The full cost of a nursing home in Ireland, including extras

Every approved nursing home has a maximum weekly price for Fair Deal residents. For private and voluntary homes this is agreed with the National Treatment Purchase Fund (NTPF), which negotiates with each home on behalf of the State, usually every year. Once agreed, the price is fixed for the length of the agreement. For public HSE homes, the HSE publishes the cost of care in each home.

These prices are published by the HSE as two lists, and they're the prices we show for each home. Look up any home by town or Eircode, or browse by county, to see its current price and how it compares with the county median.

The agreed price covers what the NTPF contract calls long-term residential care services:

• bed and board
• nursing and personal care appropriate to the person's needs
• laundry
• basic aids and appliances needed for everyday living

Your Fair Deal contribution doesn't change with the home's price. A more expensive home costs the State more, not you, though extra charges do vary between homes. Work out your contribution with the calculator in our Fair Deal guide.

If you pay privately, for example while waiting for Fair Deal funding, the home sets its own rate. Ask for it in writing. Private payments made while you wait are not refunded when Fair Deal is approved.

Fair Deal doesn't cover services outside long-term residential care, and most private and voluntary homes charge extra for some of them. The HSE and Citizens Information give activities, hairdressing and therapies as examples. Others you may see are:

• a weekly "social programme" or activities charge
• hairdressing, chiropody or other therapies not provided through the medical card
• newspapers, outings, toiletries, or dry cleaning
• escorts to hospital appointments

These charges are often a fixed weekly amount, and over a year they add up. They must be agreed with you before the admission date, and the HSE says they will be included in your contract with the home.

HIQA's regulations require every nursing home to agree a written contract with each resident when they move in. It must set out the services provided, the fees for them, the Fair Deal arrangements, and any optional services that Fair Deal doesn't cover. The Competition and Consumer Protection Commission (CCPC) explains your rights:

• The contract must list the extra services and clearly state what each one costs.
• You should know the total cost of those services before you sign.
• The home can't add new charges without your agreement.
• Fee increases, including increases to extra charges, must be made fairly and transparently, with at least 30 days' notice.

If you think a charge is unfair, raise it with the home's complaints process first. After that, the Office of the Ombudsman can look at complaints about private nursing homes. See the CCPC's guide to nursing home contracts.

GP visits, medicines and some medical equipment are not part of the Fair Deal price. They are provided the same way as they would be at home: through the medical card or GP visit card if the person has one, or the Drugs Payment Scheme if not. Many people going into a nursing home qualify for a medical card, so check eligibility early.

Ask each home which GP looks after its residents, which pharmacy it uses, and whether it charges for anything the person may already be entitled to free through the medical card.

You can claim income tax relief on nursing home fees you pay yourself, either for yourself or for someone else whose fees you pay. Revenue's rules are:

• The home must provide 24-hour on-site nursing care.
• Relief is at your highest rate of tax, up to 40%, not just the standard 20% that applies to most health expenses.
• You can only claim on what you pay. The HSE's share under Fair Deal doesn't qualify.
• You need enough income tax liability to benefit. Claims can be made in real time, or for up to 4 years back.

Example

A daughter taxed at 40% pays €5,000 a year towards her father's nursing home fees. If all of it falls in her higher-rate band, she can get up to €2,000 back. See Revenue's page on nursing home expenses for how to claim.

• What is your weekly price, and is it the same as the HSE Fair Deal list?
• What extra charges do you make each week, and can I have the full schedule in writing?
• Which extras are optional, and can a resident opt out of an activities charge they can't take part in?
• How much notice do you give of price increases, and when did prices last go up?
• Which GP and pharmacy do residents use, and is there any charge for them?
• What do you charge for a respite or convalescent stay, if we need one first?