Daily management

5 November 2018

Nursing homes : trends and challenges of the sector

ING and Probis have carried out a new study of 550 institutions representing around 1/3 of the market. This reflects the main challenges and trends facing the sector.

Key learnings from the study

A sector in full evolution

In recent decades, the emphasis has essentially been on increasing the capacity of facilities (care homes and sheltered accommodation). We are now seeing a paradigm shift towards the diversification of care delivery that goes beyond the traditional residential care centre concept. A growing number of managers and executives are aware that senior citizens' needs have changed. Yet the large majority of the care facilities questioned have no concrete short-term plans to introduce daycare services, daycare centres or outreach care (e.g. home-based care). 

diversification of care delivery

diversification of care delivery

Fall in the occupancy rate

Occupancy rates within residential homes for the elderly/nursing homes are slightly lower than they were three years ago. This is down to the new expectations of senior citizens, shorter lengths of stay, alternative forms of care and increased capacity. Most managers (71%) report that the structural waiting lists that existed three years ago are no longer there – or practically no longer there – today. A quarter of the facilities questioned are finding it difficult to achieve a maximum occupancy rate. In a large city such as Brussels, where accommodation capacity is high, as many as half of them do not achieve this level.

Increase in the level of dependency and in problems related to dementia

In our sample, the level of dependency on care has continued to increase in the past three years, rising from 76.2% to 78.3%. In Flanders, the median value of the level of dependency stands at 81%, which is a significantly higher median than in Brussels and Wallonia (approximately 70%). More than a third (34.4%) of residents are living with dementia, compared with 32% in 2013-14. 

Some mobility within the region

On average, nearly half of residents (47.9%) come from the town where the facility is located, approximately a quarter (25.5%) from towns nearby and around a quarter (26.6%) from the wider region. The local mission and footing are important for most of the facilities (and the senior citizens), but some mobility can nevertheless be observed within the wider region. 

Some mobility within the region

Some mobility within the region

Status quo in the number of workers

Despite the increase in the level of dependency, staff supervision has remained practically the same over the past three years. The median value stands at 10.5 full-time equivalents for nursing staff and care staff for every 30 residents. However, wide discrepancies can be observed within the sample depending on subsidies, the region and the type of manager.

Funding: growing imbalance between the different regions and types of manager

Firstly, the significant difference between Flanders on the one hand, and the Walloon Region and Brussels on the other, is largely due to regional funding policies for nursing homes. Flemish facilities consequently receive more funding, enabling adequate staff supervision to be put in place. 

Additional investment in staff despite pessimism about the financial future

The majority (57%) of those surveyed are somewhat pessimistic about the financial future of their facility. Yet the large majority of them are investing fully in care, particularly in care staff

Want to know more?

For a better understanding of the sector and its challenges, read the full story:

Maisons de repos: tendances et indicateurs (2018) - FR

Woonzorgcentra: Trends en indicatoren (2018) - NL