While most French nursing homes are in a deficit situation in a decade 2020-2030 that will see the explosion of 75-85-year-olds, representatives of the sector are sounding the alarm.
“We're in the doldrums…” That's a real warning cry that was raised this week at national nursing home hearings that took place in a crisis context marked by shortages in two-thirds of the facilities. Asphyxiated by inflation and rising costs, French nursing homes are looking for a new economic model as the picture painted these days looks bleak.
“The model is outdated, all funders are at the end of what they can do,” commented Didier Sapy, director general of the national federation of organizations that manage non-profit facilities for the elderly (Fnaqpa) on the sidelines of the event. Result, “we are on the brink. A blow from the State, a blow from the departments, a blow from the elders themselves.”
60.3% of nursing homes in poor condition
Designed in the early 2000s, the economic model of accommodation units for dependent elderly people (Ehpad) is based on three sources of funding: the resident for the accommodation part, the Departmental Council for the dependency part and the Regional Health Agency for the care part. Long considered too complex by detractors, this financial architecture stopped in 2020 with the Covid-19 crisis and that of the Orpea scandal related to the disclosures of January 2022 regarding cases of mistreatment and financial embezzlement. As for the private nursing home, these revelations have led to investor reluctance. Regarding the public nursing home, there is distrust among families and a growing dislike of the structures.
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In the public EHPADs of Occitanie, red alert for finances
In 2022, 60.3% of public and private non-profit units were in deficit compared to 49.3% in 2021, according to a study by the National Solidarity Fund for Autonomy (CNSA) published in July. In Occitania, the result of the annual survey carried out last March by French Hospital Federation (FHF) painted an even more troubling picture. 89% of public nursing homes in the region are in poor condition. In the private commercial sector, if “confidence is gradually returning with increasing occupancy, we are still very weak,” commented Jean-Christophe Amarantinis, president of the main union of private nursing homes, Synerpa. Faced with the worsening of the situation, public authorities have unlocked additional funds, but these amounts are insufficient to finance the necessary investments (updates to safety standards, adaptation to heatwave periods or the increase in the number of residents with neurological conditions, etc.), noted the think tank- ul Matières grises in a note published in June.
“Inaction is no longer an option”
Elected officials and players in the sector have urged the new prime minister, Michel Barnier, to make the old-age law, promised in 2018 by Emmanuel Macron but repeatedly postponed, a priority in the face of the approaching “demographic wall”, according to the latest forecasts from 2040, 15% of the population will be over 75 years old. The priority of the future government and the future minister responsible for the matter must be the “law of old age”, estimated the president of the Federation of French Hospitals (FHF), Arnaud Robinet, during the meeting judging that: “Inaction is 'no more'.” an option today.