Nursing home fees and extra charges: what you pay and what must be in the contract

Who this is for

• Families comparing homes and trying to understand the difference between a home’s published weekly price and what they will actually pay.^[2]
• Residents and relatives reading a contract of care, or facing an extra charge or a fee increase.^[6]
• People paying privately, who can still apply for Fair Deal later.^[6]

Before you start

• The home’s entry on the HSE price list: the weekly contract price for private and voluntary homes, or the cost of care for public homes.^[4][5]
• The home’s own list of extra services and their prices; Citizens Information says to ask the home directly for its cost and conditions.^[10]
• The draft contract of care, which the home should give you before admission and which only the resident (or a person with legal authority) can sign.^[6]

Step by step

1. 1

   Read the published weekly price

   The NTPF negotiates a maximum weekly price with each private and voluntary home in the scheme, fixed for the term of the contract, based on the home’s reasonable costs, previous prices, the local market price and the budget.^[1] The HSE publishes the full list, and a separate list of the cost of care in public homes.^[4][5][12] From the September 2026 lists, examples are €1,220 a week at Beechwood Nursing Home in Carlow and €1,321 at Beaumont Residential Care in Cork among private homes, and €1,908 at Sacred Heart Hospital, Carlow, and €2,741 at St Finbarr’s Hospital, Cork, among public ones.^[4][5] FairCare shows each home’s published price on its profile with the list date.
2. 2

   Understand what you will actually pay under Fair Deal

   The listed price is the full weekly cost, split between you and the HSE. Your share is a fixed amount from the financial assessment and is the same in any approved home, however much it charges.^[2] The HSE pays the balance only where your contribution is below the home’s cost; if your assessed contribution is higher than the price, you may not be eligible for Fair Deal at that time.^[3] In a public or voluntary home you pay your contribution to the HSE; in a private home you pay the home and the HSE pays the rest.^[7] See how to apply for Fair Deal.
3. 3

   Ask for the extras in writing before admission

   Fair Deal covers accommodation and food, nursing and personal care, laundry, and basic aids and appliances for everyday living. It does not cover short-term respite, convalescent or day care, or extra fees for services such as hairdressing, therapies and activities.^[2][7] The HSE says to ask what extras will be charged and to have them agreed and included in the contract; the form says the agreement must be in place by the time you enter the home.^[2][12] The CCPC says charges for social activities are common, that homes often mix mandatory and optional extras, and that the contract must state which are optional and how much each costs.^[6]
4. 4

   Check the contract of care against the law

   By regulation, the provider must agree in writing with each resident, on admission, the terms on which they reside, including the services provided under Fair Deal or otherwise, the fees for them, and since 2016 the bedroom to be provided and how many other people will share it.^[8][9] The CCPC adds that the contract must give the home’s legal name, address and phone number, the total price and how to pay, the complaints policy, the duration and how it can be ended.^[6] Only the resident can sign; a spouse, next of kin or guarantor cannot sign for them without a decision support arrangement such as an enduring power of attorney.^[6]
5. 5

   Know the rules on increases

   You must get at least 30 days’ notice of any fee increase, including increases to extras outside Fair Deal. The contract should explain when fees can rise, the notice period and how increases are calculated; the CCPC says a vague clause reserving the right to review fees may be unfair and unenforceable, and that any change to fees is a change to the contract needing your agreement.^[6] Under Fair Deal the price agreed with the NTPF is fixed for the contract term.^[1]
6. 6

   If something is wrong: who to complain to

   Every provider must have a complaints process by law. Fees, charges and contract disputes go to the Office of the Ombudsman, which covers public and private homes alike, funded or self-paying; you must first complain to the home and allow six weeks for a final response, then complain within 12 months.^[6][10][11] Contract terms that seem unfair can also be raised with the CCPC (consumer helpline 01 402 5555).^[6] HIQA inspects homes and reviews every concern it receives against the regulations, but it does not investigate individual complaints; concerns go to concerns@hiqa.ie or 021 240 9646.^[10]

What the contract should show before you sign

Covered by Fair Deal or charged separately

Paying privately

Homes are available privately or through the scheme, and someone who moves in as a private payer can still apply for Fair Deal afterwards.^[6] The NTPF agreement fixes the maximum price the home can charge Fair Deal residents; none of the official pages we read says whether private payers can be charged a different rate, so ask the home for its private price and conditions in writing.^[1][10]

Nursing home fees you pay yourself qualify for tax relief at your highest rate; under Fair Deal only your own contribution counts, and a repaid Nursing Home Loan can be claimed too. See tax relief on health expenses.

The two HSE public price lists differ: the list effective 1 September 2026 adds homes that the January 2026 list still linked from the financial assessment page does not carry. Use the September list.^[5]

What happens next

Keep the signed contract and the list of extras. Ask the home for a written schedule of any change, and remember the 30-day notice rule and the option of a Fair Deal financial review 12 months after the last assessment if your own finances change.^[3][6]

If something goes wrong

Fair Deal and prices: your local Nursing Homes Support Office or HSE Live, freephone 1800 700 700.^[12] Contract disputes: CCPC, Bloom House, Railway Street, Dublin 1, 01 402 5555.^[6] Complaints after the home’s own process: Office of the Ombudsman.^[11] Concerns about care standards: HIQA, concerns@hiqa.ie, 021 240 9646.^[10]

Common questions

Does a more expensive home cost me more under Fair Deal?

No. Your contribution is set by the financial assessment and is the same in any approved home. The HSE pays the difference between your contribution and the agreed price.

Can a home add a charge after I move in?

Extras must be agreed and written into the contract by admission, and any change to fees is a change to the contract that needs your agreement, with at least 30 days’ notice of an increase.

Can my daughter sign the contract for me?

Only the resident can sign, unless another person holds legal authority under a decision support arrangement such as a registered enduring power of attorney.

Who deals with a complaint about fees?

The home first. If you are not satisfied after six weeks, the Office of the Ombudsman, which covers both public and private nursing homes regardless of who pays.