Thursday 22 August 2019

Average weekly cost of caring for nursing home resident up year-on-year

(Stock photo)
(Stock photo)
Eilish O'Regan

Eilish O'Regan

The average weekly cost of caring for a resident in a nursing home is now €1,615 – up from €1,592 last year.

Figures revealed the highest weekly cost per resident is in the HSE-run St Finbarr’s Hospital in Cork where it is as high as €2,182.

The weekly costs are the fees agreed with the nursing home under the Fair Deal scheme which subsidises care.

A resident in the Fair Deal scheme is only liable for the amount they are assessed as being eligible to pay after a means test, regardless of the weekly cost of the nursing home they live in.

It means that because of State subsidy a resident in a more expensive nursing home does not pay a higher weekly fee than a cheaper home if they are in the Fair Deal scheme.

The weekly cost per resident in a private nursing home varies from around 850 to €1,250 per week.

Nursing Homes Ireland, which represents private nursing homes, has long claimed the HSE is being unfair in paying its own public nursing homes higher weekly rates.

The HSE which published the figures today said the increasing weekly cost of a nursing home stay is due to pay increases due under the Lansdowne Road Agreement .

The HSE said the weekly price for the cost of care in a public nursing home is based on the actual costs of operating the public centres.

The cost of running these public centres ranges from a bed rate of €889 to €2,182 per week.

"It is acknowledged that there are variations in the cost of care for public and private nursing homes, with public nursing homes generally having a higher cost of care. 

"A number of factors contribute to this including:

"*Reductions in long-stay public beds numbers.

"Many public centres were required to reduce bed numbers since 2009/2010 to comply with health and safety, fire regulations and HIQA compliance with residential care standards. However, it has been more difficult to achieve a similar reduction in fixed costs e.g. lighting, heating, maintenance, staffing costs, etc.

"*Environmental implication on staffing levels

The need to modernise/replace many public centres and improve their environments in line with HIQA standards has seen substantial Capital Plan funding committed for 2016 – 2021. The current environment of many brings challenges to staffing levels due to the layout of bedrooms and shared areas. The planned capital development will support a modern fit-for-purpose environment.

"*Geographical provision of residential placements

"The HSE provides residential care services in locations that are not viable for private providers e.g. in some rural areas, long stay beds are provided for geographical reasons in smaller centres which would not be profitable for a private provider to supply e.g. Achill Island, Donegal etc.

"*Higher nurse staffing ratios

"Public nursing homes generally have higher nurse staffing ratios in place.  A review of NHSS published in 2015, recommended that a ‘Value for Money and Policy’ review be carried out by the Dept of Health. It is planned that this review will be completed in 2019.

"*Staffing cost of providing ‘Long Term Residential Care Services’

"The cost of providing long term residential care services comprises in the main of staff pay costs (including nursing and other care staff). Public Long Stay Residential Centres are obliged to apply public service rates of pay and conditions of employment for all staff which includes paid sick leave, maternity leave etc.

"*Reliance on agency staffing

"Due to the public sector recruitment moratorium which was in place for the last number of years, the public residential care sector has relied on agency staff to support adequate safe levels of service. However, this reliance is being replaced steadily."

Responding to the release of costs ,Tadhg Daly, chief executive of  Nursing Homes Ireland, representing private nursing homes, accused the HSE of using the visit of President Donald Trump to bury the figures which are six months old.

"Nursing Homes Ireland has been demanding for months for the HSE to publish the spend by it on its nursing homes under Fair Deal.

"When the fees were last published in March 2017, they revealed HSE homes were being paid an average 60px more per resident per week by comparison with private and voluntary counterparts.

"Within some counties HSE homes were being paid fees that were up to three times those payable to private and voluntary counterparts.

"Once we have the opportunity, Nursing Homes Ireland will undertake a forensic analysis of the fees to assess the extent of the ongoing discriminatory practice being operated within the nursing home sector," he added.

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