Nursing home queries level of State support

THE HIGH Court has been asked to decide whether residents of a private nursing home are still entitled to State support if their…

THE HIGH Court has been asked to decide whether residents of a private nursing home are still entitled to State support if their relatives pay for extra facilities such as bigger and more comfortable rooms.

Belmont Care Ltd, trading as Belmont Nursing Home, Stillorgan, Co Dublin, has asked the court to rule on a dispute which has arisen between it and the National Treatment Purchase Fund (NTPF) over the matter.

The NTPF, which buys treatment and care from the private health industry for public patients, entered into an agreement with Belmont on the maximum price to be charged for the provision of long-term residential care under the State-funded nursing homes support scheme known as the “Fair Deal”.

This scheme provides for a nursing home resident to make a contribution towards the cost of care, based on a means test, with the State paying the balance. It applies whether the nursing home is public, private or voluntary.

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Belmont is seeking a declaration it is entitled to charge or receive payment from a resident’s relative, friend or benefactor, for additional services not covered by the Fair Deal scheme.

It wants the court to order such charges are not in contravention of the agreement between it and the NTPF entered into on December 3rd, 2010, and due to expire on November 30th. The case was mentioned before Ms Justice Mary Laffoy yesterday who set it down for hearing next June.

In its claim, Belmont says it has a number of different room types with a limited number offering additional services such as high dependency beds. It also has larger rooms offering enhanced privacy and comfort, such as the facility to accommodate wardrobes, other furniture, personal effects and appliances which typically came from a resident’s former home.

Belmont says these enhanced facilities ought to be offered and do not come within the definition of “long-term residential care services” which the Fair Deal agreement covers.

A resident who wishes to move or remain in one of these rooms, and who also wishes to avail of Fair Deal, may be precluded from doing so because of the interpretation being given by the NTPF to the meaning of “long-term residential care”, Belmont says.

It argues, where payment is provided by a relative or friend for enhanced comfort and privacy, that is not a breach of the agreement between it and the NTPF.

Where a person who initially comes in as a fully private resident wants to avail of the Fair Deal, Belmont says it is prohibited under Health Information and Quality Authority (Hiqa) regulations moving that person out of the enhanced room to another room.

In those circumstances, Belmont says it may be left with no option but to terminate the nursing care contract with such a resident, forcing them to move to another nursing home.

When it raised those matters with the NTPF, Belmont says the NTPF’s solicitors replied that additional payments for extra services fell outside the definition of long-term residential care as provided for under the agreement.

NTPF could not therefore confirm, as requested by Belmont, that residents who had availed of Fair Deal would not be adversely affected if extra payments were made.

Last November, the dispute went to an arbitrator who concluded the issue was not amenable to resolution by facilitated mediation, the court heard. In those circumstances, Belmont wants the High Court to determine the matter.