Nursing home run at loss over ‘fair deal’ scheme

ONE of the country’s largest care homes for the elderly is operating at a significant loss because of controversial new Government funding arrangements.

St Luke’s Home in Cork city has revealed that it is operating at 17% below break-even point after almost a year of negotiation with the Health Service Executive on the new Nursing Homes Support Scheme – the so-called Fair Deal scheme.

The home is now being forced to dip into its charitable arm to help maintain high standards of care. And it is also considering setting up a special foundation to redress the balance.

St Luke’s said it is now extremely concerned essential elements of its care service package may be seriously affected unless the funds can be raised.

Since its introduction last year, the National Treatment Purchase Fund has been negotiating new rates with providers of long-term care beds for the elderly.

“Fair Deal by legislation covers bed, board and basic nursing care only, in a private nursing home,” said David O’Brien, the director of administration at St Luke’s Home.

“It does not fund aspects of care in St Luke’s which are considered essential elements of our service package, such as physiotherapy, speech and language and other occupational therapies, social activities, or specialised care equipment. Who does, has not yet been defined or determined.”

Mr O’Brien said the Fair Deal scheme was broadly welcomed when it was introduced because it replaced a variety of support methods.

“It was designed to provide a national, standardised, means-tested method of funding residents in private nursing homes with the costs shared between the state and the resident based on their ability to pay,” he said. “Therefore, residents entering a nursing home had a choice as to where they would like to end their days.

“Now this scheme is being shown to be inadequate in some instances, especially for organisations such as St Luke’s who have more complex requirements.”

He said St Luke’s is now operating at a loss and is being funded from its charity wing. “This cannot continue as the charity’s funds are yielding diminishing returns in the current economic structures and this will impinge on our development programme for the care of the elderly which is gaining momentum as we speak.”

St Luke’s is building a multi-million euro education centre on its campus, due to open next year, and is also planning to increase by one third the number of beds, as well as improve day care and administrative facilities.

Mr O’Brien said St Luke’s is determined not to reduce its care standards, and raise safety concerns for residents and their families.

“We will tightly manage the increasing level of deficit created as beds transfer to Fair Deal, and in the interim, fund it through other means in the hope that further negotiations with the relevant parties will provide some resolution of the impasse, and enable charities such as St Luke’s to survive to continue doing what they do best.

“With that in mind, we intend to seek financial support from outside the home through the setting up of a foundation to expedite fundraising for our projects and activities and develop new fundraising streams.”

St Luke’s Home was established in 1872 and is today one of the country’s most respected specialised care homes for the elderly.

Run by an independent charity, it has 121 beds, 288 staff, a day-care facility, education and training facilities, and over the last decade, it has developed a specialist dementia care unit.

Earlier this year, the chairperson of St Luke’s board of directors, Church of Ireland Bishop of Cork Paul Colton called on the Government to intervene to ensure more realistic payments are made to specialised care homes such as St Luke’s.

The Friends of Cobh Community Hospital – a 38-bed long-term care facility for the elderly – have also expressed concerns about the Fair Deal funding arrangement.

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