Help with Payment of Nursing Home Charges

A new scheme was introduced in Autumn of 2009 to help with the payment of nursing home fees in Ireland.  The Nursing Homes Support Scheme  is  also known as  “Fair Deal” by the  Department of Health.

The Fair Deal scheme  replaced the old “subvention” scheme and can assist in the payment of charges for both Private and HSE (Public) Nursing Homes.

Nursing homes have to register to be part of this Fair Deal scheme – and they will have to agree prices with the National Treatment Purchase Fund. Not all nursing homes will be part of the scheme.

The HSE will provide you with a list of nursing homes that are included in the Nursing Homes Support Scheme. This list will include public, voluntary and approved private nursing homes. Lists Here

What is the Catch ?
Well ….. you can only choose care from a nursing home on the list, subject to the following  conditions:
The home must be able to cater for your particular needs, and The home must have a place for you.
Also  the scheme has a government budget that is  capped annually – so an inevitable problem is that the scheme has run out of money on occasions, leading to waiting lists for approval for a nursing home place.

Also  the payment doesn’t include things like hairdressing, therapies, newspapers and other activities. It covers your bed and board, laundry, nursing and personal care, and basic aids and appliances.

Financial Assessment

A resident paying nursing home fees will have to  contribute annually – 80% of their “assessable”  income and 7.5% of the value of any assets in excess of €36000 . (72000 for a couple)
If the assets include land and property, the 7.5% contribution based on those assets can be deferred until after death – and may be collected from the person’s estate.

See here for more details

A principal residence (your home) will only be included as assets just  for the first 3 years of the time in the care home. So in effect –  the maximum deferred payment based on the main home will be 22.5%  (3 times 7.5) of it’s value. (No matter how long a person remains in care).
For a couple where only one is in a care home -,  the deferred contribution based on the principal residence will be capped at 11.25%
If there is a partner still  living in the home, the deferred charge may be further deferred for their lifetime too.

Example of Calculation

A married couple living in a house which they jointly own.
The wife needs full-time nursing home care. They have a combined income of €500 per week. Their house is valued at €400,000. Under the  scheme, the wife will only have to pay €200 a week towards her cost of care. This is because half of the couple’s income is €250 and 80% of this is €200. The HSE will pay the balance of the nursing home costs.
A deferred contribution of €236.53 per week, for a maximum of three years, is also payable from the estate after the death of both of the couple. This is calculated as follows:
Value of house: €400,000
Less the Asset disregard for couple: € 72,000
Remaining Value: €328,000
50% of remaining value : €164,000 (because it is  jointly owned)
7.5% of 164,000 per annum: € 12,300
Divide by 52 to get weekly amount: € 236.53

If  the wife  is still in a nursing home after three years, the principal residence would no longer be used in the financial assessment. (Total deferred payment capped at €12,300 in this example).

The three year cap will also extend to farms and business in certain circumstances.

(i) Where the person has suffered a sudden illness or disability which causes them to require long-term residential care, and
(ii) where the person or their partner was actively engaged in the daily management of the farm or relevant business, as the case may be, up until the time of the sudden illness or disability, and
(iii) here a family successor certifies that he or she will continue the management of the farm or relevant business as the case may be.
This measure is intended to ensure the financial sustainability of family farms and businesses in cases where a person suffered a sudden illness and did not have an opportunity to put appropriate succession arrangements in place.
In the case of couples, the measure should apply where the applicant suffered a sudden and unforeseen illness and either or both members of the couple have been engaged in the running of the family farm or business.

The HSE have an infoline on 1850 24 1850.

Compared to the UK – this seems a better deal for most people in Ireland. In England – in general , if  a person has capital or property worth more that £23,500 – then they have to fund the full cost of care home or a nursing home themselves. UK State funding , in most cases, only kicks in when people have less than £23,500.