The nursing care assessment: what actually happens at home
Written by Thomas Berthier, State-registered nurse · · 2 min read
Reviewed on · Reviewed by Léa Marchand
For a dependent person, home nursing is funded by needs covered rather than by individual acts. Here is how the assessment is carried out, what it changes for you, and what it does not.
Key points
- The nursing care assessment applies to dependent people aged 90 and over and replaces the former care plan.
- It describes actual autonomy rather than the disease: mobility, hygiene, nutrition, cognition, environment.
- It sets a daily care package, reassessed whenever the person's condition changes.
- It is sent to the GP, who validates it: the assessment is a shared decision, never a nurse acting alone.
Who it is for
The nursing care assessment applies to dependent people receiving hygiene and monitoring care at home. For them, the health insurance system reasons in terms of needs covered rather than acts counted.
It follows a medical prescription. Without a prescription there is no assessment and no cover: the doctor opens the door, the nurse organises what follows.
What we look at during the assessment visit
Actual autonomy, not reported autonomy: getting up, washing, dressing, moving around the home, preparing and taking medication.
The environment: bathroom access, a suitable bed, lighting, steps, and whether a family carer is present and how heavy their load really is.
Priority risks: falls, undernutrition, pressure sores, confusion, isolation. These determine how often we come.
What it changes for the person and the family
Visit frequency follows the assessed needs, not a negotiation. A deterioration justifies a new assessment: nothing is fixed for a year.
The GP receives the assessment, so it becomes shared ground: the family no longer tells the same story twice to two professionals.
Out-of-pocket costs follow the usual health insurance and top-up rules; we tell you plainly, before starting, what will be billed.
How it is reviewed over time
An assessment is not a fixed document: it is reviewed whenever the person's condition changes — after a hospital stay, a fall, a loss of independence or, conversely, a recovery.
Between reviews, every visit feeds the observations: that continuity is what lets us demonstrate a change rather than assume one.
A review can be requested by us, by the doctor, by the person or by their family. None of those requests is treated as a challenge: they are how the system is meant to work.
What the assessment does not do
It does not open social entitlements: allowances, home help and meal delivery are handled by the département and home-help services, which we can point you to.
It does not replace medical advice. If health deteriorates, the rule stays the same: we call the GP, and 15 in a life-threatening emergency.
Frequently asked questions on this page
- Who carries out the assessment?
- The nurse who follows the person, at home, with a relative present where possible.
- How often is it repeated?
- At every significant change in health or autonomy, and at the frequency set by regulation.
- Does the assessment cost the patient anything?
- It falls within health insurance cover, on the same terms as other prescribed procedures.
Terms explained
- Nursing care assessment (BSI)
- A structured assessment of autonomy and needs for dependent people aged 90 and over, which replaces the former care plan and sets the daily care package.
- NGAP
- The official list of nursing procedures and their billing codes, which determines what can be invoiced to French health insurance.
- Long-term condition (ALD)
- A chronic condition recognised by French health insurance, granting 100 % cover for care related to that condition.
- Prescription
- A doctor's written order stating the procedure, frequency and duration. Without it, nursing care cannot be delivered or reimbursed, apart from procedures allowed in direct access.
Official sources
What we write is based on public references you can check for yourself.
- Nursing care assessment (BSI): the dedicated serviceAssurance Maladie (ameli.fr)
- Reimbursement: what is covered, what you payAssurance Maladie (ameli.fr)
This page is informational and replaces neither a medical consultation nor a prescription.