Annual private nursing home survey, 1994.

Transcription

1 Annual private nursing home survey, Item type Authors Citation Publisher Study Irish Nursing Homes Organisation (INHO); Horwath Bastow Charleton Irish Nursing Homes Organisation in association with Annual private nursing home surveyirish Nursing Homes Organisation in association with Horwath, Bastow, Charleton., Dublin: Irish Nursing Homes Organisation in association with Horwath, Bastow, Charleton. Downloaded 29-Apr :54:39 Link to item Find this and similar works at -

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4 i- ~--, [1 I ~ Introduction & Forewords Foreword by Paul Costello, Chief Executive INHO Foreword by Minister Sean Power Foreword by Brian McEnery, Partner, Executive Summary & Highlights Introduction & Methodology General Facts and Figures Relating to the Elderly in Ireland The Nursing Home Subvention Scheme Where to apply Review of the Nursing Home Subvention Scheme Capital Allowances Sheltered housing units Survey Results - Supply Registered homes & beds Population Older population Supply growth Planning applications Nursing home extensions Breakdown of accommodation Contract beds Day care facilities Day care rates Income from subvention Sheltered accommodation units Years in operation Survey results - occupancy lib Bank 1 i

5 Occupancy by location Occupancy by size Survey Results - Financial Average weekly rates Rates by size Turnover by location Turnover by size Staff costs Staff costs by location Staff costs by size Hourly rates Weekly food bill Survey results - profile of residents Dependency levels Age profile of residents Dementia Long-stay residents Area Summaries Eastern Regional Health Authority Midland Health Board Mid-Western Health Board North Eastern Health Board North Western Health Board South Eastern Health Board Southern Health Board Western Health Board Summary schedule by location Summary schedule by size Directory of Nursing Homes

6 ~",\llg 40 <:'G~ IRISh URSI C;.&: '".\ ~~ homes ORC;AN1SAClON ones. Foreword by Paul Costello, Chief Executive The INHO is delighted to publish the second annual survey of the private nursing home sector. This year's survey is the most comprehensive survey ever undertaken. We would like to thank all respondents for taking the time to complete and return the questionnaire and without whom, this survey could not have been published. We specifically would like to thank Horwath Bastow Charleton for the work they have put in to making this years survey as comprehensive as it is. This year's survey includes useful information on other associated areas and a diredory of the nursing homes across the country. HOME CARE MEDICALu,..o 8'-"f'f There is no doubt that there would not have been anything like the level of investment in the sedor if the tax incentives were not there. There comes a time when an imbalance between demand and supply arises, and as shall be seen from th is year's survey, the occupancy levels have fallen in the year since the first review. In Ju ly of 2006, many of the tax breaks associated with other tax based developments will expire, and the INHO recommends that the tax incentives for private geriatric care facilities should terminate also at this point, as they have now served their purpose. The private nursing home sector has grown significantly again in The supply of private beds has grown by approximately 10 per cent in the year since the last survey was published and growth is forecast to continue at least at a similar level in the near future. While new tailor made, high specification beds are welcome, the addition of so many beds in such a short time period, inevitably throws up challenges for the exi sting operators in the sector. Allied to this, the Department of Health & Children appear to be unrelenting in their desire to develop additional geriatric care beds through Public Private Partnerships. Were these PPP beds to be developed, the sector would face worrying oversupply issues. The fad of the matter is that such growth in the private geriatric care sedor is somewhat artificially led, due to the tax breaks available on nursing home developments. Paul Costello Chief Executive lib Bank 3

7 Foreword by Minis er ean P er It has long been the policy of my Department to develop services for older people which allow them to remain living at home or in the community for as long as possible in dignity and independence in accordance with their wishes. However, when an older person can no longer live in the community, it is important that he/she can have access to long-term care of a high quality. I am working with the private nursing homes to continue to enhance and develop their services and facilities. I am impressed with the comprehensive range of activities, day outings, arts and crafts, music and dance etc in some of the private nursing homes along with the roll out of services such as rehabilitation, physiotherapy, chiropody, speech and language therapy. With the current Government incentive there has been tremendous capital investment in the Private Nursing Home sector in the last number of years which has encouraged the development of centres of excellence and high quality purpose built nursing units. The publication of the report Protecting Our Future was a momentous occasion for the older people in this country. This report, in starting with a definition of elder abuse and recommending the putting in place of structures to deal with suspected cases will, hopefully, give older people who feel they are the subject of abuse in any shape or form, the confidence to report their anxieties, appropriate, to such as a social worker, a public health nurse, a member of the Garda Siochana or, indeed, any professional or care worker. Furthermore, a National Implementation Group has been established, as recommended in the Elder Abuse Report. -- lib Bank 4 as HOM ECAIU ME 0 ICALt.zc.o 8 1Jo1f'f I am determined to press ahead with the gradual implementation of the report. 0.8 million was made available in 2003 and 0.7S million was made available this year, to commence the process. The nursing home sector can play its part in ensuring that adequate safeguards are in place for the protection of vulnerable adults in its care and by participating in the efforts to raise public awareness of elder abuse. These are exciting times for the health system in Ireland. Following an audit of the structures and functions of the system, it was decided to put in place a comprehensive programme of change for the health sector. I firmly believe that the decisions made will reinforce and build on the efforts to date in order to provide a framework for developing services and optimizing the impact of these services on the patients and clients who rely on them. I want to reassure those in the private nursing home sector of my Department's and the health agencies willingness to work with them on a partnership basis in the future and of our intention to engage with them in meaningful consultation as and when this is required. Finally, I welcome the publication of this survey and I would like to thank Paul Costello for inviting me to write this foreword. Sean Power. T.O. Minister of State.

8 Foreword by Brian McEnery. Partner. Horw h B ow Charleton is delighted to present the second annual Private Nursing Home Survey. Last year saw the publication of the inaugural survey, and it was widely used as a benchmarking document for operators, financial institutions and investors in the sector. is proud of our association with this publication as specialist advisors to the health care sedor. - Healthcare Consulting is led out of our Limerick Office, and has a mixture of corporate finance, audit and taxation experts therein, who provide advice to our clients and contacts. is one of Ireland's largest accountancy and advisory firms and is a member firm of Horwath International, which is the seventh largest worldwide firm of accountants and consultants. Horwath Bastow C harleton - Healthcare Consulting specialises in the provision of strategic advice to: The geriatric healthcare sedor The acute healthcare sector The primary healthcare sector The medical products and devices sedor. HOM ECARE MEDICALu,..o 8 "",1 tremendous resource for the industry as a whole. The second annual survey is much expanded and includes additional sections on: Tax based financing initiatives for the geriatric sector Subvention Planning applications within the last 12 months Directory of nursing homes in the country In a similar way to last year, the survey continues to cover the areas of occupancy, financial analysis etc. We wish to thank lib Bank and Homecare Medical Supplies for their commitment to the private nursing home sector, through the sponsorship of this annual survey. Importantly, we wish to thank the private nursing home operators throughout the country who responded to a very detailed questionnaire. Without their assistance the survey would not exist. Finally, I wish to thank my colleagues in for their assistance and in particular, Caitriona Callaghan who has again provided invaluable assistance to me in the compilation of this report. leads feasibility studies through to project financing and tax struduring of transactions. The compilation and produdion of the annual survey helps our firm to stay abreast of the trends within the geriatric health care sector. We would like to congratulate the INHO for promoting the survey, which will be a m- lib Bank 5 Brian Mc Enery Partner Horwath Bastow (harleton

9 HOME CAR E 8..,.,-f' p utive Summary & HiQhliahts This is the second annual survey of the private nursing home sector in Ireland undertaken by Horwath Bastow Cha rleton on behalf of the Irish Nursing Homes Organisation. This year's survey reveals a significant increase in the bed supply throughout the country, with 1,515 new private beds, representing an increase of over 10% on 2003 levels. The Southern Health board area saw the greatest number of beds added, with 371 extra beds this year. The total number of beds (both public and private) in the country is in the region of 27,000 beds. According to the National Council on Ageing and Older People 5% of the older population require long stay care. If this is applied to the population over 65 of each health board area and compared with the total bed supply (publ ic and private beds) in that area, it would indicate an oversupply in every health board area at present. Were a more reasonable occupancy level of 90 per cent chosen, then although the oversupply lessens, there would still be a slight oversupply across the country. With regard to staff costs the survey found that the average staff cost per bed was 13,585. It also found that the average weekly food bill per resident was 37.17, or almost 2,OOO per annum. Therefore the annual cost of staffing and food alone amounts to in excess of 15,500 per annum. The weekly rates charged by nursing homes increased marginally, with an overall increase on 2003 levels of 21 per bed. If these trends of falling occupancy levels and increasing costs are to continue it is likely that the profitability of the private nursing home sedor will be put under pressure. All indications are that this trend is likely to continue, with planning applications submitted to date for 47 additional new-build nursing homes, and 22 extensions to existing nursing homes. In addition to an increasing bed supply, this year's survey has seen a drop in the average occupancy, from 89% in 2003 to 86.8% in It is likely that we will see a further drop in occupancy levels in the future due to the continuing growth in bed numbers due to the ongoing availability of capital allowances and the planned additional community nursing beds under the PPP's. The survey also examined some of the costs associated with providing nursing home care. lib Bank 6 Horwath Bastow (harleton

10 HOMECARE ME8~ Intro rtion & Methodolo The INHO is the largest private nursing homes organisation with the greatest geographical spread across the country. The INHO has highlighted the issues of: Falling occupancy rates; Inadequate subvention levels, and Rising costs In order to scientifically report on the key issues affecting the industry, the INHO initiated an annual survey, which will report on the key statistics for the year under review. In addition, over a number of years, trends from one year to the next will emerge and as has already happened, the analysis of these trends will help shape INHO strategy and policy. The annual survey is derived from responses to detailed questionnaires sent to private nursing home operators throughout the country. There are 427 registered nursing homes in Ireland and of this amount, 103 nursing homes returned the completed questionnaire to. The response rate is in excess of 24 per cent, which is a high response rate for industry surveys of this kind. From the responses that we received, we are confident that they are representative of the industry as a whole. Based upon statistical sampling theory we can state that we have a confidence level of 95 percent that the results have a relative statistical precision of plus or minus 4 percentage points. 0- lib Bank 7 Horwath Bastow (harleton

11 HOMECIlRE 8 t.vf'f General Facts F P ela thp In I p According to the National Council on Ageing and Older people 5% of persons in the over 65 age group require nursing home care. Dementia affects 5% of persons over 65 years, with the figure rising to 20% of those aged 80 or rrae. Family care accounts for almost 50% of care provided to persons suffering with Dementia. In 2002 the total population over 65 years of age was 436,000 (11.1 % of the total population). This is projected to increase to 859,000 by 2031, which will represent 18.8% of the total projected population at that time. This is a considerably higher proportion of older people than that which currently exists in any country in Europe. According to the Central Statistics Office (CSO) population projections the number of old persons will increase in every reg ion by 2031, with the most notable increases in the Kildare, Meath & Wicklow area (+211 %) and Dublin (+ 140%). Those aged 80 years and over is projected to double by the year The average life expectancy at birth for Ireland as compared with the EU average is: Ireland EU (15 countries) EU (25 countries) Males Females The life expectancy at age 60 In Ireland is below the average for the EU: Ireland EU (15 countries) EU (25 countries) Males Females According to the National Council on Ageing and Older People, 17.8% of voluntary home residents and 22.6% of private nursing home residents have been in care for over one year. c- lib Bank 8

