Public care homes charge 62% more than private alternatives for residents

The average cost of public nursing home residents is 62% higher than the cost of private residents, a recent Comptroller and Auditor report has found.

Comptroller and Auditor General Seamus McCarthy said: “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.”

Residents of public nursing homes have to pay more than €500 per week on average than private alternatives. The Health and Safety Executive said the difference amounted to better pay and conditions, higher ratios of workers to resident and including the implementation of national pay awards.

The rates for public nursing homes were based on previous operating costs and bed occupancy levels, whereas those for private nursing homes were negotiated.

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

It is stated that the higher proportion of residents with maximum dependency and higher costs associated with older buildings used as nursing homes, which typically were not designed for long-term residential care.

A report called Fair Deal was published in 2009 to provide financial support to residents for the cost of treatment. The scheme applies to the operation of the Nursing Homes Support Scheme, which covers private nursing homes, voluntary nursing homes and public nursing homes.  

The funds were distributed to public nursing homes on the basis of the calculated weekly charge rate.

Funding deficits may occur for homes where the occupancy rate is lower than anticipated or where current operating costs are higher than those of the previous period.

In order to cover those deficits, additional funding of €23 million was required from other monetary resources for 2018.

Stephen Donnelly, The Minister of Health has appointed the National Medical Purchase Fund (NTPF) to negotiate with individual private and voluntary nursing homes.

The audit office found that there was a lack of documented guidance to assist NTPF staff involved in these negotiations.