Care homes in Norway

The Municipal Health and Care Services Act (Law-2011-06-24-30) and the Health Personell Act (Law-1999-07-02-64) are important pieces of legislation in terms of regulating both the public and private health care sector. 

Private care homes are most often financed by the municipalities outsourcing the public care services to private operators through public procurement. 

While there is no specific such requirement for care home operators, a Norwegian business organization number is required for any and all foreign entities who wish to conduct business activity in Norway. Therefore, a foreign enterprise wishing to operate a care home in Norway must either register a Norwegian-registered foreign business (NUF), or establish a subsidiary under Norwegian corporate legislation. Limited liability companies (aksjeselskap/AS) are the preferred form.

No, entities such as companies and foundations, as well as individuals may operate a care home. 

In accordance with section 3-2 of the Care Home Regulation, any care home is required to have the following personnel:

• A director (or otherwise administrative leader),
• A licensed doctor in charge of any medical treatment,
• A licensed nurse in charge of the nursing services.

Any care home is also required by law to employ “the number personnel otherwise required to ensure the patients’ well-being”. The health and care services provided must also as a general legal principle meet a minimum standard of quality.

In principle, no. However, as most privately operated care homes in Norway operate on the basis of public procurement, a certain form of approval by the municipality in question is often needed in order to win the tender.

A small proportion of Norwegian care homes are run on a wholly commercial basis and are thus financed by the tenants. These establishments are not subject to approval ahead of opening. However, any health service provider must at all times meet the minimum legal qualifications in terms of quality and staffing, see paragraph 4 above. Compliance with such regulation is subject to supervision by both national and regional health authorities.

Thus, a certain form of “approval” from the authorities is, in practical terms, required in order to operate a wholly commercial care home, but the establishment of such is largely unregulated, as long as the care home meets the minimum legal requirements at the time of opening.

No, private and public care home providers are largely equivalent in terms of market restrictions (or lack thereof).

No. As of 2021, there are no specific restrictions on how care home providers manage their profits. Some operators operate on an ideal, non-profit basis; however, it is not a regulatory requirement to do so. Legal form and revenue management may, however, make the care home provider in question more or less attractive to municipalities, thus potentially limiting public funding.

Public funding of private care homes in Norway usually takes the form of municipalities outsourcing public care services to private operators. While some commercial care homes operate primarily in the private market, most base their revenue solely on public procurement. 

For wholly commercial care homes, public funding opportunities are limited. 

Yes, the superior supervisory authority is the Norwegian Board of Health Supervision, which delegates regional supervisory authority to the respective County Governors. The supervisory authorities’ primary objective is to enforce national health legislation, and ensure that private, as well as public care providers comply with relevant regulations.

As private care providers often operate on the basis of a contract with the municipality in which the services are provided, see above. Therefore, the municipality may also carry out supervisory measures to ensure that the care home provider complies with the contract and otherwise meets the legal requirements. 

5 347 896 (2019 World Bank estimate).

17.527 % (World Bank 2020 estimate). Approx. 922 886.

926 (Statistics Norway).

There is no reliable statistic because Norway has both private and public care homes and the waiting time varies greatly depending on the type of care home. 

Norway has no supervisory authority relating specifically to the care home sector. However, all care service providers in Norway, including care home operators, whether operated publicly or commercially, are subject to supervision and government by the Norwegian Board of Health Supervision (Helsetilsynet), a national supervisory authority organized under the Ministry of Health Care Services. 

The Board of Health supervision further delegates its supervisory responsibilities to the regional County Governors’ offices, of which there is one for each county, 11 in total. 

The Board of Health Supervision and the County Governors, collectively termed the Health Supervisory Authority (Tilsynsmyndighetene), is tasked with ensuring compliance with national law and regulations concerning the field of health care services. The main responsibilities of the health service supervisory authorities are:

• Determining what specific health care services shall be offered to the public
• Setting the minimum requirements for quality of care
• Regulating authorities and permits for providers of health care providers, both on an institutional and personnel-based level
• Determining and safeguarding the minimum rights of patients under treatment.

Although the above-mentioned points are the core areas of supervisory authorities’ activities, the scope of supervision is wide. As health care providers are obliged by law to provide their services to patients, every such service and treatment are subject to supervision and enforcement by the supervisory authorities. The overall aim of supervision is to prevent, identify and act upon any deficiencies in the provision of services. 

The supervisory activity mainly consists of providing a general picture of the quality of services. This involves collecting, organizing and interpreting information about health and social services. Such information provides the basis for evaluating whether the patients’ are offered the services they require and whether the quality of services is adequate and meet the legal requirements. Reports from area surveillance are distributed to the services and to the public. The supervisory authorities may also employ “system audits” where documents and sample tests are collected and examined. A report is of the supervision is compiled and includes a description of conditions or factors that are not in accordance with acts and regulations. The supervision authority follows up any nonconformities until the requirements set forth in acts and regulations are met. Follow-up involves the management of the organization, and if necessary the owners, i.e. the municipality, the board of directors, etc.