12 IRISh NURS1NC; hocdes ORC;r\ The Nursing Home Subvention c e e The Nursing Home Subvention Scheme was introduced in 1993 as part of the Health (Nursing Homes) Act The subvention scheme is a system whereby a Subvention is payable by the Health Board to people who are sufficiently dependant to need nursing home care and who are unable to pay the cost (means tested). The subvention payment is made by the health board to a registered Nursing Home on behalf of a person qualifying for Subvention. The amount paid by the Health Board is merely a contribution towards the cost of nursing home care; it does not cover the full cost of a nursing home bed. The levels of subvention vary in accordance with dependency as follows: Medium Dependency: High Dependency: Maximum Dependency: In 2001 there were over 6,000 Health Board Subvented beds and over 1,200 contract beds in private nursing homes. 80% of all beds in the long stay sector receive public funding of some sort. 1 In 2004, 1 15 million was allocated to the Health Boards for the subvention scheme. Since its inception in 1993 the number of people in receipt of subvention has more than doubled, however the cost of the scheme has increased by 633%.' In March 2000 work began on a review of the subvention scheme to examine the operation of the scheme, the outcome of which included a revised model for the funding of older people in long stay care. This model is designed to encourage a move towards home based care in favour of residential care. Under the Health Strategy 2001 it is planned to introduce a home-based subvention in order to encourage and enable older people to remain in their own homes for lib Bank 9 HOMECARE 8""f'f as long as they wish. To date no separate budget has been allocated. The means test always takes account of your income and it may also take your assets into account. Your house may be taken into account and, if it is, there are specific rules about how it is treated, in keeping with the Nursing Home (Subvention) Regulations. The health board has considerable discretion in relation to how assets are treated for the purposes of assessing means. The subvention is designed to help with nursing home costs. It was not designed to meet the full costs. However, there are circumstances in which the health board may pay the full cost of a private nursing home bed. This is the case where the health board has what are called "contracted beds" in private nursing homes. There are no clear rules about who is entitled to a contracted bed or in what circumstances the health boards offers this arrangement. Contract beds in the ERHA are being phased out and replaced with " fully enhanced subvented beds". There are "maximum" rates of subvention related to the level of dependency. However, these maximum payments may be increased in the case of contracted beds and "enhanced payments" may be made in other cases. 1 Soo«:e RevIeW 01 ttw N\Jf5Ing ~ Subvention Scheme by ProfessoOf Eamon O'S~a 2 Source Spt'Kh by MinISter Ml(he-a1 Mart,n TD, Mlmster for HealTh JUnl.' 2003

13 HOMECAU MEDICALUc" 8~ Rules You must apply for a subvention before going into the nursing home, unless there is an emergency. If you go into a nursing home before you apply, you may not be allowed apply for a subvention for 2 years, unless the Chief Executive Officer of the health board decides otherwise. You must be told the result of your application within 8 weeks - there may be a delay if you do not supply all the relevant information. If you are refused a subvention or granted less than the maximum applicable to your level of dependency, you must be told the reason and you must be told about your right to appeal. Qualifying for a subvention In order to qualify for a subvention you must be: sufficiently dependent to require maintenance in a nursing home and unable to pay any or part of the cost of maintenance in the home, i.e., you must pass a means test. Dependency An assessment of your level of dependency is carried out on behalf of the health board by a doctor, nurse, occupational therapist or physiotherapist. The assessment may involve interviewing you and your nearest relatives. Your medical condition is taken into account and the assessment also includes an evaluation of your ability to carry out the tasks of daily living and of the level of social support available to you. Daily living The assessment of your ability to carry out the tasks of daily living takes into account your: degree of mobility ability to dress unaided ability to feed unaided ability to communicate extent of orientation lib Bank 10 level of co-operation ability to bathe unaided quality of memory degree of continence. Social Support The assessment of your social support takes into account: your housing conditions the number of people in the household the ability of the household members (if any) to care for you the extent of support from your community and the services you are receiving. Levels of dependency Medium Dependency - this exists when your independence is impaired to the extent that you need nursing home care because the appropriate support and nursing care required cannot be provided in the community. Your mobility would be impaired to the extent that you would require supervision or a walking aid. High Dependency - this exists when your independence is impaired to the extent that you need nursing home care but you are not bed bound. You may have a combination of physical and mental disabilities, may be confused at times and be incontinent. You may require a walki ng aid and physical assistance to walk. Maximum Dependency - this exists when your independence is impaired to the extent that you require constant nursing care. You are likely to have very restricted mobility, need assistance with all aspects of physical care or be confused, disturbed and incontinent. The means test The means test takes into account the income of yourself and your spouse (or cohabiting

14 IRISh NURSl c:; homes ORC:;r\NlSAClO HOME CARE ME8~ partner). It may also take account of your assets (but not those of a spouse or partner). The means test is usually carried out by the Community Welfare Officer. Income The means test involves looking at the income that you and your spouse (or cohabiting partner) received in the previous 12 months. Income from all sources is taken into account, including wages, salary, pension, allowances, payments for part-time and seasonal work, income from rentals, investments and savings and all contributions from all sources. Income is assessed net of social insurance (PRSI), income tax and the health contribution. Th e income of a marri ed or cohabiting person is taken to be half the total income of the couple. You may not deliberately try to reduce your income in order to qualify for a subvention, e.g., by diverting it to someone else. If you do, this income may be taken into account anyway, even if you no longer have access to it. Your total income for the purposes of the means test is your net income less one-fifth of the weekly rate of the Old Age Non Contributary Pension payable at the time. In effect, you must be allowed retain this amount, which is sometimes referred to as pocket money. Assets The following assets may be taken into account: house property (excluding household furn iture and goods) stocks, shares or securities money on hand, in trust, lodged, deposited or invested interests in a company or business of any kind (including a farm) interest in land life assurance or endowment policies valuables held as investments current value of equipment of a business or machinery, excluding a car, not covered under a previous heading. If you disposed of any assets in the previous 5 years, the value of those assets may also be taken into account. That value may include the value of benefit and privilege arising from the transfer. If a business was transferred without any agreement on benefit and privilege, the health board may take into account any payment on transfer or may impute a notional value of 5% of the market value on the date of transfer, whichever is the higher. In the case of a fa rm transfer, the health board may take into account any payment on transfer or any continuing income from the earnings of the farm. The first 7, euro of any assets must be disregarded. Your house Your principal private residence is not taken into account if it is occupied immediately before the application and continues to be occupied by your spouse, child aged under 21 or in full-time education or relative in receipt of disability allowance, blind person's pension, c- lib Bank 11

15 HOMECA' RE M E DICAL~ 8 '-"'f'f disability benefit, invalidity pension or Old Age Non Contributory Pension. To assess the notional annual income of your house, the board may take 5% of the estimated market value if it was not occupied before or at the time of the application by one of the people listed. This is calculated net of mortgage, loan rental or purchase repayments. Selling your house If you sell your house, the proceeds may be taken into account in the assessment of your means for a nursing home subvention. (There is a social welfare rule that allows the proceeds of a house sale to be disregarded in certain circumstances - if you are eligible for an Old Age Non Contributory Pension, blind pension or a disability allowance and you sell your home in order to move into a nursing home or other more suitable accommodation, the amount of money obtained from the sale up to 190,461 euro is not taken into account in the social welfare means test. This does not apply to the nursing homes subvention means test) Your children's income When the nursing home subvention scheme was introduced in 1993, your subvention could have been reduced if it was considered that your children could contribute to the nursing home costs. An assessment of the income of any children living in Ireland was carried out. This arrangement ended on 1 January So, your children 's income is no longer relevant to the assessment of your entitlement to a subvention. Of course, in many cases, children help towards the costs of a nursing home because the patient cannot afford to pay the charges, even with a subvention. That, however, is not the same as taking the children's income into account. Ref usal of subvent ion A health board may refuse to pay any subvention if either of the following apply: if your assets, excluding your house, are greater than 25, or if the principal residence is valued at 95, or more (and is not occupied by any of the people outlined above) and your income is greater than 6, per year. Pocket Money When a person is being assessed for subvention, a sum equivalent to one fifth of the old age (non-contributory) pension is disregarded. In this way, on ly four-fifths of a person's income is taken into accou nt, the remaining one-fifth is available for the person 's use and is often referred to as "pocket money". Choice of Nursing Home If you are considered to be eligible for a subvention, the health board may offer you a place in a health board institution instead. The rules do not specifically say that you may be refused a subvention if you refuse the health board offer of a place but the implication is that you may. If you are not offered a health board institution place, the health board must pay the subvention to the nursing home chosen by you or by someone on your behalf, provided it is a registered home. The nursing home does not have to be in your own health board area and you are entitled to move to a different nursing home and have the subvention transferred to it. You may choose a nursing home in Northern Ireland if it is registered by a health and social services board there. lib Bank 12

16 ~.."owho..r::~~\ IRISh NURSINC:; ~Q.;> homes ORC:;r\NISAClON ~qes\ HOMECARE 8"'"" Review If a major change occurs in your level of dependency or in your means, the health board may review your entitlement to a subvention. (They also have the power to review every 6 months but this does not happen very often.) The board must hold a review if you or the person in charge of the home requests them to do so. The assessment of dependency and means in the review is carried out in the same way as the initial assessment. As a result of the review, the health board may increase or decrease the subvention or withdraw it or offer accommodation in a health board home or make arrangements for your care in your own home. The existing subvention is paid while the review is being conducted. If the board decide to reduce or stop the subvention, it must notify you and continue to pay the subvention for 28 days. You are entitled to appeal against any decision to reduce or withdraw the subvention. If the appeal is successful the arrears of subvention due will be paid. Nursing home care and tax allowances You or any other person who is paying the costs involved may be able to claim tax relief on the costs of your care in a private nursing home. Where to apply Apply to the health board for a subvention before going into a nursing home. If you or your family wish to make an application for an enhanced payment, you should put your application in writing directly to the Chief Executive of your health board. Each application is assessed on an individual basis and is at the discretion of the health board. lib Bank 13

17 HOME CARE MEDICAL/,i.c-O 8"",,1 Review of the Nursing Home Subvention Scheme A review of the subvention scheme was launched by the Minister for Health in June This review was commissioned as a result of the spiralling costs of the subvention scheme and raised a number of interesting issues. The report highlights that the scheme has biased resource allocation in the direction of residential care rather than community care. It recommends that funds should be allocated for a community-based subvention, thus reducing the number of low and medium dependency elderly people requiring residential nursing home care. At the launch of the review the Minister for Health stated that it was planned to introduce this home-based subvention, if and when t he necessary resources are available. The report also advocates the provision of more publicly funded beds for older people through the development of new Community Nursing Units. The proposed PPP development of public beds should be scrapped, as the private sector has a proven track record in the last seven years of developing long term geriatric beds efficiently. The basis of subvention should be consistent, equitable and uniform and non discretionary across the country. The level of subvention needs to increase and the subvention should be index linked as opposed to being reviewed periodically. There needs to be a greater level of efficiency in operating the subvention scheme so as to ensure there isn't bed blocking of acute hospital beds. There needs to be universal inspection of both public and private nursing home beds. In the longer term, the public sector should become a regulator only and not a provider of long term beds. There should be a subvention for residents who choose to stay in independent housing units associated with a registered nursing home. This would conform to the concept of home subvention. If the recommendations of this review are adopted it may have implications for the private nursing home sector, reducing demand and thus occupancy levels in private nursing homes. In early 2004, the INHO through Horwath Bastow C harleton made contributions to the Review Group on Subvention, setting out the private operator's perspective. The work of the Review Group is ongoing and the ultimate result of the deliberations is not yet known. The INHO made a number of recommendations in their submission, some of which are : lib Bank 14 Horwath Bastovv Charleton

