Nursing Homes (Subvention) Regulations, 1993.
Statutory Instruments
Source: Statutory Instruments

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paragraphs: These Regulations may be cited as the Nursing Homes (Subvention) Regulations, 1993.
2 Commencement.
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paragraphs: These Regulations shall come into operation on the first day of September 1993.
3 Interpretation.
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paragraphs: In these Regulations:—
"the Act" means the Health (Nursing Homes) Act, 1990 (No. 23 of 1990),
"circumstances" for the purpose of these Regulations is the capacity of a son and/or daughter, aged twenty one years and over residing in the jurisdiction, of a person who has qualified for a subvention to contribute towards the cost of nursing home care of his or her parent,
"contract of care", means the contract of care within the meaning of articles 7.1 to 7.3 of the Nursing Homes (Care and Welfare) Regulations, 1993,
"dependency" refers to the level of physical or mental dependency of a person applying for a subvention, in accordance with the meaning given to "dependent person" in Section 1 (1) of the Act,
"designated officer" means an officer of a health board authorised by the chief executive officer of a health board or of a person acting as deputy chief executive officer of a health board in accordance with Section 13 of the Health Act, 1970 to carry out functions under the Act and these Regulations,
"health board" in relation to a nursing home, means a health board within the meaning of the Health Act, 1970 (No. 1 of 1970),
"means" for the purposes of these Regulations are the income and the imputed value of assets of a person in respect of whom a subvention is being sought and the income and imputed income of his or her spouse,
"the Minister" means the Minister for Health,
"person in charge" means the person in charge of the care and welfare of patients in a nursing home,
"nursing home" means a nursing home registered in accordance with Section 4 of the Act,
"responsible health board" means the health board in whose functional area the person, in respect of whom a subvention is being sought, ordinarily resides,
"registered proprietor" has the meaning given to it in Section 1 (1) of the Act,
"subvention" means a payment payable by a health board under Section 7 of the Act and these Regulations.
4 Application for Subvention.
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paragraphs: 1 With the exception of persons referred to in articles 4.2, 4.3 and 4.4, an application for a subvention shall be made to the responsible health board by or on behalf of a person prior to his or her admission to a registered nursing home.
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paragraphs: 2 A person who is resident in a registered nursing home on the date of commencement of these Regulations or a person acting on his or her behalf may make an application for a subvention to the responsible health board.
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paragraphs: 3 A person who commences residence in a registered nursing home after the date of commencement of these Regulations, and who has not made an application for a subvention prior to his or her admission to the registered nursing home as specified in article 4.1, may not apply for a subvention sooner than two years from the date of his or her admission, unless the chief executive officer of the health board determines otherwise.
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paragraphs: 4 A person who is admitted to a nursing home in emergency circumstances or a person acting on his or her behalf, may apply to the responsible health board for a subvention provided that the health board is satisfied that the person needed to be admitted as a matter of emergency and that the registered proprietor or person in charge had no option but to admit the person at that time.
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paragraphs: 5 On receipt of an application for a subvention in respect of any person, the responsible health board shall make arrangements for the carrying out of an assessment of the dependency and the means and circumstances of the person to whom the application refers, as provided for under these Regulations.
5 Onus on applicant to furnish information.
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paragraphs: 1 An applicant for a subvention shall furnish on request to the responsible health board all relevant information as regards the means and dependency of the person in respect of whom a subvention is being sought to enable the health board to make a determination as regards his or her qualification for a subvention.
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paragraphs: 2 A health board may refuse to consider an application for a subvention unless the relevant information has been supplied by the applicant to enable the health board make a determination as regards qualification for a subvention.
6 Qualification for payment of subvention.
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paragraphs: 1 A person in respect of whom a subvention is being sought shall not qualify for a subvention unless the responsible health board is of the opinion that the person to whom the application refers is:—
(i) sufficiently dependent to require maintenance in a nursing home, and
(ii) unable to pay any or part of the cost of maintenance in a nursing home.
7 Assessment of Dependency.
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paragraphs: 1 The responsible health board in assessing the level of dependency of a person who has applied for a subvention or on whose behalf an application has been made, shall follow the procedures as set out in the First Schedule to these Regulations to determine whether a person is sufficiently dependent to require maintenance in a nursing home and if so, to which of the three levels of dependency set out in the First Schedule the person's level of dependency corresponds.
