Question 16075 — elderly people

Summary

Mr. Jean-Noël Barrot questions the Minister of Solidarity and Health on the fact that the services of the regional health agency in certain regions seem to have a heterogeneous interpretation of the legislation relating to them, and more particularly to EHPADs, concerning in particular the provisions relating to the authorization of an establishment such as mentioned in articles L. 313-1 and following of the code of social action and families (CASF), which stipulate two conditions. The first condition concerns obtaining an opening authorization for a period of 15 years corresponding to the technical compliance of the establishment allowing the reception of dependent elderly people. This administrative authorization is issued and notified for a specific number of beds to the owners of the walls who manage the establishment, charging the owners to operate their own establishment or mandate an operator approved by the ARS. The second condition concerns obtaining an operating authorization given, for a period of 5 years, to an operator approved for medical care and hospital services through a tripartite agreement (today CPOM) between the regional health agency, the department and the operator. It turns out that a number of cases demonstrate that authorization opening linked to a medico-social establishment would not be perfectly controlled by ARS and, moreover, they seem to confuse the authorization to open an establishment with the authorization to operate said establishment. This can be very problematic because after several years of operation, and with financial profitability as their sole objective, some operators present a new project and ask the ARS to transfer the beds to a new and larger establishment (110 to 120 beds). This request is made unilaterally without any consultation with the owners of EHPADs approved by the public authorities. Given in particular the constraint of the number of beds per department, EHPAD owners can only wonder about the future of their establishments and their investments. Thus, for example, a private for-profit group was granted operating authorizations in fourteen different establishments, establishments whose leases were subsequently terminated by the operator itself, leaving the owners in suspense. Individuals who have invested their savings in EHPADs, supervised by the State, have mainly done so with a view to precautionary savings for their retirement and participated, and still participate today, in the construction of this type of care establishment for dependent elderly people that France so badly needs. More broadly, more and more disputes are appearing between small individual co-owners of EHPADs and large groups, often listed on the stock exchange, the operators. Consequently, he asks for clarification on this issue and whether, in particular, an investigation or even an evaluation report on the aforementioned bed transfer phenomenon has been commissioned. He also asks what initiatives could soon be taken in order to better preserve the rights of individuals in the face of the financial arrangements of certain managers of private EHPADs, in order to avoid a significant disaffection among citizens with regard to the financing of medical-social establishments, disaffection whose consequences would be eminently detrimental even as we face an exponential increase in structural and human needs in terms of accommodation for dependent elderly people.

Machine translation from French. The official text remains authoritative.

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