The Nursing Homes Support Scheme is a system of financial support for individuals who require long-term nursing home care. Under the Scheme, nursing home residents contribute towards the cost of their nursing home care based on their means, and the HSE pays the balance. The budget for the Scheme in 2013 is €974m.
Currently, an individual’s contribution towards the cost of their care is calculated based on 80% of their income and 5% of their assets per annum. If the person is a member of a couple, the assessment is based on half of the couple's combined income and assets.
The average weekly contribution under the Scheme is currently about €280.
It was announced in Budget 2013 that the asset contribution would be increased from 5% to 7.5% per annum. The legislation underpinning the Scheme must be amended before this change can take effect and this is being progressed in the Health (Amendment) Bill 2013. The increased asset contribution will only apply to new entrants to the Scheme after the enactment of the Bill. In the case of the principal residence, there will be a cap of 22.5% (i.e. three years).
The Scheme contains several important safeguards which ensure that both the person in the nursing home and their spouse/partner, if applicable, are adequately provided for:
1. Nobody will pay more than the actual cost of care.
2. The first €36,000 for a person's assets, or €72,000 for a couple, is not taken into account during the financial assessment.
3. The principal residence is only included in the financial assessment for the first three years of a person's time in care. This three year cap can also apply to family farms/businesses in certain circumstances.
4. Where an individual's assets include land and property in the State, the contribution based on such assets may be deferred and collected from their estate. This is the optional Nursing Home Loan element of the scheme.
5. Individuals keep a personal allowance of 20% of their income, or 20% of the maximum rate of the State Pension (Non-Contributory), whichever is the greater.
6. If there is a spouse/partner remaining at home, s/he will retain 50% of the couples income, or the maximum rate of the State Pension (Non-Contributory), whichever is the greater.
7. Certain items of expenditure, called allowable deductions, can be taken into account during the financial assessment. These allowable deductions include health expenses.
8. There is a financial review mechanism which takes account of the fluctuating value of assets and the fact that cash assets will naturally deplete over time as payments are made to the nursing home etc.