'Unscrupulous' homes use hospitals 'to free up beds'

CONCERN ABOUT allegations that some “unscrupulous” nursing homes send elderly people into acute hospitals to free up beds and save money has been expressed by Minister for Health Mary Harney.

In a letter sent in recent days, the Minster asked the chief executive of the Health Service Executive (HSE), Prof Brendan Drumm, to notify the Health Information and Quality Authority (Hiqa) of any concerns hospitals may have about inappropriate admission or referral trends from particular nursing homes.

She warned that breaches of regulations or standards by nursing homes would be treated with “the utmost seriousness” and said that she had asked her officials to identify legislative options that would help deal with such situations.

Ms Harney said the new Fair Deal scheme for providing support for nursing home care was now well into its first year of operation. However, there was “evidence of trends emerging which are causing me concern”.

“One of the most serious of these is the allegation that some nursing homes are, unnecessarily, sending residents to the acute hospitals in order to free up beds for a period to save money, or with a view to taking in patients who have less dependency requirements or to avoid the patient dying in their homes.

“The central intention of all of my, and Government’s, initiatives in this area over the last number of years, is to protect very vulnerable people. We have put in place an entirely new quality inspection and financial regime with this specific goal in mind.

“It would be wholly unacceptable for all of this work to be undermined by the actions of a few unscrupulous care providers. Assured quality patient care in appropriate settings is, and must continue to be, at the centre of all our work,” she said.

Tadhg Daly, chief executive of Nursing Homes Ireland, the representative body for the private and voluntary nursing home sector, said last night that if the claims made by the Minister were accurate, it would be unacceptable to his organisation.

However, he said he was surprised that the Minister would take the first step of writing to the HSE, rather than contacting his organisation or nursing homes about which the department had concerns. He said that clearly it was in everyone’s interests that the Fair Deal scheme operated as successfully as possible.

Ms Harney said she wanted hospitals to advise Hiqa of any concerns they may have in relation to inappropriate admission or referral in addition to the requirement, following the Leas Cross report, that they have protocols for notifying the authority of worries about individual patients admitted from nursing homes.

“The National Quality Standards for Residential Care Settings for Older People in Ireland, which I approved last year, stresses the concepts of dignity, care and welfare and which must apply to all the residents in nursing homes.”

“The Health Act 2007 [Care and Welfare of Residents in Designated Centres for Older People] Regulations 2009 reinforce, amongst other things, the requirements for a care plan for residents and procedures and choice regarding location of end-of-life care. Any breach of these standards and regulations will be regarded with the utmost seriousness by Hiqa and could, ultimately, lead to deregistration of offending homes,” she said.