The Nursing Home Support Scheme (NHSS) is to help those who need it by assisting in paying for long term care in private, voluntary or public nursing homes.
Although you would need to pay a contribution towards the cost of your care, the HSE will pay the difference between what you contribute and what the overall cost of the care. This is essentially a loan that can be paid back at any time but is typically repaid upon the individual’s death, from the sale of their assets.
Who can apply for the scheme?
The scheme has a specific but not overly complicated criteria, in order to qualify you must be an Irish citizen, living in Ireland as your primary residence.
You will also need to require long term nursing home care.
Finally to apply you must own assets, land or property are preferential but other assets can be considered on a case to case basis.
What exactly does the Fair Deal cover?
The Fair Deal or NHSS scheme covers the required amount of care appropriate to the applicant’s medical needs; it also covers necessities such as board, laundry services and of course the bed and nurse.
It also covers certain alternative therapies activities and some specific appliances needed to help the applicant/individual with day to day living activities .
If the applicant has a medical card this would normally subsidise aid, appliances and GP costs
If the applicant does not have a medical card. Then the cost would need to be appropriate elsewhere, such as a nominated individual or family members. The medical costs must be covered by the individual or their family. Typically the home would discuss this with the family, in some cases the families are just invoiced directly from the home.
If someone your close to is going into care without a medical card ensure the facility makes you aware of any costs you stand to incur.
Do I pay the same contribution for as long as I am in nursing home care?
Yes, as long as your circumstances remain the same, so will your contribution towards care. But the HSE retains the right to review your care requirements and financial situation at any point.
If my circumstances change?
If your circumstances change, you have a legal obligation to make the HSE aware within 10 working days of the aforementioned change.
Changes include, your health, level of care required and changes to your financial situation. Changes to your situation include that if you or your spouse sell your home. Failure to report changes to the HSE is a criminal offence and you could be prosecuted and fined.
What proportion of the estate must be paid back?
The amount of money you pack back is different for everyone, it depends on your net worth property value and amount of care required.
Although not all of an asset is not taken into account for example the first €36,000 for a single person, their home’s value will not be taken into consideration when calculating your finances and ability to pay for care out-of-pocket.
If you’re in a couple then the amount of the main asset that’s not considered is €72000, this means your contribution is worked out on SAVE VALUE – €72000.
So if your property is worth was work €172,000, then the calculations of would be based on a property value of €100,000
The HSE can keep more than 11.25% of your calculated properties value.
Single person 3 year cap
For a single person, on some of your assets your contribution is capped at 3 years @ 7.5%. These assets include your home, land, proceeds from your home and or your farm/business.
After 3 years you will no longer need to pay the contribution from these assets, any other assets can still be taken into consideration.
If you have already been in care for 3 years when you apply to the scheme then you will not need to pay the contribution from your home.
If you get the NHCC grant for your home, then your partner can opt to defer the loan till the end of their lifetime meaning they can still live in the property until death or they themselves require long term care.
Couples and the ‘three-year cap’
Similarly for couples, you pay a 3.75% contribution based on the value of your home for 3 years. The total contribution over that time period is capped at an upper limit of 11.25% of your properties pecuniary value.
Again if you have already been in care for 3 years prior to an accepted application then you also do not have to make a contribution from your main residence value.
If both partners require long term care, the total contribution of their assets is capped at 22.5% over 3 years.
How to apply
The first step is to fill out a paper application form , which can be downloaded from the “How does the application process work?” Section of this article.
The second step is to send supporting documents to your local nursing homes support office.
- Most recent assessment from the Revenue Service
- RTB registration approval letter
- Rental agreement showing the rental amount
Even if you have not yet registered your property with the RTB (Residential tenancies board) You may still be accepted for the 40% rate on home rental income. You should consult with the RTB on this matter directly. To register the property with the RTB you can do this online at https://www.rtb.ie/portal
How does the application process work?
Once a paper application has been completed , you will need to conduct a two phase assessment.
The first stage is to assess the level of care you require.
The second is a financial review to value your assets, which for most applicants will be their home. The second stage is to calculate what contribution should be made towards your own care.
Its strongly advised to get an independent valuation form a reputable real estate expert so you can compare it against the valuation that the HSE provide you. There are still some companies specialising in Fair Deal Valuations such as Leonard Patrick Wilson in dublin.
We can provide you with a free application form. Simply enter your email address below and we will instantly send you a copy of the application.
How to apply on behalf of someone else?
To apply for the scheme on behalf of someone else you must be appointed by the Irish circuit court, this person is known as a care representative.
What is a Care Representative?
A care representative is an individual who is empowered by the Irish Courts to apply for NHSS on behalf of someone who lacks the mental or physical capacity to do so for themselves. This person is granted control over that individual’s care and is responsible for making decisions on their behalf and completing any required paperwork.
The care representative is often a relative of the individual applying for care, but can also be a court appointed professional such as social workers, GP’s or a solicitor.
Although this is the law as it stands, it’s advisable to keep an eye on it. As Assisted Decision Making Law is rolled out, it’s likely the law on this will change in tandem.
How long will it take to get the Fair Deal?
The first thing to remember is that if a person is admitted into a care home before an application is submitted or approved the HSE will not cover the cost.
If a person is admitted to a nursing home from a hospital, it may be that a transitional bed is available while a NHSS application is processed.
If there is no transitional bed available then the hospital can apply for temporary funding from the local NHSS office.
On the other hand if you make the application in advance then it really depends on the individual circumstances of each applicant.
What happens if I am refused the nursing loan?
Applications are based around a few key metrics, in the most part as long as the application criteria is met 98% of applications are accepted.
In the few cases that have been rejected so far, it has been down primarily to the applicant being wealthy enough to afford the full cost of care themselves.
How to appeal a decision
When an application is received by the HSE it is reviewed by a case officer, upon their review they are empowered to make a decision on whether or not you are eligible. Once they have made their decision they will write to you about the outcome.
The HSE will detail in their letter the outline of the appeals process.
If you are not happy with the decision or feel there may have been a mistake then you may visit your local appeals office to dispute the decision.
NHSS Nursing Support Scheme Advice
At LWK we are committed to ensuring the continuity of life for our elder clients, that’s why we are proud to be able to assist with customers looking to receive the optimum value from their properties. So that they may utilise the fair deal scheme while retaining value in their assets.
We understand that this is undoubtedly one of the more difficult decisions you will make and our experienced team can make sure that no more stress is applied.
We will value your home free of charge and if you decide to sell we will make the process as straightforward as possible.
If you want advice on any of the topics raised in this article please use the message form below.