Nursing home fees system set for overhaul

A radical overhaul of the fees system for the nursing home sector will see residents charged according to their needs and the type of care facility for the first time. A scaled level for fees will apply according to a resident’s dependency needs, as well as the home’s quality of services.

Residents or their families would not face higher charges under proposed changes. Budget talks later this year will need to factor in the reforms. The Irish Examiner understands the recommendations in the National Treatment Purchase Fund-led report are expected to be published in the next fortnight.

The previous government in 2015 promised to review the fees system for nursing homes. Consultants DKM also advised the Department of Health that the system was not “fit for purpose”.

A review of the fees private and voluntary nursing homes can charge under Fair Deal has recommended significant reforms. It is understood that the report recommends a new formula should calculate prices based on local costs incurred by the nursing home.

The current system only caters for a county-wide average rate. Minister of state with responsibility for older people Jim Daly said he is aware of details of the report, which will be submitted to several ministers this week.

“Since my appointment I have been been pushing for a tiered system of payment when it comes to nursing home care,” he said.

This is the only way that we will be in a position to meaningfully deal with high-dependency residents, particularly those who are cognitively impaired and suffering from dementia, and make a meaningful contribution towards building a system that will offer the resident the highest standard of care.

“The current system of charging that operates a ‘one size fits all’ is no longer fit for purpose. We need to work towards developing a 1-5 scale of dependency that will entitle the patient or resident to extra services as they require them.”

Currently, prices for nursing homes under Fair Deal average around €12,000 a year. Nonetheless, they are not set according to facilities or different locations or on a resident’s dependency needs. It is understood residents would not face higher costs under the proposed changes and would continue to pay 80% of their income or 7.5% of their assets. Instead, the HSE and Fair Deal would pay extra costs.

Nursing Homes Ireland chief executive Tadhg Daly said there is a lack of clarity around Fair Deal contributions, which need to change

“An evidence-based cost model on how fees are calculated is better for the industry and for residents too, as it will reflect their care needs,” he said. “And with more scaled fees, that remuneration will be there for their care plan.”

Age Action head of advocacy Celine Clarke said a system bringing more clarity to Fair Deal fees is welcome.

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