Israel's Health Ministry Recalculates Family Contributions for Elderly Nursing Care
Israel's Ministry of Health has updated its procedures for determining family contributions towards the cost of elderly nursing home care, a system colloquially known as 'nursing code.' The process involves a geriatric committee assessing patients for nursing needs or cognitive impairment. While the ministry initially covers the full cost of care, it then recoups a portion from the patient and their family based on income assessments.
The updated procedure, outlined in directive 8/2018, specifies four contributors to the funding: the patient, their spouse, children aged 21 and above residing in Israel, and the Ministry of Health itself. A key change impacting families is the inclusion of adult children, even those with independent households, mortgages, and their own children, in the financial assessment. These adult children must submit income declarations and supporting financial documents.
The assessment prioritizes funding sources in a specific order: first, the current income of the patient and their spouse; second, income from real estate owned by the patient and spouse; third, financial assets of the patient and spouse; and finally, the current income of adult children aged 21 and over. The patient's minimum contribution is set at 37% of their individual old-age pension, approximately 680 shekels per month, while the maximum contribution for the entire family is capped at the actual cost of care.
Certain income sources are excluded from the calculation for both patients and their adult children, including long-term care insurance payouts. For adult children, private insurance payouts, their own savings and pension funds, their spouse's income, and child or disability benefits are also disregarded. The calculation for adult children considers their net income after deducting housing expenses, divided by the number of household members, with specific weighting for individuals, married couples, and children of different age groups. The final contribution is determined by comparing this per-person income to a tiered scale, with higher incomes resulting in increased contributions.