18 .::,...:;w ho.j::~~\ IRISh NURS1NC:;.~~~ hocdes ORC:;(\N1SAt:lO l1es\-s Capital Allowances In 1997 Capital allowances were introduced on all new nursing homes built in order to encourage investment in the sector to increase the bed supply. Since 1997 the number of nursing home beds in the country has increased to approximately 26,500. The number of private nursing home beds has increased from 10,400 in 1995 to almost 15,000 in mid During the year from June 2003 to June 2004, there was an increase of almost 1,500 private beds, which represents a 10 per cent increase in a twelve month period. There is no date scheduled for the termination of the scheme of capital allowances for the nursing home / independent housing units for the elderly, therefore the expectation is that the number of new private nursing homes being built will continue to grow. The level of growth in supply is a threat to the financial viability of existing and new nursing homes. In certain areas of the country, there has been a particularly high level of development, and this has caused occupancy levels to fall and put their viability in doubt. Horwath Bastow Charleton particularly notes that there has been a significant number of planning applications in rural settings, where the alternative use value of land is not particularly high. In contrast, there are not as many planning applications in large urban cities such as Dublin, where land values are high. HOMECARE 8"'1'f requires such accommodation by reason of their old age or infirmity. A number of detailed requirements must be met to enable residential units to qualify for capital allowances. These requirements (as amended by the Finance Bill of 2004) are set out below: The residential unit must be constructed on the site of, or on a site which is immediately adjacent to the site of a registered nursing home, The units may be in a building of any number of floors provided a fire safety certificate in relation to the building is issued by the building control authority, The unit must be comprised of a development of not less than ten qualifying residential units where; The development also includes a day care centre and back up medical care, The units are operated or managed by the nursing home and an on-site caretaker is provided and; At least 20% of the units are made available to persons eligible for a rent su bsidy from a health board, the rent charged for those units must not exceed 90% of the rent that would be charged if that unit were rented to a person not in receipt of a rent subsidy. Sheltered housing units In the Finance Act of 2002, allowances were introduced on residential units constructed on the site of a registered nursing home, which are built to meet the needs of the elderly or infi rm, and which are leased to a person who m- lib Bank 15

19 ",,,;\ngh o.c:~'::'g~~ IRISh NURSl lc:; on 0.~~ $ hocde s ORC:;AN1Sf\ClON l1es\~ HOM E C ARE 8~ Table 1 Percentage Distribution of Patients Resident by Category of Home at 31 December 2003 by Medico/Social Status Chronic Chronic Convs Mental Category Mental Physical lescence Infirmityl Physical Mental Social Terminal Other Total of Unit Rehab Disability Handicap Reasons Dlness IUness Dlness i1itation Dementia Health Board Geriatric Homel Hospital Health Board Welfare Home Health Board District I Community Hospital Voluntary Geriatric Home I Hospital Private Nursing Home Average This table indicates that the private sector should not be accused of "cherry picking" the long term residents who are low dependency. The private sector cares for a fair proportion of the chronic, dementia, disabled and terminal residents. The private sector is frequently accused of not having its fair share of high dependency residents as compared with the public homes. This is not borne out by these statistics. lib Bank 16 Horwath Bastow (harleton

20 HOMECARE MEDICAL.i.&" 8 <1'j'f The Health Board/Regional Authority Areas lib Bank 17

21 Survey Results - Supply HOMECARE 8""f This section examines all aspects relating to existing and planned bed supply, population, growth and decline in bed stock, type of accommodation, income from subvention, contract beds, average age of nursing home, and the effect of capital allowances. Registered homes & beds The table below illustrates the number of Private Registered Nu rsing Homes in each Health Board area. Health Board Area Number of private registered nursing homes in 2004 Number of beds East Coast Area HB 57 2,423 Northern Area HE 28 1,39 1 South Western Area HB 36 1,578 Midland HB Mid-Western HB 4 1 1,628 North-Eastern HB 38 1,500 North-Western HE South-Eastern HE 50 1,709 Southern HB 68 2, 167 Western HB 68 2,334 Total ,461 Population The chart below illustrates the total population of each health board area per nu rsing home bed. This table indicates that the Western Health Board has the highest number of beds per head of population and the Midland Health Board has the lowest per head of population. Health Board Area Population Number of Population per private beds private bed Eastern Regional Health Authority 1,401,44 1 5, Midland HE 225, Mid-Western HB 339,591 1, North-Eastern HB 344,965 1, North-Western HB 22 1, South-Eastern HB 423,616 1, Southern HB 580,356 2, Western HB 380,297 2, Total 3,917,203 16, lib Ban k 18 Horwath Bastow (harleton

22 ~,,\ng ho -,=~~l lr1sh NURSl c::;.~~~ home s ORC::;AN1SAC10N lles\... HOMECARE E;""'f'f Older population While the table above illustrates the supply of beds per capita and thus the overall picture as to supply and potential demand as a w hole, it is also useful to look at the supply of beds per head of popu lation aged 65 and over, and thus identify the current supply and potential demand situation. Health Board Area Population> Number of Population> private beds per private bed Eastern Regional Health Authority 136,329 5, Midland HE 26, Mid-Western HB 39,493 1, North-Eastern HE 36,47 1 1, North-Western HE 29, South-Eastern HE 49,775 1, Southern HE 69,391 2, Western HE 49,222 2, Total 436,001 16, S From the analysi s above it would appear that the health board area w ith the greatest current demand is the North Western Health Board, with over 32 persons over 65 years of age per private bed. According to the National Council on Ageing and Older People, 5% of the population over 65 require nursing home care. If this is applied to the population over 65 of each health board area as outlined above, and compared with the t otal bed supply, both private and public in those health boards, the pattern is as outlined in the chart below. Number of beds & Population > < EAHA MHB MWHB NEHB NWHB SEHB SHB WHB Number 01 beds... ".. 5% of population If the theory that 5% of the older population require nursing home care is correct, then the chart above would indicate an oversupply of beds in every health board area, most notably in t he Western Health Board area, which has an oversupply of almost 900 beds. -- lib Bank 19

23 Supply Growth A comparison of the numbers of registered private nursing homes and beds in 2003 and 2004 is set out in the table below: Number Number Health Board Homes Homes % of beds of beds Area increase Eastern Regional Health Authority , , % Midland HB % ~id - VVes te rn HB ,525 1, % North-Eastern HB ,429 1, % North-VVestern HB % South-Eastern HB ,538 1, % Southern HB ,796 2, % VVestern HE ,982 2, % Total ,946 16, % Th e total private bed stock has increased by 10% in just one year. Th e health board area with the highest growth in beds is the Midland Healt h Board area, with a 22.6% increase in beds. The Southern Health Board area had the highest number of beds added, w ith 371 new beds since last year. - lib Bank 20

24 HOMECARE 8 <4f Planning applications The table below sets out the number of applications for planning permission for new nursing homes and bedroom extensions to existing nursing homes. The table shows new, approved and appealed applications received within the past twelve months. Location Number of New Home Number of applications Applications for extensions Eastern Regional Health Authority Dublin 7 3 Kildare 3 I Wicklow 2 I Midland HB Laois 2 1 Longford 0 0 Offalv 1 2 Westmeath 1 0 Mid-Western HB Limerick 2 1 Clare 0 0 Tipperary North Riding 0 0 North-Eastern HB Cavan 0 2 Louth 2 0 Meath 1 0 Monaghan 0 0 North-Western HB Donegal 3 0 Leitrim 1 1 Sligo 1 0 South-Eastern HB Carlow 3 0 Ki lkelmy 3 0 Tipperary South Riding 2 1 Waterford 0 0 Wexford 1 0 Southern HB Cork 4 4 Kerry 0 1 Western HB Galway 4 3 Mayo 2 1 Roscommon 2 0 Total Of Which Approved New application Appeal 3 I c- lib Bank 21

25 <:-9% ~",\ngho IRISh URS1NC:;.l: '".\ '...;l homes ORC:;(\ N1S(\C10!l1!S\ HOMECARE 8""'ff Nursing home extensions 16.5% of respondents to the survey extended existing nursing homes to create new bed spaces in the past two years. The number of additional beds built by respondents was % of nursing homes indicated plans to construct additional beds within the next twelve months. Th e table below outlines the location of respondents planning additional beds and the number of new beds they intend to create. Healtb Board Area Number of bomes planning extension Number of beds planned East Coast Area HB Northern Area HB South Western Area HB Midland HB Mid-Western HB North-Eastern HB North-Western HE South-Eastern HB Southern HB Western HB Total I 2 I I I * * number of beds not specified Breakdown of Accommodation Bedroom type The table below illustrates the breakdown of bed type of the respondents. This table illustrates that the largest category of bedroom type is the single en-suite type. This result would coincide with the level of investment in new tailor developed facilities in recent years. Room type Single en-suite Single Double Multiple % of beds 32.7% 2 1.3% 30.4% 15.6% Purpose built I conversion 60% of nursing homes surveyed were purpose built homes, with the other 40% being converted from an alternative use. lib Bank 22 Horwath Bastow Charlet on

26 HOME CARE 8...-rt' Contract beds The average percentage of total beds contracted to the health boards amongst respondents throughout the country was 31.9%. Contract beds in the ERHA are being phased out since August Th e percentage of respondents within each health board which accept contract beds is set out in the chart below. % of nursing homes with contract beds "" MHB WHB The respondents were also asked what percentage of their beds were contracted beds. The results are outlined in the table below. % of beds contracted 80 --~ ECAHB SWHB NAHB MHB MWHB NEHB NWHB SEHB SHB WHB lib Bank 23

27 HOMECARE 8'-"ff Day care Faci lit ies 22% of nursing homes surveyed provided day care facilities. The percentage of homes providing facilities in each health board area is as follows: Health Board Area % of nursing homes providing day care facilities East Coast Area HB 13% Northern Area HB 45% South Western Area HB 20% Midland HB 0% Mid-Western HB 18% North-Eastern HB 25% North-Western HB 0% South-Eastern HB 0% Southern HB 26% Western HB 25% The results of the survey indicate that day care facilities are more commonly provided in the larger nursing homes, with 40% of nursing homes with more than 60 beds providing day care. Day care rates The average rate per day for day care was Sl.79. The rates charged ranged from per day in the Western Heath Board to per day in the Northern Area Health Board. Income from subvention The nursing homes were asked to state what percentage of their total income came from subvention. Overall, the average was 29%. The averages by health board are set out below: Percentage of income (rom subvention... fa~...,...,.. "'",.% J..I","",""';'--'- "'",,% J.OI~,"",",~'" 20% Lof.-... '5% '0% 5%... lib Bank 24

28 HOMECARE 8"",f Sheltered accommodation units The Finance Act of 2002 introduced capital allowances on residential units for the elderly constructed on the site of a nursing home. Only 5 of the respondents to the survey had constructed such units, providing a total of 67 units and 144 beds. The average occupancy for the units was 60%. While the level of sheltered housing may seem low, it may well be that due to the planning and construction time lag, units constructed to avail of capital allowances will only be coming on stream now and in the future, and it is quite likely that in the near future we will see a significantly higher proportion of nursing homes having a mix of nursing home beds and sheltered housing units to cater for varying dependency levels among the elderly population. Years in operation The average number of years in operation of the respondents throughout the country was 16.6 years. This figure is somewhat skewed by the existence of two nursing homes within the population which have been in operation for in excess of 130 years. When these nursing homes are omitted, the average number of years in operation is Capital Allowances Capital allowances were introduced on nursing homes in Since then the bed stock has increased from 9,628 ' to 16,461 today, an increase of almost 71 %. Overall 24% of nursing homes which took part in the survey had been constructed since capital allowances had been introduced in It would appear from the results of the survey that the introduction of capital allowances has had a varying impact on the bed stock in different areas. For example, in the North-Eastern Health Board, 58% of nursing homes which responded to the survey had been constructed since 1998, whereas in the East Coast Area Health Board, all of the respondents were operating pre-capital allowances, although 20% of these had claimed capital allowances, which would imply that existing homes had been extended or renovated. In total 36% of respondents had claimed capital allowances, either on the construction of a new nursing home or extensions to existing homes. 3 Source Oep;Jrtment 01 Health long Stay ActMty StatIStICS 1998 c- lib Bank 25

29 HOME CARE MEDICALl,i.,.o 8 "'ff e Results - Occupancy Occupancy by location The respondents were asked to provide their average occupancy rate over the previous twelve months. The results show the average occupancy rate nationally was 86.8%. This is a drop of 2.2% on the average occupancy compared with the 2003 survey. The average occupancy over each health board area was as follows: Average Occupancy by location ECAHB SWHB NAHB MHB MWHB NEH8 NWHB SEHB SHB WHB The highest occupancy is in the Northern Area Health Board (95.5%) with the lowest occupancy in the Midland Health Board (70%). The respondents were also asked about their occupancy on the day that the questionnaire was completed, in April The outcome of this snapshot view of occupancy shows a slightly higher overall rate, at 88.7%. Occupancy by size The survey results indicate that there is little variation in occupancy levels within different size categories as outlined in the table below, although, in general, larger nursing homes tend to have lower average occupancy levels. Size of nursing home >25 beds beds beds > 60 beds Average Occupancy 89% 87.6% 86.6% 82.2% lib Bank 26

