Nursing Homes Support Scheme, a Fair Deal
A Fair Deal
The Nursing Homes Support Scheme is a scheme of financial support for people who need long-term nursing home care. Under the Nursing Homes Support Scheme, you will make a contribution towards the cost of your care and the State will pay the balance. This applies whether the nursing home is public, private or voluntary.
The HSE administers the Fair Deal Scheme within the resources available and in line with the Nursing Home Support Scheme legislation. Applicants cannot avail of State funding for a nursing home place prior to receiving approval of their Fair Deal application.
The scheme has a number of steps and these are set out in the detailed Nursing Homes Support Scheme Information booklet, which you can read or download on this page.
Step 1 is an application for a Care Needs Assessment. The Care Needs Assessment identifies whether or not you need long-term nursing home care.
Step 2 is an application for State Support. This will be used to complete the Financial Assessment which determines your contribution to your care and your corresponding level of financial assistance (“State Support”). Steps 1 and 2 must be completed by all applicants (if you were resident in a nursing home before the scheme started please see section 10 of the information booklet).
Step 3 is an optional step which should be completed if you wish to apply for the Nursing Home Loan (this is termed “Ancillary State Support” in the legislation).
The application form should be completed and signed by the person applying for nursing home care. However, in certain cases, another person may apply on their behalf
The Care Needs Assessment identifies whether or not you need longterm nursing home care. Its purpose is to ensure that long-term nursing home care is necessary and is the right choice for you. The assessment will consider whether you can be supported to continue living at home or whether long-term nursing home care is more appropriate. The Care Needs Assessment will be carried out by appropriate healthcare professionals, for example, a nurse etc., appointed by the HSE. An assessment may be completed at any time in a hospital or a community setting such as your own home.
The assessment will include consideration of the following:
your ability to carry out the activities of daily living, e.g. bathing, shopping, dressing and moving around the medical, health and personal social services being provided to you or available to you both at the time of the carrying out of the assessment and generally the family and community support available to you, and your wishes and preferences.
The Financial Assessment looks at your income and assets in order to work out what your contribution to care will be.
The HSE will then pay the balance of your cost of care. For example, if the cost of your care was €1,000 and your weekly contribution was €300, the HSE will pay the weekly balance of €700.
This payment by the HSE is called State Support. The Financial Assessment looks at all of your income and assets.
Here your assets include land and property in the State, the contribution based on such assets may be deferred. This means that you do not have to find the money to pay this contribution during your lifetime. Instead, if approved, the HSE will pay the money to the nursing home on your behalf and it will be collected after your death. This is an optional benefit of the scheme. It is effectively a loan advanced by the State which can be repaid at any time but will ultimately fall due for repayment upon your death. Its purpose is to ensure that you don’t have to sell assets such as your house during your lifetime. The legal term for the Nursing Home Loan is “Ancillary State Support”. You may choose to apply for this element of the scheme at the date of initial application or at any stage while resident in the nursing home.
You may wish to consider taking independent legal advice if applying for the Nursing Home Loan and you are free to do so.