FAQs – Nursing Home Support Scheme

June 19, 2024

What is it? The Nursing Homes Support Scheme, or “Fair Deal” provides financial support to people who need long term nursing home care. It is operated by the Health Service Executive.

Who can apply? Anyone who needs long term nursing home care can apply. You must ordinarily be a resident in the state and must be living in Ireland for at least 1 year prior to the making of the application. The Nursing Homes Support Scheme does not make a distinction on age grounds.

How can I apply? You must complete an application form which can be found here. There is a list of documents which you will need to gather and send the completed form and documents to your Local Nursing Homes Support Office. The HSE will let you know when they have received your application. The next step has two parts:

  1. Care Needs Assessment

This assessment is carried out by a healthcare professional appointed by the HSE who will consider whether you need long term nursing home care.

  1. Financial Assessment

The HSE looks at your income and assets to work out what you can contribute to your care. In the case of assets, the net value of the asset is assessed. The net value is the value minus any borrowings for the purchase or improvement of the asset. The first €36,000 of your assets is excluded from the assessment.  The contribution will be 80% of your income per year and 7.5% of the value of any assets per year for a maximum of three years. The HSE will then pay the balance of the cost of care.

If you are part of a couple, the assessment will be based on half of your combined income (40%) and assets (3.75%) and the first €72,000 of your assets is excluded from the assessment.

How long does it take? Waiting times can vary for individual circumstances.  It is important to apply for Fair Deal funding as soon as possible. If you are admitted to a nursing home before the Fair Deal application is approved, the cost of the nursing home care will be borne by you or your family. The HSE will not cover it.

You can choose to pay privately for care while you wait for funding however, it is important to note that Fair Deal funding cannot be backdated and will only be paid from the date it is approved.

Can I go to any nursing home of my choosing? It is important to 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. Your payment will be the same for voluntary, private or a public nursing home.

I want to stay in my home, can Fair Deal assist me with this? No, however the HSE Home Support Service aims to support older people to remain in their own home for as long as possible. The Home Support Service is free. You do not need a medical card to apply and your income will not be assessed. If you arrange additional home supports, over and above the level funded by the HSE, you will have to pay for these. The services include support for everyday tasks like getting in and out of bed, bathing and dressing, doing daily activities. The Home Support Service is available to people aged 65 or over who may need support to continue living at home or to return home following a hospital stay. Sometimes exceptions are made for people younger than 65 who may need support. For example, people with early onset dementia or a disability. The application form can be found here.

My home is my only asset, will I have to sell that to pay for my nursing home fees? Your principal private residence, the main property where you live, will only be included in the financial assessment for the first three years while in the nursing home. This is known as the ‘three-year cap’. Your home will be removed from your financial assessment after you have been in care for three years. You do not need to do anything. The cap applies whether you choose to get the Nursing Home Loan or not.

My husband is still living in the family home, will he be forced to leave to cover my nursing home fees? Where one partner remains in the home while the other enters long-term nursing home care, the contribution based on the principal residence will be capped at 11.25% for the first three years. You will never owe any more than that on the family home unless it is sold. But if it is sold, the HSE will continue to charge 3.75% against the sale price every year for the balance of your time in the nursing home. If however the family home is unsold until you die, the cap on what the HSE can take is 11.25%.

Both my husband and I are in a nursing home. We want to keep our home but we don’t want it to fall asunder while we are in the nursing home. Is there anything we can do? Since 1 February 2024, 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. Previously, 40% of this income had to go towards your nursing home care. The property must have been your principal residence before you were admitted to the nursing home.

My only assets are land and property and I have very little cash, how can I raise funds without selling something? The contribution on these assets may be deferred. If your assets include land and property, you can defer paying the contribution by applying for an optional nursing home loan.

What is the Nursing Home loan? This is an optional element of the Fair Deal scheme for people who have assets including land and property. If approved, the HSE will pay the money to the nursing home on your behalf and it will be collected upon death. 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. In order to apply for the nursing home loan you must provide written consent to having a Charging Order registered against your asset. If you are part of a couple, your spouse/partner must also provide written consent. Generally, a nursing home loan will not be called in against a family home until the surviving partner has died.

If you do not have the capacity to consent to the nursing home loan and the Charging Order, it will need to be established whether you have an Enduring Power of Attorney in place which requires to be activated or a Decision-Making Representative will need to be appointed to act on your behalf. I have previously offered some guidance in respect of these applications here.

My daughter and her son have been living in my home with me all along. They have no home of their own. How can I ensure that they can remain there while also cover my nursing home costs? You can still apply for the loan because the deferral of the loan is also open to what are called “connected people”. These are expressly people other than a spouse or partner. If your daughter has assets of no more than €36,000, she can apply to defer the payment of the loan. There are three basic conditions:

  1. The home needs to be your daughter’s only residence.
  2. Your daughter must also have lived there for at least three years before any application for Fair Deal State support is made.
  3. Your daughter must not have any financial or other ownership interest in any other property.

You will need to contact your local nursing home support office to arrange the deferral. However, the bottom line is that the money is still due for repayment. If your daughter goes on to sell the property down the line or move out of it for any other reason, the loan will fall due and must be repaid within 12 months. If the loan is not repaid within 12 months, interest will be applied. The interest will start from the date of death.

I am a farmer. What happens to my farm? The three-year cap can also apply to your farm or business if you meet some conditions. These include:

  • You must apply to the HSE to appoint your family successor who will commit to running the farm or business for at least 6 years
  • Your farm or business must have been actively run by you, your partner or your proposed family successor for at least 3 of the last 5 years
  • A charge in favour of the HSE will be placed on the chargeable property of a business or farm

The transfer or otherwise of the farm should be considered and family involvement in planning for succession is essential. See here for my previous advice on the transfer of the family farm.

I transferred my house to my son 3 years ago, does this form part of my assessable assets? The assessment will 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 include that in your application.

Can I sell an asset while I am in the nursing home? If you sell your home while you are in care, the net proceeds of sale will also qualify for the three-year cap. You need to contact your local Nursing Homes Support Scheme Office if you sell your home. This is so a new assessment of your weekly contribution can be carried out. If you had the benefit of the nursing home loan and sell your home while still in care, the loan must be repaid within 6 months of the date of sale or transfer. Interest will be charged from 6 months after the sale.

I do not own a property, I only have some cash in the bank, what will happen with my financial assessment? If you do not have any assets, other than cash income, you will be required to pay 80% of your income but the HSE will pay the rest of the cost of care.

 

By Aislinn Collins Solicitor.

This article is for general information purposes/general overview only and does not constitute legal or other professional advice.  We recommend seeking legal advice to interpret and advise on any aspect of the law.

June 2024 Wolfe & Co. LLP Solicitors