How to apply for Fair Deal (the Nursing Homes Support Scheme)

Who this is for

• Anyone ordinarily resident in Ireland (living here, or intending to, for at least a year) who may need long-term nursing home care.^[2][9]
• Families applying on behalf of someone who cannot apply themselves, through a “specified person”.^[1]
• People already paying privately or in hospital awaiting a long-term place, because funding only runs from approval and hospital long-stay charges can apply.^[5][9]

Before you start

• The application form: download it from the HSE or pick one up at a primary care centre or hospital. All applicants complete Parts 1 to 4; Part 5 (the loan) is optional; Parts 6 and 7 apply only to farms or businesses and co-decision-making agreements.^[1][2][9]
• Six months of bank statements for every account, and the income, asset and expense documents listed on page 11 of the form (see the checklist below). The HSE says a missing item delays the application.^[2][4]
• If someone applies for you, their legal basis: decision-making representative, enduring power of attorney, ward of court committee, or otherwise a spouse or partner, a child over 18, or a registered doctor, nurse or social worker.^[1][9]

Step by step

1. 1

   Complete and sign the form

   Signing the form applies for both the care needs assessment and financial support. Send it with the page 11 documents to your local Nursing Homes Support Office (list below); the HSE writes to confirm receipt.^[1][2] You can get help from a friend, relative, decision-making assistant or co-decision-maker and give their contact details on page 16; a person legally authorised to apply on your behalf enters their details on page 18.^[2]
2. 2

   Have the care needs assessment

   The HSE arranges the assessment, in hospital or at home, by a geriatrician, public health nurse or occupational therapist. It looks at everyday activities, mental abilities, the services you already get, family and community support, and your own wishes and preferences; you may be asked for a GP referral.^[3] The HSE writes with the decision and a copy of the report, within 10 working days according to Citizens Information. If you are found not to need long-term care you can apply again after six months, or sooner if your health changes.^[3][9]
3. 3

   Have the financial assessment

   The HSE works out your contribution from income and assets; the price the nursing home charges does not change what you pay. You get one letter confirming the amount and another confirming funding approval.^[1] The published formula: a single person pays 80% of assessable income plus 7.5% of assets a year, with the first €36,000 of assets exempt; a couple pays 40% of combined income and 3.75% of combined assets, with €72,000 exempt; the home counts for the first three years only.^[4] You can ask for a financial review 12 months after the last one, and the HSE can review at any time.^[4]
4. 4

   Decide on the Nursing Home Loan

   The optional loan lets the asset-based part of the contribution be deferred until after death, secured on property. It can take several months, so the HSE advises applying for it with the main application; you do not have to accept it if approved.^[1][10] Part 5 needs proof of ownership: the folio number, a copy of the deeds, or the lease.^[2]
5. 5

   Find a place, then confirm the start date

   Approval and a place are separate. Contact your preferred home early: it must have a bed, be able to meet your needs (it carries out its own assessment) and be part of the scheme; if it is full you can go elsewhere temporarily and apply for a transfer.^[6][9] Funding starts from the later of the approval date and the admission date and is never backdated, so people who move in earlier pay privately for that period.^[5][9] Because the scheme has a set budget each year, your name may go on a waiting list after approval.^[9]
6. 6

   Report changes, and appeal if you disagree

   Tell the office within 10 working days if you sell an asset (including the house) or your circumstances change; fines can apply.^[4][7] Appeals go within 40 working days to the National Appeals Service, HSE, Ballyshannon Health Campus, An Clochar, College Street, Ballyshannon, Co. Donegal, F94 TPX4, or nationalappeals@hse.ie, quoting the six-digit reference on the decision letter; the help line is 071 982 2124 or 071 982 2125, Monday to Friday 9.30am to 1pm.^[2] The form lists every appealable decision, from the care needs result to the loan and any review, and notes the Ombudsman as a further route.^[2]

Documents listed on page 11 of the form

The four steps at a glance

Applying on someone else’s behalf

If the person cannot apply themselves, a specified person may. The HSE lists a spouse or partner, a child over 18, a registered medical professional, nurse or social worker, a ward of court committee, the holder of a registered enduring power of attorney, or a decision-making representative appointed by the Circuit Court.^[1] Citizens Information ranks them: a decision-making representative, an enduring power of attorney holder or a ward of court committee come first; a spouse or partner, an adult child, or a registered professional come after.^[9] A specified person must act in good faith and for the person’s benefit, respect their dignity and privacy, give effect to their past and present will and preferences, and keep records secure.^[2]

