What is the Nursing Home Support Scheme?

You can apply for financial support to help pay for the cost of care in a nursing home through the Nursing Homes Support Scheme, also known as the Fair Deal scheme. Under Fair Deal, you pay a certain amount towards the cost of your care and the HSE pays the rest. Fair Deal covers approved private nursing homes, voluntary nursing homes and public nursing homes.

Who can apply?

You must be ordinarily resident in Ireland and need long-term nursing home care to apply for the scheme. You need to be approved for Fair Deal before you can get funding for a nursing home.You can apply for a Nursing Home Loan if you have assets including land or property. With a nursing home loan, you can postpone paying for your care until after your death, using your assets to secure the loan.

How does the Fair Deal scheme work?

When you apply, your care needs are assessed by the HSE to confirm that long-term nursing home care is the most appropriate option for you. The HSE also assesses your financial situation to see how much you can afford to pay towards your nursing home care.  The HSE then pays the balance between what you can pay for your care and what the nursing home charges for providing that care. Your assets, such as savings and property, are taken into account when assessing your financial situation.

What does Fair Deal cover?

The scheme covers long-term nursing home care only. The Fair Deal covers accommodation and food, nursing and personal care, a laundry service, and basic aids and appliances needed to support you with everyday living. Other goods and services may be available under schemes such as the medical card or Drugs Payment Scheme. It does not cover short-term care such as respite, convalescent or day-care or extra fees charged by the nursing home for services like hairdressing, therapies or activities.

What is involved in applying for Fair Deal?

There are four steps to the Fair Deal application process: 

1. Fill in the application form, which you can pick up in your local CIC or print from the intranet.

2. Complete a Care Needs Assessment. 

3. Complete a Financial Assessment. 

4. Apply for a Nursing Home Loan (this step is optional)

What is the financial assessment?

The Financial Assessment works out how much you can pay towards your nursing home care. The HSE will pay the remaining balance of the weekly cost of your care e.g. if the total weekly cost of your care is €1,000 and your weekly contribution is €300, the HSE will pay €700. This payment by the HSE is called State Support.

The Financial Assessment looks at all of your income and assets. If you are part of a couple, the assessment will be based on half of your combined income and assets. 

The assessment will look at assets that you have transferred since applying for State support or in the five years before the application. For example, any land, money or property you have given to another person.

How much do you pay towards your care?

After assessing your income and assets, the Financial Assessment will work out how much you pay towards your care. You pay 80% of your income (less some deductions), and 7.5% of the value of your assets per year. The first €36,000 of your assets, or €72,000 for a couple, are not counted in the Financial Assessment.

If you are part of a couple, you will contribute half of the amounts above, that is, 40% of your income and 3.75% of the value of your assets per year.

If your assets include land or property, the 7.5% contribution based on these assets may be deferred and paid to Revenue after your death. You can defer paying the 7.5% contribution by applying for an optional nursing
home loan.

How is rental income from your home calculated?

If you own your home and are renting it out to a tenant while you are in a nursing home, you can apply to keep 100% of this rental income, instead of having to pay some of it towards your nursing home care. This means you can keep all of the rental income from renting your own home. Your home is your principal private residence. If the property you are renting is not your own home, you must pay 80% of the rental income to nursing home care.

What is the three-year cap?

Some assets are only included in the financial assessment for the first three years you are in care. This is known as the ‘three-year cap’. It means that you pay a 7.5% contribution based on the value of certain assets for up to three years. These assets can include your home, the proceeds of the sale of your home and your farm or business. After three years, you will not give any further payment based on these assets, even if you are still getting long-term nursing home care. All other assets will be taken into account for as long as you are in care.  If you are part of a couple, you will pay a 3.75% contribution based on your home for a maximum of three years. Your total contribution over the three years is capped at 11.25% of the property’s value. If both partners are in care, the total contribution is capped at 22.5%.

How does the three-year cap apply to farms and business owners?

Family-owned farms and businesses can be included in the ‘three-year cap’ if they meet some conditions. You must apply to the HSE to appoint your family successor who will commit to running the farm or business for at least six years. Your farm or business must have been actively run by you, your partner or your proposed family successor for at least three of the last five years 

A charge in favour of the HSE will be placed on the chargeable property of a business or farm. Your successor must be aged 18 or older and must be your partner, your relative or your partner’s relative.