Payment for Nursing Home care fees
Providing funding for fees in relation to care in a nursing home where a patient has insufficient assets or means to pay for such care comes from two main sources: 1) The Health and Social Services Trusts which operate under Health legislation and 2) The DHSS ( Department of Health and Social Security) which operates under the Income Support legislation. The legislation in both areas is largely similar. Anyone with capital (savings, property etc.) of more than £23,250.00 is not entitled to any help with care fees, meaning they would need to fund fees for nursing home care privately. If this person owns their home or a property, it may mean such property having to be sold to cover the costs of care. This figure reduces to £12,000 in a situation where a person is receiving domiciliary care in their own home or in a nursing home for respite care of up to 52 weeks.
Capital and the value of your home
If you have over £23,250 in capital, the Trust assesses you as able to pay for all your care.
The relevant Health Trust will assess your capital according to information shown below:
-If you have capital over £23,250, You will be assessed as being able to pay for all your care;
-If you have capital between £14,250 and £23,250, Capital between these amounts will be calculated as providing you with an income of £1 per week for every £250 of your savings;
– If you have capital of £14,250 or under , your capital will be ignored in calculating how much you have to pay towards your care.
When you pay towards your care home fees, you must have at least £27.19 remaining a week to spend as you wish. This is known as the “Personal Expenses Allowance (PEA)”. You’ll also get up to £5.75 a week savings credit if you are over 65. If you are in receipt of the mobility component of Disability Living Allowance benefit, you will continue to be entitled to this but you will no longer be entitled to the care component of Disability Living Allowance. Similarly if you are in receipt of Disability Living Allowance and you go into hospital or care for a period of 28 days or more, you must notify this benefit provider as you will no longer be entitled to the care component of Disability Living Allowance. Of course if you are discharged from hospital and recover without the need for imputed care, you will be entitled to the care component of Disability Living Allowance again.
The Family Home
In relation to temporary or respite stays in a nursing home of up to 52 weeks, the value of the family home will not be taken into account in assessing means of the person receiving such care. The value of the family home will also be ignored if the spouse of the person in care still lives there or if a child under the age of 16 or a relative aged 60 or over, or who is in receipt of incapacity benefits, resides in the property. The definition of incapacitated includes anyone claiming invalidity benefit, incapacity benefit, attendance allowance, etc. In addition, Health Trusts have a discretion to disregard a patient’s home where it has become the sole residence of someone who has given up their own home in order to care for the resident or someone who is an elderly companion/friend of the resident particularly if their home has been given up. If the carer later passes away or moves out of the property, then the value of the home is likely to be taken into account in any assessment of means of the person receiving care. If none of these considerations apply, then usually the value of the property will be included as an asset in determining a patient’s ability to cover the cost of their care. Permanent residents will have the option to have the value of their former home disregarded for the first 3 months of their stay in residential care. Where a patient’s funds are frozen pending a Controllership Order from the Court, all frozen funds will be disregarded in any such assessment of means until the release of the Controllership Order from the Court.
Health and Social Services Trust Rules
Before committing public funds, Health Trusts have to determine need; for example they will need to decide that a patient requires care. This is essentially a question for medical practitioners. If the Trust decides that with assistance a patient can continue to live at home, domiciliary care will be recommended. Necessary nursing care may be provided however cleaners and cooks have to be paid for in accordance with a patient’s means. If the medical assessment shows that a patient’s needs can only be fulfilled by residence in a nursing home, the Health Trust will decide upon the type of nursing home required to meet the needs of the patient and the patient’s ability to pay for such care there.
If a patient has given their home away with the intention of increasing their entitlement to help from a Health Trust with such care fees, this Health Trust can assess the patient as if the patient still owns the property. The Health Trust would however still be obligated to provide care and in practice the patient simply incurs an accruing debt. This can create two potential obstacles. If the patient has given the home away in the six months before going into care, or after going into care, the Trust has the legal power to recover the property from the person(s) this has been gifted or transferred to. The Trust can however take a tougher line. In the event that the Health Trust decides that the patient gave away this asset such as a home to avoid paying nursing home fees, and the asset was given away more than six months before going into care the Health Trust can initiate legal proceedings to recover the debt/fees owed for care and if successful, declare a patient bankrupt. In this event, any gifts that were made within five years of the patient going into care may be set aside. A gift may also be set aside without time limit if the Court is satisfied that the transfer of such gift was made for the purpose of putting assets beyond the reach of potential creditors. In other words, if your intention at the time of gifting your property can be proved to have been the avoidance of the responsibility to pay nursing home fees then the gift can be set aside by the Court without a time limit. The Court has power to demand to see solicitor’s files and records to try and identify the intentions of the patient at the time of the gift being made.
Income Support Legislation
Assistance with the cost of care from a Health Trust when added to pension, disability allowance and any other income a patient has, may have to be topped up in which case it is necessary for a patient to apply for Income Support benefit. The responsibility for care residents with preserved rights to higher rates of Income Support is with the appropriate Care Management Trusts. The Social Security Agency in assessing needs of a patient can take into account any of a patient’s assets even though they were gifted away at any time in the past. If it is determined such gift was to avoid payment for care, the Social Security Agency would disregard such gift and assess the patient as if they still had the asset and disallow their benefit claim for Income Support.
For more information in relation to this area, please do not hesitate to contact our firm.
