Fair Deal Scheme

You can apply for financial support to help pay for the cost of care in a nursing home through the Nursing Homes Support Scheme, also known as the Fair Deal scheme. The Fair Deal scheme is managed by the Health Service Executive (HSE).

Under Fair Deal, you pay a certain amount towards the cost of your care and the HSE pays the rest. Fair Deal covers approved private nursing homes, voluntary nursing homes and public nursing homes.

This page explains what Fair Deal covers, how to apply, how much you pay and how to appeal a decision.

Who can apply?

You must be ordinarily resident in Ireland and need long-term nursing home care to apply for the scheme. You need to be approved for Fair Deal before you can get funding for a nursing home.

You can apply for a Nursing Home Loan if you have assets including land or property. With a nursing home loan, you can postpone paying for your care until after your death, using your assets to secure the loan.

How does the Fair Deal scheme work?

When you apply, your care needs are assessed by the HSE to confirm that long-term nursing home care is the most appropriate option for you.

The HSE also assesses your financial situation to see how much you can afford to pay towards your nursing home care.  The HSE then pays the balance between what you can pay for your care and what the nursing home charges for providing that care. Your assets, such as savings and property, are taken into account when assessing your financial situation.

The scheme covers long-term nursing home care only.

The Fair Deal covers:

• Accommodation and food
• Nursing and personal care
• Laundry service
• Basic aids and appliances needed to support you with everyday living

Other goods and services may be available under schemes such as the medical card or Drugs Payment Scheme.

The Fair Deal scheme 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

Ask your nursing home what extra fees you may need to pay. You must agree with your nursing home about these extra costs before you go into the nursing home (your admission date).

Choosing a nursing home

Contact your preferred nursing home as soon as possible. You will need to see if they have a place available and if they 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 to your preferred nursing home when the space becomes available.

Moving from hospital care to long-term care

If you are in hospital, but no longer need acute care, then you can be charged for long-term care in that hospital. If you are waiting to move to long-term care, then you should apply for Fair Deal as soon as you can.

In a limited number of cases, the HSE may pay for your care in a private nursing home while your application for Fair Deal is being processed. This is known as Transitional Care Funding.

There are 4 steps to the Fair Deal application process:

• Step 1: Fill in the application form
• Step 2: Complete a Care Needs Assessment
• Step 3: Complete a Financial Assessment
• Step 4: Apply for a Nursing Home Loan (this step is optional)

Step 1: Fill in the application form

Complete the Nursing Home Support Scheme application form (pdf) to apply for Fair Deal.

The form should be completed and signed by the person applying for nursing home care. If they are unable to apply, a specified person can apply for them. See ‘How to apply for someone else as a specified person’ below.

On the form, there is a list of documents you need to send with your application form, including proof of your income and assets. After you gather all the documents, 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.

If you need help with your application, contact your Local Nursing Homes Support Office.

When you submit the application form, you are applying for a care needs assessment and financial support.

Step 2: Complete a Care Needs Assessment

The Care Needs Assessment will check if you can be supported to continue living at home or if long-term nursing home care is more appropriate.

The HSE will contact you to complete the Care Needs Assessment.

Healthcare professionals appointed by the HSE such as a public health nurse will carry out the assessment.

The assessment may:

• Take place in a hospital or a community setting like your home
• Involve a physical examination

The care needs assessment (pdf) will look at:

• Your ability to do daily activities like bathing, shopping, dressing and moving around
• How you currently use any health and personal services such as a home-care assistant or nurse
• The family and community support available to you
• Your wishes and preferences

You may be asked for more information to complete the Care Needs Assessment, such as a referral from your GP. You should provide this as soon as possible to complete your application.

When the Care Needs Assessment is complete

After the Care Needs Assessment, the healthcare professional writes a report. Based on the report, the HSE decides if long-term nursing home care is the best option for you. After they make a decision, the HSE will write to you within 10 working days. You get a copy of the report and the reasons for the decision.

The HSE may use the Care Needs Assessment to identify other health or personal social service needs. However, there is no legal requirement for them to provide the services they identify.

You must be assessed as needing nursing home care to be eligible for either State support or the Nursing Home Loan.

If you do not qualify for long-term nursing home care

If you do not qualify for long-term nursing home care, you must wait 6 months before you can apply again. If there is a change in your health or circumstances, you can apply before the 6-month waiting period ends.

Step 3: Complete a Financial Assessment

The Financial Assessment works out how much you can pay towards your nursing home care. The HSE will pay the remaining balance of the weekly cost of your care.

For example, if the total weekly cost of your care is €1,000 and your weekly contribution is €300, the HSE will pay €700. This payment by the HSE is called State support.

The Financial Assessment looks at all of your income and assets.

If you are part of a couple, the assessment will be based on half of your combined income and assets.

A couple is either:

• A married couple living together
• An opposite or same-sex couple living together as life partners for at least three years

It does not include relatives who live together, or two adults living together but not as life partners.

