Pflegestärkungsgesetz 2: What changes

What is the Care Strengthening Act 2?

In Germany, when people talk about the Care Strengthening Act 2017 (new Care Act 2017), they generally mean the second Care Strengthening Act. It came into force in 2016, but some of the changes have only been in effect since January 2017.

However, this should not be accompanied by an increase in bureaucracy. The Care Strengthening Act 2 has attempted to restructure regulations and make them clearer. Unnecessary bureaucratic hurdles and application requirements have also been abolished. For example, since January 1, 2017, it is no longer necessary to submit a separate application for certain aids (such as bath lifts, walking aids, shower chairs) if they are specifically recommended by an expert from the Medical Service of the German Health Insurance (MD).

Why a new care law?

However, this should not be accompanied by an increase in bureaucracy. The Care Strengthening Act 2 has attempted to restructure regulations and make them clearer. Unnecessary bureaucratic hurdles and application requirements have also been abolished. For example, since January 1, 2017, it is no longer necessary to submit a separate application for certain aids (such as bath lifts, walking aids, shower chairs) if they are specifically recommended by an expert from the Medical Service of the German Health Insurance (MD).

Why a new care law?

Care Strengthening Act 2: Degrees of care instead of care levels

Another key topic in the Care Strengthening Act 2 is the new assessment procedure for assessing the need for care and the classification into five care levels (instead of the previous three care levels). Since January 1, 2017, the assessors from the Medical Service of the Health Insurance Funds (MD) have taken the following six areas into account when assessing a patient’s need for care:

  • Mobility: How is the patient’s physical mobility? For example, can they get up alone in the morning and go to the bathroom? Is it possible to climb stairs?
  • Behavioral and psychological problems: For example, is the patient restless or anxious at night? Does aggression occur? Does the patient resist care measures?
  • Self-care: Can the patient wash and dress themselves without help? Does he go to the toilet alone? Do they need help with eating and drinking?
  • Coping with and independently dealing with stress caused by illness or therapy: For example, can the patient take their medication alone, measure their blood pressure, handle their walking frame or go to the doctor?

The aim of the Care Strengthening Act 2 is to use the new assessment tool to determine the individual abilities and limitations of each patient more accurately and comprehensively than before. The individual assessments (scores) of all six areas are combined to produce an overall result. Based on this, the patient is classified into one of the five care levels: The scale ranges from minor impairment of independence or abilities (care grade 1) to the most severe impairments that place special demands on care (care grade 5).

Automatic transfer from care level to care grade

  • Those who previously belonged to care level 0 were assigned care level 2 under the Care Strengthening Act 2.
  • From 2017, patients in care level 1 were assigned care level 2 (for physical limitations) or 3 (for impaired everyday skills).
  • Patients in need of care at care level 2 were assigned care level 3 (with physical limitations) or 4 (with impaired daily living skills).
  • Patients in care level 3 were assigned to care level 4 (with physical limitations) or 5 (with impaired daily living skills).

Care level 1 is only possible for people whose need for care is newly established.

The benefit amounts in the individual care grades

The following benefit amounts are provided for the various care levels:

Cash benefit outpatient

Outpatient benefit in kind

Inpatient benefit amount

Care level 1

—

—

—

Degree of care 2

316 Euro

724 Euro

770 Euro

Care level 3

545 Euro

1.363Euro

1,262 euro

Care level 4

728 Euro

1,693 Euro

1,775 Euro

Care level 5

901 Euro

2.095 Euro

2,005 Euro

Care Reinforcement Act 2: Changes for care homes

There is now a uniform care-related co-payment for care grades 2 to 5 within the same facility. This means that all residents in care grades 2 to 5 within the same facility pay the same care-related co-payment. Even with a higher classification, the person concerned does not have to dig deeper into their own pockets.

Changes for relatives due to the new Care Act

2017 brought better social security for family caregivers: since January 1, more family caregivers have been entitled to pension insurance contributions. The new Care Act also improves unemployment insurance protection.

Care Reinforcement Act 2: Costs & financing

The redefinition of the term “in need of care” in the Care Strengthening Act 2 makes it possible to now also classify patients as needing care who were previously denied this and therefore did not receive any support (e.g. dementia patients). Of course, this means additional costs. This also applies to the other changes and additional measures introduced with the Care Strengthening Act 2 to improve the situation of those in need of care, relatives and care staff.

However, the Care Reinforcement Act 2 not only entails additional costs, but also savings and additional income. For example, the municipalities (social welfare payers) will be permanently relieved of around 500 million euros. In addition, the Care Strengthening Act 2 will lead to the recruitment of additional care staff and higher benefits in kind – increasing tax and social security revenues.