Care homes (also known as nursing homes or hospital-level care facilities) provide 24/7 registered nursing care for seniors with significant medical needs or complex health conditions. These facilities offer the highest level of residential aged care in New Zealand, with trained medical staff, specialized equipment, and comprehensive health services.
Whether you need dementia care, post-hospital rehabilitation, palliative care, or long-term medical supervision, this guide helps you understand care home options, costs, and how to choose the right facility for your loved one.
Compare Care Home Providers
Premium Care Homes
Key Features:
- 24/7 nursing care
- Specialist medical staff
- Private rooms
- Rehabilitation services
- Palliative care
Pros:
- + Expert care
- + Medical support
- + Quality facilities
- + Therapy options
- + Family involvement
Cons:
- - High cost
- - Limited availability
- - Location dependent
Heritage Care NZ
Key Features:
- Registered nurses
- Dementia care
- Activity programs
- Garden views
- Family rooms
Pros:
- + Specialized care
- + Beautiful setting
- + Activity focus
- + Family support
- + Quality meals
Cons:
- - Premium pricing
- - Waiting lists
- - Strict routines
Senior Care Plus
Key Features:
- Medical director
- Therapy services
- Special diets
- Social activities
- Respite care
Pros:
- + Affordable option
- + Good care
- + Dietary focus
- + Short-term stays
- + Social program
Cons:
- - Shared rooms
- - Basic amenities
- - Fewer services
What is a Care Home?
Care homes (hospital-level aged care) provide 24/7 registered nursing care for seniors with complex medical needs. This is the highest level of residential aged care in New Zealand, offering:
- 24/7 Registered Nurses: Qualified nurses on duty around the clock to provide medical care and emergency response.
- Medical Supervision: Regular GP visits, medication management, wound care, and treatment of complex conditions.
- Specialized Care: Dementia care, palliative care, post-surgical care, and rehabilitation services.
- Full Personal Care: Assistance with all activities of daily living including bathing, dressing, toileting, and mobility.
- Therapeutic Services: Access to physiotherapy, occupational therapy, and speech therapy as needed.
- Nutrition & Meals: Specialized diets for medical conditions, texture-modified meals, and feeding assistance.
Understanding Care Levels in New Zealand
| Care Level | Medical Support | Typical Weekly Cost | Best For |
|---|---|---|---|
| Rest Home (Assisted Living) | Care staff, limited nursing | $1,195-$1,350 | Help with daily activities |
| Hospital Care (Care Home) | 24/7 registered nurses | $1,495-$1,650 | Complex medical needs |
| Dementia Care | Specialized nursing | $1,550-$1,800 | Memory care needs |
| Palliative Care | End-of-life nursing | Varies by facility | Terminal illness care |
Understanding Care Home Costs
Weekly Fees & Government Subsidies
Care home costs in New Zealand range from $1,495-$1,650 per week for private payment. However, most residents qualify for government subsidies:
Residential Care Subsidy
The government provides substantial subsidies for hospital-level care through the Residential Care Subsidy. Eligibility requirements:
- • Needs assessment certifying hospital-level care required
- • Assets below threshold (approximately $240,000 for couples, $130,000 for singles in 2025)
- • Income assessment
- • New Zealand resident for 10+ years
The subsidy can cover most or all costs for eligible residents. Contact Work and Income for assessment.
Included in Weekly Fee:
- • 24/7 registered nursing care
- • All meals and snacks
- • Medication management
- • Personal care assistance
- • Housekeeping and laundry
- • Medical equipment
- • GP visits
- • Continence products
Potential Extra Costs:
- • Hairdressing services
- • Chiropody/podiatry
- • Newspapers and magazines
- • Personal toiletries
- • Outings and entertainment
- • Specialist appointments
- • Private room upgrade
- • Cable TV or internet
Who Needs Care Home Level Care?
Care home (hospital-level) care is appropriate when seniors have complex medical needs that require registered nursing supervision. Common scenarios include:
- • Complex medication regimens requiring nursing oversight
- • Chronic wounds requiring regular dressing changes
- • Advanced dementia with behavioral challenges
- • Post-stroke care and rehabilitation
- • Advanced Parkinson's or neurological conditions
- • Oxygen therapy or respiratory support
- • Diabetes with complications requiring monitoring
- • Feeding tubes or specialized nutrition
- • Catheter or stoma care
- • Palliative or end-of-life care
- • Severe mobility limitations
- • Multiple co-morbidities requiring medical management
How to Choose a Care Home
Check Certification & Audit Results
Verify the facility is certified by the Ministry of Health for hospital-level care. Review recent audit results - 4-year certifications indicate excellent standards, while provisional certifications may indicate concerns.
Assess Nursing Staff Qualifications
Ask about nurse-to-resident ratios, qualifications of the clinical manager, and how many registered nurses are on duty per shift. Higher ratios mean better care.
Visit at Different Times
Tour the facility multiple times, including during meals and evening shifts. Observe how staff interact with residents, cleanliness standards, and the overall atmosphere.
Review Specialized Services
If your loved one has specific needs (dementia care, palliative care, rehabilitation), ensure the facility has specialized training, dedicated units, and appropriate programs.
Talk to Families of Current Residents
Ask to speak with families of current residents. They can provide honest feedback about communication, care quality, and how the facility handles concerns.
Understand the Contract & Costs
Read the admission agreement carefully. Understand what's included in the weekly fee, what costs extra, and what happens if care needs change. Get help applying for the Residential Care Subsidy if eligible.
Frequently Asked Questions
What's the difference between a care home and assisted living?
Care homes provide 24/7 nursing care for those needing significant medical support, while assisted living focuses on help with daily activities while maintaining independence.
How is payment handled?
