# Residential Care Overview ## Health New Zealand | Te Whatu Ora **Source:** [https://www.healthnz.govt.nz/hospitals-services/services-support/support-services/older-people/residential-care](https://www.healthnz.govt.nz/hospitals-services/services-support/support-services/older-people/residential-care) **Capture Date:** 2026-06-07 --- ## Overview Residential care is provided for older people who can no longer live independently at home and require 24-hour nursing or personal care in a licensed residential care facility. These facilities are regulated by Health New Zealand | Te Whatu Ora under the Health and Disability Services (Safety) Act 2001. --- ## Types of Residential Care ### 1. Rest Home Care (Level of Care: Low) - For people who need help with daily activities (e.g., washing, dressing, eating, mobility) but do not require 24-hour nursing care. - Care staff are available around the clock, but registered nurses are not necessarily on-site 24/7. - Suited for those who are relatively mobile and have stable health conditions. - Social activities, meals, and housekeeping are typically included. ### 2. Hospital Care (Level of Care: High) - For people who need 24-hour registered nursing care and regular medical supervision. - Suitable for those with complex medical needs, chronic conditions requiring monitoring, or who are bed-bound. - Registered nurses are on-site 24 hours a day. - Often called "private hospital" or "geriatric hospital" care. ### 3. Dementia Care (Specialist) - Secure, specialised facilities for people with dementia (mate wareware) who have behaviours that challenge or who wander. - Staff are trained in dementia care and communication techniques. - The environment is designed to be safe and supportive, with secure outdoor areas and cues to aid orientation. - May be a dedicated unit within a rest home or hospital, or a stand-alone facility. ### 4. Psychogeriatric Care (Specialist) - For older people with significant mental health conditions alongside age-related needs, such as severe depression, anxiety, psychosis, or complex behavioural and psychological symptoms of dementia (BPSD). - Requires input from specialist mental health services for older people. - Typically provided in specialised units with higher staff-to-resident ratios. --- ## How to Access Residential Care ### Step 1: Needs Assessment (NASC) - Contact your local Needs Assessment and Service Coordination (NASC) service — also known as a Needs Assessment Service — to arrange an assessment. - NASC services are provided by district health boards (DHBs) or contracted providers. - The assessment is free of charge. - A trained assessor (usually a nurse, occupational therapist, or social worker) visits you in your home, hospital, or current care setting. ### Step 2: Assessment Process The NASC assessment evaluates: - **Functional ability:** mobility, personal care, transfers, continence, meal preparation - **Medical needs:** current diagnoses, medications, pain management, pressure area risk - **Cognitive function:** memory, decision-making, safety awareness, behaviour - **Social circumstances:** carer support, living situation, community connections - **Rehabilitation potential:** whether a short-term restorative approach might help ### Step 3: Care Level Decision - The assessor determines the appropriate level of care (rest home, hospital, dementia, psychogeriatric). - This is documented in a **Support Needs Assessment** form. - If you meet the criteria for residential care, you receive approval for the relevant level. ### Step 4: Choosing a Facility - Once approved, you (or your family/whānau) can choose a facility from the list of licensed providers. - Most facilities offer trial visits or short-term stays. - The facility will do its own assessment to confirm they can meet your needs. --- ## Funding ### Residential Care Subsidy (RCS) The government provides a subsidy to cover the cost of care for those who meet eligibility criteria. **Criteria:** 1. **Level of care:** You must have been assessed as needing rest home, hospital, or specialist care. 2. **Residency:** You must be a New Zealand citizen or permanent resident, and ordinarily resident in New Zealand. 3. **Age:** Usually 65 years or older (or 50+ if receiving a benefit and living in aged residential care before turning 65). 