The Nursing Home Support Scheme (NHSS), commonly referred to as 'Fair Deal', is a system of financial support for people who require long-term residential care. The primary legislation underpinning the NHSS is the Nursing Homes Support Scheme Act 2009. Participants in the NHSS contribute to the cost of their care according to their means while the State pays the balance of the cost. The Scheme aims to ensure that long-term nursing home care is accessible and affordable for everyone, and that people are cared for in the most appropriate settings.
All participants within the NHSS contribute up to 80% of their income (40% if part of a couple) and 7.5% per annum of the value of their assets (3.75% if part of a couple). The first €36,000 (€72,000 if part of a couple) is excluded from assessment. The value of a person's principal residence is only assessed for contributions for their first three years on the scheme.It is a core principle of the scheme that those who have more, pay more, and those who have less, pay less.Assets assessed include cash assets as well as non-cash assets such as the principal private residence, other property and land, including farmland.The process of the determination of financial assessment of means is described in Schedule 1 of the Act and can be viewed by following this link: www.irishstatutebook.ie/eli/2009/act/15/enacted/en/print#sched1. As the scheme is governed by primary legislation, applicants have no leave to appeal inclusion of the Principal Private Residence in financial assessment of means calculations.There are currently no plans to revise the legislation to remove the Principal Private Residence from assessment, however the Department of Health is consistently seeking to identify improvements and introduce enhancements to the scheme, where feasible, which aims to ensure that long-term nursing home care is sustainable, accessible and affordable for everyone and that people continue to be cared for in the most appropriate settings. Given the size, complexity and cost of the NHSS, implementation is complex and any changes in policy direction need to be carefully assessed and kept under review.One feature of the NHSS is that NHSS participants who own property/land-based assets in the State also have access to Ancillary State Support, or the Nursing Home Loan, an optional feature of the Fair Deal Scheme. It is a loan advanced by the HSE to help people meet the portion of their contribution to the cost of care that is based on property/land-based assets, most typically against the personal residence. If an individual secures Ancillary State Support, they will not need to contribute against the value of the relevant property during their time on the scheme, unless the property is sold during that time.Allocation of the Nursing Home Loan (Ancillary State Support) by the HSE results in the creation of a charge (a simple type of mortgage) in favour of the HSE against the interest of the applicant and his/her partner in the asset(s). The HSE will notify the Property Registration Authority of the charge who will register it against the specified asset(s).It should be noted that Ancillary State Support becomes repayable following the occurrence of a relevant event, most commonly after the death of the client. If the loan is repaid in a timely fashion (in the event of the death of the scheme participant, this is 12 months), no interest is applied. The Revenue Commissioners are responsible for recouping the loan amount.In certain conditions - for example, where a partner or child continues to reside in the property - a further deferral to the repayment of the loan can be granted.
