FAQ's - Frequently Asked Questions
Do I have to pay for nursing home care in Ireland?
There are no free nursing home beds in Ireland. Everyone must pay something towards the cost of their care.
There are two ways of paying for nursing home care, one through the Nursing Home Support Scheme (NHSS), which is commonly called the Fair Deal, and the second is by paying a private nursing home the full cost of the care directly. If you apply for the NHSS the HSE will assist with the cost of the nursing home. If you choose to go privately then either the older person or someone on their behalf will have to pay the full cost of the nursing home.
Where do I get a list of nursing homes?
If you apply for the Nursing Home Support Scheme (NHSS), better known as the Fair Deal scheme, you do so through a regional NHSS office and it will have a list of registered nursing homes in your area.
A list of the approved nursing homes and their cost of care is available on the HSE website. You can find the contact details for the NHSS office in your area by either consulting the HSE website or ringing the HSE helpline 1850 24 1850.
What proportion of the estate must be paid back?
It is a basic principle of the NHSS that nobody will pay more than the cost of their care. The portion of the value of the family home that will be due is capped at 7.5% per year for a maximum of 3 years. For other chargeable assets there is no cap although a cap may apply to farms if the older person is admitted to a nursing home as a result of an accident or emergency.
If the Ancillary State Support is not applied for the 3 year cap still applies. This means that when calculating the amount due from the older person the 7.5% of the value of the home is not included in the calculation after 3 years. So after 3 years the amount of money due should fall. It is also important to note that the amount due from the value of the family home cannot be collected if a partner or dependent (adult or child) or carer is living there.
If an individual does not have any assets (other than cash income) and their cash income is deemed low they will still have to pay the 80% of their income but in this case the HSE will pay the rest of the cost of care.
What is the nursing home allowed to charge for?
One common source of frustration for people living in nursing homes or their families can be confusion about the additional charges put in place by nursing homes.
Nursing homes are allowed to charge for all therapeutic or recreational activities unless they are covered by the medical card. They are also allowed to charge for any personal services provided by the nursing home such as hair dressing, delivery of newspapers, etc.
HIQA Standards, published July 2016, require that the nursing home must agree ‘a contract’ with the resident within one month of admission. The nursing home’s management must communicate clearly with each resident, setting out the services that they receive and the required fees. You can only be charged for services as set out in the contract.
What is the difference between a Contract of Care and a Care Plan?
There is a difference between the Contract of Care and the Care Plan.
The Contract of Care is the legal document that outlines the relationship between whoever is responsible for paying the nursing home bill and the nursing home. It should record all charges that will be payable by the bill payer and all services that will be provided by the nursing home. The resident may have requirements that will be met by the HSE through the medical card scheme and these will not be listed in the contract of care. As was stated above there should be no additional charges levied by the nursing home outside of the contract.
The Care Plan is a confidential document outlining the resident's medical condition(s) (if any) and how the individual care needs of the older person will be met. This document is only available to the nursing home resident (and their next of kin) and the nursing home itself.
What is a Care Representative?
A Care Representative is a person appointed by the Circuit Court to apply for the NHSS on behalf of someone who lacks the capacity to make certain decisions on their own behalf and to complete the necessary forms.
They can be relatives of the older person or professionals (social workers, solicitors, GP etc.) working with the older person. The legislation governing this role may change as the new Assisted Decision Making legislation is rolled out.