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Nursing homes report disorganised discharge processes are contributing to hospital delays

Wednesday January 8, 2020

2,000 nursing home beds available nationwide to facilitate hospital discharges

8th January 2020: An estimated 2,000 beds are available in private and voluntary nursing homes across the country to facilitate timely discharge of patients from acute hospitals to nursing home care, NHI today revealed. However, NHI states feedback from Members is the discharge process within hospitals is disorganised, inconsistent and supports are not available to enable staff facilitate the timely discharge of patients to nursing home care, where required.

NHI undertook a snapshot survey Tuesday 7th January asking private and voluntary nursing homes the number of available beds within their homes to facilitate transfer of patients from hospital. 136 nursing homes informed the survey of 861 beds being available. 445 private and voluntary nursing homes are operating in communities across the country, positioned to provide specialised step-down and long-term care. 80% of the nursing homes replying to the survey had at least one bed available.

HSE figures inform circa 60% of the hundreds of patients clinically fit for discharge in our acute hospitals are awaiting long-term nursing home care. Recent figures state at the end of November, almost 700 patients within our hospitals were delayed discharges.

Tadhg Daly, NHI CEO states: “Engagement with nursing homes the past number of days has informed of huge level of frustration with regard to the discharge process within our acute hospitals. We have nursing homes informing us they are aware of patients requiring discharge to nursing home care but many of these patients are being deterred due to delays in accessing funding support or bureaucracy within the hospital. We’ve hundreds of beds available to provide specialised care for people in our hospitals who need step-down care but these are not being utilised. Our Members are reporting extreme frustration that patients assessed as requiring nursing home care are experiencing unnecessary delays and are remaining within hospital for periods of days in many instances.

“Late Saturday, NHI fielded an urgent request from the HSE at local level seeking information regarding nursing home beds immediately available to facilitate discharges from two severely overcrowded hospitals. Over 20 beds from ten nursing homes surrounding the hospitals were identified within a matter of hours but only one bed has since been utilised. These hospitals remain severely overcrowded.

“While discharges occur every day to nursing homes, the urgency and focus required during this national emergency is not evident.

“Nursing home care has a lead role to fulfil in alleviating overcrowding within our acute hospitals and engagement has been undertaken with the HSE at national level. But it is damning upon the Government that no engagement is undertaken with the nursing home sector prior to the Winter period with view to planning timely discharge of the hundreds of patients requiring nursing home care that are within our hospitals on a daily basis. Year-on-year it fails to comprehensively plan for the Winter period and the outcome is distress for hospital patients, their families and hospital staff.”

Tadhg Daly, NHI CEO, is available for further interview. For further information contact Michael McGlynn, NHI Communications and Research Executive at 01 4699806 or 087 9082970.

Appendix 1

As part of the snapshot survey, NHI provided opportunity for nursing homes to inform of issues arising that are hampering timely discharge of patients from hospital to nursing home care.

  • We are currently waiting on three long term residents finances to be approved – two from Cavan Hospital and one from Monaghan for step down
  • Paperwork is delaying the discharge of residents awaiting transfer from our local overcrowded acute hospital
  • We’re still seeing big delays in the allocation of transitional care funding for patients assessed as requiring nursing home care
  • Awaiting funding for 2 beds for residents in hospital already assessed as requiring nursing home care
  • We’re seeing delay in Fair Deal funding approval
  • Wrote to the Minister [for Health] some time back to offer beds during a different beds crisis and the correspondence was sent back to our local hospital for response. We were eventually told that beds are allocated as per patient/family requests and in our case, the patient/families had probably not requested our home. I received a call just before this Christmas from a very distressed family member stating the family had requested our home but had been told that the patient ‘had’ to go to HSE home elsewhere. The family member told me that their loved one begged them to send her to our home because family wouldn’t be able to get to the person but again she was told it “had” to be done. I received a further call back on Christmas Eve to tell me that the person was being transferred by taxi and the family were extremely distressed over this.
  • Delays occurring in approving Fair Deal funding
  • Delays are occurring in getting approval for Transitional Care Funding for hospital patients
  • We’re received no admission from UHL since 12th December. We inform the hospital on a regular basis regarding bed availability. There is overcrowding in UHL but the elderly people are not being transferred to nursing homes for respite or long-term care.
  • Pre-admission assessments need to take place in a more timely manner to assess suitability for discharge to nursing home care
  • Hospitals are keeping in residents waiting Fair Deal approval. We have two beds assigned for residents that are medically fit for discharge but who are awaiting Fair Deal approval while remaining within the hospital.
  • We’re over 40 patients awaiting a bed in our local hospital yet we have received no contact from the HSE regarding admissions.
  • There are delays in transitional care funding for people in hospital requiring nursing home care
  • [Local] Hospital is informing potential residents and families of available beds in our nursing home. However, families not accepting as beds not in the right location for families to visit. Therefore, beds remain blocked in the acute sector.