The customer's payments and rights depend on the nature of the agreement
- A resident placed in a care home based on a municipal outsourcing agreement pays the municipality an amount determined by his or her income.
- The municipality may also grant the customer a service voucher, the value of which is determined by the customer's income. In these cases, the recipient of the service voucher pays the service provider the amount by which the service price exceeds the value of the service voucher.
- One may also seek private residential care housing by paying the fees in their entirety oneself.
Living in residential care housing is considered outpatient care, but the line between institutional care and enhanced round-the-clock care in a care home may often be blurred. Drawing this line may be difficult, but the difference is significant in terms of customer fees and social security.
In a care home the resident pays rent or maintenance charges for the apartment and additional fees for services as needed. Care homes have common areas for residents, many of which also operate as service centres for senior citizens in the area.
Institutional care covers all care, accommodation and other upkeep such as medication. Unlike those residing in care housing, those in institutional care do not receive pensioners' housing allowance, care allowance or compensation for medical treatment from the Social Insurance Institution of Finland (Kela).
In a private care home under a municipal outsourcing agreement
A municipality may outsource residential services, in which case the care home produces care and nursing services under the outsourcing agreement.
- The municipality charges residents of outsourced care homes fees according to the municipal service fee schedule determined by each municipality itself. The care home may not necessarily be aware of the amount of these charges.
- The municipality may also decide that residents in a care home pay the municipality the same amount as a customer in institutional care (fees according to the Patient Fees Act and Decree).
The customer is provided services according to his or her personal care and service plan.
- The customer pays the municipality in proportion to his or her income.
- The customer is charged the same patient fees as he would be charged for a corresponding municipally produced service.
- The fee charged may not exceed the costs of producing the service.
The service provider generally collects rent directly from the resident and the municipality collects other charges in amounts proportional to income. The person's savings and wealth do not affect the fees charged.
Certain services are considered to be external to service packages and the resident pays them himself in addition to rent and care home fees. Costs payable by the resident himself include, among other things, hygiene costs, costs of using one's own phone, hairdresser's costs, doctor's charges and medical fees and other personal expenses and payments. If the customer is unable to pay for these types of fees, he may be eligible for social assistance. In cases of payment problems the first course of action is, however, attempting to lower the fees charged from the resident.
Paying for care home residency by municipal service voucher
A service paid for by service voucher is a municipally provided service. The municipality makes the decision on adopting service vouchers and approves the care homes which are entitled to accept payment by municipal service voucher.
The municipality determines the customer's service needs and decides on the content and quantity of services to be purchased as well as the value of the service voucher.
The value of a service voucher is determined by the customer's income. In determining the value of a service voucher, services purchased by the customer from the service provider on his own initiative are not taken into consideration.
The recipient of a service voucher can choose which care home to reside in from those approved by the municipality. The customer and service provider conclude an agreement for service provision and the service provider submits certain documentation on this to the municipality.
The customer pays the excess between the value of the voucher and the price of the service. The municipality must set the value of the service voucher at a level that is fair to the customer. In isolated special cases, the municipality may set the value of the service voucher for an individual customer at a level higher than normal, if the customer's subsistence would be at risk due to the excess amount payable by him.
Eligible citizens apply for the service voucher at the social office of their municipality of residence. The service voucher is a non-taxable benefit. The excess fees payable by the customer on top of the service voucher are not subject to tax credit for domestic costs.
As municipalities are under no obligation to provide service vouchers, not all of them offer this alternative. A customer may also decline a service voucher, in which case the municipality must organise the service in an alternative manner.
Care home customers who pay their own fees
When a customer seeks residence in a private care home as a self-paying resident, he is personally responsible for all costs of accommodation and care.
Residents paying their own way should take great care to find out detailed information on pricing, the basis of pricing and what services are included. In addition, they should look into other aspects that are essential to care and the ability to function, e.g. the arrangements for night-time care.
Terms of agreement should be reviewed in detail and attention paid to what happens when additional services are needed and the ability to pay is compromised.
If service needs to increase significantly as the elderly individual's ability to function deteriorates, the resident of a private care home may request the municipal home care of his domicile for a service needs assessment as well as guidance and counselling to receive the necessary services.