The cantonal Social Insurance Court of St. Gallen dismissed the complaint by the City of Rorschach regarding its obligation to finance residual care costs for an insured person’s stay at a nursing home between May 2019 and October 2021. The court also found the complaint inadmissible insofar as it related to the subsequent period starting in January 2022, as there was no relevant appealable decision.

The Federal Supreme Court confirmed the previous finding that the City of Rorschach remained responsible for the residual care cost contributions under art. 25a para. 5 Swiss Federal Law on Health Insurance (Bundesgesetz über die Krankenversicherung, KVG). The main issue concerned whether the insured person had effectively changed his legal residence due to multiple moves and periods in hospitals and various forms of housing, including a year in a shared flat outside Rorschach. The Court stated that a change of residence would require clear intention to remain permanently at the new place, which it held was not demonstrated, especially given the temporary and need-driven character of the insured’s living arrangements. The Court emphasised that, for individuals under guardianship with irregular housing, determining residence is often a matter for the administrative authority’s discretion. The Court held that none of the new arguments or facts brought forward established a manifest error in the original 2019 decision. Furthermore, it rejected the argument that inadequate prior information from the authority justified a retrospective challenge. Ultimately, the Court saw no basis for re-evaluating the allocation of cost responsibility, confirming Rorschach’s ongoing liability for the period in question.

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