4. **Income and assets test:** Your income and assets are assessed to determine subsidy eligibility. **Income and Asset Thresholds (as at 2026):** - **Single person:** - All assets under the threshold (approx. $265,000–$290,000 depending on circumstances) — you may qualify for full subsidy after the asset test. - Assets above threshold — you pay the full cost (often referred to as "asset-rich"). - **Married or in a civil union/de facto relationship:** - Combined assets assessed; thresholds differ for couples where one partner is in care and the other remains living independently. **What the Subsidy Covers:** - The "contract price" for your care (board, meals, nursing care, personal care, activities). - It does **not** cover "extra" charges such as: premium room upgrades, entertainment, personal items (haircuts, toiletries), GP visits, medications, or specialist appointments. ### Paying for Care Privately - If you do not qualify for the RCS (e.g., your assets exceed the threshold), you can pay the full cost privately. - If your assets reduce below the threshold while paying privately, you can apply for the subsidy at a later date. ### Other Funding Options - **Veterans' Support Act funding** for eligible veterans. - **ACC** if the need for care arises from an accident. - **Temporary Additional Support** (a Work and Income benefit) may help with some costs. ### Charging for Residential Care For those who do qualify for the RCS, the government pays the facility the contract rate directly. You are required to contribute most of your NZ Superannuation or Veteran's Pension (minus a small personal allowance) toward the cost — this is called the "resident's contribution." --- ## Rights and Responsibilities All residents of aged residential care facilities are protected by the **Code of Health and Disability Services Consumers' Rights** (the Code of Rights). ### Key Rights Include: - **Right to be treated with respect:** dignity, individuality, and cultural needs (including Te Tiriti o Waitangi obligations). - **Right to freedom from discrimination, coercion, harassment, and exploitation.** - **Right to dignity and independence:** to make your own decisions about care and daily life. - **Right to services of an appropriate standard:** safe, competent, and timely care. - **Right to effective communication:** information in a format you understand; access to an interpreter if needed. - **Right to be fully informed:** about your care, treatment, costs, and any changes. - **Right to make an informed choice and give informed consent.** - **Right to support:** you can have a support person or family/whānau member present. - **Right to complain:** to the facility, the Health and Disability Commissioner (HDC), or an independent advocate — without fear of retaliation. ### Advocay Support - **Nationwide Health and Disability Advocacy Service:** Free, independent advocates can help you understand your rights and raise concerns. - Phone: 0800 555 050 - Website: www.advocacy.org.nz --- ## Quality and Regulation - All residential care facilities must be certified under the Health and Disability Services (Safety) Act 2001. - Certification is granted for a set period (typically 1–4 years) after an audit by HealthCERT (part of the Ministry of Health / Health NZ). - Audit reports are publicly available on the Ministry of Health website. - Facilities must meet standards covering: clinical care, cultural safety, human resources, environment, and quality improvement. --- ## Related Services - **Carer Support (for informal carers):** Available through NASC for people caring for someone at home. - **Home Support Services:** Personal care, housework, meals, and other support at home to delay or avoid residential care. - **Respite Care:** Short-term residential care to give carers a break; can be funded through NASC. - **Day Programmes:** Social and therapeutic activities in a community setting. --- ## Key Contacts | Service | Contact | | ---------------------------------- | ------------------------------------------- | | NASC (local Needs Assessment) | Contact your local DHB / Health NZ district | | Health and Disability Commissioner | 0800 11 22 33 | | Advocacy Service | 0800 555 050 | | Work and Income (financial help) | 0800 559 009 | | Elder Abuse Helpline | 0800 32 668 65 | | Age Concern | 0800 65 2 105 | --- ## Summary of Key Facts | Topic | Detail | | ----------------- | ------------------------------------------------------------------------------- | | **Types of care** | Rest home, hospital, dementia, psychogeriatric | | **Access** | NASC assessment (free) determines level of care needed | | **Funding** | Residential Care Subsidy (income/assets tested), private payment, veterans, ACC | | **Rights** | Code of Health and Disability Services Consumers' Rights applies | | **Regulation** | Certified under Health and Disability Services (Safety) Act 2001 | | **Age threshold** | Usually 65+ for public funding |