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paragraphs: 2 For the purpose of establishing the dependency of a person in respect of whom a subvention is being sought, a designated officer of a health board may request information, conduct interviews and carry out an examination of the person.
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paragraphs: 3 Nothing in article 7.2 authorises any person other than a designated officer who is a medical practitioner to inspect any medical record relating to a person in respect of whom a subvention is being sought.
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paragraphs: 4 Nothing in article 7.2 authorises any person other than a designated officer who is a registered medical practitioner, a registered nurse, an occupational therapist or a chartered physiotherapist to carry out an examination of a person in respect of whom a subvention is being sought.
8 Assessment of Means.
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paragraphs: 1 A health board, in assessing the means of the person in respect of whom a subvention is being sought, shall do so on the basis of the calculation of means in the Second Schedule to these Regulations.
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paragraphs: 2 A health board in assessing the means of an applicant for a subvention under these Regulations shall disregard income equivalent to one fifth of the weekly rate of the Old Age Non-Contributory Pension payable at the time, such sum to be retained by the person for his or her own personal use.
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paragraphs: 3 For the purpose of establishing the means of a person in respect of whom a subvention is being sought, a designated officer of a health board may request information and conduct interviews with the person and his or her spouse and child or children, if any.
9 Assessment of Circumstances.
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paragraphs: 1 Having decided that a person qualifies for a subvention, a health board may take into account the circumstances of the person qualifying for the subvention in accordance with the provisions of the Third Schedule to these Regulations.
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paragraphs: 2 For the purposes of establishing the circumstances of a person who has qualified for a subvention, a designated officer of a health board may request information and conduct interviews with the person or his or her spouse and a son and/or daughter aged twenty one years and over.
10 Rate and Amount of Subvention.
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paragraphs: 1 The maximum rates of subvention payable in respect of each of the three levels of dependency of persons assessed as requiring maintenance in a nursing home shall be as set out in the Fourth Schedule to these Regulations.
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paragraphs: 2 A health board, in calculating the rate of subvention to be applied in respect of a person whom it has determined as qualifying for a subvention shall base its decision on the level of dependency of that person as assessed in accordance with the First Schedule to these Regulations.
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paragraphs: 3 A person whose sole means as assessed by the health board is a sum equivalent to or lower than the weekly rate payable at the time of the Old Age Non-Contributory Pension shall qualify for the maximum amount of subvention per week set out in the Fourth Schedule to these Regulations which is appropriate to the level of dependency of the person as assessed by the health board in accordance with the First Schedule to these Regulations.
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paragraphs: 4 A health board, in calculating the amount of the subvention to be paid to a person who is not resident in a nursing home, may abate the maximum rate appropriate to that person's level of dependency by no more than the amount by which the person's means and circumstances have been assessed by the board as exceeding the rate of the Old Age Non-Contributory Pension payable at the time.
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paragraphs: 5 A health board, in calculating the amount of subvention to be paid to a person who was resident in a nursing home on the day the Act is commenced or who applied for a subvention in accordance with article 4.3, may abate the maximum rate appropriate to that person's level of dependency by an amount in addition to the amount which that person's means and circumstances have been assessed by the board as exceeding the rate of the Old Age Non-Contributory Pension, by reference to the actual payments payable by or on behalf of the person to the nursing home on the day the Act is commenced, in the case of persons resident in a home on that date, or at the time the application for the subvention is made in the case of persons applying for a subvention under article 4.3.
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paragraphs: 6 If the means and circumstances of an applicant are assessed by a health board as less than the weekly rate of the Old Age Non-Contributory Pension payable at that time, the health board may pay an amount in addition to the maximum rate of subvention appropriate to his or her level of dependency not exceeding the weekly rate of the Old Age Non-Contributory Pension payable at the time.
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paragraphs: 7 If a health board makes a payment to a person in accordance with article 10.6 a sum equivalent to one fifth of the weekly rate payable at the time of the Old Age Non-Contributory Pension shall be allowed for his or her personal use.
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paragraphs: 8 The Minister may adjust the rate of subvention from time to time following the commencement of the Act taking into account the general movement in prices or other relevant factors and may vary the maximum payable rate in respect of any level of dependency.
