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Nursing home accommodation costs 62% more in public residences than in private alternatives

A new report has looked at the operation of the Nursing Homes Support Scheme.

THE AVERAGE COST of accommodating a resident in a public nursing home is 62% higher than accommodating them in a private home, a new report has found.

The report by the Comptroller and Auditor General also revealed that those living in private nursing homes are more likely than those in public nursing homes to incur charges for additional services.

The report looked at the operation of the Nursing Homes Support Scheme, known as Fair Deal, established in 2009 to provide financial support to residents towards the cost of their care.

The scheme covers approved private nursing homes, voluntary nursing homes and public nursing homes.

According to the report, the HSE was providing financial support for more than 23,300 people under the scheme by 2018.

The support amounted to €969 million in 2018, including some €51 million in the form of loans to residents to assist them in paying their contributions.

The HSE estimates that an additional €343 million was paid directly to nursing homes in 2018, in the form of residents’ contributions.

Almost 550 nursing homes are involved in providing care within the scheme.

According to the Comptroller’s report, the annual number of applications for support under the scheme is relatively constant at around 10,000 a year.

However, it was found that the cost of accommodating a resident in a public nursing home is higher than accommodating them in a private home.

A difference amounting to more than €500 a week in 2018 was attributed to better pay and conditions and higher staff to resident ratios, the HSE said.

Rates for public nursing homes were based on prior-period operating costs and bed occupancy levels, whereas those for private nursing homes were agreed by negotiation.

“Over the period 2010 to 2018, the average weekly charge rate in public nursing homes was consistently higher than the average weekly charge rate for private and voluntary nursing homes,” Comptroller and Auditor General Seamus McCarthy said.

In 2018, the average for public nursing homes was €1,564 per week. The agreed average maximum price chargeable for private or voluntary homes was €968 per week.

The HSE has attributed the difference to better pay and conditions for staff in public nursing homes, including the implementation of national pay awards.

It also pointed to the higher proportion of maximum dependency residents and greater costs associated with older buildings used as nursing homes, which typically were not purpose built for long-term residential care.

The audit office said: “Some public nursing homes located in rural or isolated areas may not be commercially viable.

“However, the HSE has not undertaken formal analysis of these cost drivers.”

Meanwhile, budgets were allocated to public nursing homes based on the calculated weekly charge rate.

Funding deficits may arise for homes where the occupancy rate is less than expected or if current operating costs are higher than the prior period costs.

For 2018, additional funding of €23 million was required from other Exchequer resources to meet such deficits.

With reporting from Press Association.

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