Brian Stanley (Laois-Offaly, Sinn Fein)
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Question 39: To ask the Minister for Health the way in which the setting of fees by nursing homes under the nursing home support scheme is monitored; if his attention has been drawn to the fact that some nursing homes are setting additional service charges on top of the agreed fees and that, in some cases, these charges are for services supposed to be covered by the nursing home support scheme, including beds; if any sanction can be taken against such improper charging; and if he will make a statement on the matter. [16273/12]

Kathleen Lynch (Cork North Central, Labour)
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The Nursing Homes Support Scheme provides financial support towards the cost of long-term residential care. The cost for long-term residential care in private nursing homes is agreed between the each individual nursing home and the National Treatment Purchase Fund (NTPF). The services which fall within the scope of long-term residential care and which are covered by this cost are: nursing and personal care appropriate to the level of care needs of the person; basic aids and appliances necessary to assist a person with the activities of daily living; bed and board; and laundry service.

The cost for each public nursing home has been determined using the definition of long-term residential care services underpinned by an agreed set of cost components which has been laid before the Houses of the Oireachtas. The cost components are consistent with the services outlined above but differ in format in order to mirror existing cost coding structures within the HSE. Incontinence wear, where required, is provided free of charge by the HSE to all Nursing Homes Support Scheme residents that possess a Medical Card.

Under the scheme, all residents retain their eligibility for other schemes, such as the Medical Card Scheme or the Drugs Payment Scheme. Individuals can continue to receive goods and services in accordance with the terms of these other schemes regardless of whether they are in a private nursing home or elsewhere. In determining the services covered by the Nursing Homes Support Scheme, it was considered very important that the care recipient and the taxpayer would be protected and would not end up paying for the same services twice. For this reason, medications and aids that are already prescribed for individuals under an existing scheme are not included in the services covered by the scheme, as this would involve effectively paying twice for the same items or service.

Individuals who avail of the Nursing Homes Support Scheme should not be charged any additional fee over and above the cost agreed with the NTPF, except where he or she chooses to obtain additional services over and above long-term residential care services, for example, hairdressing, social programmes or the delivery of daily newspapers. Under the Health Act 2007, statutory responsibility is given to the Chief Inspector of Social Services, part of the Health Information and Quality Authority (HIQA), for the independent inspection and registration of certain categories of designated centres. This includes residential care settings for older people. This responsibility is underpinned by a comprehensive quality framework comprising the Health Act 2007, the Health Act 2007 (Care and Welfare of Residents in Designated Centres for Older People) Regulations 2009, as amended, and the National Quality Standards for Residential Care Settings for Older People in Ireland. Article 28 of the Regulations provides that the registered provider shall agree a contract with the resident within one month of admission and that the contract shall include details of the services to be provided and the fees to be charged. The Chief Inspector has the power to refuse to register, attach conditions to a registration or cancel the registration of a designated centre in the event of non-compliance with the regulations or the standards.