‘Nobody just chooses to close a nursing home’: sector struggles amid ‘a lot of problems’

Inflation and cost of living among issues but biggest problem is being locked into Fair Deal agreement, says nursing home owner

Nursing home owner Nuala Cormican, who realised her dream of opening her own “home away from home” facility in 1994 in Aughrim in Ballinasloe, Co Galway, says she is in despair at seeing private nursing homes similar to hers close because of ever-escalating costs.

Ms Cormican, who is going in to her 29th year as owner and director of nursing at the Hillside Nursing Home, says that they have no intention of closing. However, they, like other nursing homes, are “enduring a lot of problems”.

“I suppose inflation and cost of living have impacted on us big time. That goes from the price of food to the price of everything. And energy – I have reservations about how much we are going to be compensated [by the Government] for the increase. It is very vague and I don’t think it is going to amount to much.”

Ms Cormican operates the nursing home with her husband, former psychiatric nurse Michael, and says that their biggest issue is that they are locked in to a Fair Deal agreement.

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“It started in May with us and our contract doesn’t expire until the end of 2023. So regardless what our expenses are that is not going to change.”

Nursing Homes Ireland (NHI) says that 17 private nursing home facilities have closed so far this year, with the loss of almost 500 beds and more than 600 job losses.

Ms Cormican says that it is not just about numbers but instead the damage caused to communities when they lose trusted service providers.

“Our nursing home caters for all of the local people. We have one resident who can see his farm from here. Another lady, the nursing home was built on her land. It is very much a home from home.”

Ms Cormican is already seeing the impact of the closures of homes nationwide in her own facility.

Closed down

“I have a resident who has come nearly 30 miles because she came from a nursing home that closed down. Now she is happy at the moment, but it was a big transition for her. That is impacting on the elderly and on the families as well.”

Ms Cormican says that when elderly people have to relocate to a new area in order to get a place in a nursing home, it can be more difficult for family members to visit.

“You would have people who don’t like or feel safe driving too far or driving at night so they wouldn’t visit at night when they usually would have come. They try to come during the day.”

The Hillside Nursing Home is starting to receive calls from social workers looking for beds for individuals who live many miles away.

“I had a social worker on the phone the other day but I didn’t have a bed. She was looking for a bed for a man a long, long way from Aughrim. And they just didn’t have any place for him to go to after the nursing home he was in closed down.”

Ms Cormican says that private nursing home owners rarely leave the industry without a good reason. She stresses that proper funds have to be introduced by the Government to help private homes to come through the current crisis.

“It is terrible. Nobody just chooses to close a nursing home if they are in position for a long time and are compliant with regulations. The Hiqa regulations are very stringent and I thoroughly agree with regulations and a good standard of care. But at the same time we are expected to be regulated the same way as the HSE nursing homes. They have much more financial support than we have.”

Ms Cormican says that the other big problem that she faces is losing staff members to the HSE, which can offer better sick pay, holidays and maternity leave.

“I source nurses from India through an agency. I pay for their RCSI exams which is €1,000. I have to pay for their visas and their permits. Each one amounts to about €4,000 to get them here to my door.

“And then I train them because they need induction training. They are registered nurses after about three weeks. They are supervised for quite a well and are trained up. And everything is grand.

“Then they apply to the HSE and they get a job with the HSE because they are already trained.”

Ms Cormican admits that the last few years have been her most difficult in a job that she still loves.

“It is the worst time in my 28 years. I am having flashbacks from Covid. We only had one outbreak and thankfully we had no lives lost. It was after we had a full booster vaccination.

“There was nobody sick or hospitalised because of Covid but at the same time it was just the threat and the fright and the fear. I think if I had lost anyone to Covid I would have closed my doors. I wouldn’t have been able to continue. I don’t think I could live with it.

Ms Cormican was particularly upset by a comment she says that was made by Minister for Older People Mary Butler about private nursing homes.

“Minister Mary Butler had the cheek to say that the patients in private nursing homes were of lower dependency than the patients in public nursing homes. That is not true. We take patients who have peg tubes, who need artificial feeding... people who need a maximum level of care.”

‘Struggle’

Meanwhile, she says that her 18 members of staff are very good but that that they need “more State support and recognition” of their contribution to society.

“I think now we are running at a loss. I am going to be shocked at the end of the year. I am staying here but at the same time I am finding it a struggle and I don’t think it should be a struggle. If you are giving your best I think you should be remunerated and respected a bit more.”

Ms Cormican adds that she is in the nursing home so long that she is beginning to see multiple generations come through the doors. She wants to be able to concentrate on her work, not on worrying about bills.

“I want to be able to do my job without having to worry about financial issues. Private nursing homes are being put in a very precarious position.

“The National Treatment Purchase Fund, or as they call it the Fair Deal Scheme, needs to be upped as a matter of urgency. And it needs to be comparable with the public nursing home.”

Separately, NHI has written to Taoiseach Micheál Martin to inform him that the sector is facing “extreme challenges”.

NHI chief executive Tadhg Daly says that they are asking the State to reduce residential rates to be more in line with the Fair Deal Scheme, which offers financial assistance to those living in nursing homes.

“We’re calling on the Government to inject a stabilisation fund for the sector to ensure that we can stem the current tide of closures and ensure a sustainable sector for the medium term.

“And then to undertake the long-awaited view of the pricing mechanism of Fair Deal that has been recommended by numerous government reports over many years.”

Mr Daly says that the independent report would suggest that the cost of care has risen by about 35 per cent in the last number of years, whereas the Fair Deal rate has risen by about 11 per cent.

“So there’s a significant gap there and that’s exacerbating an already difficult situation leading to closures.”

In a statement the NHI said that it welcomed a newly published report by the Health Information and Quality Authority which set out the “extreme challenges” that were presented to nursing homes in caring for residents during the pandemic, highlighting just how difficult a time it was for residents, their families and staff.

In its report Hiqa repeated its call for introduction of a sustainable funding model which is commensurate with the care needs of nursing home residents, Mr Daly said.

“The regulator has issued this call on a repeated basis and given the levels of closure that are occurring within the nursing home sector, which the report highlights, it is incumbent upon the Government to act with haste and prioritise reform of Fair Deal to enable it to reflect the reality of resident care needs.”