30 HOME CARE 8..vff Su R ul Average weekly rates The average weekly rate by room type is as set out below. Room type Single en-suite Average weekly rate 609 Single Double Multiple 564 Rates by location The overall average weekly rate for the entire country across all bed types was 578, an increase of only on 2003 average rates. The highest average weekly rate was in the Northern Area Health Board, where the average rate amongst respondents was 704, over 50% higher than the lowest, the Midland Health Board, where the average weekly rate was 464. There are a number of logical reasons for variations in the weekly rate between different locations. These include: Significantly higher land costs and values in the greater Dublin area and in other cities as opposed to rural locations. Significant difference in the hourly wage rates in different parts of the country. Differences in overhead costs, e.g. rates in urban as compared with rural locations Average Weekly Rate "'" ECAHB SWHB NAHB MHB MWHB NEHB NWHB SEHB SHB WHB The weekly rates for individual nursing homes surveyed ranged from a low of 425 per week to a high of 925 per week. Rates by size The average weekly rates categorised by size are as follows: Size of nursing borne 1-25 beds beds beds > 60 beds Average weekly rate The highest rates were in the nursing homes with more than 60 beds. Incidentally, this is also the category with the lowest occupancy rates. -- lib Bank 27

31 HOMECARE 8""" Turnover by location The average turnover for nursing homes throughout the country was 1,089,121. Th is in itself is not a very meaningful indicator as it is based on various sized nursing homes, which have varying income and cost levels. It is interesting however to compare the average turnover within the various health boards, and more importantly the turnover per registered bed for each area. It should be noted however that the response rate for this question was somewhat lower than the overall response rate and the analysis set out below is based on 56 responses only, representing 14% of the total population. Health Board Area Average turnover Average turnover per registered bed East Coast Area Health Board 1,287,000 32,681 South Western Area Health Board 1,042,100 30,762 Northern Area Health Board 1,868,500 26,376 Midland Health Board 848,000 21,200 Mid-Western Health Board 1,496,900 20,317 North-Eastern Health Board 807,000 21,146 North-Western Health Board 789,500 17,937 South-Eastern Health Board 897,100 25,301 Southern Health Board 1,051,000 26,492 Western Health Board 725,300 20,3 11 There is a significant variance in the average turnover per registered bed based on location as depicted in the chart below. The lowest turnover per registered bed is in the North Western Health Board, at 17,937 per bed with the highest in the East Coast Area Hea lth Board being almost 15,OOO higher at 32,681. Thrnover per registered bed ECAHB SWHB NAHB MHB MWHB NEHB NWHB SEHB SHB WHB lib Bank 28

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33 HEALTH CARE.r Caring.., A Commitment to Quality" "A!v1is ston OJ Olver Stream Healrhcare is one of the largesr and most professionally administered groups of Kursing Homes, Dementia units and Respite Care Cenu es in Ireland. The group cultently comprises of five Homes throughout the counlly, and is hoping to expand in Silver Stream Hea lthcare has been providing care for elderly people si nce We are commined to providing consistently the highest standards of ca re for residents throughout all our homes. The company employs over 260 dedicated Nursing professional and suppon staff. providing care and service across five homes for 260 residents. The holisric approach to ca re of our residents is centred on fulfilment of the individual. The dignity, privacy and rights of our residents are respected whilst promoring the physical, emorional, social and spiritu:d aspecrs of their care. In addition to 2~ hour GP cover and Professional nurses on duty. Silver Stream homes also offer: Occupational Therapy. Activities Co-ordinaLOrs, Chiropody, Dental and OphthalmiC Ca re, PhYSiotherapy, Speech Therapy. DietiCians and Counselling. Art Classes. Outings, Li braly services, Film nights... the list is endless. Killiney Grove Nursing Home Killiney Hill Road, Kininey. Co. Dublin Tel: Fax: killiney@silverstream.ie Nenagh Manor Nursing Home Yewston, Nenagb, Co. Tipperary Tel: Fax: nenagh@silverstream.ie Ratoath Manor Nursing Home Ratoath. Co. Meath Tel: Fax: ratoath@silverstream.ie St. Pappin's Nursing flome 8allymun Road, Ballymun. Dublin 9 Tel: Fax: stpappins@silverstream.ie The Croft Nursing Home 2 Goldenbridge Walk, Inchicore. Dublin 8 Tel: Fax: thecroft@silverstream.ie Silver Stream Health Care Group, Ratoath Manor, Ratoath, Co. Meath Tel: Fax: admin@silverstream.ie

34 Tara Nursing Home 5/6 Putland Road Bray, Co.Wicklow Tel : +353 (0) I Fax: +353 (0) nirocan@eircom.net Website: (For further information please contact Anne or Paul Costello) One of the leading Nursing Homes in Ireland Luxurious Surroundings Strong Focus on residents needs and dignity Continuous improvement is a way of life at Tara lib Bank Umited Is rqubted by the Irish FINlndlJ Sertkn R~iatory Authority. The reptration number Is and the repstered office Is ~ndwlth Street. Dublln lib Bank

35 Ct,) CHOICE Catering Illdustry Suppliers of Quality Catering Equipment & Supplies to the Nursing Home Products Include: Furniture Table Ware. Cutlery & Glassware - Porcelain & Melamine & Acrylic Kitchen Equipment & St Steel Products Paper & Cleaning Products & Janitorial Supplies Uniforms, Safety Wear & HACCP related supplies Choice Catering Supplies Ltd. Unit 28 Waterford Business Park. Cork Road. Waterford. Tel: Fax: 05 I info@ cboicecatering.net Choice Catering Supplies - The Professionals Choice ST. ATTRACTA'S NURSING HOME Hagfield, Charlestown, Co. Mayo Tel: stattracta@eircom.net St. Attracta's is a purpose built Nursing Home set on two acres of peaceful unspoilt countryside, in County Mayo. Our dedicated and professional staff provides high-quality 24-hour care. We also provide additional professional services including physiotherapy activities and aromatherapy to maintain exceuent care and wellbeing of our residents. FirstCare When you are considering nursing home care, it is reassuring 10 find a home you can really trust. A FirstCare home offers the very best of care, tailored to the needs of each individual. Please contact us for a brochure or visit our website Website: info@firstcare.ie Long Term. Convalescent. Respite Rehabilitation Care. Day Care Activity & Entertainment Programmes Enquiries: FirstCare LoCall Earlsbrook House Bray Northbrook House Dublin Blainroe Lodge Wicklow Beneavin Lodge Dublin FirstCare - "Where excellence is standard" ~ ISO 9001 :2000 Quality Standard ~ _, _ I.S. 343 Food Safety Standard ~" FAS Excellence Through People Standard 32

36 HOME CARE 8"""f Turnover by size The average turnover by size category of nursing home is as follows: Size of nursing home >25 beds beds beds Average weekly rate 522, ,70 1 1,077,122 Average turnover per registered bed 25,220 24,966 22,969 > 60 beds 2,4 11,198 27,365 As illustrated above, larger nursing homes appear to have a higher turnover per registered bed, however, this is also the category with the lowest occupancy levels, and highest staff costs per bed. The high turnover levels in larger nursing homes is as a consequence of a higher average rate per week for this classification of nursing home. Staff costs The most significant cost involved in running a nursing home is staff cost. The average annual staff cost per bed for the entire the country was 13,S8S. The survey also examined other benefits provided to staff and the results are as follows: Yes No Shift premium 67% 33% Night premium 23% 77% Saturday premjum 18% 82% Sunday premium 64% 36% Pajd meal breaks 80% 20% Paid sickness absence 14% 86% Mjscellaneous other benefits (pension, health insurance etc) 37% 63% Staff costs by location As the total staff cost is generally directly dependant on the size of nursing home, the survey examined the total staff cost per registered bed. The results show a large variation between the health board areas as illustrated below. Unsurprisingly, the highest staff costs per registered bed are experienced in the Eastern Regional Health Authority area. Health Board Average annual Average annual staff cost per staf(cost reltistered bed East Coast Area Health Board 687,659 18,508 South Western Area Health Board 366,500 10,682 Northern Area Health Board 1,026,29 l 17,092 Mdland Health Board 439,000 JO,975 Mid-Western Health Board 969,904 12,965 North Eastern Health Board 604,087 15,364 North Western Health Board 1,026,29 J 13,031 South Eastern Health Board 566,976 15,570 Southern Health Board 494,065 J2,325 n, H p., lth Board R It should be noted that the average annual staff cost per registered bed is based only on the number of registered beds in those nursing homes that provided information on their annual staff cost. lib Bank 33

37 :\,>\Ilg ho.r:~'::':s~~ IRISh URSl c:; '" 0.~~ ';p'r hocdes ORC:;AN1SADON l1es\ HOME CARE 8"",f The staff cost per registered bed is illustrated in the chart below: Average Annual Staff Costs per Registered Bed ECAHB SWHB NAHB MHB MWHB NEHB NWHB SEHB SHB WHB An interesting measure to examine is the average annual staff cost expressed as a percentage of the average annual turnover for the various areas. Again, as mentioned earlier, the response rate in relation to average turnover is lower than the response rate as a whole, nonetheless it is interesting to view the overall trend. Staff cost as a % of turnover '1)% OO% ~ r~ 50% 40% "'" 2('" ECAHB SWHB NAHB MHB MWHB NEHB NWHB SEHB SHB WHB lib Bank 34 Horwath Bastow (harleton

38 HOMECARE 8..vf'f Staff costs by size Staff costs per bed were highest in nursing homes with more than 60 beds, and in fact grew in proportion to the size of nursing home. Average staff cost per bed , ,000 10,000 ' beds beds beds > 60 beds The pattern is the same when the staff costs are expressed as a percentage of t urnover. Nursing homes with less than 25 beds had an average staff cost of 52 % of turnover while nursing homes with more than 60 beds had an average staff cost of 66% of turnover. Staff cost as a % or turnover by size lib Bank 35

39 ~,>\ng 40.J::<:"~\ IRISh NURSI NC:;.~~~ home s ORC:;ANISADON HOME CARE 8..v(f Hourly rates Hourly rates for nurses and care assistants are outlined in the table below. Health Board Area Hourly rate nurse Hourly rate care assistant East Coast Area Health Board South Western Area Health Board 14.l Northern Area Health Board Midland Health Board Mid-Western Health Board North-Eastern Health Board J3 North-Western Health Board South-Eastern Health Board Southern Health Board Western Health Board Nationwide average Weekly food bill Another major cost involved in the running of a nursing home is provi ding food for the residents. The average weekly food bill per resident by location is set out below. Average Weekly Food Bill ( 's) per resident analysed by Healtb Board Area o ECAHB SWHB NAHB MHB MWHB NEHB NWHB SEHB SHB WHB As expeded the average weekly food bill per resident was less in larger nursing homes as a result of economies of scale. The averages in the various size categories were: Size of nursidg bome >2Sbeds beds beds >60beds Weekly food bill per resident lib Bank 36

40 ~,"WQo..r:::~'::'G~<;;, IRISh NURS1N~ '" 0.~~ f}l" hocdes OR~AN1S('\DON nes\~ HOMECARE 8..,-rf. fi f residents Dependency levels The dependency levels of residents in participating nursing homes throughout the country was as follows: Dependency level Low Medium High 12.5% 33% 54.5% Age profile of residents The age profile of residents in respondent's nursing homes was as set out below. Age category < >85 3.5% 10.1 % 41.5% 44.9% According to the National Council on Ageing and Older People, providing care for those over 85 years of age costs three times as much as providing care for those aged just over 65 years of age. Dementia 34% of all residents in nursing homes which responded to the survey had been diagnosed with dementia. The percentages by health board ranged from 15.5% in the North Western Health Board to 46.5% in the Northern Area Health Board. Long-stay residents On average, 93.3% of residents in respondent's nursing homes were considered to be long-stay residents. There were no major variations from the average within the various health boards or size categories. lib Bank 37

