Important notes

Important Notes – (Please read carefully before application)

Official application process

The actual application process takes time to complete and it may be some time before you receive confirmation or otherwise of your application. It does not preclude you from entering a nursing home but if you do :-

  1.  You may have to pay all costs yourself until you have been accepted into the scheme.
  2.  You must have selected a nursing home that has been approved by the HSE otherwise if you subsequently qualify for the Scheme you may have to move to one that is approved.

Costs and contributions

The HSE generally calculates costs and contributions on a weekly basis. In this website all cost and contributions are shown on an annual basis.

Documentation

Income – A checklist of the required documentation is attached to the official Application Form (NHSS1)

Assets –  A checklist of the required documentation is attached to the official Application Form ( NHSS1)

For the estimated Market Values (EMV) you will need to provide some documentary evidence of value at the date of application.

  • In the case of property you will need a letter/valuation from an estate agent/valuer
  • In the case of a farm or business you will need a letter/valuation from an accountant/ solicitor or other professional acceptable to the HSE.
  • In the case of cash assets a bank statement or other form of statement from the relevant institution involved should suffice e.g stockbroker, insurance company, etc
  • You will need to supply bank statements for all accounts up to the date of application.
  • You may be asked to provide copies of all bank statements for the  the 5 years preceding the date of application especially where transferred assets may be involved.

Change in circumstances

Your contribution to the cost of your nursing home care will remain the same throughout your time in the nursing home unless your circumstances change i.e there has been a change in either your own or your partner’s financial circumstances. You are obliged to inform the HSE of any change within 10 days of the change and your financial support may be affected.

There are penalties for not informing the HSE.

Change in circumstance could include, amongst other things, death of a partner, loss or transfer of income or assets, however incurred, and acquisition of additional income or assets.

You need to be particularly aware that if your principal private residence is sold or after you have been accepted into the scheme it no longer qualifies for special treatment and the proceeds or Estimated Market Value at the time of sale or transfer will become a Cash Asset or Relevant Asset for the entire period you are receiving State support , not just 3 years. You also need to be mindful of the date when the principal private residence ceases to be assessable  and advise the HSE in advance so that your contribution and the HSE contribution are adjusted to reflect the change in a timely manner.

If you rent out your principal private residence whilst receiving State support the net rent will fall to be assessed as income and you will pay an additional contribution to your care. This can lead to problems when it is the wish of the the Applicant to leave a property in a will and there is no family member that can live in the property whilst the owner is in care, for whatever reason. It may be more convenient to leave the property vacant, perhaps with a caretaking arrangement in place.

Similar problems can arise with farms and businesses which have special treatment under the scheme. Professional legal and accounting advice is a necessity in these cases.

Cap on assessed contributions on principal residence – two members of a couple receiving support

There is a cap on the assessed contribution based on the same principal private residence where a second member of a couple enters the Scheme. The assessed amount for the second person when aggregated with that of the first person cannot exceed 22.5% of the Estimated Market Value of the property at the time of the first person’s Financial Assessment, less allowable deductions.

The second person will continue to be assessed on the principal private residence until the 22.5% threshold has been reached whereupon it shall cease to be a Relevant Asset.

Transferred Income and Assets

If income and assets have been transferred within 5 years prior to the date of Application they are added back into the appropriate section of the Financial Assessment Form as if they belonged to the Applicant at the date of application.

It is important to note that when you first apply for State support and declare transferred income and assets and are not accepted into the Scheme based on your Financial Assessment, if you subsequently re-apply because the transfer date now falls outside the 5 year limit, the date of transfer becomes irrelevant and transferred income and assets may still be added back for assessment purposes.

Deferral of your contribution

You may be entitled to defer your contribution based on property assets in the State until the settlement of your Estate. You may do this by applying for Ancillary Support ( The Nursing Home Loan Scheme).

In the case of contributions based on your principal private residence this may be further deferred where certain conditions are satisfied.

If a deferral is allowed ,the amount owing will be adjusted by the amount of the change in the Consumer Price index (CPI) over the period of the deferral.

Reviews

The HSE can , either at your request or its own initiative, review :-

  • Your care needs
  • Your Financial Assessment
  • The amount of the Nursing Home Loan

Re-application

You may re-apply to the HSE for admission to the Scheme if your circumstances change but you may have to wait 6 months or more from your previous application.

Taxation Issues

Tax allowances and nursing home care

Your contributions to the Scheme are allowable for tax relief at your marginal rate of tax. It is not necessary that you pay these costs yourself but they can be paid on your behalf by anyone and tax relief obtained by the payer. This also applies to (1) to (3) below. There are anti avoidance measures in place where the payer is reimbursed .

Where a person defers their contribution based on property assets in the Financial Assessment for the Nursing Home Support Scheme until his/her death then those contributions are deemed to have been paid by the deceased person immediately before his/her death and may be claimed for Income Tax purposes in that year.Nursing home care costs can be claimed at marginal rate and other health expenses at standard rate. The claim may be made by the Executors/Administrators of the deceased person’s estate.

If the Assessed figure in the Financial Assessment is greater than the cost of nursing home care

If you find that after applying for admission to the Scheme you are turned down on the basis of your Financial Assessment you may look at alternatives. It is likely that you will need taxation and legal advice to seek the most tax efficient method to pay the costs.

  1. Paying the full cost of care yourself or somebody else paying on your behalf. Depending on your level of income you could get tax relief  on nursing home care at your marginal rate of tax. This could also apply to any additional nursing care  provided by Registered nurses  that is purchased on your behalf.
  2. Staying at home and paying for care. As in (1) above you can get tax relief if you get home care from any one of the registered suppliers of such services. The costs are allowable against Income Tax at marginal rate.
  3. Employing a person or persons to look after you at home. This is the most difficult to administer as you or the payer might have to register as an employer and deal with all the HR and legislative issues that might arise. If the person is not just a carer but a fully Registered nurse it may be possible not to engage them as an employer but there are requirements in order to claim tax relief :-

A medical certificate can ( if requested ) be provided which :-

  • Shows the nature of the person’s illness
  • States that constant nursing care by fully qualified nurses in the patient’s home is required, and covers the full period for which nursing is being claimed.

The nurses providing the nursing care are fully qualified and their full names, addresses and qualifications can be supplied and receipts can, if requested, be provided in respect of all payments to the nurses, and, where necessary , a breakdown of the payments can be provided. This is to ensure that relief is given only in respect of the amounts paid which directly relate to nursing care and not to nurses expenses.

In addition, you or anyone paying on your behalf can claim tax relief at standard rate on qualifying medical expenditure that is not reimbursed by an insurer e.g Laya, VHI, or the HSE or any other body or person.