Home care can be provided by anyone, family, neighbors, social institutions, professional caregivers or a mixture of all. Insofar as the home care is regulated independently, one is entitled to a long-term care allowance according to the established care level. Conditions to receipt care-subsidies: The person in need of care must ensure the necessary basic and domestic care in a suitable way. This is given if the care is actually provided by type and scope, as well as sufficiently qualified and knowledgeable.
If the care is provided by non-approved services, relatives or neighbors, etc., the amount of the care subsidies are less than the benefits provided for the use of an authorized nursing service. If a professional service is added to the services provided privately, the so-called combination benefit is applied. Both packages are to be calculated pro rata and supplementary.
To the upper terms of nursing counts the professionals who care for the elderly. To mention are the examined nurses and examined caregiver and those who have not completed comparable training, such as nursing assistants, assistants of caregivers for the elderly. The quality of the care services must meet minimum requirements.
In addition to the professional competence acquired, the social and human competence of the nursing staff plays an important role. Good nurses and care givers develop good personal relationships with their dependents and are a very important contact for the relatives concerned.
(Since January 1, 2000) - at least five years of the past ten years must have been submitted to long-term care insurance. (Since 1 July 2008) - only a two-year pre-insurance period is needed. In the event of a change between social and private insurance, the uninterrupted insurance period is calculated.
For insured children the pre-insurance period is fulfilled if one parent has fulfilled it. Anyone who has not yet fulfilled the pre-insurance period at the time the claim for benefits is filed can apply for a new application after completing the pre-insurance period.
Aid
Persons eligible for aid are obliged to get a long-term care insurance. If they are a voluntary member of the statutory health insurance scheme, they are insured under the social long-term care insurance scheme and receive the respective benefits (including Sachleistungen) from the long-term care insurance and the allowance. Non-privately or privately insured civil servants are obliged by law to conclude a pro-rata private long-term care insurance supplementary to the allowance.
Care Living allowance
Different national health care laws provide for a so-called "nursing allowance" as an independent benefit claim. This is independent of the long-term care insurance and must be applied for by the patient herself. The granting of allowance is dependent on the applicant's financial situation.
Blind Aids
The benefits of blindness do not serve the same purpose as the benefits from the long-term care insurance. A crediting of the nursing allowance is therefore only partially considered. The state legislator regulates the extent to which benefits of blindness are provided in addition to the care allowance.
Integration assistance
The benefits of the integration assistance remain unaffected by the benefits of the long-term care insurance.
Nursing aids are used to facilitate care, relieve the symptoms or support a more independent lifestyle. A maximum payment of 10% of the purchase price, a maximum of 25 euros per aid can be required if the nursing aid is transferred. In case of hardship, the nursing fund may waive all or part of the payment. Nursing aids are given on loan as a priority, so that an additional payment is not required. Care aids which can be used only once, for example, disposable gloves and suckling ducts, can only be used up to a monthly maximum of 31 euros. There is no hardship regulation.
The basic allowance is tax-exempt for the dependent.
In the case of transfer to relatives, friends, acquaintances or neighbors who take care of the care, the custodial allowance remains unpaid, provided that the benefits are derived from a moral obligation within the meaning of section 33 (2) of the Income Tax Act.
The long-term attendance allowance therefore remains tax-exempt if care is provided for human, social or humanitarian reasons. If the care is provided "commercially" or professionally, the care allowance passed on to these persons will be taxable.
The benefits of statutory long-term care insurance are independent of income and assets.
The asset situation is taken into account only in the case of subsidies for conversion measures in the context of an improvement in the individual living environment of the dependent.
There is a need for long-term care in cases of illness or disability. The statutory long-term care insurance is applicable if ordinary and regularly performed activities of daily life due to illness or disability can no longer be carried out in full - but presumably for at least six months - in full. No claim to benefits from statutory long-term care insurance is triggered by short-term care (eg eight weeks of need for a femur fracture).
The statutory long-term care insurance covers claims for basic care and domestic care.
The household assistance includes the following activities, which are considered in the assessment:
shopping, cooking, washing, cleaning the apartment, heating the apartment as well as changing and washing clothes and linen.
The basic care includes the subregions personal care, nutrition and mobility.
The functions of the body care are:
washing, showering, bathing, dental care, combing, shaving and the help with the bowel and bladder emptying.
The area of nutrition counts:
(Not meant for cooking or preparing the food, but rather for example the cutting of bread or meat) and the intake of the food (eg the feeding or the supply of probe cost).
In the area of mobility , the following allowable assistance is provided: assisting
with getting up and going to bed (including moving in bed), dressing and undressing, walking, standing, stairs as well as leaving and retrieving the apartment (only for medical and therapeutic visits, for walks).
The help can be done in various ways. Thus, a complete take over of the individual operations, a partial takeover, or just a support,
The nursing care fund or the holder of the private long-term care insurance determines the need for long-term care.
In the case of insured persons under the law, the respective nursing fund is checked by the medical service of the health insurers (MDK) whether the prerequisites for the need for care are fulfilled and the level of care required.
In the case of private long-term care insurers, this determination is made by a doctor of the medical service of the private long-term care insurance (Medicproof), appointed by the insurer.
The expert makes a proposal in his nursing report, which is funded by the nursing fund. The care fund is not tied to the expert's recommendation.
