Nursing home, care and attention home, home for the aged, hostel for the elderly — these four names aren't marketing labels. They're licence categories under the Residential Care Homes (Elderly Persons) Ordinance (Cap. 459), and each one legally caps how much care a home is staffed and equipped to give. Put a relative who needs nasogastric feeding into a home licensed only as a Home for the Aged, and you've placed them somewhere that can't legally do the job. This guide translates the four categories into plain terms, gives you the real staffing and space standards, and walks you through which one your family member actually needs. (For who runs each type — public, contract or private — see public, contract and private homes.)
The four licensed categories under Cap. 459
| Home type | Who it's for | What the home must provide |
|---|---|---|
| Hostel for the Elderly (長者宿舍) | The most independent — can manage their own hygiene and household chores, and want group living with meals and supervision. | Meals, laundry, social activities, light supervision. No nursing care. |
| Home for the Aged (安老院) | Can look after their personal hygiene but has difficulty with household chores such as cooking, cleaning, laundering and shopping. | Meals, laundry, help with daily tasks and supervision. Still no nursing care. |
| Care and Attention Home (護理安老院) | Generally weak in health, or physically/mildly mentally disabled, with a deficiency in activities of daily living — but not needing a high degree of professional nursing. | Personal care, meals, medication supervision, nursing observation, rehabilitation exercises and 24-hour staffing. |
| Nursing Home (護養院) | Functional disability that requires a high degree of professional nursing care — without needing continuous medical supervision in a hospital. | Regular basic medical and nursing care, plus everything a care-and-attention home provides, with a registered nurse on duty around the clock. |
Staffing and floor space: what the licence actually guarantees
| Requirement | High-care (Care & Attention + Nursing) | Aged home | Hostel for the Elderly |
|---|---|---|---|
| Registered nurse | 1 nurse per 60 residents, or 13 hours of cover a day (1 nurse counts as 2 health workers). Nursing homes go further: an RN on duty at all times plus a nurse-in-charge. | 1 nurse OR 1 health worker per 60 residents for 6 hours a day | No nurse required |
| Health worker | 1 per 30 residents for 13 hours a day | 1 per 60 residents for 6 hours a day | None required (care/ancillary workers at 1 per 60) |
| Floor space per resident (new homes) | 9.5 m² | 8 m² | 8 m² |
| Night cover | 2 staff on duty 6pm–7am; at least 1 staff on-site whenever a resident is present | Same as high-care | Overnight: 1 staff on-site + 1 staff on call |
These numbers are new. The Residential Care Homes Legislation (Miscellaneous Amendments) Ordinance 2023 (Ord. No. 12 of 2023) was gazetted on 16 June 2023, took force mostly from 16 June 2024, and rolls out the staffing and floor-space changes in phases. The one-nurse-per-60 / one-health-worker-per-30 / 13-hour standard for high-care homes has applied since June 2026; from June 2028, care-and-attention homes with more than 60 residents must also keep a nurse and a health worker on-site for 8 hours a day. Existing homes get until 2032 to reach the new floor space, which is why a 9.5 m² high-care home you see today may be a home that already met the bar or one still transitioning from 6.5 m². Run a home without a licence and the maximum penalty is a HK$1,000,000 fine and two years in prison. None of this is a quality rating, though — it's a legal floor, and two licensed homes on the same street can still be worlds apart in care. That gap is exactly what our dementia care guide digs into.
How SCNAMES maps your family member to a category
If you're going down the subsidised route, the category isn't yours to choose — it's decided by the Standardised Care Need Assessment Mechanism for Elderly Services (SCNAMES). You raise a request through a District Elderly Community Centre, Neighbourhood Elderly Centre, Medical Social Services Unit or Integrated Family Service Centre; a multi-disciplinary assessor does a home visit and a face-to-face interview, then recommends a service, which for residential care means a care-and-attention place or a nursing place. That recommendation goes on the Central Waiting List. Placing privately? No government assessment needed, but two things still apply: every resident must have a medical examination by a registered practitioner before admission, and the home runs its own admission assessment and can decline. In between sits the Residential Care Service Voucher (RCSV): your relative stays on the Central Waiting List but enters a participating home immediately, with the government paying the home a voucher value of HK$17,015 a month for a care-and-attention place or HK$21,982 for a nursing place (from 1 April 2026), and you paying a means-tested co-payment. Walk through the whole process in our guide to applying for subsidised care and the RCSV guide.
