Nursing Home Contract (Ireland)

A Nursing Home Contract in Ireland sets the services to be provided, the fees, the timetable, and each side's responsibilities for the engagement, as regulated by the Health Act 2007.

The regulatory framework governing nursing homes in Ireland has its origins in the Health (Nursing Homes) Act 1990, which first introduced a system of registration and inspection for private nursing homes. The sector was fundamentally reformed by the Health Act 2007, which established HIQA (the Health Information and Quality Authority) with independent powers to register, inspect, and regulate all designated centres for older people — including both private nursing homes and HSE-operated public long-term care units — on a consistent basis for the first time.

All designated centres for older people must be registered with HIQA's Chief Inspector of Social Services under Part 7 of the Health Act 2007 and must comply with the Health Act 2007 (Care and Welfare of Residents in Designated Centres for Older People) Regulations 2013 (S.I. No. 415 of 2013). HIQA's National Standards for Residential Care Settings for Older People in Ireland (first published in 2009, revised in 2016 and updated in 2023) provide the detailed quality benchmarks against which designated centres are inspected. As of October 2024, the Health (Amendment) Act 2024 strengthened HIQA's enforcement powers by enabling it to issue compliance notices requiring providers to remedy contraventions of the 2007 Act without the need for immediate criminal prosecution.

The Nursing Homes Support Scheme Act 2009 governs the 'Fair Deal' scheme, through which the HSE funds a significant portion of the cost of care for eligible residents in both public and private nursing homes. Nursing homes participating in the Fair Deal scheme are subject to additional contractual and regulatory requirements regarding fees, additional services, and the treatment of Fair Deal residents.

The Assisted Decision-Making (Capacity) Act 2015 (as amended by the Assisted Decision-Making (Capacity) (Amendment) Act 2022, commenced on 26 April 2023) reformed the framework for decision-making by persons with impaired capacity — of direct relevance to nursing home contracts, as many residents may have cognitive impairments affecting their capacity to understand and consent to the contract's terms. The 2015 Act established the Decision Support Service, which maintains registers of co-decision-making agreements, decision-making representation orders, enduring powers of attorney, and advance healthcare directives — all of which may be relevant to a nursing home resident's legal status.

A Nursing Home Contract is needed whenever a person is being admitted to a registered nursing home or designated centre for older people in Ireland on a long-term residential care basis. The requirement for a written contract is mandatory under Regulation 24 of the Health Act 2007 (Care and Welfare of Residents in Designated Centres for Older People) Regulations 2013, and the absence of a compliant written contract is a regulatory breach that HIQA can identify during inspection and that the provider must rectify.

You need a nursing home contract when your family member is being admitted to a private nursing home whether under the Fair Deal scheme (where the HSE pays a portion of the costs) or on a fully private-paying basis. The contract should be reviewed carefully before signing — ideally with the assistance of a solicitor or an advocate from the Nursing Homes Ireland complaints service — to confirm it complies with the Regulations, does not include unlawful additional charges, and clearly sets out all fees and services.

You need a nursing home contract when you are a nursing home operator preparing for a resident's admission. The contract must be consistent with the centre's HIQA-registered Statement of Purpose, must comply fully with the 2013 Regulations (particularly Regulation 24 on the contract of care and Regulation 9 on residents' rights), and must be kept on the resident's personal file throughout the period of residency.

You need a nursing home contract when a resident's circumstances change significantly — for example, if they are moved to a different unit or level of care within the facility, if the fee structure changes, or if additional services are agreed. In these circumstances, the contract should be updated and re-signed (by the resident or their legal representative) to reflect the new arrangements.

You need a nursing home contract when acting as the legal representative of a person who lacks capacity to enter into the contract themselves — for example, a decision-making representative appointed under the Assisted Decision-Making (Capacity) Act 2015, or the holder of a registered enduring power of attorney. The contract should clearly identify the representative's authority and the basis on which they are acting.

A compliant Irish Nursing Home Contract under the Health Act 2007 Regulations 2013 must address the following key elements.

The parties clause identifies the registered provider of the designated centre (full legal name, HIQA registration number), the resident (full name, date of birth, PPSN), and any legal representative acting on behalf of the resident (name, relationship, basis of authority under the Assisted Decision-Making (Capacity) Act 2015 or enduring power of attorney).

The care and services clause (as required by Regulation 24(1)(a)) sets out the full range of care and services to be provided to the resident, consistent with the centre's HIQA-registered Statement of Purpose. It should describe the standard room and care package, any specialist services available (dementia care, physiotherapy, occupational therapy, speech therapy), and the protocol for developing and reviewing the resident's individual care plan under Regulation 5.

The fees clause (Regulation 24(1)(b)) clearly sets out all fees payable by the resident, whether under the Fair Deal scheme (specifying the HSE negotiated rate, the resident's assessed personal contribution, and any permissible additional charges) or on a private-paying basis (specifying the weekly or monthly fee, what is included, and any additional charges). The fee review mechanism and advance notice requirements for fee increases must be clearly stated.

The residents' rights clause incorporates the rights guaranteed by Regulation 9 of the 2013 Regulations, including the right to dignity and respect, privacy, free communication, religious practice, access to visitors, and personal property protection.

The care plan clause confirms the nursing home's obligation under Regulation 5 to prepare a thorough individual care plan for the resident within 48 hours of admission, to review it at least every four months, and to involve the resident (and their representative) in its preparation and review.

The complaints clause sets out the nursing home's internal complaints procedure in accordance with Regulation 34 of the 2013 Regulations, including the acknowledgement timeframe (three working days), the investigation and resolution process, and the escalation route to HIQA for unresolved complaints.

The termination clause addresses the circumstances in which either the nursing home or the resident may terminate the residency agreement, the notice period required (typically one month's written notice from either party), the circumstances permitting immediate termination (for example, where continued residency would pose a risk to the health or safety of the resident or others), and the arrangements for the resident's departure and transfer of care to an appropriate alternative care setting. Where a resident is being transferred to another designated centre or to an acute hospital, HIQA's guidance on safe transfer of care applies and the sending centre must provide a thorough handover of the resident's care plan, medication record, and personal history.

The HIQA complaints process clause should set out the resident's right to complain to HIQA directly where the nursing home's internal complaints process has failed to resolve a concern satisfactorily. HIQA's Chief Inspector has power to investigate complaints about designated centres under Part 7 of the Health Act 2007 and to take enforcement action, including issuing compliance notices under the Health (Amendment) Act 2024 and, in serious cases, cancelling or refusing to renew a provider's registration. The forms-legal.com Nursing Home Contract (Ireland) template covers the mandatory elements under Sale of Goods and Supply of Services Act 1980.