The system for deciding who pays care homes fees in Northern Ireland is "unsustainable", a watchdog said.
Families are in real distress after health trusts failed to carry out assessments of need, the Public Services Ombudsman added.
If an assessment finds someone has primarily a health care need rather than social care then the trust is responsible for paying for that care regardless of setting.
If the primary need is identified as social care then trusts are entitled to recover the costs of that care.
Ombudsman Margaret Kelly said: "I believe the current system is unsustainable, which is why I am calling on the trusts, together with the Department of Health and others to agree a uniform approach for assessing all future applications for continuing healthcare (CHC) in Northern Ireland, and to make this information available to those in care and their families."
She said health trusts are reluctant to apply the existing Department of Health guidance because they are awaiting the results of a consultation it carried out in 2017.
"The failures to carry out the assessments caused the families who complained to us real distress and frustration.
"It's vital that other families who may be facing a decision over whether to use life savings or sell the family home to fund the care of a loved one are given clarity over whether they are entitled to CHC."
The Ombudsman investigated claims from a family that the Southern Health and Social Care Trust failed to carry out a continuing healthcare assessment for their father.
It upheld the complaint and concluded that the failings caused the family frustration and distress over a prolonged period.
The Ombudsman asked the Belfast Health and Social Care Trust, in consultation with the other trusts and health and social care organisations, to agree a uniform approach for assessing all future applications for continuing healthcare in Northern Ireland
