Care homes in France

1. Which laws apply to opening care homes?

In France, there is a substantial difference between social and social health-care institutions (EHPAD, EHPA, résidences autonomie) and senior rental residences (résidences services seniors).

Social and social health-care institutions are strictly regulated by Articles L. 311-1 et seq. of the French Social Action and Family Code (CASF).

Senior rental residences are housing complexes made up of self-contained dwellings enabling occupants to benefit from specific, non-individualisable services. They do not fall under the Strict regulations set forth by CASF but should nevertheless comply with French regulations applying to public-access buildings. Rules to be applied to the operation of a senior rental residences are mainly set forth at (i) Articles L.631-13 et seq. of the French Construction and Housing Code and (ii) Articles 41-1 et seq. of Law n°65-557 on coownership.

This analysis will solely focus on senior rental residences.

2. Is the care home operator required to have a presence in the local jurisdiction?

No such requirement has been identified regarding senior rental residences. It would nevertheless practically be recommended to have one.

In practice, the senior rental residence operator takes the form, but not exclusively, of either a consumer cooperative society (société coopérative de consommation), a commercial management company (société commerciale de gestion), an association, or even a free trade union association (ASL) governed by the ordinance of 1 July 2004.

4. How are the governing bodies of the care home regulated? 

A consultative body exists in senior rental residences: the resident’s council (conseil des résidents).

It is composed of the people who live primarily in the residence and it aims at providing a forum for discussion between the residents and the operator. It relays the residents' requests and proposals to the latter.

Senior rental residences in co-ownership have a specific legal status (Articles 41-1 et seq. of Law n°65-557).

5. Is a concession or approval by any regulatory authority required to open a care home?

No, unless the senior rental residence carry out an activity providing assistance to elderly people who need personal assistance at home or a mobility aid (an approval of the French administration must then be obtained by the operator).

The operator providing specific individualisable services in serviced co-ownerships are exempt from the condition of exclusive activity in order to benefit from State approval for the personal services defined in the paragraph hereabove.

Senior rental residences not subject to coownership status that manage home help services provided to the people living there are authorised, subject to compliance with a set of specifications provided for in the Code of Social Action and Families.

Senior rental residences in operation before the entry into force of the law on the adaptation of society to ageing (n°2015-1776) are deemed to hold approval subject to compliance with the national specifications and on condition that the operator of the senior rental residence and the services offered are the same.

6. Is a care home restricted in the performance of activities on the local market?

In order not to assimilate senior rental residences to social or social health-care institutions, the status of coownership is incompatible with the granting of care or assistance and support services exclusively related to the person, which can only be provided by establishments and services falling under Article L 312-1, I of the CASF or by health establishments, services or professionals falling under Parts IV and VI of the French Public Health Code.

No other restriction identified.

7. Are there any restrictions on how care homes may use their profits?

No restriction identified.

8. Does the government provide any type of subsidy?

The government may, subject to conditions, provide subsidies for occupants in senior rental residences.

9. Is there a supervisory authority in relation to the activities of the care home?

The investigators of the General Directorate for Competition, Consumer Affairs and Fraud Control (DGCCRF) are empowered to monitor certain obligations incumbent on the operation of senior rental residences.

10. What is the number of inhabitants?

67,059,887 in 2019 (source: World Bank)

11. What is the number of inhabitants older than 65 (in %)?

20% (source: World Bank)

12. What is the number of care homes?

  • Social and social health-care institutions: 10,066 (7,438: in establishments for the elderly – EHPAD; 2,278 in self-catering residences – residences autonomie; 350 in retirement homes other than EHPAD) in 2016 (source: INSEE)
  • Senior rental residences: estimate of 800 in 2019.

13. Is there a waiting list?

Yes

14. What institutions regulate and monitor the health and social care services?

N/A