Status: 01.09.2022 06:45 a.m
From today on, nursing homes nationwide have to pay according to the tariff. As a result, wages will rise for many employees. But the jumps in costs for those in need of care are sometimes enormous.
On July 28, Matthias Berend receives a letter whose content he can hardly believe. As an honorary representative, Berend looks after an acquaintance in a nursing home in western Rhineland-Palatinate. The letter to him comes from this home and announces an increase in the care rate to be paid as of September 1: by 37.54 percent. “I fell over when I read that,” says Berend.
Tariff loyalty regulation in care comes into force
The background to the letter is the so-called tariff loyalty regulation in care, which will apply from September 1st. The nursing home of Berend’s friend confirms this on request. The new regulation stipulates that nursing services and homes that have not previously paid according to collective agreements – for example in church sponsorship – must raise their wages accordingly. The regulation goes back to the old federal government, which enforced it in 2021.
Acting Minister of Health Karl Lauterbach said: “The wages of the nursing staff in the homes are increasing significantly, and that is intentional.” This is a late thank you for all active nurses and a good sign to everyone who wanted to take up this important and fulfilling profession. “Society must reward this achievement better,” explained Lauterbach.
Collective wages are an important tool to make the nursing profession more attractive, says Christel Bienstein, President of the German Professional Association for Nursing Professions (DBfK). Among other things, however, “refinancing must be guaranteed, because this must not be imposed solely on people in need of care.” Because the long-term care insurance funds only cover part of the long-term care costs and have not yet increased their “performance surcharges” on top of the personal contributions.
Cash register surcharges fizzle out
The demand from the consumer advice centers is correspondingly high. “Normally, the issue of pay increases does not play such a big role,” says Sabine Strüder, head of the health and care department at the Rhineland-Palatinate consumer center. But since July and August, inquiries and complaints have been increasing, as she describes, which is also shown by a nationwide view. The surcharges paid by the health insurance companies since the beginning of the year have largely “fizzled out” in view of the increase in care costs.
The explanation lies in the fact that long-term care insurance is designed as partial comprehensive insurance. The co-payment surcharges of the funds remain unchanged: five percent of the care costs in the first year and up to 70 percent from the third year in the home. Data from the Association of Substitute Health Insurance Funds show that the surcharges in the first years of care are quickly canceled out by increasing personal contributions. The national average in the first two years is well over 2,000 euros, to be paid by those in need of care out of their own pockets. In addition, for many, there are now the costs of the tariff loyalty scheme.
Warnings of “cost explosion” and “doomsday”
Politicians and social organizations therefore sometimes see an urgent need for action. For example, Lower Saxony’s Minister for Social Affairs and Health, Daniela Behrens, recently warned of a “cost explosion”. Lower Saxony, together with other states, wants to call on the federal government to relieve those in need of care. The social association VdK chooses even more drastic words: September 1st will become a “doomsday” for those in need. “The nursing care insurance must therefore finally take over all nursing services,” said the association’s president, Verena Bentele, in a statement.
Criticism of the regulation is immense, and private home operators are also worried about refinancing. Because the increase in costs due to the tariff connection, they have to negotiate with the long-term care insurance funds and social welfare agencies, even if those in need of care bear the costs in the end. “In many cases, health insurance companies don’t pay a cent more,” complains Bernd Meurer, President of the Federal Association of Private Providers of Social Services (bpa). The negotiations are difficult, especially for smaller homes; many of them are threatened with closure or sale to a major carrier.
Own shares rise – coffers in a bind
Meurer assumes that the own shares will increase between 300 and 1000 euros per month, depending on the federal state. An increase in shares, as in the case of Matthias Berend, would not even be the end of the road. A nursing home cannot simply increase its rates because the nursing care insurance companies check whether these are comprehensible.
The health insurance companies, in turn, have their backs to the wall financially: in 2021 they posted a deficit of 1.35 billion euros; The federal government recently granted a billion euros as a loan. The coffers speak of a “drop in the ocean”. In 2022, there could be a deficit of 2.3 billion euros, according to the association of substitute funds.
However, some nursing homes that have not yet paid according to tariffs can also gain something positive from the new regulation: “In the long term, the tariff adjustment is not bad at all,” says Benedikt Queins, manager of a private nursing home in Worms. “Now we are reaching a wage level that is similar to that of Caritas and Diakonie. This will improve our situation in the competition for nurses.”
Consequences also for social welfare offices
In any case, districts and municipalities are likely to be hit by a significant wave of costs from September 1st. Because if necessary, if a person in need or their relatives can no longer finance the care, the social welfare offices step in. “We expect that some of the self-payers will become a social case,” explains home director Benedikt Queins. Social associations and consumer organizations also fear this.
The social welfare office is now also covering the costs for Matthias Berend’s friend. Because they clearly exceed their “small pension”, as with many people in need of care.