Will disabled brothers be homeless when Fair Deal loan falls due?

My father is in a nursing home using his pensions and the family home to fund his Fair Deal. My two brothers, who both suffer from mental health issues and are on disability, live in the family home.

What happens when my father dies? Will we have to sell the house to pay Fair Deal the 7.5 per cent of the value of the house? If we sell the house my brothers would be homeless. What are the options for paying this back?

Separately, my father had to go to A&E one night and we got charged €250 by the nursing home for an ambulance and a carer to go with him. He has the medical card. Are they allowed to charge for this?

Ms MO’R, email

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Having a relative in a nursing home is generally a stressful time for family. In your case, no doubt it is compounded by concerns for the future and welfare of your brothers.

Fair Deal is a system where the State effectively subsidises the cost of care. As part of the financial assessment, your father will have agreed to contribute 80 per cent of his cash income and 7.5 per cent of the value of his savings and assets – including the family home – per annum. The contribution from the family home is capped at three years, so it could come to 22.5 per cent, not just 7.5 per cent.

Many people apply for Ancillary State Support (more commonly known as a nursing home loan) where the contribution payable against the value of the home – which is limited to three years – is deferred until the death of the nursing home patient.

This brings us to the nub of your query. When your father dies, the Revenue will come looking for an amount equal to 22.5 per cent of the value of the home – 7.5 per cent for each of the first three years. If he dies within the three years, the contribution can be less. So what happens then?

First up, there is nothing in Fair Deal that compels the sale of the home. All it states is that 22.5 per cent of the value of the home falls due – assuming the Fair Deal patient lived alone. If there is a spouse living at home, the maximum contribution is half of that.

It is up to the family of the Fair Deal patient to decide whether they want to sell the property to raise the funds or to find the money from other sources. This was something I was confused about myself until recently.

But what about your brothers? Normally, amounts owed under Fair Deal fall due upon death and must be paid within 12 months. But there is provision to further defer payment in certain circumstances – most commonly when a spouse or partner still resides in the property and the money is going to be raised by its sale.

Among the circumstances that permit further deferral is the occupation of the property by a relative (or relatives in your case) who are in receipt of a disability or similar allowance, a blind person’s pension, or the non-contributory State pension.

Qualify for deferral

You say your brothers are on disability so I assume they would qualify for this deferral. When the time comes, you will have to apply for the deferral to your local Nursing Homes Loan Support Office. It will be the place that processed your father’s application for the loan in the first place.

Once the deferral is accepted, the money will not fall due until your brothers no longer require the house, so you should have peace of mind on that front.

As for the charge made for getting your father to a hospital by ambulance with a carer, that’s not an issue for Fair Deal, but for your father’s contract with the nursing home. It will set down precisely what is included in his standard care and what services will cost extra. I am told that if a private ambulance is called, it will likely lead to a charge even for a patient with a medical card.

Make sure you have a copy of the contract and consult it as necessary where charges arise.

Please send your queries to Dominic Coyle, Q&A, The Irish Times, 24-28 Tara Street, Dublin 2, or email dcoyle@irishtimes.com. This column is a reader service and is not intended to replace professional advice.