The adverse publicity given to individual nursing homes over recent years; uncertainty regarding future standards, combined with the site value of nursing home sites in urban areas persuaded many proprietors to consider exiting the nursing home sector. The closure of a number of homes, particularly in the larger urban areas, has taken place at a time when there is increased demand for nursing home beds.  

 An important additional factor is the increasing number of elderly in our population. It is estimated that up 6% of the over 65 age population in 2006 are availing of community residential care.

In addition arising from anticipated quality standards; market forces, obsolescence of existing nursing home beds, up to one third of the existing 28,000 nursing home beds, will be replaced.  In other words by 2021 up to 21,000 new or replacement nursing home beds will be required.  

Meeting the projected demand for beds and providing these in the locations where they are most needed, will be difficult to achieve.  Site costs in urban areas add significantly to the overall capital fixed cost of a new nursing home. It will be a difficult challenge for the private sector to acquire land and build new nursing homes. Local authorities, and government bodies with large tracts of unused lands, need to be persuaded to designate land for community nursing home purposes. Brown field as well as green field sites must be considered.  

The more recent decisions of planning authorities, and confirmed by An Bord Pleanala are to restrict the building of nursing homes in rural areas, means that there is now little alternative  but to build nursing homes close to urban areas.  

The projected requirement of 21,000 new or replacement beds by 2021, will require the building of the equivalent of 350 additional 60 bedded nursing homes at building costs (2008 prices},per nursing home of €6.75.millon.in addition to site costs of €1.50.millon( 20% of total costs), and outfitting costs of €0.30 million.  

The estimated total investment required in new nursing homes over the next 15 years is in the order of €3 billion. Based on current financial arrangements attractive Capital tax allowances of up to €2.50 billon are available to investors. 

Side by side with the requirement for more community care beds is a need for greater integration of the care of older people as they move from one care need to another. As a true resource to their community nursing home beds should be operated in tandem with stay at home care, day care, sheltered housing, and acute care beds. Older people need and deserve such an integrated approach. 

The challenge will be to encourage and incentivise Developers, Investors and Operators who are willing to invest time and money to provide such facilities.

Unless existing or new service providers come forward with plans to provide the necessary beds the dire predictions regarding a shortage of community care beds will quickly become a reality. 

The coming months will bring clarity to the quality standards for community care homes, and the financial contribution, A FAIR DEAL, the state is willing to make to the care of older people.