Understanding the Fair Deal Scheme
The Nursing Homes Support Scheme, or “Fair Deal” is a method of payment support for nursing home care available to you. Anyone who needs long term nursing home care can apply. You must be ordinarily a resident in the state ie: living here for at least 1 year. The Nursing Homes Support Scheme does not make a distinction on age grounds.
To apply for the Fair Deal Scheme, ask our Administrator for the application form who can also assist with completion of forms. The applications process has two parts a) a Care Needs Assessment -This assessment is carried out by a healthcare professionals (eg a nurse, doctor, social worker) who consider whether a person needs nursing home care or whether they can be supported to continue living at home. b) Financial Assessment – The HSE looks at the applicant’s income and assets to work out what they can contribute to their care. Your contribution will be 80% of your income and 7.5% of the value of any assets per annum. The HSE pays the balance of the cost of care. This is called State support.
Nursing Home Loan
Sometimes a person’s assets are tied up in land and property, including their principal residence which is not being sold. Your contribution on these 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 upon 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 death. Its purpose is to ensure that you don’t have to sell assets such as your house during your lifetime.
Your Rights – Choosing Your Nursing Home
The HSE provide each approved applicant with a list of all approved nursing homes – private, public and voluntary. Legislation says that the choice of nursing home is the decision of the applicant and/or their family.
You can choose any nursing home on the list, subject to the following 2 conditions:
- The home must be able to cater to your needs.
- The home must have a place available.
Once your nursing home is confirmed, you pay your contribution to the nursing home and the HSE pays the balance to the nursing home each month.
About the Fair Deal Scheme
You can apply for financial support to help pay for the cost of care in a nursing home through the Fair Deal scheme.
You need to be approved for Fair Deal before you can receive funding for a nursing home.
You can choose to pay privately for care while you wait for funding. Fair Deal funding can’t be backdated and will only be paid from the date of approval.
Researching different nursing homes
It’s important to look at different nursing homes before choosing one. You should make an appointment to visit the nursing home before making a decision.
Contact your preferred nursing home as soon as possible. You will need to see if they have a place available and can meet your care needs. They may have a waiting list.
If the nursing home you want does not have space, you can go to a different one temporarily. You can then apply for a transfer when space becomes available in your preferred nursing home.
If you are assisting someone to apply for nursing home care, involve them as much as you can in the decision. Consider their preferences and personal values before choosing a nursing home.
Cost of nursing home care
The Fair Deal financial assessment will tell you how much you will pay towards the total cost of nursing home care. We will pay the balance.
Your payment will be the same for voluntary, private or a public nursing home.
The National Treatment Fund has agreed on maximum prices with all registered nursing home. This is not the amount you will pay for your nursing home care. Your contribution towards the cost of your care will be worked out after a financial assessment. The HSE then pays the balance between what you pay for your care and what the nursing home charges for providing that care.
The maximum prices of approved nursing homes:
Fair Deal does not cover:
- short-term care such as respite, convalescent or day-care
- extra fees charged by the nursing home for services like hairdressing, therapies or activities
Your payment towards care
The financial assessment will work out how much you need to pay towards your nursing home care.
The amount you pay towards your nursing home fees depends on your:
- income (money you receive on a regular basis)
- assets (savings, investments and property)
If you have little income and assets, you pay less. If you have more, you pay more.
You must provide proof of income, assets and expenses with your application. For example:
- bank statements
- pension statements
- proof of social welfare payments
- deeds of property
The amount your nursing home charges does not matter. Your contribution will stay the same and we will pay the balance.
If you own assets such as property or land, 7.5% (3.75% if you are part of a couple) of their value will go towards the cost of your care each year.
How much you will need to pay
You will pay 80% (40% if you are part of a couple) based on your assessable income.
Assessable income is your total income minus allowable deductions. Income is any money you receive on a regular basis.
You will also pay 7.5% (3.75% if you are part of a couple) of your assets such as land or property. The first €36,000 (€72,000 if you are part of a couple) of your assets is excluded from the assessment.
If your assets include your land and property, you can defer paying the 7.5% contribution based on this by applying for an optional nursing home loan.
If you sell an asset, such as your home, after your first assessment the proceeds of the sale become a cash asset. The three-year cap will no longer apply. You will need to pay a contribution of 7.5% based on this cash asset.