41 HOMECARE 8V>1'f'f rp Im,rnaries Eastern Regional Health Authority The Eastern Regional Health Authority covers three area health boards, the East Coast Area Health Board, the Northern Area Health Board and the South Western Area Health Board these three health boards are responsible for health service delivered in counties Dublin, Wicklow and Kildare. The population covered by the ERHA is in excess of 1.4 million people, and in excess of 136,000 people over the age of 65, broken down by county as follows: County Population Population> 65 Private beds Dublin 1,122, ,972 3,892 Wicklow 114,676 11, Kildare 163,944 10, Total 1,401, ,329 5,392 The table below summarises the main findings of the survey for the Eastern Regional Health Authority. Area Statistics Eastern Regional Health Authority Number of homes 121 Number of private beds 5,392 Average size ofnh 45 beds Number of planning applications for new homes 12 Number of planning applications for extensions 5 Population per private bed 260 Populati on > 65 per bed 25 Survey results Eastern Regional Health Authority A verage occupancy 92.2% Average weekjy rate 697 Average turnover per registered bed 30,6 16 Average annual staff cost per registered bed 16,9 10 Staff cost % turnover 56% Average weekly food bill per resident lib Bank 38

42 HOME CARE MEDICALu,..o 8'-"'fl' Midland Health Board The Midland Health Board covers the counties of Laois, Longford, Offaly & Westmeath. The population, population over 65 and number of private beds in each of these counties are as follows: County Population Population> 65 Private beds Laois 58,774 6, Longford 31,068 4, Offaly 63,663 7, Westmeath 71,858 7, Total 225,363 26, Summary of key findings in relation to Midland Health Board Area Statistics Midland Health Board Number of homes 22 Number of private beds 830 Average size ofnh 38 beds Number of planning applications for new homes 4 Number of planning applications for extensions 3 Population per private bed Population > 65 per bed 31.5 Survey results Midland Health Board Average occupancy 70% Average weekly rate 464 Average turnover per registered bed 21,200 A verage annual staff cost per registered bed 10,975 Staff cost % turnover 52% Average weekjy food bill per resident c- lib Bank 39 Horwath Bastow (harleton

43 ~~\ng ho.r:<:'::;;g:?~ IRiSh NURSINC; '" 0.~ ~ $ hocdes ORC;ANIS(\"ClON l1es\~ HOMECARE 8""'" Mid-Western Health Board The Mid-western Health Board covers the counties of Limerick, Clare & Tipperary North Riding. The population, population over 65 and number of private beds in each of these areas are as follows: County Population Population> 65 Private beds Limerick 175,304 19, Clare 103,277 12, Tipperary North Riding 61,010 8, Total 339,591 39,493 1,628 Summary ofkey findings in relation to Mid-Western Health Board Area statistics Mid Western Health Board Number of homes 41 Number of private beds 1,628 A verage size of NH 40 beds Number of planning applications for new homes 2 Number of planning applications for extensions I Population per private bed Population > 65 per bed 31.5 Survey results Mid Western Health Board Average occupancy 88% Average weekly rate 474 Average turnover per registered bed 20,317 Average annual staff cost per registered bed 12,966 Staff cost % turnover 65% A verage weekly food bill per resident c- lib Bank 40

44 ~;,\ng ho.<:~s~~ IRISh URSl c:; ~I ~ '~fjol1es~;/fi' hocdes ORC:;AN1Sr\DON 8",,1 '" 0 HOMECARE North Eastern Health Board The North Eastern Health Board covers the counties of Cavan, Louth, Meath & Monaghan. The population, population over 65 and number of private beds in each of these areas are as follows: County Population Population> 65 Private beds Cavan 56,546 7, Louth 101, , Meath 134,005 11, Monaghan 52,593 6, Total 344,965 36,471 1,500 Summary of key findings in relation to North Eastern Health Board Area statistics North Eastern Health Board Number of homes 38 Number of private beds 1,500 Average size ofnh 40 beds Number of planning applications for new homes 3 Number of planning applications for extensions 2 Population per private bed 230 Population > 65 per bed 24.3 Survey results North Eastern Health Board Average occupancy 79.8% Average weekly rate 589 Average turnover per registered bed 21,146 Average annual staff cost per registered bed 15,364 Staff cost % turnover 57% Average weekly food bill per resident Horwath Bastovv Charleton lib Bank 41

45 ~~\ngho ~~.::ig~~ IRISh NURSI C; '" 0.~t;..$ homes ORC;ANISACION fles\~ HOMECARE 8~ North Western Health Board The North Western Health Board covers the counties of Donegal, Leitrim & Sligo. The population, population over 65 and number of private beds in each of these counties are as follows: Coun_ty Population Population> 65 Private beds Donegal 137,575 17, Leitrim 25,799 4, Sligo 58,200 7, Total 221,574 29, Summary of key findings in relation to North Western Health Board Area statistics North Western Health Board Number of homes 19 Number of private beds Average size ofnh Number of planning applications for new homes beds 5 Number of planning applications for extensions Population per private bed Population > 65 per bed Survey results A verage occupancy Average weekly rate A verage turnover per registered bed Average annual staff cost per regi stered bed Staff cost % turnover A verage weekly food bill per resident North Western Health Board 79.6% ,937 13,031 72% m lib Bank 42

46 HOMECARE 8""'1' South Eastern Health Board The South Eastern Health Board covers the counties of Carlow, Kilkenny, Waterford, Wexford and Tipperary South. The population, population over 65 and number of private beds in each of these areas are as follows: County_ Population Population> 65 Private beds Carlow 46,014 4, Kilkenny 80,339 9, Waterford 101,546 12, Wexford 11 6,596 13,60 I 407 Tipperary South 79,121 9, Total 423,616 49,775 1,709 Summary of key findings in relation to South Eastern Health Board Area statistics Soutb Eastern Healtb Board Number of homes Number of private beds Average size ofnh Number of planning applications for new homes 50 1, beds 9 Number of planning applications for extensions Population per private bed Population > 65 per bed Survey results Average occupancy A verage weekly rate A verage turnover per registered bed Average annual staff cost per registered bed Staff cost % turnover Average weekly food bill per resident Soutb Eastern Healtb Board 91.2% ,30 I 15,570 49% lib Bank 43

47 "'0 % ~",ing ho..c: til IRISh NURSl '-1 r.\ %l hocdes OR~AN1SADON l1i!s\<s HOM ECARE 8..-rf Southern Health Board The Southern Health Board covers the counties of Cork and Kerry. The population, population over 65 and number of private beds in each of these areas are as follows: County POI»ulation Population> 65 Private beds Cork 447,829 51,183 1,508 Kerry 132,527 18, Total 580,356 69,391 2,167 Summary of key findings in relation to Southern Health Board Area statistics Southern Healtb Board Number of homes 68 Number of private beds 2,167 Average size of NH 32 beds Number of planning applications for new homes 4 Number of planning applications for extensions 5 Population per private bed 268 Population > 65 per bed 32 Survey results Southern Health Board Average occupancy 89.2% Average weekly rate 575 Average turnover per registered bed 26,492 A verage annual staff cost per registered bed 12,325 Staff cost % turnover 50% Average weekly food bill per resident lib Bank 44

48 HOMECARE 0""'" Western Health Board The Western Health Board covers the counties of Galway, Mayo and Roscommon population over 65 and number of private beds in each of these areas are as follows: The population, County Population Population> 65 Private beds Galway 209,077 23,678 1,230 Mayo 117,446 17, Roscommon 53,774 8, Total 380,297 49,222 2,334 Summary ofkev findings in relation to Western Health Board Area Statistics Western Health Board Number of homes 68 Number of private beds 2,334 Average size ofnh 34 beds Number of planning applications for new homes 8 Number of planning applications for extensions 4 Population per private bed 163 Population > 65 per bed 21 Survey results Western Health Board Average occupancy 80.6% Average weekly rate 495 Average turnover per registered bed 20,3 11 A verage annual staff cost per registered bed 10,938 Staff cost % turnover 54% Average weekly food bill per resident lib Bank 45

49 ~ t ii Summary schedule by location ortli 0 estern ::1~ = ell Area summaries ERMA Midland MldWestem Healtb Board Healtb Board ~. ~.~- ~ ~o s-a;s> Eutem Westem Eutem Healtb obi :::s ~ Healtb Board Healtb Board Healtb Boar Board Board 8-:::;' Number of homes ell Z t.fl C 070 Number of private beds 5, ,628 1, ,709 2, 167 2,334 70~ I1Z Average size of nursing home Number of planning applications for new homes Number of planning 0 Z applications for extensions :>I1 Z ~ t.fl d 0> "" Population per private bed Population > 65 per bed Survey results Average occupancy 92.2% 70% 88% 79.8% 79.6% 9 1.2% 89.2% 80.6% i Average weekly rate Average turnover per registered bed 30, ,200 20, , ,937 25,301 26,492 20,311 Average annual staff cost ~ per registered bed 16,910 10,975 12,965 15,364 13,031 15,570 12,325 10,938 ~ Staff cost % turnover 56% 52% 65% 57% 72% 49% 50% 54% (') Average weekly food bill ~ per resident ~ cp!~.ll ~E~1J \:::

50 (;'S'% ~..\ng ho IRISh URS1 N~.l: '" '?:.l;onc s~~~ home s OR~AN 1 Sr\t:lON ~I ~ HOMECARE 8""" Summary Schedule by size Size <25 beds beds beds >60 beds Average occupancy 89% 87.6% 86.6% 82.2% A verage weekly rate A verage turnover per registered bed 25,220 24,966 22,969 27,365 A verage annual staff cost per 11,583 12,395 14,764 17,33l registered bed Staff cost as a % of turnover 52% 52% 56% 66% Average weekly food bill per l resident lib Bank 47

51 ~~\1lg Q o.s::.<::'::'g~~ IRISh NURSl C; '" 0.~~ '..i!i'r h omes ORC;AN 1SADO!les\~' HOMECARE 8~ Nursing home directory Name of Nursing Home Address Phone no. No. of Beds Eastern Regionall"lcallh Authority East Coast Area Healtb Board Dublin Aclnrc Nursing Home Tivoli Tcrrncc South Dun Laoghairc Co. Dublin (0 I) Ailesbury Nursing Home 58 Pad: A vcnue Sandymount Dublin 4 (0 I) Ailadorc Nursmg Home Upper Glcnagcary Road Glcnagcary Co. Dublin (0 I) Annnbeg House Nursing Home Meadow Court BnUybrack Co. Dublin (01) Ardeeshal Lodge Nursing Home Upper Glcnagcary Rd. Glenagcary Co. Dublin (0 I) Ashbury Nursing Home IA Kill Avenue Blackrock Co. Dublin (01) Ashford I louse Nursing Home 6 Tivoli Terrace East Dun Laoghairc Co. Dublin (0 I) Becchficld Manor Nursing Home Bal1ybrnck Road Shank ill Co. Dublin (0 I) Belmont Care Centre Galloping Green Silliorgan Co. Dublin (0 I) Brabazon House Nursing Home 2 Guildford Road Sandymount Dublin 4 (0 I) Ca irn Hill Nursing Home Westminster Road Foxrock Dublin 18 (0 I) Car;las Convalescent Home Tcamamh Merrion Road Dublin 4 (0 I ) Carysfort Nursing Home Arknndale Road Glenageary Co. Dublin (0 I) Cedar House Nursmg Home Mount Anville Park Co. Dublin (01) Chenyfield Lodge Nurstng 1 lome Upper Cherryfield Ave Rnnelagh Dublin 6 (0 I) Cowper Care Cenlle 37/40 Cowper Rood Dublin 6 (01) Dalkey Lodge Nursing Home Ardurgh Road Dalkey Co. Dublin (01) Glengan. Park Nursing Home Lower Glenageary Rd. Dun Laoghaire Co. Dubhn (01) Glcnindare Nursing Home 202 Memon Road Ballsbridge Dublin 4 (0 I) K..illiney Grove Nursing Home Killiney HjJJ Road Killiney Co. Dublin (0 I) Leeson Park Nursing I-lome 10 Lei..'"Son Park Dublin 4 (0 I) Lillie Sisters orthe Poor Holy Family Roebuck Road Dublin 14 (01) Maryville Nursing Home Brookvale Road Donnybrook Dublin 4 (01) MiSSionary Sisters of tile ~I o l y Rosary 48 Temple Road Dartry Dublin 6 (01) Molynenux Nursing' lome Leeson Park Dublin 6 (0 I) Mount Tabor Care Centre Ncwgrovc A venue Sandymount Dublin 4 (0 I) New Lodge Nursing Ilome Bloomfield Avenue Donnybrook Dublin 4 (01) Newlownpark Nursmg Home NCy,10wnpark A venue Blackrock Co. Dublin (0 I) Northbrook Nursing liome 26 Northbrook Road Ranclagh Dublin 4. (01) Our Lady's Manor Bullock Castle Dalkey Co. Dublin (0 I) Regional Care Unit Sion I-lill Blackrock Co. Dublin (01) Rickard House Dunardagh Blackrock Co. Dublin (0 I) Simpsons Hospital Wyckham Ballinteer Road Dublin 16 (0 I) SI. John's I-louse of Rest 202 Memon Road Dublin 4 (0 I ) SI. Joseph's Nursing Home Cnnken Glen Shankill Co. Dublin (0 I) St. Mory's Home for the BliI'ld Merrion Road Dublin 4 (01) SI. Mary s Nursing I-lome Pembroke Park Dublin 4 (0 I) York House 30 York Road Dun Laoghairc Co. Dublin (0 1) Wlcklow Aisling Nursing Home Sea Road Arklow Co. Wieklow (0402) lib Bank 48

