By: Claire Scott, Michael O’FarrellÂ
THE HSE has dropped its demand on nursing homes to admit Covidpositive or suspected Covid patients if they want pandemic support funding, the Irish Mail on Sunday has learned.
Tadhg Daly, chief executive of Nursing Homes Ireland, said after consultation with officials, the homes were able to have this clause, and a number of others concerning indemnity, removed from the contract.
However, he described the homes’ communication with the HSE as ‘less than satisfactory’.
The original contract required homes to agree to the following: ‘We the applicant nursing home confirm that we will be open and available for admission and readmission of patients to longterm residential services and shortterm transitional care service, in line with any guidance issued.’
The guidance refers to documents issued by the Health Protection Surveillance Centre (HPSC) and the Health Information Quality Authority (Hiqa) on the transfer and treatment of Covid-19 patients in residential care.
The HSE’s operational guidelines for hospital transfers – issued on March 10 – identified transfers as a risk to nursing homes.
It reads: ‘There is a concern that patient movement may result in the introduction of the disease from an acute hospital to a residential care facility.’
Nevertheless, the guidelines go on to confirm that hospital patients can be deemed eligible for transfer to care homes even if they are showing symptoms and have been identified as close contacts of others who were Covid-positive.
This is in accordance with separate guidelines updated by the HPSC on April 7. These guidelines advise that symptomatic transfers from hospitals to residential settings should be accommodated in single en-suite rooms and treated as if they were Covid-positive.
The HSE previously told the MOS that transfers from hospitals to homes was a routine practice.
However, a spokesman confirmed that emergency Covid-19 funding had allowed the transfer from hospital of ‘some 400 patients across the country who were awaiting the availability of a placement’.
He added that any Covid-positive hospital patient must test negative twice before a transfer to a nursing home or residential care setting can happen.
Mr Daly told the MOS: ‘The clause would have been in contravention of a registry requirement, which states you have to do a pre-admission assessment of every resident that comes into the home.
‘So to have a contract that would state that you would have to take in a patient without any oversight was – I’m sure when they went back and looked at it they saw how foolish it was.’ The contract was published and recalled twice before the final version was published last Tuesday.
Mr Daly added: ‘They announced the funding on April 4 and we welcomed it but between then and the 16th the engagement was not satisfactory from our point of view in terms of the roll-out of the scheme.
‘There has been a lot of to-ing and fro-ing to make sure they understood our concerns.
‘The other issue that still hasn’t been addressed is the non-nursing home support scheme residents, if you’re not part of the Fair Deal agreement you’re not included in the scheme. That would affect between 4,000 and 5,000 people.
‘All residents should be included in the temporary financial support scheme, not just Fair Deal residents. The Minister has given us a commitment to look at it, we’re engaged with the Minister on looking for a satisfactory resolution.’
The MoS previously revealed that the HSE’s decision to transfer patients from hospitals to nursing homes in order to free up beds to cope with the pandemic was linked to fatal outbreaks in care homes.
Hospital patients were deemed eligible for transfer to care homes even if they were showing symptoms and had been in close contact with others who were infected.
Mr Daly previously told the MoS that this was ‘a big contributing factor’ and that many of the cases nursing homes were seeing were hospital transferees.
Hiqa also confirmed to the MoS that it was aware of patient transfers to nursing homes who later tested positive for the virus. The watchdog also said it raised this issue with the HSE and escalated a number of other issues.
Hiqa further revealed it was aware of instances in which ‘asymptomatic residents transferred from a nursing home to a hospital were found to be positive when tested in hospital’.
One operator of a nursing home in Dublin – which suffered doubledigit Covid-19 fatalities after accepting hospital transfers – said they believed their fatal outbreak was sparked by transfers.