Income and assets

Income includes any:

• Earnings
• Pension
• Social welfare benefits or allowances
• Income from holding an office or directorship
• Income from fees, commissions, dividends or interest
• Transferred income (any income you transferred to someone else within 5 years of your first application)
• Rental income from any properties which are not your home

An asset is any material property or wealth, including property or wealth outside Ireland.

Assets are divided into 2 categories, cash assets and non-cash assets.

Cash assets include:

• Savings and deposits
• Stocks, shares, securities and other financial instruments
• Approved retirement funds (value of fund at date of application)
• Money loaned by you to another person
• Cash assets transferred to another person in the last 5 years

Non-cash assets include:

• Your home (if you own or part-own it)
• Any property or land you own
• Businesses
• Overseas land and property

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.

Transferred assets

The assessment will look at assets that you have transferred since applying for State support or in the 5 years before the application. For example, any land, money or property you have given to another person.

Deductions

You can subtract the following deductions from your financial assessment:

• Income tax, PAYE, Universal Social Charge and PRSI
• Levies you must pay by law such as property tax
• Interest on loans for the purchase, repair or improvement of your home (if you own it)
• Rental payments from renting your home (primary residence), while you are in nursing home care (details and application form below)
• Rental payments from your partner, your child, or your partners child (aged under 21) who live in your property
• Health expenses such as GP visits, prescription charges, medicines and medical expenses after tax refund, (not including contributions paid under Fair Deal)
• Maintenance payments for a child, spouse or former spouse made under a separation agreement or a court order
• A dependent child in full-time education.
• Any redress you received under a qualifying redress scheme

After assessing your income and assets, the Financial Assessment will work out how much you pay towards your care.

You pay:

• 80% of your income (less the deductions above),

and

• 7.5% of the value of your assets per year

The first €36,000 of your assets, or €72,000 for a couple, are not counted in the Financial Assessment.

If you are part of a couple, you will contribute half of the amounts above, that is, 40% of your income and 3.75% of the value of your assets per year.

If your assets include land or property, the 7.5% contribution based on these assets may be deferred and paid to Revenue after your death. You can defer paying the 7.5% contribution by applying for an optional nursing home loan.

How is rental income from your home calculated?

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. This means you can keep all of the rental income from renting your own home. Your home is your principal private residence.

If the property you are renting is not your own home, you must pay 80% of the rental income to nursing home care.

How to apply to keep income from renting your home

Step1: Fill out the Principal Private Residence Rental Income application form (pdf).

Step 2: Send copies of the following to your local Nursing Homes Support Office:

• Residential Tenancies Board (RTB) registration approval letter
• Rental agreement showing the rental amount
• Latest notice of assessment from Revenue

The tenancy in your principal residence must be registered with the RTB unless it is a type of rental agreement or rented property that is exempt from having to register with the RTB.

If you have not registered with the RTB, you may still qualify for the reduced rate on home rental income. Contact the Residential Tenancies Board for advice on this.

3-year cap

Some assets are only included in the financial assessment for the first 3 years you are in care. This is known as the ‘3-year cap'. It means that you pay a 7.5% contribution based on the value of certain assets for up to 3 years.

These assets can include:

• Your home
• The proceeds of the sale of your home
• Your farm or business

After 3 years, you will not give any further payment based on these assets, even if you are still getting long-term nursing home care. The ‘3-year cap’ applies whether you choose to get the Nursing Home Loan or not.

All other assets will be taken into account for as long as you are in care.

If you have already been in a nursing home for 3 years when you apply for the scheme, then you do not pay the 7.5% on your home.

Couples and the '3-year cap'

If you are part of a couple, you will pay a 3.75% contribution based on your 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%.

If you get the Nursing Home Loan for your home, your partner can also apply to have the repayment of the loan deferred for their lifetime. Read about the financial assessment for couples.

Your home

Your home will be removed from your financial assessment after you have been in care for 3 years. You do not need to do anything.

If you sell your home while you are in care, the net proceeds of sale will also qualify for the 3-year cap. You need to contact your local nursing homes support scheme office if you sell your home.

Farms and business owners

Family-owned farms and businesses can be included in the ‘3-year cap' if they 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

If you want your farm or business to be included in the ‘3-year cap', see Part 6 of the Fair Deal application form (pdf) for information and application details.

Your successor must be aged 18 or older and must be your partner, your relative or your partner’s relative. Since 23 September 2024, the list of relatives who can act as a family successor includes relatives such as a great-nephew, a great-niece, a first cousin or a great-grandchild of a first cousin.

Summary table for 7.5% yearly contribution re assets

When the assessments are complete

When the Care Needs and Financial Assessments have been completed, the HSE will write to you about:

• What you need to pay as your contribution to care
• Whether you qualify for State support and the Nursing Home Loan
• What nursing homes are part of the scheme

You may choose any nursing home that is part of Fair Deal as along as:

• The home has a place for you.
• The home can cater for your needs. The nursing home will have to carry out an assessment to decide if it can meet your needs.

Your payment will be the same for voluntary, private or a public nursing home.

