Procedure descriptions

Applying for a permit for care services

Do you wish to set up a care service or care home? You must comply with the provisions of the German Nursing Care Insurance Act - Pflegeversicherungsgesetz (PflegeVG = Sozialgesetzbuch XI) in this respect and apply for a permit.

The German Social Code XI (Sozialgesetzbuch XI) regulates, amongst others

which companies can provide care services and
who finances these services.

A distinction is made between outpatient and inpatient care institutions. Outpatient and inpatient institutions are economically independent.

Outpatient care services are under the professional responsibility of trained care workers. These provide for persons in need of care in their own or other households and care for them.
In care homes, people in need of care are accommodated, fed and cared for under the constant responsibility of a qualified care worker either fully or partially on an inpatient basis.

In accordance with the so-called service guarantee, the care insurance companies must guarantee that the insured persons are provided with care in line with requirements and equally. Therefore, the state associations of the care insurance companies conclude a service and remuneration agreement with you as a care institution.

The amount of the remuneration depends, amongst others, on whether you offer outpatient or inpatient care.

Responsible department

for the registration of the business: the municipality in which your future premises are located
for the license as a nursing service: the relevant nursing care fund (National Association)

Details

Prerequisite

The requirements for the permit of an outpatient care service are as follows:

You must be permanently in the position to guarantee sufficient and equal care of persons in need.
Your care and domestic assistance must comply with the required quality. This is set out in the PflegeVG and the contractual framework agreements.
Your care service must work economically.
Your care service must be under the constant responsibility of a qualified specialist carer.
For recognition as a responsible carer, the following is required:
- Completion of an apprenticeship as a health assistant and nurse, health assistant and child nurse, old age carer, state recognised curative education therapist, provided the services of the care institution are provided for disabled persons in need of care.
- Within the last eight years, at least two years of full time work in one of the named professions, of which usually at least one year is in outpatient care.
- If your responsible care worker does not possess the necessary further training, they can obtain this qualification within a transitional deadline of seven years following conclusion of the agreement. In addition, it is possible to obtain approval exceptions. These must be applied for on a case-by-case basis. As the owner of a care service, you can also be a responsible specialist carer yourself, if you fulfil the requirements.
You must ensure that the responsible specialist carer is replaced by another in case of absence (for example illness, holiday). In addition, your care service must employ other suitable persons. As an example, this includes
- State recognised family carers
- Carers of old age persons
- Health care assistants
- Home and family health care assistants
- Housekeepers
The service guarantee of the care insurance companies provides for further requirements for the organisation and duty of your care service. Amongst others, these are:
- Organisation:
  - Your care service must guarantee care of a wide range of persons in need in your area
  - In accordance with individual care requirements, your care service must be able to be provided day and night, including on Sundays and national holidays.
  - Your care service must have its own business premises and be constantly reachable. Private apartments are not suitable for setting up a care service under any circumstances.
  - You must employ a care team of at least four employees.
  - In addition, you must demonstrate sufficient professional indemnity insurance.
- Services offered:
  Your services offered must be submitted to the contract department of the care insurance companies for agreement and approval. Here, you should provide the care insurance companies with the following information:
  - Your intended services offered
  - The way in which the services will be provided
  - Your care concept
  - The personal facility of your care service
  - The availability and accessibility of your care service
  - Ways in which you co-operate with other services
  - Your acceptance of advice functions
  - Your participation in quality assurance measures

Procedure

For the approval of your care service, please contact the state associations of the care insurance companies. The care insurance companies can only grant care in accordance with Sozialgesetzbuch XI through care institutions with which a supply contract exists. If your care service fulfils the requirements, the state associations of the care insurance companies will conclude a supply contract with you.

The care insurance company will check fulfilment of these requirements through the Medizinischer Dienst der Krankenversicherung (MDK). The care insurance company can only conclude a service contract with you if the results are positive. This inspection is also possible without your consent. Should the inspection conclude that your care service is operating uneconomically, this can lead to an amendment or even termination of the service contract.

Regardless of the application for a permit at the state associations of the care insurance companies, you must register your business at the municipality of your future premises.

Required documents

Please make enquiries of the competent body as to which documents you must submit.

Miscellaneous

The requirements for the approval of a care home are as follows:

The approval requirements, as well as the procedure for care homes correspond significantly to those for outpatient care services. The competent bodies for approval as a care home and conclusion of a supply contract in accordance with Sozialgesetzbuch XI are the state associations of the care insurance companies.

However, there are additional regulations under the Residential Home Act (Heimgesetz) for Baden-Württemberg. In particular, these concern suitable buildings in homes, the home contract wording, the personal requirements and the co-operation of the residents.

Care homes must be notified to the home supervisory authority of the respective urban district or rural district at the latest three months before the intended start date.

Legal basis

Release note

The German original version of this text was drafted in close cooperation with the relevant departments. The Sozialministerium released it on 05.01.2018. Only the German text is legally binding. The Federal State does not assume any liability for the translated texts.
In cases of doubt or if you have any questions or problems, please contact the relevant authorities directly.