I propose to take Questions Nos. 518 to 521, inclusive, together.
In order for a nursing home to be an “approved nursing home” for the purposes of the Nursing Homes Support Scheme it must have agreed the maximum amount that will be charged for the provision of long-term residential care with the National Treatment Purchase Fund.
The NTPF has statutory independence in the performance of this function and, in carrying it out, it must ensure value for money for both the individual and the State. The NTPF negotiates with each nursing home proprietor on an individual basis and under the Nursing Homes Support Scheme Act may examine the records and accounts of nursing homes as part of the process.
The NTPF assesses nursing homes under four criteria:
- costs reasonably and prudently incurred by the nursing home and evidence of value for money;
- price(s) previously charged;
- local market price; and
- Budgetary constraints and the obligation on the State to use available resources in the most beneficial, effective and efficient manner to improve, promote and protect the health and welfare of the public.
Under the NHSS services and supports which are common to the vast majority of nursing home residents are included in the cost of care. These are:
- nursing and personal care appropriate to the level of care needs of the person;
- bed and board;
- basic aids and appliances necessary to assist a person with the activities of daily living; and
- laundry service.
While the Deed of Agreement between the NTPF and the nursing home sets the maximum price an approved nursing home may charge for long term care under the Scheme the provision of all services is the subject of a separate contract between the approved nursing home and the person in receipt of those services, or his/her representatives. The NTPF Deed of Agreement states: "The Proprietor shall not demand or accept, from or on behalf of the resident or the HSE, any payment or consideration, over and above those described in remuneration for the provision of Long-term Residential Care Services to any Resident. For the avoidance of doubt and for the purpose of demonstrating that it has met this condition, the Proprietor agrees to make clear in its contract with the Resident the full extent of the services that are included in the price agreed with the NTPF under the Scheme."
The NTPF have confirmed that it refutes absolutely any suggestion that it endorsed reductions in price for long term care being passed directly or indirectly onto residents in the form of extra charges (as opposed to proprietors reducing profit levels or introducing cost efficiencies).
It has also confirmed that if similar such allegations are made, or similar price negotiating tactics used, by nursing home proprietors they will be robustly challenged and defended by the NTPF.