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Health Service Executive South - Nursing home Subvention

Year Concluded: 2007:

Complaint Details:

A 90 year old West Cork woman, whose only source of income was her Non-Contributory Old Age Pension, was refused a Nursing Home Subvention by the Health Service Executive (HSE), South.

The reason for refusing the subvention was that, in assessing the woman's notional weekly income, the HSE applied a 5% notional income to the value of her principal private residence and a farm which she had transferred to her son within the previous five years.

Using this formula the HSE arrived at a notional weekly income of €293.63 and this, coupled with the complainant's Non-Contributory Old Age Pension of €172.40 per week, brought her over the income limit for Nursing Home Subvention purposes.

In this regard, Article 13 of the Second Schedule of the Nursing Homes (Subvention) Regulations, 1993 provides that:

"A health board may impute an annual income equivalent to 5 per cent of the estimated market value of the principal residence of the person, if it was not occupied immediately prior to or at the time of the application by a spouse, a son or daughter aged less than twenty one years or in full time education ..."

In addition, Article 19 of the Second Schedule of the Nursing Homes (Subvention) Regulations, 1993 provides that if an applicant has transferred the ownership of a farm in the five years prior to the application, the HSE may take into account any payment on transfer and/or any continuing income from the earnings of the farm.

It was clear that the woman had transferred her farm to her son about three years previously. However, from my examination of the farm accounts, I noted the farm was showing a loss. Accordingly, I felt that, in this particular case, Article 19 of the Second Schedule of the regulations was relevant. This gave the HSE the discretion to take into account any income, and by extension, any loss, from the farm holding.

In relation to the woman's private residence, I accepted that the Nursing Home Regulations provide that the HSE may impute an annual income based on the estimated market value of the principal residence of the applicant. However, given that this is a discretionary decision, I felt that the HSE had some latitude with regard to each individual's circumstances. Therefore, I had to consider whether, in this particular case, the HSE was using its discretionary powers in a reasonable manner. Furthermore, I noted that, the complainant was on the HSE's waiting list for a public bed. However, when probed, the HSE was not able to say when she might be offered such a bed.

Accordingly, given that the HSE was not in a position to offer nursing home care to the woman, I asked it, in calculating her entitlement to Nursing Home Subvention, to consider dealing with the farm element in accordance with Article 19 of the Second Schedule of the Regulations and also to consider its discretionary powers under Article 13 of the Regulations in relation to the applicant's private residence.

The HSE immediately reviewed the case and, having considered my suggestions, it agreed to pay a subvention of €190.80 per week towards the cost of the complainant's private nursing home care. In addition, the HSE paid her approximately €5,000 which covered the period from when she first applied for the Nursing Home Subvention. Finally, the HSE agreed to include the complainant on its waiting list for the payment of an enhanced subvention.

I was happy with the HSE's quick response and I would like to acknowledge its common sense approach to an issue which can often cause unnecessary stress and anxiety to some of our more elderly and potentially vulnerable members of the public.

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