52 H O ME CARE 8.vff No. of Name of Nursing Home Address Phone DO. Beds Wick/ow (conti/wed) Asgard Lodge Nursing Home Kilbride Atk.low Co. WickJow (0402) Atlanta Nursing Home Sidmonlon Road Bray Co. Wicklow (0 I ) Bray Manor Nursing Home Mealh Road Bmy Co. Wicklow (0 1) Dargle Valley Nursing Home Cookstown Enniskerry Co. Wick low (O J) Donore Nursing Home Sidmonton Road Bmy Co. Wicklow (01 ) Earlshrook House Nursi ng Home Meath Road Bray Co. Wicklow (01) Florence Gardens Nursing Home 5 Florence Terrace Bray Co. Wicklow (OJ) Glcnbervic Nursing Home Sidmonton Road Bray Co. Wick low (0 1) Greystones Nursing Home Greystoncs Co. Wicklow (0404) Kinvara Nursing Home 3-4 Esplanade Strand Road Co. Wicklow (01) Kylcmorc Nursing Home Sidmonton Road Bray Co. WickJow (0 1) Norwood Nursing, Iome Sidmonton Road Bray Co. Wicklow (0]) Roseville Nursing Home Meath Road Bray Co. Wieklow (01) San Remo Nursing Home 14 Sidmonton Road Bmy Co. Wieklow (0 I) ShannlJgh Bay Nursing Home Fitzwilliam Terraee Esplanade. Bray Co. Wieklow (0 I ) Columban's Nursing Home Magheramore Co. Wicklow (0404) St. Theresa's Nursing Home I Fitzwilliam Terrace Bray Co. Wicklow (0 I ) Tara Nursing Home Putland Road Bmy Co. Wieklow (0 1) Northern Area Health Board Dublin Alzheimer's Care Centre Swords Road Whitehall Dublin 9 (01) 8J Beaumont Convalesccnt '-lome Beaumont Dublin 9 (01) Bedford House Nursing Home Church Street Balbriggan Co. Dublin (01) Becchlawn House Nursing Home High Park Grace Park Road Dublin 9 (0 I) Brymorc House Nursing Home Thormanby Road Howth Co. Dublin (OJ) Catherine McAuley House Convent of Mercy Beawnont Road Dublin 9 (0 1) Churchvicw Nursing Home 61 New Cllbrn Road Phibsboro Dublin 7 (0 1) Clontarf Private Nursing Home 516 Clontarf Road Dublin 3 (0 I) Dun Aengus St. Doolagh's Park Balgriffm Dublin 17 (01) Dun Born SL Doolagh's Park Balgriffin Dublin 17 (0 I) Elmhurst Nursing Home Hampstead A venue Glasnevin Dublin 9 (0 I) Fingal House Nursing Home Spiddal Hill Swords Co. Dublin (01) Garda Retirement Home 476 Howth Road Raheny Dublin 5 (0 1) Howlh Hill Lodge Nursing Home Thomtanby Road Howth Co. Dublin (01) La Vema Nursing Home 30 Haddon Road Clontarf Dublin 3 (0 I) Leas Cross Nursing Home Leas Cross Swords Co. Dublin (OJ) Unle Sisters of the Poor Sybill Hill Road Raheny Dublin 5 (0 I) Nazareth House Nursing Home Malahide Road Dublin 3 (0 I) New Park Nursing Home The Ward St Margarets Co. Dublin (01) Shrcwbury Nursing Home 164 Clonliffc Road Dublin 3 (0 I) St. Gabriel's Nursing Home Edenmore Dublin 5 (01) S L. Joseph's Nursing ~I ome Moumsackville Chapelizod Dublin 20 (01) St. Margaret's Nursing Home Toberure Road Co. Dublin (01) lib Bank 49 Horwath Bastow (harleton

53 IRISh NURSI NC; hocoes ORC;(i\ NISADON HOM ECA RE ME DICAL~ 8'-"f'f No. of Name of ursing Home Address Pbone no. Beds s.. Pappin's Nursing ' Iome S.. PatrIck's Nursing Home Ballymun Road Baldoyle Ballymun Co. Dublin Dublin 9 (01) (01) SUlton Nursing Home 1 12 Dublin Road Sutton Dublin 13 (01) Talbot Lodge Nursing Home Tarn Winlhtop Private Clinic Soulb Westero Area Health Board Kinsealy Lane Ncvmstown Lane Kinsealy Swords Co. Dublin Co. Dublin (01) (0 I) Dublin Alex.andra Guild Home 30 Leinstcr Rd West Rathmines Dublin 6 (01) Croft Nursing Home Glenau]in Nursing Home Griffeen Valley Nursing Home 2 Goldcnhridgc Walk Lucan Road Esker Inchicorc Chapclizod Lucan Dublin 8 Dublin 20 Co. Dublin (01) (0 I) (01) Harcourt Nursing Home 22 Harcourt Terrace Dublin 22 (01) Harvey Nursing Home 122 Terenurc Rd West Terenurc Dublin 6 (01) Jewish Home of Ireland Denmark Hi lt Lcinistcr Road Dublin 6 (0 I) Lisheeo Nursing Home Stoney Lane Rathcoole Co. Dublin (01) Lourdes Unit Loretto Abbey Rathfambam Dublin J4 (01) Lucan Lodge Nursing Home Ardeevin Lucan Co. Dubl in (01) Marian J louse Nursing Home Kimmage Manor Witchall Road Dublin 12 (01) Maryfield Nursing Home Lucan Road Chapclizod Dublin 20 (0 I) Marymount Nursing Home Westmanstown Lucan Co. Dublin (01) Orwell House Nursing Home [22 Orwell Road Rathgar Dublin 6 (01) Padre Pio Nursing Home 50/51 Cappaghmore Clondalkin Dublin 22 (01) Queen of Peace Centre Garville A venue Dublin 6 (01) Rathfarnham Nursing Home Rostrevor Nursing Home Stocking Lane 66 Orwell Road Ralhfamham Rathgar Dublin [6 Dublin 6 (01) (01) Sallypark Nursing Home TempJeogue Dublin 6 (01) Tower Nursing Home 94 Cappaghmore Est. Clondalkin Dublin 22 (01) Kildare Cloverlodge Nursing Home Craddock House Nursing I~ ome Curragh Lawns Nursing Home Athy Craddoclwown Road Kinneagb Co. Kildare Na.. Currngh Co. Ki ldare Co. Kildare (0598) (045) (045) Glenashling Nursing Home Oldtown Celbridge Co. Kildare (01) Glencarrig Nursing Home Firhouse Tallaght Co. Kildare (01) Hazel Hall Nursing Home Larchfield Park Nursing 1 lome Prosperous Road Monread Road Clane Na.. Co. Kildare Co. Kildare (045) (045) Lourdcsvi lle Nursing Home Athy Road Kildare Town Co. Kildare (045) MoYSIat(' Nursing Home Moyglarc Road Maynooth Co. Kildare (0 I) Oghill Nursing Home Monastercvin Co. Kildare (045) Park House Nursing Home Park House Kilcock Co. Kildare (01) Rosglas Nursing Rome Mooreabbcy Monasterevan Co. Kildare (045) Ryevale Nursing Home Ryevale Hill LeixJip Co. Kildare (0 I) I 73 Shalom Presentation Convent Ki lcock Co. Kildare (01) Suncroft Nursing Home The Curragh Co. Ki ldare (045) I 60 Willowbrook Nur.;ing Home Borohard Newbridgc Co. Kildare (045) lib Bank 50 Horwath Bastow Charteton

54 <::-S% ~.,,\ngqo..c: <I> IRISh URS1NC;.~~ 'l homes ORC;AN1SADON!lRS\<$ HOMECARE 8v.'f'f No. of ameof ursing Home Address Phone DO. Beds Midland Health Board lilois Ballard Lodge Nursing Home Kilmincby Lodge Nursing!-l ome Borns Road Kilminchy Ponlaoise Pon.iaoise Co. Laois (0502)61299 Co. Laois (0502) Longford Caslecorc Nursing Home Batlymahon Co. Longford (0902) Laurel Lodge Nursing Home Tcmplemichacl Glebe Co. Longford (043) NCy,1ownforbcs Nursing Home Newtownforocs Co. Longford (043) O Uf Lady's Manor Nursing Home Edgeworthstown Co. Longford (043) Orraly Carthage Nursing Home Mucklagh Tul1amorc Co. Offal}' (0506) Cloverlo<lgc Nursing Home Main Street Shinrone Co.OlTaly (0505) Elmgrovc Nursing Home Syngcfield Birr Co. Onaly (0509) Gallen Priory Nursing Home MalIISt. Fcrbane Co. Offaly (0902) Our Lady of Consolation Nursing Home Arden Road TuJ1amorc Co. Offaly (0506) Tullybeg Retirement Village Rahan Tullamore Co. OOaly (0506) Upton House Nursing Home Clara Co. Offaly (0506) Westmealh Bethany House Nursing Home Tyrrellspass Co. Westmcath (044) Maple Cout1 Nursing Home Dublin Road Castlepol lard Co Westmeath (044) Moate Care & Convalescent Centre Dublin Road Co. Westmeath (0902) Mont Vista Nursing Home Retreat Road Athlone Co Westmeath (0902) Newbrook Nursing Home Ba J1ymahon Road Mullingar Co Westmeath (044) Relfeat Nursing Home Bonavalley Alhlone Co Westmeath (0902) Camillus Nursing Centre K.iliucan Co. Westmealh (044) Claire's Nursing Home Ballinderry Mullingar Co Westmeath (044) Stella Maris Nursing Home Baylough Athlone Co Westmeath (0902) Mid-\Vestern Health Board C la re Cahercalla Community Nursing Home Cahercalla Ennis Co. Clare (065) Carrigoran House Nursing Ho me Newmarket On Fergus Co. Clare Co. Clare (061) Kilrush District Hospital Kilrush Co. Clare (065) Lakes Nursing Home Hill Road Killaloc Co. Clare (061) Riverdale 1 louse Nursing Home Bla c~""watc r Ardnacrusha Co. Clare (061) Sancta Maria Nursing Home Cratloe Co. Clare (061) SI. Dominic Savio Nursing Home Liscannor Co. Clare (065) Theresa's Nursing Home Leadmore East Kilrush Co. Clare (065) lib Bank 51 Horwath Bastow Charteton

