Regulation of the nursing home sector: authorization, pricing, social assistance agreements[Régulation du secteur des Ehpads : autorisation, habilitation, tarification, conventionnement]

In order to measure the geographical and financial accessibility of care in nursing homes (such as Ehpads), we need to take into account the various legal tools available to the departmental council to partially regulate the number of Ehpad places and their costs. In addition to the level of rates, several factors come into play to determine the regulatory regime of an Ehpad and, ultimately, the price to be paid by each resident : the proportion of places entitled to social assistance, the proportion of residents receiving social assistance for accommodation (ASH), whether or not the resident him/herself benefits from ASH, and the existence of a social assistance agreement. In the absence of statistical monitoring of social assistance agreements, the number of which is increasing sharply, it is not possible to give a complete overview of the different types of rates applied. Under certain assumptions, however, we can propose an estimate. Of the 570 000 Ehpad residents at the end of 2019, 59% would pay a market price or a semi-administered accommodation rate (under a social assistance agreement), and 41% a strictly administered rate. Of the latter, 57% would not be entitled to ASH.