You can request another financial review 12 months after your first assessment or your last review. However, the HSE may review a financial assessment at any stage.

Payment by the HSE

The HSE will start paying the State support and the nursing home loan from either of the following (depending on which date is later):

• The date that the application is approved
• Date you are admitted to the nursing home

Waiting list

There is a set level of funding for the scheme each year, so your name may go onto a waiting list until funding becomes available. If this is the case, the HSE will let you know when it writes to tell you if you are eligible for State support. While you may be on a waiting list, the HSE will confirm you have been approved for financial support under the scheme.

Payment of your contribution

If you select a public or voluntary nursing home, you pay the contribution to the HSE, and the HSE will then pay the nursing home.

If you select a private nursing home, you pay your contribution to the nursing home and the HSE pays the rest.

Financial support will only be paid if the nursing home is identified as being appropriate to your needs.

Payments after you die

When a person dies who used the Fair Deal Scheme, the following information must be sent to the HSE at least 3 months before distributing the assets of their estate:

• A Schedule of Assets - this is a list of all real and personal property and assets owned by the person at the time of their death
• Notice in writing of the intention to distribute the assets

If you fail to do this, you may be personally responsible for the repayment of any potential overpayment of the Fair Deal Scheme.

Read more about the process of dealing with a deceased person’s money and property.

Financial safeguards

As part of the Financial Assessment, the following safeguards are in place:

• You will not pay more than the actual cost of care
• You keep a personal allowance of 20% of your income or 20% of the maximum rate of the State Pension (Non-Contributory), whichever is more
• If you have a spouse or partner remaining at home, they will be left with 50% of the couple’s income or the maximum rate of the State Pension (Non-Contributory), whichever is more

The Nursing Home Loan is an optional element of the Fair Deal scheme. It is an option if the person in nursing home care has assets including land and property.

If you are approved for the Nursing Home Loan, the contribution based on your assets (land or property) can be postponed. This means the HSE will pay the money to the nursing home for you, and it will be collected after your death or after the sale of all or part of your asset.

In certain circumstances the payment may be deferred for a longer period, for example, if a spouse or partner or your former carer is still living in your home.

Repayment of the loan is made to the Revenue Commissioners.

Applying for the Nursing Home Loan

If you want to apply for the Nursing Home Loan, see Part 5 of the Fair Deal application form (pdf) for information and application details. You can apply for the Nursing Home Loan when you first apply for Fair Deal or at any stage while resident in the nursing home.

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 or partner must also provide written consent. The Charging Order is a simple type of mortgage which secures the money loaned by the HSE.

After you consent, the HSE is responsible for making the Charging Order, registering it against your asset and making Nursing Home Loan payments on your behalf. You will not need to do anything (although the HSE may need to check with you about the information in your application).

If a person does not have the capacity to consent to the Nursing Home Loan and the Charging Order, only one of the following can apply for them:

• A care representative (a person appointed by Circuit Court)
• A 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)

See 'How to apply for someone else as a specified person?' below.

You can apply for the optional nursing home loan and if you are approved, you do not have to avail if you change your mind.

Read about repaying the Nursing Home Loan.

The fair deal application form (pdf) should be completed and signed by the person applying for nursing home care. However, in certain cases, another person may apply on their behalf as explained below. There is no charge to apply for Fair Deal.

Who is a specified person?

If you are helping someone with reduced decision-making capacity to apply for Fair Deal, you need to be a specified person. A specified person may apply on behalf of a person needing care if they are unable to apply themselves.

A specified person is:

First priority

A. Your decision-making representative (a person appointed by the Circuit Court)

B. A person appointed under an enduring power of attorney who is not restricted from applying for the scheme

C. Your Committee, if you are a ward of court

Lesser priority

D. Your spouse or partner

E. A child of yours who is 18 or over

F. A registered medical practitioner, nurse or social worker

If you had a care representative, they are now called a decision-making representative (DMR). They can still act on your behalf.

You can download an application form (pdf). Forms are also available from any healthcare setting in your area, including your Local Health Office and hospitals. Send the completed form with the documents listed on the application form to your Local Nursing Homes Support Office.

If you have any questions, contact your local Nursing Homes Support Office or contact the HSE Live team on 1800 85 1500 or on 01 240 8787. If calling from outside Ireland, phone +353 1 240 8787.

Appeals

When the HSE writes to you about the outcome of your Care Needs and Financial Assessments, it will outline the appeals process and give you details of your local Appeals Office.

For example, if your Care Needs Assessment finds that you do not need long-term nursing home care, you can appeal the decision to your local Appeals Office.

Reviews

Any Care Needs Assessment can be reviewed six months after a previous assessment or earlier if one of the following apply:

• The HSE believes there has been a material (significant) change in your health or circumstances
• A registered medical practitioner states that there has been a material change in your health or circumstances since your most recent care needs assessment

Your local Nursing Home Support Office carries out the review. Contact them if you want to have your Care Needs or Financial Assessment reviewed.

After the HSE decides, they will write to you with the decision and the reasons for it within 10 working days.