55 ~.. \ng ho.j::~g~~ IRISh NURSlNC:;.\ IJl home s ORC:;ANlSA"ClON lles\ ~t ~ HOME CARE 8..-ff No. of Name of Nursing Home Address Phone DO. Beds Limerick Adarc and Dislrict Nursing Home Adll.re Road Croagh Co. Limerick (069) AId Na Ri Nursing Home Bruff Co. Limerick (061 ) Beech Lodge Nursing Home Bru= Co. Limerick (063) Beechwood House Nursing Home Newcastle West Co. Limerick (069) Belmont Nursing Home Castleconnel] Co. Limerick (061) Caherass Nursing Home Adare Road Croom Co. Limerick (061) Cabcnnoyle ]'Iouse Nursing Home Ardagh Co. Limerick Co. Limerick (069) Catherine McAuley Bishop Street Limerick Limerick J3 Corbally House Nursing Home Mill Road Corbally Co. Limerick (061) Glebe House Nursing Home Fedamore Co. Limerick (061) Good Counsel Nursing HOnle Kilmallock Road Limerick (061) Maria Goreni Nursing Home Proonts Ki lmallock Co. limerick (063) Mi lford House Nursi ng Home Castletroy Limerick (061) Respite Care Centre DroOlcollogher Co. Limerick 18 Roseville Nursing Home Kmonin Ballysimon Co. Limerick (061) SI Paul's Nursing Home Dooradoyle Co. Limerick (061) St. Anthony's Nursing Home Pallasgreen Co. Limerick (061) St.Gobnaits Nursing Home Ballyagran Co. Limerick (063) Tall Trees Nursing Home Askeaton Co. Limerick (061) Thorpes Nursing Home Clarioa Co. Limerick (061) TippenI")' Ardeen Nursing Home Thurles Co. Tipperary (0504) Ashlawn House Nursing Home Nenagh Co. Tippernry (067) Bushy Park Nursing Home Borissokane Co. Tipperary (067) Milbrae Lodge Nursing Home Newport Co. Ti pperary (06 1) Mount Cannel Nursing Home Abbey Street Roscrea Co. Tippernry (0505) Mount 51. Benidicts Nursing Home Thurles Co. Tipperary (0504) Ncnagh Manor Nursing Home Ycwstown Nenagh Co. Tippcrnry (067) Patlersons Nursing Home Lismacken Roscrea Co. Tipperary (0505) Rivervale Nursing Home RDtbnalcen Nenagh Co. Tipperary (067) St. Judes Nursi ng Home Borrisoleigh ll1urles Co. Tipperary (0504) St. Keiran's Nursing Home Rathcabbio Roscrca Co. Tipperary (0509) SI. Theresa's Nursing Home Thurles Co. Tipperary (0504) Villa Marie Nursing Home TempieOlore Road Roscrea Co. Tipperary (0505) North Eastern Health Board Cavan College View Nursing Home Clones Road Cavan (049) Esker Lodge Nursing Home Esker Place Cathedral Road Cavan (049) Fairlawns Nursing Home Bailieboro Co. Cavan (042) Omega Nursing home Belturbct Co. Cavan (049) Shedin Nursing home Tonagh Moulllnugent Co. Cavan (049) Virginia Nursing Home {St. Joseph's} Virginia Co. Cavan (049) lib Bank 52

56 HOME CARE 8""" No. of Name or Nuniog Home Address PhoDe no. Beds Louth Aras Mhuire Nursing Home Beechgrove Droghed3 Co. Louth (04 1) Blackrock Abbey Nursing Home Blackrock Co. Louth (042) Carlingford Nursing Home Old Dundalk Road Carlingford Co. Louth (042) Castle Lodge Nursing Home Sea Road Castlebellingham Co. Louth (042) Conifer House Nursing Home The Lane Dromiskin Co. Louth (042) Dealgnn House Nursing Home Tobcrona Dundalk Co. Louth (042) Moorehall Lodge NUl1iing Home Hale Street "'doe Co. Louth (041 ) MOUn! Oliver Nursing Home Dundalk Co. Loulh (042) Meath Boyne Valley Nursing Home Dowth Drogheda Co. Meath (041 ) Crecvelea Nursing Home Laytown Co. Meath (041) Devlin Lodge Nursing Home Gormanstown Co. Meath (0 1) Heathcmeld Nursing Home Raynestown Dunshaughlin Co. Meath (0 1) Hillview Nursing Home Rathfeigb T"" Co. Meath (041) Kilmainhamwood Nursing Home Kells Co. Meath (046) Navan Nursing Home Old Road Athlumny Co. Meath (046) Rntoath Nursing Home Ratoath Co. Meath (01) Sancta Maria Kinnegad Co. Meath (044) Si lver Grove Nursing Home Main street Clonee Co. Meath (01) S1. Anthony's Nursing Home Dublin Road Trim Co. Meath (046) $1. Clares Nursing Home Stedalt House Stamullen Co. Meath (01) St. Colrneillcs Nursing Home Oldcastle Road Kells Co. Meath (046) St. Columban's Nursing Home Dalgan Park Navan Co. Meath (046) St. Elizabeths Nursing Home Kells Road Athboy Co. Meath (046) SL Ursulas Nursi ng Home Bettystown Co. Meath (041) Winfield Nursing Home Waynestown Dunboyne Co. Meath (01) Woodlands ursing Home Trim Road Navan Co. Meath (046) Monaghan Castle Ross Nursing Home Carriekmaeross Co. Monaghan (042) Drumbear Lodge Nursing Home Cootehill Road Co. Monaghan (047) Mullinahinch Nursing Home Mullinahineh Co. Monaghan (047) Sacred Hean Nursing Home Clones Co. Monaghan (047) Sl. Josephs Nursing Home Clones Road Ballybay Co. Monaghan (042) SL Louis Nursing Home Louisville Co. Monaghan (047) North-Western HealthllOard Donegal Archview Lodge Nursing Horne Drumany Lcuerkenny Co. Donegal (074) Beach Hill Manor Nursing Home lisfannon Bunemna Co. Donegal (077) Brenlwood Manor Nursing Ho me l enerkenny Road Convoy Co. Donegal (074) Brindly Manor Nursing Home Letterkenny Road Convoy Co. Donegal (074) Harbour Lights Nursing Home Townasligo Bruckless Co. Donegal (074) Hill Crest Nursing Home Longlane Letterkenny Co. Donegal (074) lib Bank 53 Horwath Bastow (harleton

57 ~~\Ilg ho..c <:-G~ V> IRISh URS1NC;.\ 'o.i!l~ homes ORC;r\ nes'''''- HOMECARE 8.vff NO. or Name or Nursing Rome Address Phone no. Bed. Donegal continued Lagan Valley Nursing Home Ballindrait Co. Donegal (074) Lake House Nursing Home Portnablagb Lcttcrkcnny Co. Donegal (074) Nazareth House Nursing Home Foban LiITord Co. Donegal (074) StrangritTHousc Nursing Home Main Street Stranolar Co. Donegal (074) Ltitrim Lake View Nursing Home Lough Eml Mohill Co. leilrim (071) Mulross House Nursing Home Kilclare Carrick on Shannon Co. Lcitrim (071) (' Phclim's Nursmg Home Killananima Dromahair Co. Lcitrim (071) Sligo AId na Grcinne Nursing Home Enniscrone Co. Sligo (096) Bailey's Nursing Home Tubbcrcurry Co. Sligo (071) Community Nursing Unit Ballymotc Sligo Co. Sligo (071) Mowlan Nursing Home Ballytivnan Sligo Co. Sligo (071) Nazareth House Nursing Home Sligo Co. Sligo (071) Sancta Maria Nursing Home Enniscronc Co. Sligo (096) I S-outb-E""astem Ifealtb BOard Carlow Beechwood Nuning Home Leighlinbridge Co. Carlow (059) Borris Lodge Nursing Home Boms Co. Carlow (059) Hillview Nursing Home: Tullow Road Carlow (059) Riverdale Nursing Home Balloo Co. Carlow (059) KJlkenny Archcrsrath Nursing Home Archcrsrath Cellarstown Kilkenny (056) Aut Even Hopilai Kilkenny (056) Avondale Nursing Home Callan Co. Kilkenny (056) Drakelands House Nursing Home Mooncoin Nursing Home Drakelands Polerone Kilkenny Mooncoin (056) Co. Kilkenny (051) Sacrtd Hearl NLming Home Crosspatrick lohnstown Co. Kilkenny (056) St. Catherine's Nursing Home Freshford Co. Kilkenny (056) St. Joseph's Nursmg ' Iome Thomastown Co. Kilkenny (056) South Tipperary Acorn Lodge Nursing Home Ballyk-clly Cashel Co. Tipperary (062) Bailey House Nursing Home Killenaulc Co. Tipperary (052) Bromldgh Lodge Nursing Home Cahir Co. Tipperary (052) Cottage Nursing Home 70 I.rishtown Clonmcll Co. Tipperary (052) Decrpark Nursing Horne Lattm Co. Tipperary (062) Greenhills Nursing Home Carnck on Sulr Co. Tipperary (05 1) Meh'iew Nursing Home Clonmel Co. Tipperary (052) m lib Bank 54

58 HOMECARE MEDICAL,i. 8.vrt' No. of Name of Nursing Home Address Phone no. Beds Sowh Tipperary (continued) Padre Pio Nursing Home I-Iolycross Co. Tipperary (0504) Ralhkeevan Nursing Home Sacre Coeur Nursing Home St. Anne's Nursing Home Rlllhkeevan Station Road John Slreet Clonmcl Tipperary Cashel Co. Tipperary (052) (062) Co. Tipperary (062) Bcnnedicis Nursing Home Chapel Street St. Joseph's Nursing Home John Mitchell Street St. Lawrence's Nursing Home MocldcrshiH S1. Manha's Nursing Home Glenswil1y House S1. Theresa's Nursing Home Friar Street Suirmount Nursing Home Carrickbcg Carrick-on-Suir Tipperary Fcthard Cahir Cashel Carrick on SuiT Co. Tipperary (051) (062) Co. Tipperary (062) Co. Tipperary (052)41895 Co. Tipperary (062) Co. Tipperary (051) Woodlands Nursing Home Woodside Nursing Home Dundrum Killusly Co. Tipperary Fethard (062) Co. Tippemry (052) Waterford Ard na Farraige Nursing Home Newtown Tramore Co. Waterford (051) Drumhills Nursing Home BallydufT Dungarvan Co. Watcrford (058) Maypark Nursing Home Maypark Lane Waterford (051) Mowlarn Nursing Home Dunmorc Road Waterford (051) Padre Pio Rest Home Kilderrihecn Cappoquin Co. Waterford (058) Rockshirc Care Centre Rockshire Road Fcrrybank Waterford (051) St. Joseph's Nursing Home Manor Hill Waterford (05 1) Woodlock Nursing Home (St. Annc's) Portlaw Co. Waterford (051) J3 Wexford Carlford Private Nursing Home Clonroche Enniscorthy Co. Wexford (054) Carrig Tur Nursing Home Wexford (054) Cherryfield Private Nursing Home Kcrlogue Pri vate Nursing Home Ballygarrct Kerlogue Gorey Wexford Co. Wexford (055) (053) Knockcen Nursing Home Knockeen Bamtown Co. Wexford (053) Lawson House Private Nursing Home Glenbrien Enniscorthy Co. Wexford (054) Middletown Private Nursing ' Iome Courtown Gorey Co. Wexford (055) Ros Aoibhinn Nursing Home Drumderry 8unclody Co. Wexford (054) SI. Anne's Nursing Home Kilmore Co. Wexford (053) The Mayne Private Nursing Home Ennisconhy Co. Wexford (054) Valencia Nursing Home Camolin Co, Wexford (054) Soutbern Health Board Cork City Area Ams Aoibhinn Nursing Home Guncenroc Macroom Co. Cork (026) Ardsley Nursing Home Rocky Rood Farran Co. Cork (021) Bnllincurig Care Centre Ltd. Ballynoe Nursing Home Ballincurrig Bnllynoe Co. Cork White's Cross (021) Co", (021) Beaumont Nursing Home Woodvale Road Beaumont Cork (021) Bishopscourt Residential Care Ltd. Liskillea Waterfall Cork (021) Blarney Nursing Home Killowen Blarney Co. Cork (02 1) lib Bank 55 Horwath Bastow (harleton

