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Annual Report of the Ombudsman 2004

Chapter 3 - North Eastern Health Board - Entitlement to Nursing Home Subvention Refused

North Eastern Health Board

Entitlement to Nursing Home Subvention Refused

I was approached by the son of an elderly woman who had been refused nursing home subvention by the North Eastern Health Board on the grounds that it had insufficient funding to pay the subvention. The elderly woman, along with several other elderly applicants, had been placed on the Board’s waiting list, pending availability of additional resources. I contacted the Board emphasising that the non-payment of nursing home subvention, which is a statutory entitlement, was causing severe financial hardship to this woman and her family, as it meant that they had to bear full nursing home costs themselves. Following my intervention, the Board pressed for and received additional funding from the Department of Health and Children, but this additional funding (€52,000) only allowed the elderly woman and the other applicants on the waiting list to receive nursing home subvention from a current date, with no prospect of arrears to which I considered they had an entitlement

The Nursing Home Regulations provide that a “Health Board shall inform the applicant in writing within eight weeks of the receipt of the application, or, if all the information sought has not been provided with the application, within eight weeks of the receipt of the information requested, of its decision whether or not to pay a subvention to the person to whom the application refers and the amount of any subvention to be paid.”

Some health boards interpreted this provision as permission to withhold nursing home subvention for an eight week period following receipt of an application. However, I interpret the legislation to mean that health boards are allowed an eight week timeframe to determine an application, and once the assessment has been completed, nursing home subvention is payable from the date of application (or from the date the person is admitted to the nursing home, whichever is the later).

In this particular case, I asked the Board to review the application with a view to paying arrears to the date the elderly woman applied for nursing home subvention. The outcome was that the Board did agree to pay arrears not only to my complainant, but to the other eighteen applicants from the Cavan/Monaghan area whose subvention arrears had also been withheld. The cost of the arrears amounted to €34,000.

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