Care homes in the Netherlands

All healthcare institutions must provide care that meets certain quality requirements. This is laid down in the Healthcare Insurance Act (Zvw) and the Long-Term Care Act (Wlz). If someone runs a care institution in the Netherlands and wants to provide services insured under either the Healthcare Insurance Act or the Long-term Care Act, admission must be granted by the Ministry of Health, Welfare and Sport (VWS). One condition for admission is that the requirements of the Care Institutions (Accreditation) Act (WTZi) are met. The WTZi will most likely be replaced on 1 January 2022 by the Act on the Accession of Care Providers (Wtza).

If the WTZi is applicable to a healthcare institute and in the event this institute does not use its real estate for medical purposes, a notice obligation is applicable and the healthcare institute can only sell/transfer, rent or encumber its real estate with a real right after prior approval has been granted by the Board for the Restructuring of Care Institutions (College Sanering). This board ensures that a market-based price is paid to the institute and certain conditions may apply.

Care providers must comply with the regulations from the Healthcare Market Regulation Act (Wmg). This Act states their clients must be informed about price and quality of the care they provide. It also contains rules about rates, market competition and supervision.

Furthermore nursing homes must comply with legal requirements that are regulated by the following acts:

• The Healthcare (Quality, Complaints and Disputes) Act (Wkkgz);
• The BIG Act;
• The Client Participation in Health Care Organisations Act;

No.

A nursing home must apply for a WTZi permit if it wants to provide care that is financed via the Healthcare Insurance Act (Zvw) or the Long-Term Care Act (Wlz). An application for a WTZi authorisation is only valid if at least two persons are working for the care providing organisation. WTZi applies until the Wtza enters into force.

The governing bodies are a supervisory body and a board of directors with the following points of attention:

1. the supervisory body is responsible for supervising the policy of the board of directors and the general course of affairs in the care organisation;.
2. the board of directors supervises and advises the policy of the daily or general management of the nursing home and assisting it with advice;
3. No person may be a member of the supervisory body and of the daily or general management at the same time;
4. the members of the supervisory body shall not have any direct interest in the nursing home, for example they cannot be a director, employee or professional practising in the nursing home;
5. the articles of association stipulate which decisions of the board of directors require prior approval from the supervisory board;
6. the nursing home shall lay down in writing and in a transparent manner the allocation of responsibilities between the supervisory body and the daily or general management and how internal conflicts between the two bodies are dealt with.

A care home must have a WTZi permit from the Ministry of Health, Welfare and Sport (VWS).

No, provided that:

1. the care home has recorded in writing and in a clear manner how the healthcare is organised, which other organisations are used for that healthcare and what the nature of the relationship is, including responsibilities, tasks and decision-making powers.
2. the healthcare activities of the care home to which the WTZi admission applies are in any case financially distinct from any other activities of the care home.

Currently, care homes are not allowed to distribute profits to shareholders or investors.

There are many forms of governmental support. This can be either financial support from the Dutch national government, Province or Municipality. This financial support exists in various forms.

The supervisory authorities are:

• Ministry of Health, Welfare and Sport (VWS)
• Dutch Health Care Authority (NZa)
• Healthcare and Youth Inspectorate (IGJ)
• Board for the Restructuring of Care Institutions

17,407,585 (source: World Bank, January 1^st 2020)

17,474,693 (source CBS, January 1^st 2021

19.64% (source: World Bank, January 1^st 2020)

855 (December 22^nd 2020)

Yes, there is a waiting list as set out below (source: Zorgverzekeraars Nederland, July 1^st 2020)

The Ministry of Public Health, Wellbeing and Sports (VWS) is the coordinating government body concerning matters of health and eldercare in The Netherlands. The VWS delegates it's responsibilities concerning healthcare to a number of internal subdivisions and external affiliated institutions. These institutions are: 

• Inspectie Gezondheidszorg en Jeugd (IGJ)
  The IGJ is tasked with overseeing healthcare providers to ensure quality, safety and availability. Healthcare providers are required to provide self-improvement rapports and quality indications. This information, together with rapports developed by the IGJ, are used to determine compliance. In case the IGJ determines a case of non-compliance, it has the power to levy fines, force board compliance or make disciplinary complaints.
• Nederlandse Zorgautoriteit (NZa)
  The NZa does research into healthcare providers on behalf of, and advises the VWS on matters. The NZa is tasked with ensuring availability and affordability of care. This is done through the setting of maximum-rates, determining the definition of care services and demanding transparency in healthcare billing. When the NZa determines a case of non-compliance, they can either provide instructions or levy fines.
• CIBG
  The CIBG is the executive wing of the VWS and is, among other things, tasked with the approving of licenses for new healthcare providers. For a license to be granted a healthcare provider must comply with a set of quality and policy standards. The CIBG also maintains a central database to access the medical credentials of any healthcare provider.
• College ter Beoordeling van Geneesmiddelen (CBG)
  The CBG is tasked with determining the safety and quality of any new pharmaceuticals. All pharmaceuticals require a permit from the CBG (or – as the case may be - the European Medicines Authority) to enter the Dutch market.
• College Sanering Zorginstellingen (CSz)
  The CSz is tasked with overseeing any intended sale, rental or establishment of proprietary rights of the real estate of certain healthcare institutions. Only when a transparent and open transaction process has taken place, resulting in a fair market price, does the CSz grant it's approval. The CSz can nullify any non-approved transaction.
  Outside of the VWS also the following institutions exist which are relevant for the healthcare field.
• Individual municipalities are tasked with ensuring (youth)care services are efficiently delivered where needed, as well as conducting fraud-inquiries into healthcare providers. 
• The Authority for Consumers and Markets (ACM) is tasked with ensuring fair market competition, this also includes the healthcare market. Approval by the ACM is required before any merger, takeover of joint venture can take place. Non-compliance with the ACM can result in (percentage based) fines.