Families catalogue 'exorbitant' nursing home fees in report
Some elderly nursing home residents are being forced to pay up to €100 a week in top-up fees, including "illegal" doctors' charges - even though they have a medical card, a damning report reveals today.
The revelations are made in a report from Age Action which has been contacted by scores of distressed families over the past two years.
The catalogue of nursing homes abuses includes additional fees charged for services such as social activities, incontinence wear and therapies which private nursing home owners say are not covered by the Fair Deal scheme.
The report highlighted the predicament of one woman, Michelle, whose mother had a full medical card but was charged for a "house doctor" fee.
Age Action Director of Advocacy Justin Moran said: "The nursing home refused to provide an itemised bill and, after it was confirmed to Michelle that such a charge was illegal, she engaged a solicitor."
She was told by the nursing home that if the charge was not paid they would stop providing care to her mother.
It cited another case where Conor's mother has a long list of additional services for which she is being charged - costing almost €4,500 a year.
When it was broken down, her monthly fees included €50 for incontinence wear, €222 for social activities, €100 for doctor services and a €10 surcharge on the three "free" chiropody visits a year.
Residents with limited means face charges ranging from €15 to €100 a week. In some cases nursing homes ask for a large cash deposit before admission which can be impossible for some families to afford.
The report said nursing homes are entitled to charge for additional services beyond those covered by Fair Deal. "But the amounts being charged, the transparency of the system and in some cases the dubious legality of the charge can cause serious problems for residents and their families," it said.
While charges are normally set out in the resident's contract for care there is nothing to stop homes from changing them and imposing extra fees, putting particular stress on families with low income.
It has reached the point where even with the Fair Deal subsidy, the fees can make nursing home care unaffordable.
Mr Moran said while there is some truth in nursing homes claims they have to pass on the charges because the watchdog Hiqa insists the services be provided, it does not excuse "exorbitant fees".
Age Action wants the Department of Health to force all nursing homes to publish their fees online and amend the law to allow residents to opt out of paying for services they cannot take part in.
The National Treatment Purchase Fund should audit and regulate charges.
The HSE should assess if a resident needs therapies or supports, like incontinence wear, and take the costs into account when calculating their Fair Deal contribution.
In response, Tadhg Daly, of Nursing Homes Ireland, said the additional fees levied are "for services explicitly excluded under the Fair Deal scheme and are agreed with all residents in the contract for care".
He insisted the National Treatment Purchase Fund had "full access, by legislation, to all nursing homes' accounts and records" under 2009 legislation.
Hiqa inspectors examine contracts for care through their inspections, and in their report published in 2016 confirmed there are good levels of compliance.
"Like Age Action, Hiqa has previously highlighted the significant deficits in the provision of primary care services for residents in private and voluntary nursing homes.
"This represents discrimination of older people on the basis of where they reside," Mr Daly said.
He said HSE-run homes get a "disproportionate" amount of Fair Deal budget. There is a need for a level playing field, he said. A Fair Deal review was promised by June and this deadline has not been met.