SINGAPORE: After telling a nursing home staff he was moving to Johor and would be uncontactable thereafter, the man left his father at the home in north-eastern Singapore. Three months on, six months’ worth of bills are left unpaid.
Despite a relatively healthy economy and the rising demand for beds, some nursing homes have seen their levels of bad debt creep up with more families defaulting on payment of their elderly relatives’ fees.
Of eight operators contacted by TODAY, three said they had seen bad debt cases rise in the past year – one by over 50 per cent.
A fourth has observed bad debt cases rising from about 3 per cent five years ago to about 15 per cent now. The remaining three operators have no bad debt cases, or have experienced no change in numbers.
The issue of nursing homes dealing with errant relatives came under the spotlight last week when it was reported that 85-year-old Singaporean Lee Sai Cheng had been left in a Malaysian nursing home by her son, who owed RM6,000 (S$2,400) in arrears.
Mdm Lee’s fees were paid for by a Singaporean Good Samaritan called Mr Ang, who sent a friend to the home last week and handed the cash to Comfort Ville Home, its owner Goh Liang Hui told this newspaper yesterday over the phone.
She was moved back to Singapore on Wednesday, escorted by her daughter and two grandchildren, as well as officials from Singapore’s Foreign Affairs and Community Development, Youth and Sports ministries, he said.
Nursing homes here say the loss of employment, feuding or dysfunctional families and – for families of newly-admitted patients – the struggle with a fresh financial burden are common reasons for payment defaults.
As the population ages, some families may also “underestimate the length of stay” at the homes, said Mr Dennis Tan, Chief Executive Officer of 350-bed Ling Kwang Home for Senior Citizens. “They may have checked their parents in while they were still working and face difficulty paying the bill after they retire.”
The voluntary welfare organisation (VWO)-run Ling Kwang Home has seen its bad debt cases – which it defines as fees unpaid for more than six months – more than double from 2010 to last year, with the dollar amount increasing by 90 per cent.
Bad debt cases have risen by “10 to 20 per cent” for Ju Eng Home for Senior Citizens, said its volunteer chairman Lawrence Ang.
The 334-bed home had about S$50,000 of accumulated bad debts last year and Mr Ang said it relies on Government subsidies and donations in cash and in-kind from religious groups, schools and corporations to make up for the loss. “The main reason is because the home targets the very poor,” he said.
Nine in 10 patients at VWO homes are referred by the Agency for Integrated Care and the bulk of them receive Government subsidies ranging from 10 to 75 per cent. The vast majority of residents in private homes are unsubsidised.
It is not uncommon for tempers to flare or relatives to avoid calls and ignore email when contacted for payment, said the nursing homes. The task is even tougher when claiming fees from some relatives whose elderly have died, said Ms Irene Ong, Managing Director of Serene and Irene nursing homes.
The most drastic action Ms Ong has had to take was to refuse re-admission to a resident – whose family had not paid for 10 months – after his hospital stay.
Then, there are cases of abandonment. The Sunlove and Surya homes, which cater to the intellectually infirm, had 12 cases last year, up from 10 in 2010.
The homes usually lodge police reports for abandoned residents in order to secure Public Assistance to help pay for their fees, said Chairman Wee Lin. Of the 515 residents in both homes, 170 are on Public Assistance.
Even for those not abandoned, visits from family can be rare. The homes encourage families to take their relatives home during Chinese New Year and this year, one in four did so. But some families ended up checking their relatives into a commercial home or a hotel, said Mr Wee.
Ju Eng Home’s Mr Ang said it encountered a case three months ago of a family leaving their elderly female relative at the lobby of the home. The home could not take in the old lady as it did not have her medical report so they called the police, he said.
None of the homes interviewed said they have leveraged on the Maintenance of Parents Act since it was strengthened last March.
According to a spokesperson from the Ministry of Community Development, Youth and Sports, none of the three applications made by nursing homes to the tribunal between 2009 to last year were made after the Act was amended.
Among other things, the Act now allows the Commissioner and the Tribunal for the Maintenance of Parents the power to track down the addresses and incomes of errant children.
The homes – often already resource-strapped – cited the paperwork hassle, the unwillingness of most elderly to take action against their offspring and the uncertainty of whether fees could be successfully recouped as reasons.
With several nursing home operators expanding across the Causeway, how much of a tangle could they find themselves in, should bad debt or abandonment cases arise?
ECON Healthcare Group, which operates eight homes here and will open a medicare centre in Taman Perling later this year, said it currently conducts financial counselling prior to admission, applies for Government subsidies for patients where possible and works out “achievable payment arrangements with relatives if their financial situation deteriorates”.
“For more complicated and extreme cases, we will work with the relevant government agencies or social work groups to assist the patient and his family,” said a spokesperson.
For LC Nursing Home owner Tony Chia, his new Johor branch – where rates are up to 60 per cent lower – is an option for clients in Singapore who run into arrears. He takes bad debt cases in his stride, adopting a social enterprise model.
For cases of deliberate cheating, where the relative has no Singapore address or phone number and writes a bad cheque, making a police report is an option, said Dr Chia.
“I can sue but I don’t like to do it. I’d rather suffer a loss and help those who are genuine.”
Malaysian operator Comfort Ville’s Mr Goh said after what happened with Mdm Lee, he now requires a two-month deposit, as well as the addresses and contact numbers of children from his Singaporean residents.
For all the bad hats that nursing home operators have encountered, however, all agreed that they are by far the minority.
“By and large, Singaporeans are responsible,” said Dr Chia. –
Channel News Asia