are set for nursing home resident care by the National Treatment Purchase Fund (NTPF) on behalf of the State. Nursing homes are operating under fees that were agreed two or three years ago in an entirely different cost environment.

Mr Daly added: “On a longer-term basis, nursing homes are operating under a funding model that the State itself realises is not fit for purpose. In 2015, the review of the Fair Deal stated requirement to move towards an evidence-based cost of care model, citing the application of fees on a geographical and historical basis as not being commensurate with the reality of resident care costs. In 2020, the Comptroller and Auditor General criticised the NTPF for having no model to explain how it determined Fair Deal fees for resident care. Nursing homes are subject to a price setting mechanism administered by the State that is removed from resident care being the defining criteria for cost determination. It is astonishing the regulator HIQA states concerns the fees payable under Fair Deal are not based on resident care needs and the Government continues to submerge itself from such reality. HIQA has warned for many years regarding the closure of smaller nursing homes. The consequences of long-standing Fair Deal failings are now driving smaller nursing homes from care and our communities.”

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