Bed capacity requirements for land sites release for nursing, step-down and long-term care facilities

Name and Constituency of Member of Parliament

Mr Leon Perera

Non-Constituency MP

Question No. 151

To ask the Minister for Health (a) whether there is a requirement for land sites released for nursing, step-down and long-term care facilities to have a minimum number of beds to be provided by the tenderer and, if so, why; and (b) whether these facilities need to maintain a minimum proportion of rooms with four beds or more for their patients to receive Government subsidies for intermediate and long-term care services and, if so, what is this proportion. 

Written Reply

1.    The intermediate and long term care landscape in Singapore has to evolve to meet the needs of an ageing population.  MOH is expanding the capacity of nursing home services, and as land is scarce in Singapore, we must ensure efficient use of space so that we have sufficient capacity to meet the increase in needs.  The design and layout of nursing homes also has to take into consideration the different care needs of the residents, the required manpower to provide adequate monitoring of the residents and that residents in nursing homes can live in a safe environment.

2.    There are currently three main modalities in developing new nursing home capacity.

3.    First, MOH develops purpose built nursing homes, and appoints operators through competitive tenders to operate these nursing homes under the Build-Own-Lease (BOL) scheme.  Under this approach, MOH fully funds the development cost based on the scope of works and service provisions determined by the Ministry.  MOH also directly determines the design of the facility, taking into consideration space norms and site characteristics.  Most BOL nursing homes have some 4 to 8 beds per cubicle, but we provide for some single-bedded rooms to cater to instances where patients require clinical isolation.  Appointed BOL nursing home operators, whether private or voluntary welfare organisations (VWOs), receive operating subventions to serve subsidised patients, as long as they meet the service requirements under the tender, which include setting aside the bulk of their licenced bed capacity for subsidised residents.

4.    Second, MOH also provides co-funding, both capital funding and operating subvention, to VWO operators who want to redevelop or expand their existing nursing home facilities to care for more patients.  The funding provided is determined with reference to how MOH will fund our BOL nursing homes.

5.    Third, the government releases suitable land sites and state properties for interested providers to bid, in order to design and develop their nursing homes.  As land is scarce and there is still a growing demand for nursing home services, MOH does state a minimum capacity that each site is expected to achieve, with reference to the size of the site and allowable intensity.  Within this broad parameter, service providers are free to adopt their own designs for the nursing home facilities as they fund the development costs on their own.  MOH does not specify the specific bed configurations or mix in these tenders.

6.    Such nursing home operators who develop their own nursing homes can offer to serve subsidised patients under the Nursing Home Portable Subsidy Scheme (PSS) through the government's Requests for Proposals (RFP).  The PSS provides additional capacity to supplement subsidised nursing home capacity provided by VWOs and our own BOL facilities.  In considering bids from such operators, MOH will consider both quality and the capacity to be offered.  Bed configuration is not a factor for consideration.