The Nursing Homes 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.
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.
Assets assessed include cash assets as well as non-cash assets such as the principal private residence, other property and land, including farmland.
For the purposes of financial assessment, income includes:
- Earnings, including income from farming or business activities
- Pension income
- Social welfare benefits/allowances
- Rental income
- Income from holding an office or directorship
- Income from fees, commissions, dividends or interest
- Any income which you have deprived yourself of in the five years prior to application
Transferred assets and income, defined as assets or income transferred to another person up to five years before a person's application to the scheme, are also assessed.
The applicant’s contribution to the cost of care is therefore calculated based on the value of assets owned, or proportional share in an asset, on the date they entered care. The legal basis for the financial assessment of means is contained in Section 10 of the Act and can be viewed by following this link: www.irishstatutebook.ie/eli/2009/act/15/section/10/enacted/en/html#sec10
The calculation to determine an applicant’s contribution to the cost of their own care is contained in Schedule 1 of the Act and can be viewed by following this link: www.irishstatutebook.ie/eli/2009/act/15/schedule/1/enacted/en/html#sched1 (this link in the case of a person who is not a member of a couple: www.irishstatutebook.ie/eli/2009/act/15/schedule/1/enacted/en/html#sched1).
I am precluded by the provisions of Section 10B of the Health Act 2004 (as inserted by Section 6 of the Health Service Executive (Governance) Act 2013) from directing the Health Service Executive (HSE) as regards any function of the HSE relating to the provision of treatment or of a health or personal social service to any particular person, or as regards any decision whether or not a particular person is eligible for a particular health or personal social service or the extent to which and the manner in which a person is eligible for such a service.
Under the Health Act 2004, the day-to-day operational responsibility for the management and delivery of health services is a matter for the HSE.
All questions arising in respect of title, as they pertain to the lawful ownership of property, are matters between the HSE and the applicant and their representatives. In this instance, the family should continue to engage with their Local Nursing Home Support Office in respect of these matters.