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paragraphs: 9 The Minister may vary from time to time the rules for the assessment of means in the Second Schedule to these Regulations taking into account the general movement in prices or other relevant factors.
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paragraphs: 10 The amount of the subvention to be paid by a health board in respect of a person shall be calculated per diem.
11 Decision on payment of subvention.
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paragraphs: 1 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.
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paragraphs: 2 When a health board has determined that a person does not qualify for a subvention or does not qualify for the maximum rate appropriate to that person's level of dependency under these Regulations, it shall inform the applicant of the grounds for its decision.
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paragraphs: 3 When a health board has determined that a person does not qualify for a subvention, or qualifies for less than the maximum rate of subvention on the grounds of means and circumstances or under the provisions of article 10.5, it shall inform the applicant of his or her right to appeal the decision under article 19.1 of these Regulations.
12 Choice of Nursing Home.
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paragraphs: 1 When a health board has determined that a person qualifies for a subvention under these Regulations and has not made the person an offer of accommodation under article 17.1, it shall pay the subvention to the nursing home of the person's choice or where the person is unable to exercise choice, the nursing home which is the choice of the person acting on his or her behalf.
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paragraphs: 2 A health board shall not pay a subvention towards the cost of maintaining a person in a nursing home without the prior agreement of the registered proprietor or person in charge to the admission of the person in respect of whom a subvention is to be paid.
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paragraphs: 3 When a person or a person acting on his or her behalf requests the health board paying a subvention in respect of that person in a nursing home to transfer the subvention to another nursing home and the registered proprietor or person in charge of the other nursing home has agreed to admit the person, the health board shall transfer the subvention in respect of that person to the other nursing home.
13 Payment of Subvention by Health Boards.
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paragraphs: 1 When a health board has determined that a person qualifies for the payment of a subvention and has not offered the person alternative accommodation under article 17.1 of these Regulations, the health board shall pay a subvention towards the cost of maintaining that person in a nursing home from the date the person qualifies for a subvention or if the person was resident in the nursing home on the day the Act was commenced, from the date the person applied for a subvention, until the person is discharged from the nursing home or dies, or until the health board withdraws the subvention following a review of the dependency and means and circumstances of the person as provided for under articles 14.1 and 14.2 of these Regulations.
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paragraphs: 2 When a health board has determined that a person qualifies for a subvention under these Regulations, the health board shall pay the subvention on that person's behalf to the registered proprietor of the nursing home to which the person who has qualified for the subvention has been admitted.
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paragraphs: 3 A health board may pay a subvention in respect of a person whom it has determined as qualifying for a subvention under these Regulations in a nursing home in its own functional area, or in the functional area of another health board.
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paragraphs: 4 A health board may pay a subvention in respect of a person whom it has determined as qualifying for a subvention in a nursing home in Northern Ireland which is a nursing home registered by a health and social services board.
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paragraphs: 5 A person who qualifies for a subvention under these Regulations and who was benefiting from a payment under Section 54 of the Health Act, 1970 at the time of application shall no longer benefit from such payments from the date the subvention is paid.
14 Review.
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paragraphs: 1 A health board which is paying a subvention in respect of a person may, with the exception of persons referred to in article 14.3 or 14.4, review the dependency and/or means and/or circumstances of that person no sooner than six months from the date on which a subvention was first paid and at six monthly intervals thereafter.
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paragraphs: 2 A health board shall review the dependency and/or means and/or circumstances of a person after six months from the date on which a subvention was paid or no sooner than six months after the last review if requested to do so by the person in receipt of the subvention, a person acting on his or her behalf or person in charge of the home.
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paragraphs: 3 A review of the dependency and/or means and/or circumstances of a person in respect of whom a health board is paying a subvention may be carried out sooner than six months from the date on which a subvention was first paid if the health board has informed the person and the nursing home proprietor before the first payment of the subvention that, in the opinion of the board, the person is in need of convalescent respite care.
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paragraphs: 4 If a health board is of the opinion that a major change has occurred in the dependency, and/or means and/or circumstances of a person in respect of whom it is paying a subvention, it may, having informed the person concerned and the registered proprietor of the nursing home, initiate a review sooner than six months from the date on which a subvention was first paid or six monthly intervals thereafter.
