When Carmel Killeen opened her nursing home in Athenry, Co Galway over two decades ago, its open space design was influenced by the needs of her ageing father Tom who had dementia.
He died shortly before it opened but for the Killeen family, this mixture of familiarity and specialised care would become a defining focus.
But then late last year, frustrated by ongoing struggles with the State funding model, they decided to close.
It is a fate Nursing Homes Ireland (NHI) is concerned will spread to countless other homes in the coming months and years, presented to TDs and Senators on Wednesday as inevitable without significant reform.
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Last year, Carmel Killeen impressed upon her daughter Clodagh, who had taken over the running of Castleturvin House, that its future was no longer viable.
“I was resisting it for quite a while,” Clodagh said ahead of Wednesday’s Oireachtas briefing. But when she attended an emergency NHI meeting she realised funding issues had been an ongoing problem.
“My own grandmother was in a nursing home. I’m not going to provide substandard care because I don’t have the resources. I would prefer to close the doors than provide substandard care because it’s not the residents’ fault that I’m not getting funded.” Last October, they duly closed the doors.
According to Clodagh, Castleturvin House was receiving National Treatment Purchase Funding (NTPF) of €940 per resident per week, compared to a rate of €1,700 for a nearby HSE run unit.
She felt her home and its residents were being discriminated against. Castleturvin had 42 beds when it shut; it contributed €1.5 million to the local economy and employed 50 people, but Clodagh was tired of watching her staff leave in search of better paid jobs. It was not the consistency and familiarity they strove to provide.
NHI recently commissioned a PwC report into the sector – Challenges for Nursing Homes in the Provision of Older Persons Care – which found 31 nursing homes have closed in the last three years, taking away 915 beds.
A third of private nursing homes lost money in 2022, it said, and warned of inevitable future closures if financial conditions did not improve.
NHI has urged political representatives to act on the report’s key recommendations, including a need to reform the Fair Deal pricing mechanism.
“Ultimately there needs to be a policy change,” said its chief executive Tadhg Daly ahead of the meeting to which all TDs and Senators were invited.
“The inaction of Government is what’s causing the crisis that we find ourselves in. Nursing Home care is highly regulated from the point of view of standards and funding so the only people that can address the issue is Government.”
Mr Daly said more homes will begin to close within months, leading potentially to “a much, much more acute crisis” within two years.
Its report looked at “rapidly rising operational costs” driven by a variety of factors including infection prevention control (IPC) requirements, inflation and staff shortages.
While all nursing homes were profitable just six years ago, it said operational costs rose by 36 per cent since 2017.
The cost of developing a bed is up 47 per cent, the study found, although income from the State for residents on the Fair Deal scheme has increased only marginally.
The report has recommended the immediate funding provision to the NTPF to place private and voluntary nursing home care “on a sustainable footing” and ultimately to reform the Fair Deal rates around residents’ individual care needs.
A Government spokesman recently pointed out that the Government had committed €1.5 billion of its health budget to the Fair Deal scheme to help support 22,700 people in nursing homes.
