Twenty-one of the biggest publicly-run nursing homes are at risk of closure due to the state’s failure to invest in bringing them up to national accommodation standards.
The 21 nursing homes were listed as having “major” non-compliance issues by Hiqa, the health regulator, in recent inspection reports.
None were identified in the HSE’s service plan for 2015 as projects that will receive capital funding this year, even though the deadline for compliance with accommodation standards is imminent. The standards must be met by July, or the homes face possible sanction, up to and including closure.
Hiqa can close non-compliant nursing homes, or impose strict sanctions if they are to stay open.
Conditions can include forcing nursing homes to reduce the number of residents or high-dependency patients they house. Hiqa can also prevent nursing homes from accepting more residents.
Hiqa said that “if a centre is not in compliance by July 1, 2015 and if no realistic, time bound costed/funded plan has been agreed with the Authority, then appropriate conditions will be attached to any renewal of registration”.
The HSE has submitted costed plans for many nursing homes, but has not done so for 27 nursing homes. It is unclear whether Hiqa has approved the plans that have been submitted, or whether the HSE has outlined any plans for the 21 nursing homes that were least compliant.
Hiqa inspection reports detail those that are at minor, moderate and major non-compliance.
Hiqa inspectors described many more nursing homes as having “moderate” levels of non-compliance, although a small number were listed in the HSE’s service plan for capital investment to meet Hiqa standards.
Last Thursday, HSE director general Tony O’Brien warned there was insufficient funding to fund the upgrading of many public nursing homes. A leaked HSE document that was reported last year said €300 million would be needed to bring publicly owned nursing homes up to Hiqa standards.
Just €7.3 million is being spent on upgrading nursing home facilities this year, according to the HSE’s service plan.
Fianna Fáil leader Micheál Martin called for “absolute transparency” from the government.
“The minister [Varadkar] said he wants to be more transparent. This is an opportunity,” Martin said.
Hiqa’s inspection reports show that the worst affected county is Cork, where six nursing homes were described as having major non-compliance issues.
Martin said that the closure of public nursing homes would “break up communities. The implications are catastrophic”.
He warned the closures would reduce capacity at a time when delayed discharges were leading to emergency department overcrowding.
Over the last number of years the HSE’s capital investment programme has brought a number of its public long stay units to full Hiqa infrastructural standards.
However, the majority of HSE public long stay units were built prior to Hiqa regulation in 2009.
The HSE said “a major capital investment would be required to bring all these units to full infrastructural compliance particularly those that are in excess of 100 years old”.
A reduction in the number of nursing home beds in the public system could have serious repercussions on waiting lists, which are already under huge pressure.
Hiqa contradicted remarks made by minister Kathleen Lynch, who told radio station Newstalk that the regulator had granted the state a three-year amnesty.
“The Authority’s approach to this matter is to ensure consistency and proportionality and that each centre application for renewal of registration is deliberated upon on a case by case basis,” Hiqa said.
The new standards essentially require nursing homes to move from providing multi-occupancy wards with shared toilets to single and double rooms with en-suites.
However, many public nursing homes are located in older institutional building that are more expensive to convert.
Hiqa began regulating the sector in 2007.
At that time all providers were advised that compliance was required by July 2015.
There are 120 publicly-run homes. They accommodate more than 7,000 residents.
Nursing homes at risk of closure
The number following each home refers to the max number of residents who can be accommodated.
Breffeni Care Unit, Ballyconnell Co Cavan (30)
Lisdarn Unit for the Elderly, Lisdarn Co Cavan (44)
Raheen Community Nursing Unit, Tuamgraney Co Clare (25)
St Joseph's Community Hospital, Ennis Co Clare (120)
St Joseph's Community Hospital, Millstreet Co Cork (26)
Macroom Community Hospital, Macroom Co Cork (38)
Bandon Community Hospital, Bandon Co Cork (22)
St.Finbarr's Hospital, Douglas Road Co Cork (91)
St Joseph's Ward, Bantry General Hospital Bantry Co Cork (24)
Castletownbere Community Hospital, Castletownbere Co Cork (31)
Leopardstown Park Hospital, Foxrock Dublin 18 (171)
Peamount Hospital, Newcastle Co Dublin (48)
Tralee Community Nursing Unit, Tralee Co Kerry (43)
Arus Carolan, Mohill Co Leitrim (37)
Cottage Hospital, Drogheda Co Louth (23)
St.Joseph's Hospital, Ardee Co Louth (20)
Oriel House, Rooskey Co Monaghan (25)
St. Conlon's Community Nursing Unit, Nenagh Co Tipperary (27)
Dean Maxwell Community Nursing Unit, Roscrea Co Tipperary (30)
St Patrick's Hospital, John's Hill Co Waterford (96)
Gorey District Hospital, Gorey Co Wexford (29)
TOTAL NUMBER OF RESIDENTS: 1000
This article was originally published in the Sunday Business Post on January 18, 2014.