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paragraphs: 5 In carrying out a review in accordance with article 14.1 a health board shall assess the dependency of the person as provided for under articles 7.1 to 7.4 of these Regulations and the means as provided for under articles 8.1 to 8.3 of these Regulations and the circumstances of the person as provided for under articles 9.1 to 9.2 of these Regulations.
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paragraphs: 6 If, following a review after a six month period referred to in article 14.1, a health board determines that the dependency status and/or means and circumstances of the person have changed, the health board may increase or decrease the amount of subvention in accordance with the provisions of these Regulations, may withdraw the subvention or may make the person an offer of accommodation in a health board institution providing nursing care in its functional area in accordance with articles 17.1 and 17.2 or may make arrangements for the care of the person in his or her home.
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paragraphs: 7 A health board having decided to carry out a review as provided for in article 14.1, shall continue to pay a subvention at the same rate to the person whose dependency and/or means and/or circumstances are being reviewed, while the review is taking place.
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paragraphs: 8 If a health board does not carry out a review, as provided for in article 14.1, a subvention shall continue to be paid at the same rate on behalf of the person concerned.
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paragraphs: 9 When a health board, having carried out a review in accordance with article 14.5, determines that a person no longer qualifies for a subvention, qualifies for a lower rate of subvention or qualifies for a higher rate of subvention, it shall inform the person, or a person acting on his or her behalf, in writing of its decision and of the grounds for its decision.
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paragraphs: 10 A person who qualifies for a subvention from a health board or a person acting on his or her behalf shall inform the health board if there is any change in the means and/or circumstances of the person.
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paragraphs: 11 When a health board, having carried out a review in accordance with article 14.5 determines that a person on the basis of his or her means and/or circumstances no longer qualifies for a subvention or qualifies for a lower rate of subvention, the health board shall inform the person or a person acting on his or her behalf of his or her right to appeal the decision under article 19.1 of these Regulations.
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paragraphs: 12 A health board, having informed a person or a person acting on his or her behalf, of its decision to discontinue a subvention, to pay a lower rate of subvention or to pay a higher rate of subvention shall continue to pay the rate of subvention paid at the time the review under article 14.3 was carried out for twenty eight days from the date on which the person in receipt of the subvention was informed of the decision and shall so inform the person or the person acting on his or her behalf.
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paragraphs: 13 If a person appeals a decision of a health board to discontinue a subvention or to pay a lower rate of subvention under article 19.1 of these Regulations and succeeds in that appeal, the health board shall pay the person in respect of whom an appeal is made an amount equivalent to the total amount of subvention which that person would have been entitled to had the health board not decided to discontinue the payment of subvention or to pay a lower rate of subvention.
15 Death or discharge of a subvented person.
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paragraphs: 1 The registered proprietor or the person in charge, in notifying a death to the Medical Officer of Health as required under article 22 of the Nursing Homes (Care and Welfare) Regulations, shall inform him or her if the deceased was in receipt of a subvention from a health board.
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paragraphs: 2 When a registered proprietor or person in charge of a nursing home proposes to discharge a person in receipt of a subvention from a nursing home, the registered proprietor or the person in charge shall notify the health board paying the subvention of the date of the proposed discharge and the reasons for the discharge at least fourteen days before the proposed date of discharge.
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paragraphs: 3 When a person in receipt of a subvention leaves a nursing home for a reason other than referred to in articles 15.1 and 15.2, the registered proprietor or the person in charge shall notify the health board paying the subvention as soon as possible of the person's departure.
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paragraphs: 4 A health board may recoup from a nursing home proprietor the amount of any subvention paid in respect of any person from the date of the death or discharge of the person if the death or discharge is not notified to the health board in accordance with articles 15.1, 15.2 or 15.3.
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paragraphs: 5 A health board may continue to pay a subvention towards the cost of a person in a nursing home during a temporary absence of that person from the nursing home provided the health board has been informed of the date or dates of the temporary absence, the reasons for the temporary absence and approves of the absence.
16 Services covered by Subvention.
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paragraphs: 1 A registered proprietor or person in charge shall not seek any payment in addition to the amount of the subvention determined by a health board and the contribution of the person in receipt of a subvention payable under article 13.1 of these Regulations for any service which is considered to be essential to the maintenance of a person in a nursing home and common practice in nursing homes.
