The Nursing Homes Support Scheme (NHSS), commonly referred to as A Fair Deal, is a system of financial support for people who require long-term residential care. Participants 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.
Where a resident under NHSS has assets including land or property, they may defer their contribution to care based on such assets under Ancillary State support (also known as Nursing Home Loan). This contribution becomes payable on their death.
NHSS is underpinned by primary legislation by way of the Nursing Homes Support Scheme Act (2009). The legislation sets out that collection and recovery of repayable amounts of the Ancillary State support is a function of the Revenue Commissioners, acting as a collecting agent for the HSE. These monies collected by Revenue Commissioners are paid into the Central Fund.
The exchequer directly funds the NHSS, outside of the assessed contribution paid by nursing home residents. The NHSS budget, which covers all State support for the Scheme, including Ancillary State Support, is allocated on an annual basis based on projected needs and costs.