Hard times. Especially for those who like to be forgotten. For example, the old and the poor. They are often at home in nursing homes. This is already a costly affair in itself and is now becoming significantly more expensive. What residents and their families need to know and what needs to be considered.
On average nationwide, those in need of care in the home have to pay 2200 euros per month out of their own pocket, the so-called own contribution. These are the numbers as of July 1st. Now the home stay is likely to be significantly more expensive for many. As is well known, there are currently price explosions on the energy market, which is reflected in drastically increased costs for heating and also for electricity.
In addition, as of today, the law on the further development of health care provides for an increase in salaries in nursing. According to the law, only care providers who are either bound to a tariff or are based on a corresponding collective agreement in terms of the amount of remuneration may then bill the care insurance company for services. For nursing assistants, the nursing commission recommends an increase to 14.15 euros per hour, for qualified nursing assistants an increase to 15.25 euros per hour and for nursing staff to 18.25 euros per hour. For residents in nursing homes and their relatives, this will also increase the costs for accommodation and care.
And so these days the first announcements about sometimes drastic price increases for the home’s own contribution are already landing on the tables of nursing home residents and their relatives.
In principle, the personal contribution for residents is made up as follows:
Anyone who has regularly paid contributions to statutory or private long-term care insurance and whose need for care has been confirmed by an expert receives a subsidy towards the costs of care and support as well as training costs. The insured person must bear the remaining costs themselves. From care grade 2, the care insurance fund pays monthly benefits to the care home.
The services are graded as follows:
Anyone who has been certified as care grade 1 will receive a subsidy of 125 euros. These grants will be deducted from your own contribution. In addition, since January 1, 2022, long-term care insurance has paid a surcharge for care in a nursing home for residents in care grades 2 to 5 to reduce the care-related co-payment. This supplement increases with the length of stay in an inpatient care facility. In the first year, the long-term care insurance pays 5 percent of the care-related personal contribution, in the second year 25 percent, in the third year 45 percent and then 70 percent. Already existing supply times are taken into account. Since the beginning of the year, anyone who has been a resident of the home for five years has been relieved of a surcharge of 70 percent on their own care-related contribution. Would you like an example? The Verbraucherzentrale (VZ) Berlin has one thing ready:
Nursing and training costs: 2454.90 euros less the share of the nursing care fund for care grade 3: minus 1262.00 euros previous own contribution: 1192.90 euros less new performance surcharge 25 percent: minus 298.23 euros new own contribution: 894.67 euros
But be careful, the relief only applies to the costs of care, support and training. Increased costs for meals and accommodation, investments and any additional services are not cushioned by this. The sharp rise in energy prices can be found here in particular. And you have to pay for them yourself. If your own income and assets are not sufficient to pay the investment costs, in some federal states the social welfare agencies at least contribute to these with the so-called nursing home allowance. Information on this is available directly from the care facilities or the social welfare offices.
Irrespective of this, evaluations by the Association of Substitute Health Insurance Funds showed that the surcharges only partially cushion the self-paying shares.
Pass on information about allowances to the home
And once again, be careful: it is not necessary for the resident to apply for the subsidy. Instead, the long-term care insurance funds will inform all inpatients in need of care in care grades 2 to 5 when they move in and once on January 1, 2022 how long they have been receiving full-time inpatient benefits. But the relevant law does not regulate to whom the long-term care insurance funds should communicate the information about the previous duration. It is therefore likely that many insurance companies will give the information to their policyholders, with the request that they pass it on to the care facilities. In this case, those affected or their representatives must pass the information on to the institutions as quickly as possible, since only then can the subsidy be calculated accurately.
With that settled, back to the bad news. The nursing home announces an increase in its own contribution. What is allowed first. Because the care company calculates the costs for care, support, living space, meals and investment costs at the time when the contract is concluded with the future resident. If something changes in the costs over the course of the contract period, this can be passed on under certain circumstances. The cost of each nursing home varies.
Because if a home has concluded a supply contract with the long-term care insurance funds and the social welfare agency, it cannot simply increase the remuneration. It first has to renegotiate the costs with the long-term care insurance funds and social welfare agencies. If all sides agree, the changed rates for care, living space and meals will be recorded in the so-called care rate agreements. Only then can they be passed on to the residents.
Check the price increase carefully
Now it is important to check the letter from the nursing home carefully, as VZ Berlin warns. There is no legal limit to what percentage the costs may be increased. However, there is a fixed procedure that the home must follow. It does not matter whether you want to increase the fee for nursing or care services, accommodation, meals, investment expenses or other remuneration components. If the company does not meet even one legal requirement, the increase is ineffective. Then the consent can be denied. This sample letter can be used for this purpose. The nursing home would have to sue for approval in this case.
Here are the specifications:
The nursing home must notify in writing
The increase in pay must be justified. The justification must
If the increase is watertight, you have to bite the bullet and pay. If you then prefer to start looking for a new home or have to, you can use the statutory special right of termination in this case. This applies from the point in time at which the institution demands the increased own contribution.
And one more thing: if income and assets, together with the payments from the nursing care insurance fund and, if applicable, the nursing home allowance, are not sufficient to finance the entire home costs, the residents of the home are entitled to “care assistance” from the social welfare office.
When do children have to pay for their parents?
In principle, the Civil Code regulates that relatives in the straight line are mutually responsible for maintenance. Regardless of the age of the parents and children. This also applies in the event that parents do not have enough money (although they are allowed to keep assets of currently 5000 euros per parent) to secure their own livelihood. If the parents’ assets are used up and the benefits of the statutory and possibly private long-term care insurance are not sufficient, the children can also be asked to pay. However, only from an annual gross income of 100,000 euros. This has been regulated by the Relatives Relief Act since the beginning of 2020.
The social welfare office can request information about income and assets. Because first the office pays and then tries to recover the costs from the dependents who are obliged to pay maintenance. In the event of serious misconduct against the child, however, this can be released from parental maintenance.
Anyone who has parents in need of care who cannot pay for the costs themselves must expect the social welfare agency to write and demand that the children of those affected disclose their income and assets. Which is fine too. When clarifying the question of whether the income is above the limit of 100,000 euros per year, it is not just the income from self-employed or dependent work that counts. Other income, such as from renting and leasing, can also be included. Conversely, expenses that reduce income, such as liabilities for a real estate loan or private pension costs, can also be claimed.
Siblings, cousins, uncles and aunts are out – spouses of the children too
Only the income of the child or children is decisive for checking the income limit. A possible maintenance claim is then calculated according to the provisions of civil law. If at least one child earns more than 100,000 euros, the amount of maintenance is calculated according to the relevant guidelines (e.g. the Düsseldorf table). If there are several siblings, at least one of whom earns more than 100,000 euros, there is a quota system. The social welfare office calculates how much maintenance a child would have to pay based on their income and assets. If there are several children with incomes of more than 100,000 euros per year, each of them is liable proportionately. If a child is obliged to pay parental maintenance but any siblings are not, they do not have to contribute to the share of the others.
On the other hand, if you add your spouse’s income to more than 100,000 euros, you are not obliged to pay maintenance to your parents. In addition, the social welfare office can only use the children, but not the grandchildren, to make maintenance payments. Even siblings, cousins, uncles and aunts do not have to stand up for each other financially. And children-in-law are not related to their in-laws and are therefore not obliged to pay maintenance.
However, the Relatives Relief Act does not apply if spouses have to pay maintenance to one another. If a spouse or life partner comes to the home while the other stays at home, the person staying at home must contribute to the home costs. Even if the annual income is below the limit of 100,000 euros. So-called protective assets for spouses or life partners totaling 10,000 euros apply.
