Reading a Care Home File Like a Label

A care home admission file is a register, not a brochure. It carries four checkable parts: the contract of stay, the tariff lines, the dependency grid and the rights attached to them. A family that reads those four parts before signing can ask precise questions instead of general ones.

What the contract of stay actually fixes

The contract of stay is the written agreement between the resident and the establishment. In France it is a named document, distinct from a simple reservation form, and it states what the establishment provides and what the resident pays for. Read it as a list of obligations, not as a welcome message.

The contract normally names the room or the type of accommodation, the services included in the daily rate, the services billed separately, the notice period for leaving, and the conditions for a temporary absence. It also names the documents attached to it, which usually include the establishment's internal rules and a tariff schedule.

A family reading a file for a medically supervised retirement home in Aubenas, in the Ardeche department, can use the establishment's own pages as a working example of how those documents are presented to relatives. The site of the EHPAD Saint-Joseph Aubenas sets out the care home admission file in French, covering daily life, admission steps and costs. That page is a description of one establishment, not a rule that applies everywhere, but it shows which headings a complete file usually contains.

Three clauses deserve a slow read. The first is the list of services included in the daily rate, because two establishments can quote the same daily figure and include different things. The second is the notice period, because it decides how much a family pays after a departure. The third is the procedure for a complaint, because it names the person who receives it.

What do the tariff lines cover?

A tariff line is one row of the price schedule. Care home billing in France is usually split into three rows, and each row has a different payer.

The accommodation row, called the tarif hebergement, covers the room, meals, laundry and the general running of the building. The resident or the family pays it, and it is the row that social aid can reduce. The dependency row, called the tarif dependance, covers help with washing, dressing, moving and supervision. The health insurance fund contributes to this row for residents who qualify. The care row, called the tarif soins, covers medical and nursing care. Health insurance pays it.

A family should ask for the three rows separately, in writing. A single all inclusive figure hides which row is rising and which payer is concerned. Ask also whether the accommodation row differs by room type, by floor or by the number of occupants, and whether a temporary absence reduces the bill. In many establishments the accommodation row continues during a short hospital stay, while the dependency row is adjusted.

Ask for the date of the last tariff revision and for the document that authorises it. In France the departmental council sets the accommodation and dependency rates for establishments that receive social aid, and those rates are published. A schedule without a date is not a schedule.

What is the dependency grid and what does it decide?

The dependency grid is the national tool used to measure how much help a person needs. Its French name is the grille AGGIR, and it produces a group, the GIR, on a scale from one to six. GIR one describes a person who needs heavy and constant help. GIR six describes a person who is independent in the acts of daily life.

The grid is not a diagnosis and not a score of illness. It records what the person actually does, or cannot do, alone: dressing, eating, moving indoors, going out, using the telephone, managing money. A person with a serious disease can still be rated at a low GIR if the acts of daily life remain possible.

The GIR matters for two reasons. It decides the dependency tariff row, and it supports the application for the personal autonomy allowance, the APA. The assessment is carried out by a team that visits the person, usually at home or in hospital, and it is reviewed later. A family can ask which GIR was recorded, on what date, and by whom.

A useful question before a first visit is how the establishment uses the GIR in daily organisation. Two residents with the same GIR can receive different amounts of help, because the plan of care is individual. Ask to see how the plan is written and how often it is revised.

Which rights come with the file?

Four rights are attached to a care home admission in France, and each one has a document behind it.

The first is the personalised plan of care, called the projet d'accompagnement personnalise. It describes the help provided and the activities proposed, and it is written with the resident.

The second is the person of trust, the personne de confiance. This is a person the resident names, who can accompany them to appointments and speak for them if they cannot. The designation is written and can be changed.

The third is the advance directives, the directives anticipees. These are written instructions about care at the end of life. They are kept in the resident's file and can be revised.

The fourth is the council of social life, the conseil de la vie sociale. This is the body where residents and families discuss daily life, menus, activities and the internal rules. Ask when it meets and how a family can raise a point.

What should a family ask before a first visit?

Prepare a short written list and take notes during the visit. The list below is ordered so that the answers can be compared between two establishments.

Ask for the three tariff rows in writing, with the date of the last revision. Ask what the accommodation row includes and what is billed separately: hairdresser, telephone, transport, newspapers, outings. Ask whether a trial stay is possible and how it is billed.

Ask how many residents live in the establishment and how many staff are present during the day and at night. Ask whether a doctor is present on site and how care is organised with outside practitioners. Ask how a fall is handled and what prevention is in place.

Ask about meals: who prepares them, whether a diet is possible, and how the dining room is organised. Ask about activities and about animal assisted mediation if the establishment offers it. Ask how a room can be personalised with furniture and objects.

Ask about admission steps: which documents are required, how long the file takes, and what happens in the first days. Ask about the contract of stay, the notice period, and the procedure for a complaint. Ask about the person of trust, the advance directives and the council of social life.

Ask about costs and rights: the rates in the Ardeche department, the personal autonomy allowance, social aid for accommodation, and the obligation of support between relatives. These are separate mechanisms with separate application forms, and a family should know which one it is applying for.

How to compare two files without reading them twice

Build a table with one column per establishment and one row per item. The rows are the same for every file: accommodation row, dependency row, care row, date of revision, services included, services billed separately, notice period, number of residents, night staffing, doctor on site, fall prevention, meals, activities, room personalisation, admission documents, first days, person of trust, advance directives, council of social life, rates in the department, personal autonomy allowance, social aid, obligation of support.

Fill the table from the written documents, not from the conversation. Where a document is missing, write missing and ask for it. A file that answers twenty rows in writing is easier to compare than a file that answers them aloud.

Keep the contract of stay, the tariff schedule and the internal rules together in one folder. Those three documents are the register. The rest of the visit is context.

A care home file and a coverage rule share one habit: both list what is included, for whom, and for how long, while leaving the price to another document. The same method applies to the Dutch physiotherapy decree, which defines physiotherapy, names conditions and durations in the annex to article 2.6, and states no amounts. A reader who has already checked a dependency grid line by line can check a coverage list the same way, before trusting any figure quoted at the desk.

This page rests on one published source. The fixed statements about admission paperwork can be checked against the public page on admission, a service-public.fr page cited here as the primary reference. Readers who want to verify a line can open that page and compare it with the text above. The page adds no fact beyond what that source states, and no other document is used for the fixed statements.