Where the person lacks capacity and no arrangement exists, a court can appoint a decision-making representative through a capacity application on Courts Service Form 55A. The HSE publishes model wording for the Fair Deal decisions and warns that if the court order does not cover the decisions needed, the application cannot proceed.^[1]

Who you pay, and paying while you wait

In a public or voluntary home you pay your contribution to the HSE, which pays the home; in a private home you pay the home and the HSE pays the balance.^[9] While you wait for approval you can pay privately, and in a limited number of cases the HSE may fund a private home temporarily through Transitional Care Funding. If you are in hospital and no longer need acute care, the hospital can charge for long-term care, so the advice is to apply as early as possible.^[5][9]

The 3-year cap on the family home, the family successor rules for farms and businesses (extended in September 2024 to great-nephews, great-nieces, first cousins and their great-grandchildren), and the loan are covered on the HSE pages linked in the sources.^[7][9][10] Fees, the agreed weekly price and extra charges are in nursing home fees and charges.

Nursing Homes Support Offices

Carlow and Kilkenny: Community Services, James’s Green, Kilkenny, R95 RP26, 056 778 4761. Cavan and Monaghan: HSE Offices, Town Hall Street, Cavan, H12 W3R2, 049 437 7119. Cork and Kerry: Floor 1, Áras Sláinte, Wilton Road, Cork, T12 XRR0, 021 492 3536 to 3542. Donegal: St Joseph’s Hospital, Stranorlar, Lifford, F93 FCR6, 074 919 1734. Dublin South, Wicklow and Kildare: Hawthorn House, Millennium Park, Naas, W91 FY53, 045 920 000. Dublin North City and County: Nexus Building, Units 4 and 5, Blanchardstown Corporate Park, Dublin 15, D15 CF9K, 01 897 6121. Galway: Lá Nua, Ballybane Neighbourhood Village, Castlepark Road, Ballybane, H91 VE03, 091 748 490 (10am to 12pm and 3pm to 4pm), fairdeal.galway@hse.ie. Laois and Offaly: Bury Quay, Tullamore, R35 NF29, 057 935 9734. Limerick, Clare and North Tipperary: St Joseph’s Hospital, Mulgrave Street, Limerick, V94 C8DV, 061 461 499. Longford and Westmeath: Bury Quay, Tullamore, E35 W611, 044 939 4995. Louth and Meath: Unit 3 Ardee Business Park, Hale Street, Ardee, A92 VC53, 041 687 1515. Mayo: St Mary’s Headquarters, Castlebar, F23 HP58, 094 904 9176. Roscommon: Government Buildings, Convent Road, Roscommon, F42 VX53, 090 663 7561. Sligo and Leitrim: Markievicz House, Barrack Street, Sligo, F91 XC84, 071 932 1337. Tipperary: Community Care Centre, Western Road, Clonmel, E91 HT96, 052 617 7283. Waterford: Waterford Community Services, Cork Road, X91 VX09, 051 842 963. Wexford: Wexford Community Service, Georges Street, Wexford, Y35 AW96, 053 911 4316.^[8]

Addresses and numbers are as printed on the HSE contact page when this guide was checked. The HSE page is the current list.

What happens next

The form says processing can take some time depending on circumstances, and no HSE page states a target. Once approved you receive the contribution letter and the funding letter; keep both, tell the office of any change within 10 working days, and ask for a financial review after 12 months if your position changes.^[2][4]

If something goes wrong

Your local Nursing Homes Support Office (above), or HSE Live on freephone 1800 700 700 (01 240 8787; from abroad 00 353 1 240 8787), Monday to Friday 8am to 8pm and Saturday 9am to 5pm; the Fair Deal contact page says calls get through faster between 1pm and 6pm. HSE Live cannot be contacted by email.^[8] Citizens Information Phone Service: 0818 07 4000, Monday to Friday 9am to 8pm.^[9]

Common questions

How long does a Fair Deal application take?

The HSE does not publish a target. Its form says processing can take some time depending on individual circumstances, and that the loan can take several months. Missing documents delay the assessment.

Can funding be backdated to when my parent moved in?

No. Funding runs from the date of approval or the date of admission, whichever is later.

Does the nursing home’s price change what I pay?

No. Your contribution is fixed by the financial assessment and is the same in any approved home, whatever it charges.

What if the care needs assessment says long-term care is not needed?

You can apply again after six months, or earlier if health or circumstances change, and you can appeal the decision within 40 working days.