A significant deadline is facing the Nursing Home sector in Ireland and one that is a big concern. That deadline is for nursing homes to fully comply with the 2009 Health Information and Quality Authority (HIQA) standard for physical environments. That is section 25 in the National Quality Standards for Residential Care Settings for Older People in Ireland. In that document, dated 17th February 2009, it mentions that existing facilities must comply within six years of the implementation of the standards. It is unclear if the deadline is therefore 17th February 2015 or end of July 2015 as another HIQA document mentions (The Regulator Notice on Premises & Physical Environment RN001/2013).
In any case, the requirements specify many criteria, including:
- Bedrooms having minimum of 9.3 m2 usable floor space (excluding en-suite facilities) in all single rooms.
- Shared bedrooms to provide a minimum 7.4m2 per resident, with no more than two residents per room except for high dependency rooms where a maximum of six applies.
- One wash hand basin per bedroom (minimum of one wash hand basin per two residents, or one per 3 for the high dependency rooms).
- One assisted bath or shower per 11 residents, located in close proximity to bedrooms.
It has been claimed in a recent paper by CBRE that the nursing home sector will need a significant investment of capital in order to comply with these new regulations. Failure to do so could result in a significant number of nursing home closures, thereby leading to a critical lack of nursing home beds.
While raising the standards of the physical environment in nursing homes is laudable, and seems like a reasonable goal for HIQA to have, it does have costs. Someone has to pay for it. This will lead to an increase in nursing home fees. If nursing homes are being closed down, that in itself will put upward pressure on fees. Couple that with fee increases to cover the cost of investment to comply with the increased standards and the total could become unbearable. What will people do who are already struggling to meet fees currently?
Nursing Home Ireland in its submission to the Oireachtas Joint Committee on Health and Children in November 2013 also mentions a deadline of July 2015 and that the HSE has indicated that an investment by the State of €1.7 billion is required for the nursing homes in the public sector alone in order to achieve full compliance and to retain its share of 20% of the overall nursing home sector. Will the state make this investment and achieve compliance in time? Nursing Home Ireland is concerned that the public sector nursing homes will negotiate extenstions with HIQA. It does not want a situation where public and private nursing homes are treated differently.
Do you think that public and private nursing homes should be treated differently in respect of enforcing the national standards?
Do you think that HIQA should stand its ground and stick to the 2015 deadline, even if nursing homes have to close because they don’t have the space or the investment capital required to give extra floor space and extra bathing facilities to the residents? Is Ireland wealthy enough to pay for this increase in physical environment standards across the board?