The Fair Deal Scheme - all you need to know

The Fair Deal nursing home support scheme provides financial assistance to people in need of long-term nursing home care and people can apply to the HSE to seek financial support for the cost of their long-term care.

 
How does the nursing home support scheme work?
 
Under the scheme, you will make a contribution towards the cost of your care and the State will pay the balance. Essentially, the State will pay the shortfall between what someone can afford to pay and the actual cost of nursing home care. This applies whether the nursing home is public, private or voluntary. Any person of any age who needs nursing home care can apply for the scheme.
 
What nursing homes are included in the scheme?
 
Public and voluntary nursing homes are included, and approved private nursing homes are also involved. Approved private nursing homes are homes that have agreed the price charged for care and are approved for the purposes of the scheme.

The HSE has a list of nursing homes to choose from, and a patient can choose any home from the list provided it has a place for you and it can cater for your particular needs.
 
Regardless of whether you choose a public or voluntary nursing home, you will pay your contribution and the HSE will pay the balance.
 
How do I avail of the scheme?
 
In order to avail of the scheme, you will need a financial assessment to determine your contribution to your care. You will also need a care needs assessment to identify whether or not you need long-term nursing home care.
 
How much do I contribute to my care?
 
In order to assess how much a person can afford to contribute, every applicant must undergo a financial assessment. This will examine 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.
 
What is included in the financial assessment?
 
The financial assessment will look at all of your income and assets. Income includes any earnings, pension income, social welfare benefits/allowances, rental income, income from holding an office or directorship, income from fees, commissions, dividends or interest, or any income which you have deprived yourself of in the five years leading up to your application. An asset is any material property or wealth, including property or wealth outside of the State. The assessment will not take into account the income of other relatives such as your sons or daughters.
 
How is my contribution calculated?
 
Having looked at your income and assets, the financial assessment will work out your contribution to care. You will contribute 80% of your assessable income and 7.5% of the value of any assets per annum.  However, the first €36,000 of your assets, or €72,000 for a couple, will not be counted at all in the financial assessment. In the case of a couple, the assessment will be assessed the basis of half of the couple’s combined income and assets.
 
Where your assets include land and property in the State, the 7.5% contribution based on such assets may be deferred. This means that the HSE will pay the money to the nursing home on the applicant’s behalf and it will be collected after the applicant’s death. This benefit, the nursing home loan, is optional, aimed at ensuring that the person doesn’t have to sell assets such as their home during their lifetime. It can be repaid at any time but will ultimately fall due for repayment after your death. As well as this, the applicant’s home will only be included in the financial assessment for the first three years of their time in care.
 
Every patient will keep a personal allowance of 20% of your income or 20% of the maximum rate of the state pension, whichever is the greater.
 
If the patient has a spouse or partner remaining at home, he or she will be left with 50% of the couple’s income or the maximum rate of the state pension, whichever is the greater. 

No person will pay more than the cost of the care.
 
How will my care needs be assessed?
 
A care needs assessment will identify whether or not you need long-term 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 who are 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:-

1. Your ability to carry out the activities of daily living such as bathing, shopping, dressing and             moving around.

2. 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

3. The family and community support available to you

4. Your wishes and preferences.

Assessment may include a physical examination by a healthcare professional.
 
What is the next step?
 
Once your care and financial assessments have been processed the HSE will write to you. Firstly, it will advise you of your contribution to care and whether you are eligible for State support. Secondly, if you have applied for the nursing home loan, it will also advise you about your eligibility for this. Thirdly, it will provide you with a list of nursing homes to choose from. The list will include public nursing homes, voluntary nursing homes and approved private nursing homes, as mentioned above. Your choice of nursing home is not connected in any way to the level of your contribution to care.

How does it apply to people currently in a public or private nursing home?

People who are already living in a public nursing home will continue to contribute to their care on the same basis as they have been. If a person is already resident in a private nursing home, they will continue with the existing arrangement or they may avail of the new scheme if they wish. 
 
How do I apply for the scheme?
 
In order to apply for the scheme, you must be ordinarily resident in Ireland. This means that you have been living here for at least a year or that you intend to live here for at least a year. A standard application form can be obtained from the HSE’s website, www.hse.ie.

Please contact Loraine N. Hanratty for a consultation.