59 .,;.",W =II 1$0.<:~=~ IRISh NURSINC; :\ ' :l hocde s ORC;ANISv\DO lles\~ ~ HOMECARE 8""'" Name or Nuniag Home Address Phone no. Beds So. or Cork City Area (conlinllcd) Brookfield Care Centre Leamlara Carrigtwohill Co. Cork (02 1) Caherten Nursing Home Codrum Macroom Co. Cork (026) Castlemahon Nursing Home Castle Road Blackrock Co,k (02 1) emmer's Court Nursing Home 8etgooly Near Kinsale Cock (02 1) Cuskinny Court Nursing Home Cuskinny Cobh Co. Cork (02 1) Darraglynn Nursmg Home Camgalinc Road Douglas Cork (021) Douglas Nursing Home Moneygoumey Douglas Co. Cork (02 1) East Feny Nursing Home East Ferry Midlclon Co. Cork (021) Glendonagh Nursmg Home Dungoumey Co. Cork (021) Grange Con Nursing Home Coolatanavally Carrigrohanc Co. Cork (02 1) Madonna House Nursing Home Station Road Ballincollig Co. Cork (021) Maryborougb Nursing Home Maryborough Hill Douglas Cork (02 1) Monfield Nursing 1 lome Clarkes Hill Rochestown Cork (02 1) Montenoue Care Centre LId. Middle Glanmire Road Montenone Cork (02 1) Norwood Grange Nursing 1 lome Ballinoro Waterfall Co.Cork (02 1) Padre Pia Nursing Home Sunnyside Rochestown Cork (02 1) Powdermill Nursing Home Ballineollig Co. Cork (02 1 ) Rochestown Nursing Home Monastery Road Rochcstown Co. Cork (02 1) Rosenalee Care Centre Ltd. Poulavone Ballineollig Co. Cork (021) SI. Albert's Nursing Home Blair's Hill Sunday's Well Cork (021) SI. Joseph's Bon Secours Care Village Mount Deser1 Lee Road Cock (02 1) SI. Luke's Home Castle Road, Mahon Blacklock Cock (021) Upton House Nursing Home lnnishannon Co. Cork (02 1) White Frairs Residential Centre Glyntown Glanmirc Co. Cork (021) Woburn Nursing Home Lower Glanmire Road Cork (02 1) No.-th Co.-k Arta Bridhaven Nursing Home Spa Glen Mallow Co. Cork (022) Conna Nursing Home Conlla Mallow Co. Cork (058) Corpus Christi Nursing I lome Brigown Milchelstown Co. Cork (025) Fairy Hill Nursing Home Annabella Mallow Co. Cork (022) Nu.areth House Nursmg Home Newberry Mallow Co. Cork (022) Padre Pio House Churchtown Mallow Co. Cork (022) Resthaven Nursing Home Mcelin Newmarkct Co. Cork (029) St. Martha's Nursing Home Cly"'" Charleville Co. Cork (063) Strnwhall Nursing Home Fermoy Co. Cork (025) Teach Altra Nursmg Home Seaneen Newmarket Co. Cork (029) West Cork Arell Dcerpark House Seofield Bantry Co. Cork (027) Fairfield Nursing Home Drimoleague Co, Cork (028) Golden Meadows Nursing Home Clogheen Clonakilty Co. Cork (023) Oide School Nursing 1 lome Church Cross 5kibberccn Co. Cork (028) Pauls Nursing Home Bushmount Clonllkil ty Co. Cork (023) lib Bank 56

60 HOME CARE 8"",,1 No. of Name of Nursing Home Address Pbone no. Beds Kerry Arns Mhuirc Nursing I-lome Gn:cnvillc Listowcl Co. Kerry (068) Cui] Didin Residential Care Facility Skahanagh Tralec Co. Kerry (066) Dromorc House Nursing '-lome Bil lcrough Listowel Co. Kerry (068) First Citizen Resideoljal Nursing Home Milhown Co. Kerry (066) Glen Haven Nursing Home The Village G lcnbeigh Co. Kerry (066) Graiguc Nursing Home Grniguc Ardrert Co. K erry (066) II Healherlea Nursing Home Lawlors Cross Killarney Co. Kerry (064) Kenmare Nursing Home Killaha East Kenmare Co. Kerry (064) Kennedy Nursing Home Church Strcct Lislowcl Co. Kerry (068) Kilcara House Nursing Home Duagh Co. Kerry (068) Lysloll Lodge Nursing Home Skchenerin Listowel Co. Kerry (068) Oaklands Nursing!-Iome Derry Listowel Co. Kerry (068) Ocean Vicw Nursing Home Camp Tralte Co. Kerry (066) Our Lady or Fatima Nursing Home Oak Park Tralee Co. Kerry (066) Our Lady of Lourdes Nursi ng Home Kilcummin Killarney Co. K.erry (064) Riverside Nursing Home Milltown Abbeydorney Co. K.'rry (066) Joseph's Nursing Home Killorgin Co. Kerry (066) Joseph's Nursing Home Derrymore East Tralee Co. Kerry (066) Joseph's Nursing Home Killowen Kenmare Co. Kerry (064) L Louis Nursing Home C lonemore Trnlee Co. Kerry (066) Woodview Nursing Home Woodview Lixnaw Co. Kerry (068) Western Health Board Roscom mon C loverhill Nursing Home Lisagallon Clovcrhill Co. Roscommon (090) Drumdcrrig Nursing Home Dru"lderrig Boyle Co. Roscommon (071) Fearna Elphin Nursing Home Elphin Co. Roscommon (07 1) Fcama Nursing Home Knockroe Castlerea Co. Roscommon (094) Forest View Nursing Home Newtown Road Ballymunay Co. Roscommon (090) Innis Ree Lodge Nursing Home 8allyleague Lanesborough Co. Roscommon (043) Manor Court Nursing Home Tannon Road Castlerea Co. Roscommon (094) Meadowlands Nursing Home Dunmore Road C loonfad Co. Roscommon (094) Oakwood Private Nursing Home Circular Road Bal laghaderrcen Co. Roscommon (094) Oakwood Private Nursing Home Acres! Ardsallagh More Athlonc Road Co. Roscommon (090) Tearmainn Bhride Nursing Home 8rideswell Co. Roscommon (090) Vale View Nursing Home Ba llyleague Co. Roscommon (043) M ayo AbbeybrealTy Nursing Home Cas tlebar Co. Mayo (094) Ave Maria Nursing 1 lome Ba lly haunis Co. Mayo (094) BaHinamore Nursing Home Ballinamore Kiltimagh Co. Mayo (094) B1ackrock Nursing Home Foxford Co. Mayo (094) Brookvale Manor Nursing Home Ballyhaunis Co. Mayo (094) 963 I Carewell Nursing Home Ballyhaunis Co. Mayo (094) lib Bank 57

61 ~"Who =II ~.<::"'B~~ IRISh NURS1N C:;.~ ~f? home s ORC:;A lsadon ~0.trf!S\;st HOMECARE MEDICAL/.i-CP 8..vff No. of Name of Nursing Home Address Phone no. Beds Castlemacgarrct NUBing Home Clarcmorris Co. Mayo (094) Cuan Chaitriona Nursing Home Casllebar Co. Mayo (094) Friars Lodge Nursing Home Ballinrobc Co. Mayo (094) Ho\lymounl Nursing Home Hollymount Co. Mayo (094) Marion House Alzheimer's Home Ballindinc Co. Mayo (094) Moy Ridge Nur!>ing Home Ballina Co. Mayo (096) Pilgrims Rest Nursing Home Westport Co. Mayo (098) Queen of Peace Nursing Home Knock Co. Mayo (094) Annes Nursing Home Charlestown Co. Mayo (094) St. Attractas Nursing Home Charlestown Co. Mayo (094) Brendan's High Support Unit Mulranny Co. Mayo (098) Galway funs Bhride Nursing Home Creggs Road Glen::unaddy Co. Galway (094) Ballinderry Nursing Home Ballinderry, Kilconncl Ballinasloe Co. Galway (090) Ballygar Nursing Home Ltd. Ballygar Co. Galway (090) Caiseal Geal Nursing Home Casllcgar Galway (091) Casllcturvin Nursing Home Athcmy Co. Galway (091) Central Park Nursing Home C lonbcme Vi llage BaUina.<;loc Co. Galway (093) C leggan Beach I'louse ursing Home C lcggan Co. Galway (095) Coral Haven Nursing Home Hcadford Road Galway (091) Corrandulla Residential Nursing Home Old Monastery Corrandulla Co. Galway (091) Garbally Rest Home 76 Brackemagh Ballinasloc Co. Galway (090) G lenlara Nursing Home IUlkerrin Road Glcnamaddy Co. Galway (094) Grcenpark Nursing Home Tullinadaly Road Tuam Co. Galway (093) Hillcrest Nursing Home COrr.lndula Co. Galway (091) Hillside Nursing Home Attidennot, Aughrim Ballinasloc Co. Galway (090) Holy Family Nursing Home Magheramore Killimor Co. Galway (090) Kiltonner Nursing Home Kiltonner Co. Galway (090) Lakelands Nursing Home Loughrca Co. Galway (09 1) Little Flower Nursing Home Labane Ardrahan Co. Galway (09 1) Lough Corrib NUf$ing Ilome Kilbeg Headrord Co. Galway (093) Lynam's Nursing Home Creagh Road Ballinasloe Co. Galway (090) Maryfield Alzheimer's Nursing Home Famablake Athenry Co. Galway (091) Mountbellew Nursing Home Treanrcvagh Mounlbellew Co. Galway (090) Moycullen Nursing Home Ballynahallia Moycullen Co. Galway (091) Mystical Rose Nursing Home Knockdocrnorc C larcgalway Co. Galway (091) Nightingale Nursing Rome Lowville. Ahascragh Ballinasloc Co. Galway (090) Oranmore Nursing Home Bushficld Oranmore Co. Galway (091) Owen RilTNursing 1 lome Camp Street Oughterard Co. Galway (091 ) Pointe Boise Nursing Home Sallhill Galway (091) Rosemount Nursing Home Church Slrcel GM Co. Galway (091) Rushmore Nursi ng Home Knocknacarra Galway (091) Sacred Hean Nursing Home P",k Spiddal Co. Galway (091) SI. Anne's Nursing Home Woodford Co. Galway (090) Sl. Columba's Nursing Home Cloughballymore House Kilcolgan Co. Galway (091) lib Bank 58

62 ~,,\ng qo.s::t::':'g~~ IRISh NURSl C; '" 0.~~,$ hocdes ORC;AN1SAC10N lll!s\<s HOMECARE 8"""" SI. David's Nursing Home SI. Francis Nursing Home Gentian Hill Kilkcrrin Knocknacarra Ballinasloe Galway (09 1) Co. Galway (094) SI. Joseph's Tuum Co. Galway 39 Stella Maris Nursing Home Cummcr Tuam Co. GBlway (093) Teach Allranais Chama Nursing Home Carna Conamara Co. Galway (095) Villa Maria Del Mar Nursing Home Bama Co. Galway (09 1) s lib Bank 59

63 52 South Mall, Cork Gee wtilte Tel. 021 EnteI'prhe H_ AdeWde Street, Belfast, BTl 8FE lib Bank lib Bank Umrted is regulated by the Insh Flmncial Services Regulatory Authorny. The retistration number is and the registered office is Sandwlth ~ Dublin 2.

64 The seperate and,ndependent Horwatil Bastow C harleton " s are contactable at Business Advisors Bastow Charleton Clanwilliam Court Tel +353 (0) Fax+353 (0)