knowledge 7 April 2020 |

COVID-19: Specific Financial Measures in Respect of Nursing Homes

Background

Following pressure from Nursing Homes Ireland, the national representative body for the private and voluntary nursing home sector, Minister for Health, Simon Harris, announced a suite of financial measures on 3 April 2020 to assist in tackling the COVID-19 crisis within nursing homes. These measures come as a result of the 99 identified clusters in nursing homes, causing a significant strain on the nursing home staff and the health service.  A cluster has been defined as three cases or more within an institution over a 72-hour period.

It is estimated that the nursing home financial support scheme will cost up to €72 million in the event that every nursing home in the State receives this support at the maximum level.  It is envisaged that the scheme will operate for a 3 month period.  It will be reviewed after the first month’s operation.

There are two parts of the scheme as follows:

1. Assistance for nursing homes in implementing COVID-19 measures

Funding will be provided to each applicant nursing home for COVID-19 related measures and expected costs for the month ahead, the first of which will be the month of April. These measures include the implementation of enhanced testing processes in nursing homes and changes to staffing and governance arrangements. Financial support will be provided based on the number of Nursing Home Support Scheme residents in situ as reported for the month of March by the HSE Nursing Homes Support Office.

The nursing home will receive:

• €800 per resident per month for the first 40 residents,

• €400 per resident per month for the next 40 residents, and

• €200 per resident per month thereafter.

2. Enhanced outbreak assistance

Where a nursing home has incurred significant further costs or undertaken necessary enhanced actions arising directly from a COVID-19 outbreak in the nursing home, it may submit a separate business case for enhanced funding. The outbreak must be certified as such by the HSE. In such cases, the nursing home in question will be required to submit evidence of the measures undertaken and the costs incurred, along with independent certification from an auditor that the expenditure was incurred and it relates directly to COVID-19.

The maximum assistance available to an individual nursing home per month will be the lesser of:

• twice that of the agreed monthly support (see 1 above), or

• a maximum amount of €75,000 inclusive of the monthly support.

Further information

Although these measures have been welcomed as a positive step, industry feedback has demonstrated potential inequities in the nature of the reliefs on offer, including as follows:

• whereas the reliefs are effective for the period after 1 April, certain nursing homes were dealing with the impact of COVID-19 long before this date and incurring significant unforeseen outgoings in this respect for which it would appear they will not receive any support;

• the ratcheted and capped support structure means that the measures are proportionately speaking less effective for larger homes where the impact of COVID-19 can be most acute; and

• the measures take no account of the underlying (non-COVID-19) acuity profile in a particular nursing home, notwithstanding the very material variations which can exist.

Clearly operators of private nursing homes will need to study the conditions attaching to the scheme quite carefully and be aware of its limitations. It remains to be seen whether, perhaps on the basis of appeals made to the HSE/NTPF from particular nursing homes which are particularly impacted by COVID-19 and who may not see themselves as being adequately compensated by this scheme, further supports can be obtained on an ad hoc basis.

If you require any further information on this briefing, please contact any of the individuals listed below.