What each category costs
| Route | Care & Attention | Nursing home |
|---|---|---|
| Subsidised resident fee | HK$1,660–2,060 per month (subvented, contract, EBPS) | HK$2,060 per month (NHPPS / contract) |
| RCSV voucher value the government pays the home | HK$17,015 per month (from 1 April 2026) | HK$21,982 per month (from 1 April 2026) |
| Private, typical range | HK$8,000–25,000 a month; single rooms HK$12,000–25,000 | Priced above the care-and-attention rate for the same room — 24/7 registered nursing is the sector's biggest staff bill. Specialist dementia-nursing services reach HK$38,000–59,850 |
A self-check for families placing privately
- Bathing: can they shower or bathe themselves, or do they need supervision or a full bed-bath?
- Toileting: independent, or do they need prompting or scheduled continence changes?
- Mobility: walk unaided, or need a walker, wheelchair or a hoist to get out of bed?
- Eating: feed themselves, need food cut up, or need thickened fluids or a feeding tube?
- Nursing procedures: any wounds, catheters, stomas, oxygen, injections or suctioning?
- Cognition and behaviour: dementia, wandering, aggression or evening agitation?
- Medication: can they self-administer, or does staff need to manage and supervise it?
Frequently asked questions
What's the difference between a Care and Attention Home and a Nursing Home?
Think of it as a staffing question. A Care and Attention Home is licensed for personal care — help with bathing, dressing, toileting, meals, medication supervision and nursing observation — and since June 2026 must have at least one nurse per 60 residents or one health worker per 30 residents for at least 13 hours a day. A Nursing Home is licensed for a high degree of professional nursing care: wound and stoma care, nasogastric feeding, oxygen, catheter and suction procedures, with a registered nurse on duty at all times plus a nurse-in-charge. If your family member needs nursing procedures or round-the-clock nursing watch, a care-and-attention licence isn't enough.
Do I need a government assessment to place my family member privately?
No. SCNAMES and the Central Waiting List only apply to subsidised places and the RCSV voucher. For a private place you deal directly with the home: the home does its own admission assessment, and every resident must have a medical examination by a registered medical practitioner before admission. The home is also free to decline — many turn away elders who are bed-bound, need tube feeding, or show severe behavioural issues they can't manage — so call ahead and ask before you book.
What happens if my family member's care needs go up after admission?
It depends on the home. A home can hold residents at different care levels, but its licence type is set by the mix — once 30% or more of its aged-home-plus-care-and-attention places need care-and-attention care, the whole home is licensed as a care-and-attention home. What a licence can't do is let a lower category deliver a higher category's care: a Home for the Aged can't lawfully run nasogastric feeding, and a care-and-attention home can't provide nursing-home-level care. If needs escalate beyond the licence, you're looking at a transfer. In the subsidised system the step beyond a care-and-attention home is an Infirmary Unit — 19 subvented care-and-attention homes run 559 infirmary places with constant nursing care. Our [how-to-choose guide](/guides/how-to-choose-elderly-care-home-hong-kong) covers planning for this before you sign.
Which category is cheapest, and which is most expensive?
Within the subsidised system, almost nothing — resident fees are set centrally at HK$1,660–2,060 a month regardless of category, though nursing places are rarer and the waiting list is longer. Privately, the categories price in that order: hostels and aged homes are cheapest, care-and-attention homes sit in the middle, and nursing homes are the most expensive because of the round-the-clock registered nurse. The government's own RCSV voucher values are the cleanest estimate of the gap — a nursing place is worth roughly 29% more than a care-and-attention place: HK$17,015 a month versus HK$21,982 from 1 April 2026. Our [cost guide](/guides/elderly-care-home-cost-hong-kong) breaks down all four funding tiers with real fees.