Weakened by inflation, nursing homes (Ehpad) are hoping for a gesture from the government in the next budget, but in the meantime, a new decree facilitates price increases for certain residents, a breath of fresh air for their finances.
“The budgetary situation of establishments is catastrophic,” said Annabelle Vêques, director of the Federation of Directors of Establishments for the Elderly (Fnadepa), to AFP. “Despite political instability and the public deficit”, it is necessary to invest in the elderly sector so that structures can continue to “pay salaries” and to “avoid any risk of bankruptcy”.
A survey carried out in September among 1,600 members of this federation showed that 71% expected to close the year 2024 in the red, an increase of six points compared to the previous year. The average loss is estimated at 156,600 euros. However, half of establishments no longer have sufficient cash reserves to compensate.
“We have no room for maneuver,” Pierre Roux, president of the Association of Directors Serving the Elderly (AD-PA), also told AFP.
Reducing the number of caregivers, turning down the heating or spacing out cleaning of premises: saving on expenses would amount to “reducing the quality of life and care of residents”, an unthinkable option for him.
– Revaluation –
These expenditure items have increased significantly over the past two years, mainly due to inflation. But the revenues of some 7,000 public, associative and private commercial French nursing homes have not increased at the same pace.
Nursing homes benefit from three sources of funding: a grant from the State for care, funding from the department to take care of issues related to dependency and payment from the resident to pay for accommodation costs ( meals, maintenance of premises, etc.).
The public authorities have increased their funding too limitedly in recent years, according to the establishments.
“The allocations linked to care and dependency have undoubtedly not been upgraded to sufficient levels,” Olivier Richefou, vice-president of the Départements de France (DF) association, told AFP.
“Establishments must regain momentum and be able to invest to modernize, everyone must participate [à l’effort]including residents, without putting the most modest in difficulty,” he believes.
To find a little fresh air, the sector hopes above all to benefit from a “consequent increase” in the amount granted by the State for care. It will be determined during the next parliamentary discussions on the Social Security budget (PLFSS 2025).
“We are waiting for a strong signal from the government,” confirms Jean-Christophe Amarantinis, president of Synerpa, the main union for private nursing homes. He hopes for “at least 5-6%” increase.
– Differentiated prices –
Nursing homes could not freely increase their accommodation prices until now, the increases being governed by different rules.
While awaiting discussions on the budget, the government published a decree on January 1 — in application of the law on “aging well” adopted in 2024 — which facilitates increases in accommodation rates for the wealthiest residents, those who do not receive social housing assistance (ASH).
This measure mainly concerns public and associative establishments, which accommodate around 20% of low-income residents, but until now had the habit of charging the same price to everyone. The decree specifies that the wealthiest will be able to pay up to 35% more for an identical service.
For Marc Bourquin, strategy advisor at the French Hospital Federation (FHF), which represents public nursing homes, this is a welcome measure: “it is not a miracle solution, but it should help establishments to exit the head of the water”.
As for the families of residents, on the other hand, it’s a cold shower: “a lot of residents already have difficulty paying for their place and this risks becoming a barrier to entry”, reacted to AFP Françoise Gobled, president of the Federation of Friends of the Elderly (Fnapaef), who said she was “shocked” by this measure.
Its effects will be felt in the accounts of nursing homes gradually because it will only apply to new arrivals.
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