Nursing Homes Support Scheme

Ultan Hynes

The Nursing Homes Support Scheme (Fair Deal) is a scheme of financial support for those who need long term residential care.

Under Fair Deal, you pay a certain amount towards the cost of your care and the HSE pays the rest.

The Fair Deal scheme was introduced under the Nursing Homes Support Scheme (NHSS) Act 2009 to make the cost of care more affordable and to ensure that the residents’ contributions are based on their ability to pay.  The HSE manage the application process and payments to registered nursing homes.  The scheme supports 24,000 residents monthly and has an annual budget of €1.35bn.

The resident can choose their Nursing Home, assuming it has capacity to provide for their care needs.

The Application Process

The Fair Deal application form is available here, or from your local Community Care Office or Nursing Home Support Office. It must be submitted to a Nursing Home Support Office.

The application process:

• A care needs assessment, which decides whether the person requires long-term care.
• A financial assessment, which determines how much the person will pay towards their care.

Who Can Apply?

The person who needs care should apply. A Specified Person can apply on their behalf if they are unable to do so themselves.

Where a person cannot make decisions for themselves, and a Specified Person is not available, a legally appointed person may apply on their behalf, for example someone with Enduring Power of Attorney or a court‑appointed Decision‑making Representative. Such a legally appointed person may also be necessary to apply for Ancillary State Support and/or 3-year cap on family farms/businesses.  Further details of who can apply are on the NHSS application form.

How the Financial Assessment Works

The financial assessment looks at income and assets to calculate a fixed weekly contribution which is paid by the resident directly to the nursing home.

For a single person:

• 80% of weekly income is included
• 7.5% per year of the value of assets is included
• The first €36,000 of assets is disregarded

For a couple where one person is in care:

• The assessment is based on combined income and assets
• 40% of combined income is included
• 3.75% per year of assets is included
• The first €72,000 of assets is disregarded

The 3-year Cap on the Family Home

A feature of Fair Deal is the 3‑year cap.  This limits how long the family home is included in the financial assessment.  After three years in care, the family home is no longer included in the assessment, even if the person remains in long‑term care.

Ancillary State Support (Nursing Home Loan)

The scheme offers an optional support called Ancillary State Support, often referred to as the nursing home loan.

This allows part of the weekly contribution to be deferred and paid later. The loan is secured against property, such as the family home or farm, and does not need to be repaid immediately. Title to the applicant’s property must be established & a charge is placed on property.

Repayment generally occurs following the sale of the property or the death of the person receiving care.  In certain circumstances, repayment may be deferred for a surviving spouse or connected person.

The 3-year Cap on Family Farms and Businesses

Family farms and businesses may also qualify for the 3‑year cap benefit, provided specific conditions are met.

To qualify, the farm or business must have been actively worked for at least three of the five years prior to the person entering care and a family successor must be appointed and approved by the HSE. The list of who is eligible to be appointed a family successor, and obligations placed on them, are available on the HSE website and NHSS application form.

For further information visit the HSE website, view the NHSS application form or contact your local Nursing Home Support Office.