The Fair Deal paperwork is manageable, but it has a few moving parts: a care-needs assessment, a financial assessment, supporting documents, and possibly a decision on the Nursing Home Loan. This guide walks through every step in the order it happens, so you know what to expect and what to prepare.

Before you start

Make sure the applicant actually needs long-term nursing home care. Fair Deal doesn't cover short-term stays — for those, speak to the hospital discharge planner or your GP about respite schemes instead. If you're unsure whether residential care is the right step at all, a public health nurse can help you think it through.

Step 1 — Get the application pack

You have three options:

  • Download the form from the HSE Fair Deal page
  • Ring HSE Live on Freephone 1800 700 700 (Mon–Fri 8am–8pm, Sat 9am–5pm) and ask for a pack
  • If the applicant is in hospital, ask the discharge coordinator or medical social worker — they usually have forms on the ward

The form is available in English and Irish.

Step 2 — Fill in the Care Needs Assessment section

The first part of the form describes the applicant's medical and functional needs. Be specific and concrete:

  • Current medical conditions and medications
  • Mobility (stairs, transferring, falls)
  • Day-to-day activities they struggle with (washing, dressing, continence, meals)
  • Cognitive function (memory, orientation, safety)
  • What support is currently in place (family, HSE home support hours, private care)

The HSE Care Needs Assessor will verify this during a home or hospital visit — don't under-state the situation trying to sound positive; the goal is to match the applicant with the right level of care.

Step 3 — Fill in the Financial Assessment section

This is where Fair Deal calculates the weekly contribution. You'll need to declare, for both the applicant and their spouse (if any):

  • Income — pensions (state, occupational, foreign), rental income, investment income, any income in the last 5 years you might have transferred
  • Cash assets — bank accounts, savings, credit union, shares, bonds, life assurance surrender values
  • Non-cash assets — principal residence, other property, land, farm, business
  • Debts secured on the principal residence (these reduce its assessed value)

Be thorough. The HSE cross-checks with Revenue data and will ask about any mismatches.

Step 4 — Gather supporting documents

Attach copies (not originals) of:

  • Photo ID and PPS number
  • Most recent bank statements (typically 6 months)
  • Pension statements / P60 / P21 balancing statement
  • Property valuation for the principal residence (a local auctioneer's letter is usually accepted)
  • Title deeds or Land Registry reference for property/land
  • Any enduring power of attorney or decision-making order

Step 5 — Decide about the Nursing Home Loan

If the assessable assets include the principal residence, land, or another property, you can apply for Ancillary State Support — the optional nursing home loan — on the same form. The loan lets the HSE pay the asset portion of the contribution during the stay; the debt is typically repaid after the applicant's death, usually when the property is sold.

You don't have to decide now — the loan can be taken up any time during the stay. But it's simplest to tick the box in the initial application if you're already confident.

Step 6 — Send the application to your local office

Send the completed pack (by post) to your Local Nursing Homes Support Office. The list of regional offices is on the HSE site. If you're not sure which office covers you, ring HSE Live and they'll direct you.

Step 7 — The Care Needs Assessment visit

A nurse or other qualified assessor will visit the applicant (at home or in hospital) and confirm what you described on the form. They may speak to the GP, hospital team, and family. The output is a decision on whether long-term residential care is appropriate. If the answer is no, Fair Deal funding isn't available — the HSE will usually suggest home support or a different pathway.

Step 8 — The Financial Assessment is processed

This is mostly a paperwork exercise on the HSE side. Your file is reviewed and the HSE calculates the weekly contribution. They may come back with follow-up questions — respond quickly, because the file pauses while they wait.

Step 9 — The funding determination

You'll receive a letter stating:

  • Whether the Care Needs Assessment approved residential care
  • The weekly contribution the applicant will pay
  • Approval (or not) for the Nursing Home Loan
  • The funding reference number, which you use when contacting approved homes

Step 10 — Choose a home on the NHSS list

Once approved, the applicant can move into any Fair Deal–approved home that has a bed. Contact individual homes (they'll ask for the funding reference) and they'll confirm their Section 40 weekly price — what the HSE pays plus what you contribute.

Timeline expectations

Processing times vary, but a typical window is 4 to 8 weeks from a complete application to a funding letter. Incomplete applications or unusual asset situations take longer. Hospital-based applications are sometimes prioritised for discharge planning.

If you disagree with the outcome

You can ask the HSE to review the decision. If you're still not satisfied, the decision can be appealed to the Office of the Ombudsman. The appeal process is free and the Ombudsman is independent of the HSE.

Practical tips from families who've done it

  • Start the paperwork before a crisis — you can always pause or withdraw
  • Keep a copy of everything you submit; post it registered
  • If the applicant has capacity concerns, look into Enduring Power of Attorney before it becomes necessary — it's much harder once they can't sign
  • Ask the nursing home to confirm availability in writing before you tell the HSE where you're placing

Sources: HSE — About Fair Deal, Citizens Information — Fair Deal scheme, Office of the Ombudsman. This guide is general information, not legal or financial advice.