Health Insurance Nursing Home costs while fair deal processing?

[Meerkat]

Hello all,

My Dad is being discharged from hospital and they tell me that I can't care for him on my own. He needs 2 people to care for him and there is no one that can do it with me. I am his and my mothers carer. She has early stage dementia and living at home.

There is a bed in a nearby nursing home but the fair deal scheme is being processed, I am very concerned that they will discharge him to the nursing home and we are going to get a big bill to be paid for the time it takes for the application to be processed. During an earlier meeting the the social worker implied there would be help available for this bridging period but has become very vague. The interest has shifted to expediting the discharge to nursing home, with no clarity as to who will pay the bill for the time the application is being processed. I have arranged a meeting for Monday to try to get more information.

Has anyone had a similar experience? Anyone know if there is a grant or scheme to be applied for that will cover or help cover the cost while the fair deal scheme is being processed?

Any information/ideas would be greatly appreciated...

 

[gipimann]

My father was in a similar position a few months ago. He was discharged from hospital to a nursing home, and we were told that the hospital would cover the costs while the Fair Deal assessment was being processed. The home didn't ask for any payment while we waited.

The assessment was completed 3 months later, backdated to the date he was admitted. My mother was presented with a bill from the home for the balance due for the 3 months plus the current month - about 4000 euro, to be paid within 2 weeks from the date of the invoice.

 

[Meerkat]

My father was in a similar position a few months ago. He was discharged from hospital to a nursing home, and we were told that the hospital would cover the costs while the Fair Deal assessment was being processed. The home didn't ask for any payment while we waited.

The assessment was completed 3 months later, backdated to the date he was admitted. My mother was presented with a bill from the home for the balance due for the 3 months plus the current month - about 4000 euro, to be paid within 2 weeks from the date of the invoice.

Thank you for your reply gipimann.

Did they break down the bill? Could the bill have been made up of, the amount that the fair deal scheme calculated to be your dads contribution to his care, multiplied by the number of weeks they back dated it?

 

[twofor1]

The assessment was completed 3 months later, backdated to the date he was admitted. My mother was presented with a bill from the home for the balance due for the 3 months plus the current month - about 4000 euro, to be paid within 2 weeks from the date of the invoice.

So €1K a month, is that roughly what your Dad's monthly contribution was assessed at under Fair Deal ?

If so, had he been admitted under Fair Deal immeaditely, he would have been paying this €1K monthly anyway towards the typical €4K -€6K monthly, that most nursing homes charge.

Seems reasonable that one would pay their assessed contribution from the start, but very wrong to unexpectly present your Mam with a €4K bill.

If this is the normal procedure, it should have been explained before his discharge from hospital to the nursing home.

 

[Slim]

Fair deal, if approved, will be backdated to date of admission to the nursing home. The cash contribution due from your father(family) can be reduced upfront by availing of the ancillary support, ie 'nursing home loan' which is in respect of the value of his home, which becomes payable on his death. I assume your dad is 65+!

 

[gipimann]

Thank you for your reply gipimann.

Did they break down the bill? Could the bill have been made up of, the amount that the fair deal scheme calculated to be your dads contribution to his care, multiplied by the number of weeks they back dated it?

Yes, the bill was broken down - the daily rate for the nursing home minus the daily fair deal allowance, plus the extra charges incurred (barber, medicines, laundry, etc). My father is expected to contribute about €230/240 per week - I don't have the exact figure to hand.

twofor1, we understand that the amount paid after 3 months was the same as we would have paid had the paperwork been completed. There was no option to pay anything to the home while we waited, not even their extra charges for 'social activities' or medicines. The hospital social worker had mentioned that the hospital would be covering bills, which turned out not to be the case. There was no advance warning of a large bill until it arrived, with 15 days to pay it.

Slim, we have availed of the ancilliary loan.

 

[Meerkat]

Thank you all for replies.

Just to update anyone else in a similar situation, perhaps things have changed with time or depending on location.

I am just back from the HSE office regarding the application for Nursing home support Scheme and the Nursing home loan. The office has told me that they do not backdate any of this scheme. The nursing home support will only be paid from the date that it is approved. So, the cost until this application has been approved will either be undertaken privately by the patient or alternatively the Hospital that dad is being discharged from will have to apply for "Interim Funding".

I am now extremely worried as to what will happen at the end of the week when he is meant to be moved. Do I refuse to let him be transferred until the hospital gives us something in writing? Do I contact the nursing home and tell them we have no funding and they should refuse to take him until funding has been clarified?

 

[cremeegg]

I also had this experience with my father earlier this year.

Like gipimann we were told the hospital would cover the costs of the nursing home, between the date of admission to the nursing home, and the date the nursing home support scheme "fair deal' was available. In or case they did with no problem.

We had already started the fair deal application before this and the length of time involved was about 3 weeks.

There was a person in the hospital, a social worker I believe who had responsibility for discharge, who arranged this.

I definitely think you need something in writing from the hospital, and notify the nursing home.

 

[twofor1]

I am now extremely worried as to what will happen at the end of the week when he is meant to be moved. Do I refuse to let him be transferred until the hospital gives us something in writing? Do I contact the nursing home and tell them we have no funding and they should refuse to take him until funding has been clarified?

Yes and Yes.

They cannot discharge your Dad from hospital without a care plan been in place to meet his needs. The hospital will have to keep him until interim funding is approved.

I would notify the nursing home that you are not in a position to pay for his care until Fair Deal approval, they then will not take him until an arrangement is in place regarding payment.

I would notify the hospital that you are not in a position to pay nursing home charges until you get Fair Deal approval, therefore he cannot be discharged from hospital until interim funding is approved.

 

[Meerkat]

I also had this experience with my father earlier this year.

Like gipimann we were told the hospital would cover the costs of the nursing home, between the date of admission to the nursing home, and the date the nursing home support scheme "fair deal' was available. In or case they did with no problem.

We had already started the fair deal application before this and the length of time involved was about 3 weeks.

There was a person in the hospital, a social worker I believe who had responsibility for discharge, who arranged this.

I definitely think you need something in writing from the hospital, and notify the nursing home.

Many thanks for your reply.

I'm glad to hear that it worked out for you and the costs were covered as promised. Did you get any confirmation other than verbally from the social worker? I feel vulnerable without something in writing and the social worker doesn't think they can get anything in writing for me. What option will I have if they refuse to give me anything in writing?