Facts
B., born in 1916, lived in the retirement center C. from June 10, 2010 until her death on January 20, 2015. On February 13 and March 8, 2012, she applied to the Compensation Fund of the Canton of St. Gallen for benefits from the cantonal nursing care financing. By decision of April 10, 2012, the Compensation Fund granted her residual financing benefits from January 19, 2012. B. appealed against this decision, which was partially upheld by the Insurance Court of the Canton of St. Gallen. After the case was remanded to the administration, the Compensation Fund issued a new decision on May 27, 2014 regarding the payment of residual financing benefits.
In the appeal proceedings against this decision, the Insurance Court obtained an expert opinion on nursing care economics. After B.'s death, her executor A. continued the proceedings. The court partially upheld the appeal and remanded the case to the Compensation Fund for a new determination of the benefits.
Considerations
The Federal Supreme Court first examines its jurisdiction and the admissibility requirements. It finds that the II. Social Law Division is responsible for handling the appeal, as it concerns the residual financing of nursing care costs after the occurrence of an insured event.
On the merits, the Federal Supreme Court states that since the entry into force of the new regulation on nursing care financing on January 1, 2011, on the one hand the mandatory health insurance (OKP) contributes to the nursing care services, and on the other hand the insured persons and the public authorities have…