Findings and recommendations within nursing home report of seismic important for health sector

The findings within the newly published DKM report Potential Measures to Encourage Provision of Nursing Home & Community Nursing Unit Facilities – commissioned by the Department of Health – are of seismic importance for our health services and it is imperative the recommendations within it are rapidly acted upon.


The report highlights:

  • The supply gap emerging in the nursing home sector

  • “The lack of reference to efficient cost levels and return on efficient capital in the Fair Deal negotiations represents a disconnect from the reality that the State expects the private sector to potentially provide 80% of nursing home capacity going forward.  It is unsustainable in terms both of rational market operation and enabling new investment in areas of the country where payment rates are lower.”

  • The pricing model is acting as a barrier to investment, has been developed in an ad hoc way, lacks logic and is not fit for purpose.

  • The lack of reference to the level of dependency of residents within the pricing mode is discouraging the development of more specialised facilities where more expensive care is required, and creates an incentive to actively discourage acceptance of high-dependency residents by nursing homes

  • The very significant variation in price paid for care from the private and voluntary nursing home sector, unprecedented within State procurement

  • The constraint placed upon the Exchequer because of requirement to invest in public nursing homes and these nursing homes being “significantly more expensive to operate”

  • A review of the pricing model is critical to ensure the supply gap is addressed


    Tadhg Daly, NHI CEO states: “The significance of the findings and recommendations within this report should not be underestimated. They should represent a defining moment for provision of nursing home care in Ireland and for provision of healthcare within this country. We welcome the findings of this independent analysis of nursing home care. They support NHI’s consistent pronouncements during the term of this Government and prior that the pricing model to support nursing home care is not fit for purpose. As consistently stated, it is threatening the sustainability of providers and stifling their ability to meet the rapid growth in requirement for nursing home care. This report highlights the paucity of the Fair Deal review, which raised questions surrounding the suitability and transparency of the pricing model but put the issue of addressing it on the long-finger. Against a backdrop of requirement for nursing home places increasing by 1,000 per year, the review kicked for touch by recommending a further review of the pricing model within a two-year period. The stark findings within this analysis highlight the absurdity of this Government not addressing the very serious issues surrounding care provision within the nursing home sector in an urgent and meaningful way. The report highlights the gap in provision, particularly in urban areas. Providers of nursing home care simply cannot keep pace with requirement because of the not-fit-for-purpose pricing model we have consistently brought to the attention of this Government. Independent analysis has previously highlighted the unsuitability of it and requirement for the price paid for care to be evidence-based. This is completely logical, yet the State has turned a blind eye to this imperative requirement. The gap in supply will leave persons in acute hospital care with nowhere to go - unable to avail of the long-term or respite care provided by nursing homes.