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 NHSS covers the cost of the standard components of long-term residential care which are:
- Nursing and personal care appropriate to the level of care needs of the person;
- Bed and board;
- Basic aids and appliances necessary to assist a person with the activities of daily living; and
- Laundry service.
A person's eligibility for other schemes, such as the medical card scheme or the drugs payment scheme, is unaffected by participation in the NHSS or residence in a nursing home. Although the NHSS covers core living expenses, residents can still incur some costs in a nursing home, such as social programmes, newspapers, hairdressing or transport just as they would if they were being cared for at home. Transport to and from medical appointments is not covered under the Scheme.
As transport is not included in the agreed price with private nursing homes and as there is no statutory requirement for the HSE to provide transport, a nursing home resident or their representative is responsible for costs incurred in conveying the resident to hospital appointments. Where a private nursing home provides a transport service to residents, details of this service and associated costs should be included in the written agreement between the resident or their representative and the nursing home.
Whilst there is no statutory requirement for the HSE to provide transport, a limited service is available with priority given to persons receiving cancer treatment and dialysis. In exceptional circumstances the HSE can arrange for persons to attend critical clinical appointments if the family or the individual are unable to provide it independently. In such cases transport is arranged on the basis that it is shared between patients to ensure that the maximum number benefit. A referral to avail of this service must be made by the local public health nurse, registered general nurse or the person’s General Practitioner.