You can request another financial review 12 months after your last review. However, the HSE may review a financial assessment at any stage.
Income, assets and deductions
You will need to tell us about regular income and any property you own. If we don’t have all this information your application will be delayed.
We look at both you and your partner’s income. This includes:
- social welfare benefits and allowances
- rental income
- income from holding an office or directorship
- income from fees, commissions, dividends or interest
- income you deprived yourself of in the 5 years before your application
The assessment won’t include your relatives’ or children’s income. It will include your partner’s income.
Assets include, but are not limited to, property, investments, money owed to another person (which is repayable) and cash. This includes assets outside Ireland.
Two types of assets are considered:
- cash assets
- non-cash assets
Cash assets include:
- savings and deposits including those with banks, credit unions or post offices
- stocks, shares, bonds, securities and other financial instruments
- money loaned by you to another person
- cash assets transferred to another person within the last 5 years
Non-cash assets include:
- your home, if you own or part-own it
- any property you own
- any land you own
- overseas land and property
The assessment will also look at any assets that you have transferred in the last 5 years.
If you have given any land, property or money to another person in the last 5 years, you will need to tell us. You will also need to tell us if you transfer any property, money or land after you make an application.
Deductions you can subtract from your total income during the financial assessment:
- Income tax, PAYE, Universal Social Charge and PRSI
- Health expenses (GP visits, prescription charges, medicines and medical expenses after tax refund).
- Maintenance payments to other people.
- Interest on loans on your home.
- Levies required by law to pay such as property tax.
- A dependent child in full-time education.
The National Treatment Fund has agreed on maximum prices with all registered nursing home. You can see the maximum prices of approved nursing homes here (this is not the amount you will pay):
A person will contribute 7.5% of the value of assets each year towards the cost of your care.
The main property where you live will only be included in the financial assessment for 3 years while in care. This is known as the 22.5% or ‘three-year cap’.
After 3 years you will not pay anymore based on the value of your home. This will apply even if you are still getting long-term nursing home care.
The three-year cap applies whether you choose to take out a nursing home loan or not.
Couples and the ‘three-year cap’
You will pay a 3.75% contribution based on your main home for a maximum of 3 years. Your total contribution over the 3 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%.
A spouse or partner of an applicant can apply to defer repaying loan until their death.
The assessment includes your other assets for as long as you are in care.
Farmers and business owners
If you own a farm or business, the ‘three-year cap’ will also apply to you if you fulfil all of the following:
- Have suffered a sudden illness or disability which causes you to need long-term care.
- You or your partner ran the farm or business up until the time of the sudden illness or disability.
- A family successor certifies that he or she will continue the management of the farm or business.
This is to make sure family farms and businesses can continue in business if you suffer a sudden illness.
If you sell your home, farm or business before or after the ‘three-year’ cap has expired
If you sell an asset that was subject to the ‘three-year’ cap at any stage, the money of the sale becomes assessable as part of cash assets.
You must tell the Nursing Homes Support Scheme Office about any sale. You must do this within 10 working days of the date of the sale. This is so we can carry out a new assessment of your weekly contribution.
Couples and the
If you have a spouse or partner, the financial assessment will look at both your incomes and assets.
A couple is:
- a married couple
- an opposite or same-sex couple who are living together as life partners for at least three years
When you are part of a couple applying for Fair Deal, half of the couple’s total income will be assessed.
If a couple’s income is €600 per week, the assessment of the person needing care would be based on 50% of €600, or €300. In other words, we would consider the person needing care to have a total income of €300 per week.
Couples and applying
for a nursing home loan
All of the couple’s assets are assessed. Both partners are required to sign the application form if applying for a nursing home loan.
If either partner has reduced capacity to make decisions the other partner will need to be either a:
- care representative (a person appointed by Circuit Court)
- Ward of Court (a person appointed by Office of Ward of Courts)
- a holder of a registered enduring power of attorney (chosen to act on behalf of another person)
A registered enduring power of attorney needs to be in place before the applicant becomes unable to make decisions.
The above has been taken from https://www2.hse.ie/services/fair-deal-scheme/about-the-fair-deal-scheme.html