Costs can be covered through private payment or government funding via the Residential Care Subsidy. Asset and income testing determines eligibility for government support.
What medical care is available?
Care homes have registered nurses on duty 24/7, regular GP visits, and access to specialists. They manage medications, treatments, and coordinate with other healthcare providers.
Can residents personalize their rooms?
Yes, residents are encouraged to bring personal items and small furniture pieces to make their space feel like home, within safety and space guidelines.
How do I get a needs assessment for care home placement?
Contact your local needs assessment service coordination (NASC) agency through your DHB or GP. They'll assess whether you require rest home or hospital-level care, which determines your care level and subsidy eligibility.
What is respite care and is it available?
Respite care provides short-term care home stays (usually 1-4 weeks) to give family caregivers a break. Most care homes offer respite care beds, and government subsidies may be available for eligible residents.
How are dementia residents cared for?
Many care homes have specialized dementia units with secure environments, staff trained in dementia care, memory-friendly design, and programs tailored to residents with cognitive impairment.
Can I visit anytime?
Most care homes have open visiting policies and encourage family involvement in care. Some may have quiet hours during mealtimes or rest periods. During health emergencies (like COVID-19), visiting policies may be temporarily restricted.
Real Care Home Costs in NZ 2025
Here's what New Zealand families actually pay for rest home and hospital-level care:
✓ Rest Home Care (Low Needs)
Care level: Help with daily activities, medication management
Typical resident: Can walk with aid, some memory issues, needs supervision
Cost: $1,200-$1,600/week
- • Room, meals, laundry included
- • 24/7 staff supervision
- • Medication management
- • Activities and outings
- • Subsidy available: Up to $1,100/week if asset-tested
Hospital-Level Care (High Needs)
Care level: Nursing care, dementia, complex medical needs
Typical resident: Bedbound, advanced dementia, feeding assistance required
Cost: $1,600-$2,200/week
- • Everything in rest home PLUS:
- • Registered nurse on duty 24/7
- • Specialized dementia care
- • Palliative/end-of-life care
- • Subsidy available: Up to $1,350/week if asset-tested
Dementia Unit (Secure)
Care level: Wandering risk, challenging behaviors, memory care
Typical resident: Moderate-severe dementia, needs secure environment
Cost: $1,800-$2,400/week
- • Secure unit (locked doors)
- • Higher staff ratios (1:4-5)
- • Specialized dementia training
- • Behavioral management
- • Subsidy available: Same as hospital-level
Premium Care Home
Care level: Any level, but luxury accommodation and services
Typical resident: Family wants best quality care, private room, premium food
Cost: $2,500-$3,500/week
- • Large private rooms/ensuites
- • Chef-prepared meals
- • Hotel-style amenities
- • Premium location/views
- • ⚠️ Subsidy: Only covers standard rate - pay $1,000-2,000/wk extra
💡 Understanding Care Home Costs
- • Government subsidy: $1,100-1,350/week if assets under $242,279 (2025)
- • What you pay: Shortfall between subsidy and facility rate ($100-1,000+/week)
- • Asset testing: Family home exempt if spouse still living there
- • Income testing: Keep first $51/week personal spending, rest goes to care costs
- • Regional variation: Auckland 20-30% more expensive than regional
- • Average stay: 2-3 years rest home, 12-18 months hospital-level
Care Home Admission Process: Step-by-Step
Needs Assessment (interRAI)
GP or hospital refers to needs assessor (NASC):
- ✓ Assessor visits home/hospital (2-3 hours)
- ✓ Tests: mobility, cognition, personal care abilities
- ✓ Determines care level: rest home OR hospital-level
- ✓ Issues certificate (required for subsidy)
- ✓ Timeframe: 7-14 days from referral
Find & Visit Facilities
Visit 3-5 care homes with certificate in hand:
- ✓ Location near family (visiting ease)
- ✓ Certification level matches needs
- ✓ Check cleanliness, smell, staff attitude
- ✓ Talk to other residents/families
- ✓ Ask about staff ratios and turnover
- ✓ Request to see actual available room
Financial Assessment
Work & Income assesses subsidy eligibility:
- ✓ Provide bank statements (last 2 years)
- ✓ Property valuations, investment details
- ✓ Gift history (5-year lookback)
- ✓ Assets under $242,279 = full subsidy
- ✓ Over threshold = self-fund until assets depleted
- ✓ Decision in 10-15 working days
Admission & Moving In
Facility prepares room and admission paperwork:
- ✓ Sign admission agreement (read carefully!)
- ✓ Medical handover from GP/hospital
- ✓ Bring personal items (photos, favorite chair)
- ✓ Label all clothing (laundry service)
- ✓ First payment due on admission day
- ✓ Settling-in period: 2-6 weeks typical
How to Choose the Right Care Home
✓ Green Flags (Good Signs)
- ✓ Happy residents: Smiling, engaged, well-groomed, chatting with staff
- ✓ Clean & fresh: No urine smell, clean floors, bright communal areas
- ✓ Staff engagement: Talking to residents by name, gentle touch, patient
- ✓ Activities happening: Music, crafts, games, visitors present
- ✓ Manager available: Willing to answer questions, transparent about issues
✗ Red Flags (Warning Signs)
- ✗ Smell: Strong urine/feces smell = understaffing or poor care
- ✗ Sedated residents: All sleeping in chairs during day = over-medication
- ✗ Staff rushed/stressed: Running, ignoring call bells, looking exhausted
- ✗ Recent audit failures: Check Ministry of Health website for facility audits
- ✗ Pressure to sign quickly: "Decide today or lose the room" = red flag
Need Help Finding the Right Care Home?
Visit facilities and speak with clinical managers about your loved one's specific needs
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