Singapore - Nursing home raises fees - will more follow suit?

SINGAPORE - More nursing homes are considering revising their fees in the coming weeks.

One already has, and the fee hike has taken its clients by surprise.

But the inevitable will soon happen at other homes, which may cause more families to default on their payments, say observers.

Last month, Channel NewsAsia reported that some eldercare facilities here were seeing more cases of people defaulting on their payments, with the patients' family members becoming uncontactable.

The report cited the case of Lee Ah Mooi Old Age Home, where about half of the 110 residents there had defaulted on their payments, ranging from about one to two months.

Of the six nursing homes The New Paper checked with, two said they were in the midst of reviewing their fees. The other four did not reply by press time.

For the two homes that responded, neither wanted to go on record to discuss the proposed fee hikes as the details were still being finalised.

Dr Lam Pin Min, who chairs the Government Parliamentary Committee (GPC) for Health, said: "With medical inflation, rising manpower cost and the overall higher cost of living, nursing homes are facing real cost pressures. Adjusting the fees is inevitable."

TNP learnt that starting from this month, Peacehaven Nursing Home will be increasing its fees by between $60 and $160 a month.

Letter

Mrs Adeline Lee, 49, whose father stays at the home on Upper Changi Road North, found out after receiving a letter from the nursing home in May.

She said she accepts that costs will go up, but would have to discuss with the home on how to make the new monthly payments.

Mrs Lee, who was recently unemployed, said she has been paying the same amount since her father, 88, who has dementia, moved into the home more than five years ago.

She said she pays between $610 and $820 every month for the maintenance cost and other services or non-standard medication that her father needs.

For the last five years, she said, the maintenance cost was about $1,700 a month.

For that, she pays about $300 monthly after deducting $800 in government subsidies and more than $500 in charity dollars.

Charity dollars - distributed by The Salvation Army, which runs the nursing home - help to further offset fees for those who need financial help.

But starting from this month, Mrs Lee, an only child, will have to pay about $950 a month in maintenance costs as not only has the nursing home revised its fees, it is also reviewing how it distributes its charity dollars.

Previously, the home gave out its charity dollars with no conditions attached, with the amount given varying from patient to patient, said Peacehaven Nursing Home's executive director, Madam Low Mui Lang.

But now, those who want to receive them will have to submit an application.

The review on the distribution of charity dollars is part of the home's annual exercise to "allocate limited charity dollars more effectively and efficiently, and to channel them towards genuinely needy residents", explained Madam Low.

Although worried about how she will meet the extra expenses, Mrs Lee said she isn't upset at the home for the fee hike.

She said: "It's a new problem, but it's my responsibility to solve it. It's nobody's fault. I understand that for every service, there's cost involved."

Mrs Lee is thankful for the help she receives from the home in taking care of her father.

Before her family made the difficult decision to put her dad in a nursing home, they had noticed a change in his character for some time before he was diagnosed with dementia around 2005.

During those years, her family struggled to care for her dad and were affected daily by his condition.

Her mother became afraid of her own husband, who behaved like a complete stranger, said Mrs Lee.

She explained: "(My mum) would run and hide when (my dad) was in the same room as her. When he was at home, we were constantly fighting and crying. We were always on edge."

Her mother who had always been healthy, developed high blood pressure as a result, while her two children, who were in their teens then, ended up staying away from home.

Her husband also did not know how to deal with the situation, she said.

So in 2007, Mrs Lee finally decided to move her father into a Peacehaven Nursing Home so that he could get round-the-clock professional care.

"It's (for) peace of mind," she said.

"For all that trauma and stress taken away from the family and knowing that there is a team of people who can take better care of him, price becomes secondary."

Mrs Lee added that after receiving news of the fee hike, she has appealed to the home for her monthly maintenance payment to not exceed $500 as she is currently unemployed and would have difficulties making the payment.

It is subject to approval and would be reinstated to $950 when she finds a job.

Madam Low from the nursing home told TNP that the home last revised its fees in 2005.

She said: "We adjust our charges only when necessary, and we have absorbed most of the cost increases for medication, daily necessities, equipment and utilities for some years now.

"We are mindful of the impact of fee increases on our residents and we constantly work towards moderating costs..."

Madam Low added that 90 per cent of the home's residents receive government subsidy and they will also benefit from the enhanced nursing home subsidy in the third quarter of the year.

In addition, there are financial assistance schemes such as Medifund and charity dollars to help those with payment difficulties, she said.

She urged families who are unable to pay to approach the home for help in applying for financial assistance.

Dr Lam, too, suggested that families look to avenues like Comcare programmes and charitable organisations for help.

Lediati Tan and Koh Hui Theng

This article was first published in The New Paper .