With the Nursing Act 2 (PSG II, PSG 2) are redefined in contrast to the original PSG long-term care - for example, dementia patients are now also taken into account in the classification. New in the Nursing Welfare Act 2 is also the classification in five levels of care (instead of the three levels of care). Read more about the Nursing Act 2, the associated benefits and what changes for the relatives!
What is the Nursing Law 2?
If there is talk of the Nursing Welfare Act 2017 (new Nursing Act 2017), this generally means the second Nursing Welfare Act. It has already come into force in 2016, although some changes will only take effect in January 2017. The Nursing Welfare Act 2 (or Nursing Welfare Act II) is considered to be the most far-reaching reform since the introduction of nursing care insurance (1995).
The Welfare Act 2 (PSG 2) aims to provide even better support to people in need of care, their relatives and carers. The aim is to offer every patient so much help that his independence and his abilities are preserved, or even improved.
But that should not be accompanied by an increase in bureaucracy. With the Nursing Act 2, an attempt was made to restructure regulations and make them clearer. In addition, unnecessary bureaucratic hurdles and application obligations were abolished. For example, from 1 January 2017, you will no longer have to submit a separate application for certain aids (such as bath tub lifter, walker, shower chair) if they are specifically recommended by the medical service's medical service (MDK).
Why a new care law?
A second Nursing Act (according to the first Nursing Welfare Act in 2015) became necessary on the one hand because the number of people in need of care in Germany continues to rise. On the other hand, the number of dementia patients is increasing, and so far most of them could not be classified as requiring care. The Nursing Act 2 changes this by redefining the concept of long-term care.
Nursing Welfare Act 2: Long-term care - newly defined
The redefinition of the concept of long-term care is a central point in the Nursing Act 2. Previously, especially patients with physical limitations were considered to be in need of care, ie, for example, those with a disability. On the other hand, mental and emotional impairments were neglected in the assessment.
This changes with the Nursing Act 2: Physical, mental and emotional restrictions are equal to each other from 2017. For example, the approximately 1.6 million dementia patients in Germany are treated in the same way when assessing the need for long-term care as people with a purely physical disability.
Nursing Strengthening Act 2: Nursing degrees instead of care levels
Another core topic in the Nursing Welfare Act 2 is the new assessment procedure for assessing the need for long-term care and the division into five levels of care (instead of the previous three care levels). The assessors of the Medical Service of Health Insurance (MDK) will consider the following six areas when assessing the need for care of a patient from 1 January 2017:
- mobility: What about the physical flexibility of the patient? Can he, for example, get up alone in the morning and go to the bathroom? Is it possible to climb stairs?
- Cognitive and communicative skills: Can the patient be oriented in space and time? Can he understand other people in conversation and understand facts?
- Behaviors and mental health problems: For example, is the patient restless or anxious at night? Do aggression occur? Does the patient fight against care?
- Self-sufficiency: Can the patient wash and dress without help? Is he going to the toilet alone? Does he need help with food and drink?
- Coping with and dealing with the burden of illness or therapy: Can the patient alone take his medication, measure his blood pressure, handle his rollator or go to the doctor?
- Everyday life and social contacts: For example, can the patient design his or her own daily routine and make contact with other people on their own?
The Nursing Welfare Act 2 aims to use the new assessment tool to determine the individual abilities and limitations of each patient more precisely and comprehensively than before. The individual scores (points) of all six areas are combined into one overall result. Based on this, the patient is classified in one of the five levels of care: the scale ranges from minor impairment of self-reliance or abilities (grade 1) to the most severe impairments that place special demands on the nurse (level 5).
Automatic transfer of care level to degree of care
Anyone who was assigned to one of the three levels of care as a patient in need of care before the PSG 2 enters into force does not need to be re-examined. Instead, the Nursing Act 2 provides for the automatic transfer to one of the five new levels of care:
- Those who previously belonged to care level 0 will be assigned to nursing degree 2 in the future according to the Nursing Act 2.
- As of 2017, patients in care level 1 will be assigned care level 2 (for physical limitations) or 3 (for impaired everyday life skills).
- Nursing in care level 2 will in future receive the care level 3 (for physical limitations) or 4 (for impaired everyday skills).
- Nursing level 3 patients are classified in care level 4 (for physical limitations) or 5 (for impaired everyday life skills).
Grade 1 care is only available for people whose need for care has been redefined.
In the automatic transfer of care level to care, as provided for by the Nursing Act 2, no one must fear disadvantages: Almost all people in need of care are even better off under the new system than before. No one is classified worse (ie less dependent on care). The care funds will inform the patients about their new care level.
The amounts of benefits in the individual levels of care
The following amounts of benefit are intended for the different levels of care:
Cash benefit on an outpatient basis
Benefit in kind outpatient
Amount of benefits inpatient
Care level 1
Care level 2
Care level 3
Care level 4
Care level 5
Nursing Welfare Act 2: Changes for Nursing Homes
So far, the classification into a higher level of care for those affected by full-time care facilities meant that their own share also increased - so the people in need of care or their relatives had to pay more. This changes with the Nursing Act 2: There is now within the same institution a uniform care-related contribution for the nursing grades 2 to 5. This means: Within the institution concerned, all residents of the nursing degree 2 to 5 provide the same nursing-related contribution. Even with a higher classification, an affected person does not have to dig deeper into his own pocket.
In addition, as of 1 January 2017, additional care offers for insured persons in full and part-inpatient care facilities, such as reading aloud or walking, are provided for by the Nursing Welfare Act 2. Until now, these only existed when the institution had negotiated this with the care fund. The facilities have to hire additional supervisors for the extended offer.