Rural Ireland ‘facing shortage of nursing home beds’

Parts of rural Ireland are facing an acute shortage of nursing home beds unless Fair Deal rates are reviewed, an expert in the sector has claimed.

Current projections suggest a shortfall of up to 7,500 nursing home beds for the over-65s by 2026, with the undersupply expected to be more of an issue regionally than in Dublin.

Speaking at a breakfast gathering hosted by Bank of Ireland, Hilary Coates, the bank's head of health sector, said rural counties can expect significant shortfalls of nursing home beds in the near future.

According to the bank's own projections, Donegal could have a shortage of up to 581 beds, Cork up to 526 beds, Kerry up to 500 beds, Galway up to 487 beds and Mayo up to 480 beds unless capacity is increased.

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She suggested the shortage of nursing home places is a direct result of the lower Fair Deal rates paid to nursing home operators in rural areas in comparison with Dublin.

In Dublin, nursing home operators are paid €1,320 per resident per week; in Tipperary, which has the lowest rate in the country, the figure is €760.

The fees reflected the rates that were paid by the HSE and the old health boards before the Fair Deal scheme came into place in 2009.

Ms Coates pointed out construction costs for nursing homes have gone from €90,000 to €160,000 per bed in the space of just four years, but Fair Deal rates have increased by only 3.9 per cent in the same time frame.

The Nursing Homes Support Scheme, also known as the Fair Deal scheme, provides financial support to people who need long-term nursing home care. The scheme is operated by the HSE. Under this scheme, residents make a contribution towards the cost of their care, and the State pays the balance. The scheme covers approved private nursing homes, voluntary nursing homes and public nursing homes.

Ms Coates said nursing home beds might not materialise where they are needed “because the capital value of greenfield nursing homes, once operational, may, as a result of those rates and increased staff costs, be lower than the actual development costs”.

She added: “Dublin is benefitting from those Fair Deal rates. In reality it may require a change in policy direction and possibly Fair Deal rates to promote a more balanced regional development to ensure that capital investment is directed towards the regions where bed stocks will be most needed and people can actually age in their communities.”

Bank of Ireland chief executive Francesca McDonagh said the bank had done a county-by-county analysis because otherwise an oversupply meant nursing homes with empty beds and and an undersupply will have negative repercussions for people and communities who will require them.

“Therefore, at the heart of every funding decision is an assessment of the alignment of interest between those requiring care and the customer seeking finance,” she told the bank’s conference on long-term care.

“The word community is a very significant word here, as nursing homes countrywide play such an important role in enabling older people to stay connected with the places and people they know.”

Nursing Homes Ireland chairman Maurice Pratt criticised the Government for its delay in publishing the review of the Fair Deal Scheme.

He said a report done in 2015 showed the scheme was “not fit for purpose”. A review was supposed to have been published in June 2017 but has not been published.

“It is hard to talk to long-term investors in the sector if you don’t have a sense of where the direction of travel is going to be. That is a big issue,” he said.