Questions about the Nursing Homes Support Scheme

My mother is in a contract bed in a private nursing home. Will she have to pay more under the Fair Deal scheme?

Contract beds in private nursing homes were paid for by the Health Service Executive ( HSE) where there were no public beds available for someone who would be eligible for one. Your mother, like anyone who was in long-term care before the new scheme started, can choose to stay with her present arrangement or apply for the Nursing Homes Support Scheme. It is likely that she is better off staying with her present arrangement; find out more about the Financial Assessment.


What is an “approved” nursing home?

To become approved for the scheme, a private nursing home must:

1. Be registered and subject to inspection by the Health Information and Quality Authority (HIQA)

2. Have agreed a price for the purposes of the scheme with the National Treatment Purchase Fund (NTPF), and

3. Hold a valid tax clearance certificate.


My uncle is in a nursing home which is not on the list of "approved" homes for the Nursing Homes Support scheme. He is currently paying all the costs himself. What does he do to apply for the scheme?

He will have to start by applying for a Care Needs Assessment and then continue to the Financial Assessment. (If he had been living in an approved home, then he does not need to do the Care Needs Assessment). To get financial help from the HSE he will have to move to an approved home.


Is there any difference between the Care Needs Assessment now and the assessment for the subvention scheme?

Yes, the assessments are now carried out by a multi-disciplinary team, which looks at all aspects of the person’s life and needs. Where possible, specialist geriatricians will be involved.


If my husband goes into a nursing home, what income will I be left to live on?

You will still have half of your joint income. You cannot be left with less than the maximum rate of the State Pension (Non-Contributory).


We have a holiday house as well as our main home. Can we get a Nursing Home Loan to cover the contribution on both houses?

Only if the holiday home is in Ireland; the Loan cannot cover foreign property.


We lent money to our daughter to buy a house. Does this count as assets?

Any money which was transferred or given away within the five years preceding the application for the scheme can be taken into account whether it is repayable or not.


Do I have to apply for a Nursing Home Loan for my property?

No, you may choose to fund your contribution from your savings or, for example, through a loan from a family member.

You can also choose to apply for the Nursing Home Loan after you have received the Financial Assessment which will show your contribution to care; you do not have to apply for it with your initial application.


Can I get a Nursing Home Loan even if I don’t qualify for State support?

Yes, even if you don’t qualify on grounds of the Financial Assessment. However, if you do not qualify under the Care Needs Assessment you cannot get State support or a Nursing Home Loan.


How is property assessed?

It is assessed at current value at the time of application. You will submit a valuation alongside your application form. The HSE has the authority to undertake its own valuation at its own expense; this is important from an audit and accountability perspective.

The Act also provides for an annual review of the financial assessment. A financial review can be undertaken within 12 months if the HSE is satisfied that there is a material change in circumstances. These provisions allow the applicant to take account of fluctuating asset values.


I took out a loan some time ago, using my home as security. Will that be taken into account?

Yes, your home will be assessed on its value minus any borrowings incurred specifically for its purchase or improvement.


Do I need a Care Representative to apply for a Nursing Home Loan?

A Care Representative is only needed where the applicant does not have the mental capacity to apply for themselves. The HSE will assume that you have capacity if you sign the application form for the Nursing Home Support Scheme yourself.


My aunt has Alzheimer’s disease. How do I apply for a Care Representative so that she can get a Nursing Home Loan when she goes into long-term care?

You apply to the Circuit Court in the area where your aunt lives. You can also download the application form from the Courts Service website. It currently costs €71.50 to apply.

Your aunt does not have to have a Care Representative if, for example, you or a member of your family has Enduring Power of Attorney for her, or is already permitted by law to act on her behalf.


What is the difference between a Care Representative and an Enduring Power of Attorney?

You must take out Enduring Power of Attorney before the person becomes incapacitated. It usually gives a range of powers with regard to the person’s welfare. The powers of Care Representative are limited to the actions under the Nursing Home Support Scheme, including the Nursing Home Loan.


What do I do if my aunt's situation suddenly deteriorates?

General acute hospitals will have dedicated “assessment beds”, where your aunt may stay without incurring long-term charges while her application for the Nursing Home Support Scheme is assessed.

In the case of an emergency admission to a nursing home, the State support could be backdated to the date of application; the HSE's Guidelines on the Standardised Implementation of the Nursing Homes Support Scheme (pdf) say that, subject to overall resources, people who enter nursing homes after the commencement of the scheme will have their financial support paid either from the date that the application was made or from date of admission to the nursing home, whichever is the later.

In addition, a person could opt to enter a nursing home and fund the cost of care themselves while waiting for a decision on their application.


What happens if the money for the scheme runs out towards the end of the year?

Applicants will be put on a national waiting list. When further funds become available applications will be dealt with in the order in which they were determined.

Once resources become available again, support must be offered to qualifying applicants in order of placement on the list and selection of a suitable nursing home place. In other words, the same principle of ‘first come, first served’ based on both determination of an application and selection of a suitable nursing home place applies.

If you are in an acute hospital, you may remain there until your application is processed, without payment of long-stay charges.


What happens to our house when I die?

The Revenue Commissioners are responsible for collecting the Nursing Home Loan. On your death, the HSE will notify the person responsible for the making of the payment (known as the relevant accountable person) as well as notifying Revenue of the amount due. Revenue will then contact the person to make arrangements for the payment.

If your spouse or partner or certain other “connected persons” is still living in the house, then they can apply to the HSE for the Loan repayment to be further deferred.