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Thursday 20 June 2019

Nursing homes in extra charges threat

Leaked records reveal how meeting of private operators urged to make 'full utilisation' of ability to charge outside of Fair Deal

The records reveal the depth of anger of nursing home owners that the fees paid by the State are too low and don't cover the full cost of care. Stock picture
The records reveal the depth of anger of nursing home owners that the fees paid by the State are too low and don't cover the full cost of care. Stock picture
Maeve Sheehan

Maeve Sheehan

Private nursing home owners were urged to consider making "full utilisation" of extra charges, new records reveal.

The claim was made at a forum of nursing home operators in 2015 which was held weeks before the infamous "boycott" meeting that resulted in a competition watchdog examination.

Records of the forum show that operators also discussed giving "consideration" to "a threat from the sector to focus minds" on their "funding challenges" and also asked whether there would be "concerted action" regarding the fees set by the National Treatment Purchase Fund over the price they are paid for residents by the State's Fair Deal scheme.

Details of the forum, which took place on October 7, 2015 emerged last week after a tranche of records was leaked to the Sunday Independent.

The records reveal the depth of anger of nursing home owners that the fees paid by the State are too low and don't cover the full cost of care. It was in this context that members of the industry body, Nursing Homes Ireland, were told that they "need to consider full utilisation of ability to charge for services outside of Fair Deal".

Extra charges imposed on residents for activities, such as bingo and social outings, came under intense scrutiny last year, with families complaining that fees were not excessive and not transparent. A Sunday Independent investigation, into more than 300 homes, found that two thirds quoted additional charges that ranged from €1 a day to €325 per week in one luxury facility.

The leaked records reflect the frustration in the sector over the price they are paid for residents under the Fair Deal scheme, which has contributed to additional charges being imposed. Operators say the fees paid by the State under Fair Deal pay for bed and board only and do not cover the full costs of care.

The forum - at the Clarion Hotel in the Liffey Valley - was organised by Nursing Homes Ireland and 134 delegates attended. It was addressed by the Small Firms Association and employers' body, IBEC and the PR firm Q4, on "the campaign of lobbying - mobilising the Nursing Homes Ireland movement to influence change".

Members trenchantly criticised the National Treatment Purchase Fund (NTPF).

According to a memo of the meeting, other issues raised included:

  • To consider Nursing Homes Ireland's "legal standing" regarding its "capacity to provide collective representation/concerted legal action".
  • A "collective fear" of the NTPF and how Nursing Homes Ireland as a "powerful organisation that galvanises members to oppose NTPF pressures".
  • A Nursing Homes Ireland lobbying campaign, noting that families are "unlikely to become involved" given their satisfaction with the Fair Deal scheme.
  • "Exploring the option of a tag-line" to encompass the pressures facing the sector, similar to the Irish nursing organisation's 'trolley watch' campaign.
  • The forum also discussed pressing for a national forum on long-term care involving all State agencies and care providers.

Because of members' immense frustration, a second meeting was organised on October 23. It was at that meeting that a proposal to "boycott" the Fair Deal scheme was mooted by members. .

The Sunday Independent's revelations of that "boycott" meeting, along with an instruction to "delete and destroy" the records of it, triggered an examination by the competition watchdog into "potential anti-competitive practices".

The Competition and Consumer Protection Commission (CCPC) examination found that nursing home operators did not carry through on their threats.

It insisted on the nursing home sector providing "undertakings" that it would not organise meetings to discuss "unlawful collective actions" or the influence of pricing decisions.

It is not clear whether the records of the earlier October 7 meeting were available to the Competition and Consumer Protection Commission during its examination, although given its findings that no threat was carried through, they are unlikely to have influenced the outcome.

Asked for comment, Nursing Homes Ireland forwarded the Sunday Independent a copy of its agreement with the competition watchdog.

When questioned by the Public Accounts Committee on the "boycott" meeting in June, Tadhg Daly, chief executive of Nursing Homes Ireland, said the competition watchdog found "no infringement by the organisation".

He also told the PAC that NHI members were frustrated and their fees are now, on average, 60pc below the fees paid to public nursing homes run by the Health Service Executive. It was "unsustainable" that private operators should be tasked with providing specialist care for such low fees, he said.

He also criticised the NTPF's appeals process.

Stephen McMahon, of the Irish Patients' Association, said private nursing homes have "real concern about Government funding and pricing transparency but transparency should also apply to extra charges. Some are maximising extra charges, which means that it is residents who are carrying the can," he said.

The Government has yet to complete a review of the nursing home sector, including fees paid to private operators and additional fees imposed on residents.

Sunday Independent

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