Care homes in Italy: RSA, casa di riposo, ASL assessment and costs

Care by country · 4 min read · Last updated 30 October 2026

Italy's care system is organised by region, so rules, waiting lists and fees differ across the country. Public support for long-term residential care is arranged through the local health authority (ASL), while many families, especially those living abroad, use private homes. This guide uses Piemonte's regional rules as a worked example, so check the rules of the region you are interested in.

Casa di riposo and RSA

  • Casa di riposo (also residenza protetta or casa protetta): residential care, usually for people who are self-sufficient or need limited help. Names vary by region.
  • RSA (residenza sanitaria assistenziale): a health-oriented residence for people who are not self-sufficient, with nursing and medical support.
  • Alzheimer units: some RSAs have dedicated units. In Piemonte, for example, temporary Alzheimer units (NAT) accept people with moderate to severe dementia and serious behavioural problems, usually for 60 to 180 days.

The public route: the ASL assessment

Regione Piemonte describes the route to a publicly supported RSA place like this. Other regions use different names (for example UVM instead of UVG) and different timelines.

  1. The person, or someone acting for them, asks the Unità di Valutazione Geriatrica (UVG) of the health district of their ASL for a multidimensional assessment. Requests can go through the district, the single access point or the social services body.
  2. The request needs a referral from the family doctor, a health information form and proof that an ISEE (Italy's household economic indicator) has been requested.
  3. The UVG has 90 days to assess health and social needs, decide whether the person is non-self-sufficient and draw up an individual care plan.
  4. The result sets a priority. Urgent cases can be admitted within 90 days, non-urgent cases within a year, and deferrable cases have no set admission date.
  5. The person and family then choose among RSAs authorised and accredited by the health system.

How costs are split

In Piemonte's regional tariff, the daily fee is split 50% health and 50% social. The ASL pays the health share. The resident pays the social share, and the comune can cover part or all of it if the resident's income is not enough. Other regions use different shares and rules, and homes may charge extra for optional services. Private homes set their own prices.

For a sense of scale, financial press reporting in August 2026 put typical RSA fees at roughly €2,200 to €3,500 a month, with Alzheimer units higher and averages lower in the south. Treat this as a rough guide only, and get written quotes. See our guide to care home costs.

Indennità di accompagnamento

INPS pays a monthly accompaniment allowance to people recognised as totally disabled and not self-sufficient. It is not means-tested. The press reported an amount of around €550 a month for 2026; check the current figure and the rules, including what happens on admission to a care home, directly with INPS or a patronato.

If your relative lives abroad

Publicly supported places are arranged through the ASL of the person's place of residence. Our sources do not set out the rules for people who have just moved, so ask the local ASL or the comune directly. Many families moving a relative to Italy start with a private home while sorting out residency and healthcare registration. Our guide to moving a parent abroad covers the legal side, including powers of attorney: Italy has signed the 2000 Hague Adults Convention but has not ratified it.

What to ask an Italian home

  • Is the home authorised and accredited (autorizzata e accreditata), and does it have places under agreement with the ASL (convenzionata)?
  • What is the daily fee, and how is it split between the health share (quota sanitaria) and the accommodation and social share (quota alberghiera)?
  • Which services cost extra?
  • Which languages do staff speak?
  • Is there a dementia unit, and what are its admission rules?

Ready to look? Browse care homes in Italy, and use our visit checklist.

Frequently asked questions

What is ISEE?

ISEE is Italy's indicator of a household's economic situation. It is used to work out contributions to public services. Regione Piemonte requires proof that an ISEE has been requested when applying for an RSA assessment.

Is an RSA free?

No. In a publicly supported place the health share is paid by the health service, but the resident normally pays the social share, with municipal help if income is low. In Piemonte the split is 50% and 50%, and other regions differ.

Can a foreigner apply for a public RSA place?

Public places are arranged through the ASL where the person lives. Our sources do not say how this works for people who have recently moved, so ask the local ASL or comune about eligibility.

Sources and further reading

This guide is general information only, compiled from the public sources listed above as of the date shown. It is not legal, medical, tax, financial or care advice, and we cannot guarantee that it is complete, accurate or up to date. Rules, thresholds and prices change and differ by country and region, and some sources describe other countries' rules as examples. Check details with the authorities and care homes named, and take professional advice for your own situation before you act. If you spot an error, please email [email protected] and we will correct it.