Nivernais nursing home: where does the money of the residents go?

Ehpad has a cost, it’s no secret. But at what point does it become irrational? Why do some nursing homes ask for less than € 2,000 and others sometimes more than € 3,000, or even € 8,000 in other departments?

To answer this question, we must look at the managers of nursing homes. Whether the actor is private or public, the cost is definitely different. There are still private non-profit and commercial actors. In these branches, prices continue to be higher. To try to understand the price differences, we contacted over twenty establishments in Nièvre. All members of the Department responded through the department council president. (empty)

Those with commercial intent simply ignored our requests. Others find it difficult to respond, but we have to believe that recruitment difficulties are forcing directors of establishments to get their hands dirty: “I received your request for a solicitation. The priority is the organization of our residents, I have no ability to accept you (sic). »

For protection, ARS financial

For non-profit associative establishments, the medical residence Les Logis du Nivernais, in Dornes, has agreed to answer us. According to the government nursing home directory, in this nursing home, the cost of a single room starts at € 2,389.50 per month. For a double room it is € 2,103.60.

According to the management of the establishment, the cost is broken down as follows: “25% for rent and operating costs (about 600 euros). Between 45% and 48% (approximately € 1,100) of the costs of staff (secretarial, catering and maintenance), 6% (approximately € 140) associated with food purchases as well as between 20% and 25% (€ 500) associated with recreation and administration. »

The former Ehpad director is now rating the establishments, for transparency

At this institution, the staff-to-staff ratio is 0.67. Understand a little more than a staff for a resident. The Nivernaise average was 0.6.
For funding care, the Regional Health Agency (ARS) incurs costs. According to the organization: “The care budget is the sole responsibility of Medicare and is paid directly by ARS to the establishment. This budget, calculated based on the establishment’s health care costs, covers costs primarily associated with medical and paramedical care. »

Salaries represent approximately 65% ​​of ARS staff. The rest is for care and medical equipment

In Nièvre, still according to the ARS, more than 63.7 million euros will be allocated in 2021 to Nièvre establishments (including fixed credits, specifically within the framework of crisis management).

The Daniel-Benoist nursing home in Nevers, which shows a price of € 1,828 plays a transparency card and fully details its budget. “In total, we have a budget of 3.95 million euros for 2022. This total includes three components. Our 81 residents contribute up to 1.7 million euros through what they pay (including assistance). € 450,000 is from the personalized autonomy allowance and € 1.8 million is from ARS ”, explained Christian Kratz, deputy of the SOS group that took over the establishment on January 1, 2022.

“Salaries represent 65% of ARS staffing”

ARS staffing is evaluated according to the dependency of the patients. It is also used in the payment of nurses, and 70% of the salary of carers. “Salaries represent approximately 65% ​​of ARS staff. The rest is for care and medical equipment,” Christian Kratz added.

According to him: “What a resident pays is related to the hotel services of the establishment. We leave the rent, laundry, etc. to be paid by the resident. Of course, the department assistants were there. »

Control of establishments: how does it work?

Ehpad must be controlled. Be it by the Department, when it’s an actor, or by health organizations like ARS.

According to the ARS of Bourgogne-Franche-Comté: “Nièvre has 40 nursing homes; there are 424 establishments at the regional level. The levels of control that can be exercised are the same for all nursing homes, regardless of their status. In this statement, the organization sets the tone, no one should be able to get through the cracks.

Each year, approximately 10% of establishments are inspected by ARS

Inspections conducted by ARS and the department council are conducted on a scheduled or unannounced basis. “These inspections are often conducted jointly by several inspectors and may be related to equipment approval, respect for user rights, organization of care or prevention of maltreatment …”, says refers to the organization.

Controls, but not in Nièvre ??

Asked about the number of inspections conducted in Nièvre in 2021, ARS replied: “Each year, approximately 10% of establishments are subject to the control of the ARS inspection (46 inspections in Bourgogne-Franche-Comté in 2019 , the last year of reference excluding the health crisis). “There is no answer about Nièvre …

In 2022, an Ehpad was reviewed at its ARS request. Imphy’s, the establishment of Pierre-Bérégovoy.

Simon Dubos

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