Nutriscore, room size… a new report to rebuild the nursing home system published by the Senate

On September 25, 2024, the Senate published a report to "rebuild" the nursing home system. After the Covid crisis and the Orpéa scandal, it wants to help the sector do better. 

To breathe new life into a sector that is "out of breath", a Senate report presented on Wednesday recommends to "rebuild"the Ehpad model, in particular by creating a second solidarity day and establishing a quality label.

In total, the report of the Social Affairs Committee issues around twenty recommendations intended to consolidate accommodation establishments for dependent elderly people (Ehpad) weakened by a succession of crises.

A report born from a scandal

These structures, which accommodate more than 600,000 residents and which rely on three sources of funding (the departments for the dependency part, the regional health agency for the care section and the residents for the accommodation), have emerged drained of Covid-19, du "Orpea scandal" and inflation.

As a result, between 2020 and 2023, the share of loss-making nursing homes increased from 27% to 66%, according to figures from the Directorate General for Social Cohesion (DGCS).

In this context, the Senate report calls for "rebuilding" the current model and consolidating its financing in order to meet the demographic challenge to come – the number of dependent elderly people will increase by 46% by 2050.

The first recommended measure, the creation of a second solidarity day, "which could result in the elimination of a public holiday, would make it possible to generate 2.4 billion euros in additional revenue”, according to the report.

The three rapporteurs – senators Chantal Deseyne (LR), Solanges Nadille (RDPI) and Anne Souyris (EELV) – suggest at the same time to “perpetuate” the emergency fund of 100 million euros that was released in July 2023.

Concerning the accommodation part, which is mainly responsible for deficit situations, an "annual revaluation floor, indexed to inflation, would make it possible to secure the resources of nursing homes", they write.

A real framework

On the quality of life aspect, the report recommends setting a supervision ratio of 8 for 10 residents in a programming law or even generalizing a minimum size of 26m2 room.

To restore confidence, the rapporteurs suggest publishing the results of the quality assessment of nursing homes, based on the model of the "Nutriscore", with "an overall score displaying a letter and a color".

They also recommend installing public services (France Services house, post office, etc.) or basic necessities (mini-market, etc.).

Finally, the report recommends integrating into the scope of the care and dependency sections “expenditures currently financed by the accommodation section although they relate to care and prevention of loss of autonomy”.