What is cost of a nursing home in France?
This is an edited extract from our 2018-2019 French Inheritance Law helpguide, which has a chapter on dependency issues in older age. The guide costs €9.90 (plus P&P) and is available (print or PDF version) from our website, by calling 06 40 55 71 63 or via selected newsagents.
A nursing home for elderly people with ongoing medical needs is known as an EHPAD and can be either state run and thus under the responsibility of the council / public hospitals or private. Private homes cost up to 50% more than state ones and have shorter waiting lists.
Price factors include staff-to-patient ratio, services and location (rural ones are cheaper) and the cost is between €1,500 to €4,000/month.
Costs fall into three parts. The first is accommodation, including board and lodging and leisure. This is at a rate fixed by the departmental council if it is a public sector home accredited to accept people who are eligible for means-tested state aid – otherwise it can be set freely but annual increases are subject to set limits. It is €47 to €108 per day according to a recent analysis by Cnsa, a body involved in aid to the elderly, and includes meals, utilities, cleaning and laundry.
The social security system (Cpam) covers medical costs, the second part of fees.
Finally there is dependency care (€4.30 to €26 per day) for day-to-day non-medical assistance and special equipment and adaptations, depending on a person’s needs. This includes, for example, help with washing and getting around. It rises depending on how major the needs are from a set classification of six (the least serious) to one (the most serious).
The first part will usually be paid by the resident from income such as a pension but can in part be paid via various benefits and state aid.
You can compare costs of nursing homes in a given area at pour-les-personnes-agees.gouv.fr. You need to click at the top right on Comparer les prix et les restes à charge en EHPAD.
Depending on your means, housing benefit can help with the accommodation part of the fees, either (or both) from the Caf or departmental council. However, in French law descendants have an obligation towards needy parents and grandparents to help with their essential needs and the council can request they contribute. Recipients of council help must spend 90% of their own incomes on the fees and council benefit can be recuperated from a person’s estate after they die.
The APA benefit is available from departmental councils to help with dependency fees. It is for anyone with dependency needs rated one to four but the amount is means-tested.
If you own your home it is not included in means calculations and you are not expected to sell it. Those who pay income tax may also benefit from a tax reduction of up to €2,500/year.