Care homes in Germany

1. Which laws apply to opening care homes?

The 16 Federal States are responsible for specific legislation on care homes. Therefore, there are 16 different legal bases, which all differ.

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

No specific requirements.


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

The care laws of the Federal States provide for different requirements. In general, the institution and the management must be able to provide proper quality of care, guarantee a certain minimum ratio of skilled personnel and are reliable to operate a care home.

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

No formal concession is required. However, the commencement of operation requires prior notification (at least three months in advance), clearance from the local care home regulatory body (Heimaufsicht) and a care agreement (Versorgungsvertrag) with the competent regional association of the public healthcare insurance (Pflegekasse).

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


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


8. Does the government provide any type of subsidy?

There is a comprehensive care subsidy system by which – considering the degree of care care dependency – the public healthcare insurance pays fixed amounts directly to the care home operators. As far as the residents cannot afford the co-payments, the public welfare assumed the payment.

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

The competent care home regulatory body monitors the activities of care homes and can perform on-site inspections as part of the monitoring process. In addition, the Medical Review Board of the Statutory Health Insurance Funds (MDK) carries out site visits in order to monitor the quality of care.

10. What is the number of inhabitants?

83,132,799 (source: World Bank)

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

21.562% (source: World Bank)

12. What is the number of care homes?

15,380 (source: Statistisches Bundesamt)

13. Is there a waiting list?

There is no reliable statistic because Germany has both private and communal care homes. The waiting time therefore varies greatly and also depends on the location.

Portrait of Stefan Voß
Dr. Stefan Voß