Nursing home applicants in future could face tougher financial data checks, greater scrutiny of their wealth, and have their properties assessed by HSE-appointed valuers, the report says.
The Government pledged that, despite concerns about how to care for an ageing population, there will be no increased contribution expected from Fair Deal home residents.
The review of the Fair Deal system outlines a series of measures to help boost revenue for the scheme. Introduced in 2009, it allows residents to make a contribution towards the cost of their care and the State pays the rest.
More than 22,600 people use the scheme at a cost of €993m. The review predicts that numbers will increase by 1,126 over the next three years at a cost of €49m to the State.
The scheme requires people to contribute 80% of their income and 7.5% of the value of their family home annually for up to three years. An assessment of someone’s assets can be postponed until after an applicant’s death.
The report makes recommendations on how to increase the amounts people pay into the scheme, amid concerns that the wealth of residents is being underestimated or undervalued.
While 54% of applicants were assessed as owning a home, the report says this figure for elderly people is far greater among the general population.
The report considers ways that people are getting around valuation rules for homes.
It suggests “robust initial financial assessments” should be applied to home applicants. Furthermore, health authorities should “rigorously” follow up by seeking a full declaration of assets following the death of a client.
The report notes the difficulties in accurately assessing the values of properties. It suggests greater co-operation with Revenue, whose valuation bands for areas under the property tax could be used.
HSE officials could also appoint a panel of valuers for property assessments, it says. The report points to a sample survey carried out by the HSE which showed that in the 30% of cases where a schedule of assets was available, almost a quarter of these had underdeclared cash assets.
Random spot checks of applicants’ financial data, a greater follow up with Revenue, and amending assessments to allow for fluctuating values of homes or assets should proceed, it is suggested.
However, the report also says that a cap should be applied on amounts taken out on assets such as farms or businesses as this affects the ability of an inheriting son or daughter to properly run a business.
The department review notes that the average weekly cost of care in a public facility is €1,390 as opposed to €893 in a private home. However, this has no direct impact on a resident, as their contribution is determined according to their means.
A more transparent explanation of charges in homes is recommended by the report and another overall review should be carried out in 18 months, it states.
The report concludes that, given the demographic changes ahead, more State support should be provided for the Fair Deal scheme.
Kathleen Lynch, the junior health minister who has responsibility for older people, yesterday ruled out increased contribution costs for residents. She said the Government had agreed on this.
Age Action, a support group for the elderly, welcomed the pledge.
However, nursing home representatives warned of the danger of “kicking the can down the road” to fund the sector. Tadhg Daly of Nursing Homes Ireland said: “Further prolonging actions required will likely present crisis for older person care and for wider health services.”