The Nursing Homes Support Scheme (NHSS), commonly referred to as A Fair Deal, is a system of financial support for those in need of long-term nursing home care. Participants contribute to the cost of their care according to their income and assets 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. An applicant to the scheme can choose any public, voluntary or approved private nursing home. The home must have availability and be able to cater for the applicant's particular needs.
Participants in the Scheme contribute up to 80% of their assessable income and a maximum of 7.5% per annum of the value of assets held. In the case of a couple, the applicant’s means are assessed as 50% of the couple’s combined income and assets. The first €36,000 of an individual’s assets, or €72,000 in the case of a couple, is not counted at all in the financial assessment. The capital value of an individual’s principal private residence is only included in the financial assessment for the first three years of their time in care. This is known as the three year cap.
The Scheme has a number of important safeguards built into the financial assessment which ensures that:
- Nobody will pay more than the actual cost of care;
- An applicant will keep a personal allowance of 20% of his/her income or 20% of the maximum rate of the State Pension (non-Contributory), whichever is greater. This is in recognition of the fact that, although the NHSS covers core living expenses, residents can still incur some costs in a nursing home, such as social programmes, newspapers or hairdressing;
- If an applicant has a spouse/partner remaining at home, he/she will be left with 50% of the couple’s income or the maximum rate of the State Pension (non-Contributory), whichever is greater;
- If both members of a couple enter nursing home care, they each retain at least 20% of their income, or 20% of the maximum rate of the State Pension (non-Contributory), whichever is greater;
- Certain items of expenditure, called allowable deductions, can be taken into account for the financial assessment, including health expenses, payments required by law, rent payments and borrowings in respect of a person’s principal private residence;
- A person’s eligibility for other schemes, such as the Medical Card Scheme or the Drug Payment Scheme, is unaffected by participation in the Nursing Homes Support Scheme or residence in a nursing home.
Income from public, private or State pensions are treated in the same manner as other sources of income having regard for the fact that the Scheme is a financial support scheme with the level of State support provided dependent on the financial means of the applicant. There are no plans to make changes to how pensions are assessed under the NHSS.