Care Home Claims
Our Reclaims Service helps families to reclaim care home fees and nursing home fees which have been paid incorrectly because an individual in care was wrongly assessed for their eligibility for NHS Continuing Healthcare Funding, or not assessed at all.
In many cases, we act for the families of relatives who have passed away in care and often they have used their life savings, or had to sell their homes to pay for care unnecessarily and unfairly.
The process for claiming back care home fees incorrectly paid, follows a similar process to the Full Assessment, however the assessment is done on a retrospective basis, using evidence from GP, hospital and care records and any previous Full Assessments that may have been carried out. We use our specialist team of Nurses to undertake a clinical retrospective analysis of the individuals care needs over their period of care and our specialist solicitors present the arguments for entitlement to Continuing Healthcare Funding to the Clinical Commissioning Groups (CCG’s), who will assess the retrospective eligibility arguments through a Panel Meeting.
An overview of our Reclaims Service for care home claims is outlined below.
Our 360 degree Decision Support Tool Assessment is based on the following care criteria
In many circumstances CCG’s agree refunds for part periods of care only and our legal team then decide whether to appeal for refunds against those periods in dispute. There are also issues of interest payments due on the care costs paid and again our legal team are highly skilled at working out the often complex interest calculations, to make sure that the maximum entitlement is refunded.
It should be noted that the Government has now imposed deadlines beyond which refunds of incorrectly paid care costs cannot be reclaimed. Any retrospective care home claims can now only be made for care costs paid after 31st March 2012. Care costs paid before that date cannot be reclaimed.
However, if you have already made a claim before 31st March 2012, which has been unsuccessful in terms of its assessment, you can still challenge that assessment, for payments made for care dating back to 2004.
In Wales a similar deadline was imposed limiting claims to any period after 31st July 2013. However, in Wales the rules also state that the claim period to be considered will be no longer than 12 months from the date of the first application.
These deadlines were supposed to be well publicised but few people were aware of it. It may be subject to legal challenge as it is another obvious and cynical move by the Government to protect their budget without regard to the unfair practices the NHS often undertook in failing to properly assess individuals’ entitlement to NHS Continuing Healthcare Funding.
It seems entirely wrong to us, that individuals can have spent their life savings and sold their houses to pay for care which should have been available for FREE and now can’t reclaim those care home or nursing home fees just because the Government has imposed an arbitrary cut off for claims being registered. Farley Dwek is again working tirelessly to bring this injustice into the national spot light, but more needs to be done.
Please don’t miss out.
People often miss out on Funding in many circumstances, including:
- Being discharged from hospital straight into a care home.
- Those whose eligibility has been assessed and rejected, whose condition subsequently worsened.
- Those who received NHS Nursing Care – which pays for the nursing, but not accommodation – who never had an assessment for the benefit that would also have paid for their accommodation.
- More affluent patients who assumed no help would be available. NHS Continuing Healthcare Funding is NOT means-tested so if you qualify for health reasons, you get it.
To find out whether you might be entitled to claim back your care home fees, speak to one of our friendly solicitors about a FREE INITIAL ASSESSMENT.
If we think you might be able to reclaim your nursing or care home fees, we will act for you on a NO WIN NO FEE * basis, so it won’t cost you a penny if we can’t recover your care costs.
Farley Dwek helped Brian Marshall to recover more than £40,000 after his father was wrongly charged for care home fees.
Brian, 62, from Surrey, says: “I don’t like to take money out of the health service but I feel strongly that my dad, who has now passed away, was hard done by and didn’t get his entitlement.
“My dad left school at 15, joined the Army at 16 and worked hard, paying his taxes, all his life. Then he got dementia.
* – Subject to terms and conditions
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