Nursing home ownership moves represent major risk to future survival of sector, report finds

The consolidation of nursing home ownership by bigger corporations “represents a systemic risk” to the sustainability of the sector, a report by the health sector watchdog has found.
On Thursday, the Health Information and Quality Authority (Hiqa) published a 15-year overview report on the regulation of nursing homes.
The report shows that significant progress has been made in enhancing the quality of care in nursing homes, although it said continued improvement is necessary.
The report also examined the current and future challenges facing the sector. It acknowledged the closure of smaller nursing homes in recent years, stating rural areas were most affected, “with a disproportionate impact on some counties, especially in the west of Ireland”.
In 2023, 12 designated centres for older people closed voluntarily. The report said the closure of smaller nursing homes “should be considered in the context of a loss of a particular model of care and not just in terms of bed numbers”.
Hiqa also highlighted the change in ownership following the closure of the smaller homes.
A recent report for the Economic and Social Research Institute (ESRI) said 15 medium/large operators made up 38 per cent of all nursing home beds, with 14 of these being private-equity financed.
“One challenge posed by the consolidation evident in the nursing home market is that of financial viability. Should one large organisation experience financial difficulties – due to exposure to international economic dynamics in the nursing home sector – this could have a significant impact on capacity in the sector and on the residents who rely on these services,” the report said.
“We support the view that the consolidation of nursing home ownership by a small number of large operators represents a systemic risk to capacity in the nursing home sector that should be addressed as part of an overall strategy for social care in Ireland.”
In more positive developments, the report said nursing home care has moved away from a medical, institutional model towards a social model of care.
Carol Grogan, chief inspector of social services in Hiqa, said many providers have worked hard to improve their compliance, “resulting in stronger governance and management arrangements being put in place”.
“This has led to better outcomes for residents and tangible improvements to their lived experiences,” she said.
[ Selling the home of a family member who is in nursing home careOpens in new window ]
“Many services are now providing care that is more person-centred, with residents exercising more choice, enjoying a greater degree of privacy and dignity and being supported to live more meaningful lives.”