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paragraphs: 2 For the purposes of articles 16.1 and 16.3, a service which is considered to be essential to the maintenance of a person in a nursing home and common practice in most nursing homes shall include bed and board, nursing care appropriate to the level of dependency of the person, incontinence wear and bedding, laundry service and aids and appliances necessary to assist a dependent person with the activities of daily living.
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paragraphs: 3 A registered proprietor or person in charge shall not discriminate against a person in the nursing home in receipt of a subvention from a health board in favour of a person in the nursing home not in receipt of such a subvention as regards the provision of any service which is referred to in article 16.2.
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paragraphs: 4 A special service or item of equipment required by a person in receipt of a subvention in a nursing home shall be the subject of a separate arrangement between the health board and the registered proprietor or person in charge which shall be detailed in the contract of care.
17 Provision of alternative care by a Health Board.
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paragraphs: 1 A health board having determined that a person who was resident in a nursing home on the day the Act was commenced qualifies for a subvention, may, instead of paying the subvention, offer that person accommodation in a health board institution providing nursing care within the board's functional area.
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paragraphs: 2 A health board which proposes to make an offer under article 17.1 shall have regard to the general welfare and religious affiliation of the person qualifying for a subvention and the general welfare of his or her spouse and child or children, if any.
18 Misleading Information.
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paragraphs: A health board may refuse to pay a subvention, may cease payment of a subvention or may reduce the rate of subvention if the health board is or becomes of the opinion that false or misleading information has been given in respect of any application for a subvention or on review of a subvention as regards the dependency and/or the means and/or circumstances of the person to whom the application refers.
19 Appeals.
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paragraphs: 1 A person applying for a subvention, or a person acting on his or her behalf, may appeal to an appeals officer designated by the Minister against a decision of a health board, on the grounds of his or her means and circumstances or in accordance with the provisions of article 10.5, not to pay a subvention, to pay a lower amount of subvention than the maximum rate, to withdraw a subvention or to reduce a subvention, within twenty eight days of the date on which the health board notified the person of its decision and the grounds for its decision.
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paragraphs: 2 The designated appeals officer shall consider an appeal under article 19.1 and shall inform the person making the appeal of his or her decision within twenty-eight days of the receipt of the appeal.
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paragraphs: 3 For the purpose of deciding the appeal, the designated appeals officer may request information from the health board and from the person to whom the appeal refers or a person acting on his or her behalf.
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paragraphs: 4 A decision of an appeals officer shall be final and conclusive.
20 Limits on Expenditure.
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paragraphs: If, under Section 31 of the Health Act, 1970 (No. 1 of 1970 ), the Minister specifies a limit on the expenditure to be incurred in providing services under the Act, a board may, in respect of persons qualifying for a subvention after the date on which the limitation on expenditure is specified, pay such amounts as would enable the board to contain its expenditure within the specified limit.
21 Recoupment of Subvention.
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paragraphs: 1 A health board may recoup an amount as specified in article 21.3 from a person in respect of whom it has paid a subvention if it becomes of the opinion that the person did not disclose in full his or her means and circumstances at the time of application for subvention or review.
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paragraphs: 2 A health board may recoup an amount specified in article 21.3 from the estate of a person in respect of whom it has paid a subvention after his or her death if it becomes of the opinion that the person did not disclose fully his or her means and circumstances at the time the application for subvention was made.
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paragraphs: 3 A health board may recoup from a person or the estate of a person the difference between the amount of subvention paid in respect of the person and the amount of subvention he or she would have been entitled to if the person's means and circumstances had been fully disclosed at the time of application or review.
22 Arrangements on Commencement of Act.
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paragraphs: 1 If a health board, before the day of commencement of the Act has entered into an arrangement with a home which was a home notified to a health board under the Health (Homes for Incapacitated Persons) Act, 1964 (No. 8 of 1964), to provide in-patient services under Section 52 of the Health Act, 1970 (No. 1 of 1970 ) such an arrangement shall be considered to be in accordance with the provisions of these Regulations for so long as the home is registered under the Act and provided that with the exception of articles 10.1,10.3 and 12.1 the provisions of these Regulations are observed.
23 Enforcement.
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paragraphs: These Regulations shall be enforced and executed in the functional area of each health board by the chief executive officer of the health board concerned or by a person acting as deputy chief executive officer of that board in accordance with Section 13 of the Health Act, 1970 .