In the new assessment committee (NBA), a scale of 0 to 100 is given depending on the severity of the impairment of self-employment points. The degrees of care are assigned as follows:
PG 1: 12.5 to 27 points
PG 2: 27 to 47.5 points
PG 3: 47.5 to 70 points
PG 4: 70 to 90 points
PG 5: 90 Up to 100 points
Self-employment is tested in the following six modules:
1. Mobility (10%) Physical agility: stand alone; To go from bed to bath; Move independently in the living area; Climb stairs; Change of position in bed; Stable sitting position; Stand up and move.
2.Cognitive and communicative skills (15% for module 2 + 3) Understanding and speaking: temporal and spatial orientation; Understand the facts; Identify people from the surrounding area; Identify risks; To participate in talks; To make general decisions; Elementary needs; To understand the requirements.
3. Behavioral and psychological problems: nightly restlessness; Fears and aggression that are burdensome for others; Defense measures; Depressed mood; Aggressive and self-damaging behavior.
4.Self-care (40%) Self-sufficiency in: body care; Nutrition; Separate toilets; Urinary incontinence; Fecal incontinence.
5. Self-responsibility in cases of illness or therapy (20%): self-sufficient medication; Independent blood glucose measurements; Independent medical visits; Independent visits to therapeutic or medical facilities; Independent use of rollator or dentures.
6.Group of everyday life and social contacts (15%): independent organization of the day; Adaptation to changes; To make contact with people; Independent visit to the Skatrunde; Contact management; To take over; Self-employed in everyday life.
The modules "Out-of-home activities and budget management" are used by nurses to create a more personalized nursing plan and are not included in a nursing degree. Design of everyday life and social contacts (15%): independent design of the day; Adaptation to changes; To make contact with people; Independent visit to the Skatrunde; Contact management; To take over; Self-employed in everyday life. The modules "Out-of-home activities and budget management" are used by nurses to create a more personalized nursing plan and are not included in a nursing degree. Design of everyday life and social contacts (15%): independent design of the day; Adaptation to changes; To make contact with people; Independent visit to the Skatrunde; Contact management; To take over; Self-employed in everyday life. The modules "Out-of-home activities and budget management" are used by nurses to create a more personalized nursing plan and are not included in a nursing degree.
In the case of insured persons under the law, the respective nursing fund is checked by the medical service of the health insurers (MDK) whether the prerequisites for the need for care are fulfilled and the level of care required.
In the case of private long-term care insurers, this determination is made by a doctor of the medical service of the private long-term care insurance (Medicproof), appointed by the insurer.
The expert makes a proposal in his nursing report, which is funded by the nursing fund. The care fund is not tied to the expert's recommendation.
In Grade 1, people with minor physical impairments, such as spinal or articular disorders, which require support in some areas. The autonomy of those affected is to be maintained as long as possible and to allow life in one's own home. Comprehensive free consultations are offered for persons with a nursing degree of 1, who can identify possible incentives. For full-term care in a nursing home, they receive a grant of 125 euros per month from the long-term care insurance and are entitled to additional care and activation. The benefits for nursing care and short-term work-related care are also available at nursing degree 1.
Care degree 2 covers persons whose self-sufficiency is significantly impaired and will no longer rely solely on time as a criterion according to the new evaluation criteria. The focus is on general self-employment, as well as physical and communicative impairments. Care degree 2 is a means between care level 0 (restricted daily competence) and care level 1.
Care degree 3 is a severe impairment of self-employment. In order to maintain the nursing degree 3, the degree of his still existing self-employment is examined in six areas. Points are awarded and the degree of care is determined. If the expert evaluates between 47.5 and below 70 points, severe impairment of self-employment and thus degree of nursing 3 are present. Insured persons who were in Pflegestufe 2 and dementile patients who were in Pflegestufe 1 before January 1, 2017 receive the new nursing degree 3 as of January 1.
Care degree 4 is the most severe impairment of self-employment, which must be determined upon request and after an assessment. Dependent care with care level 2 and reduced everyday competences as well as people in need of care with care level 3 receive without further care degree of care 4.
In order to be assigned a nursing degree of 4 from the nursing fund, 70 to 90 points must be determined during the assessment.
Degree of care grade 5 bdsd severest impairment of self-employment with special requirements for nursing care.
Degree of care 5 requires 90 to 100 points at the assessment committee (NBA).
If the person in need does not agree with the respective decision, he can object. If the objection is dismissed, action may be brought before the Social Court.
A contradiction must always be submitted in writing with justification. It may be useful to take an insight into the assessment of the need for care.
The usual activities within the context of long-term care insurance can not be provided by children, or only in part, in self-government. For this reason, when assessing a child in need of care, the time spent in the areas of personal care, nutrition and mobility as well as a possible additional need for assistance in the provision of domestic care to a healthy child is taken into account in the determination of the temporal need for assistance.
The following changes in the benefit allowance for people in need of care in accordance with the PfNG (Continuing Education Act) will result in 2012: :
Care Subsidies (Pflegegeld)
The subsidies are paid for people in need of care and be cared for in their home and thus ensure home care in accordance with the necessary basic care and home care. From January 1, 2012 in the care level I subsidies increase to 235 Euro, in care level II to 440 Euro and in care level III to 700 Euro. The allowance is paid monthly in advance. The benefits are also increased in "preventive care". If a nursing person leaves because of illness, the nursing care insurance covers the cost of a replacement care for up to four weeks to a value of 1,550 euros.
Benefits in Outpatient Care
In principle, care services must be provided by the nursing care funds as a contribution in kind. The focus of the service increase is in the field of home care services. There is a right to a home care allowance if care is provided by nursing staff. As of January 1, 2012, these benefits will be increased to € 450 in Pflegestufe I, to € 1,100 in Pflegestufe II and to € 1,550 in Pflestufe III. Special performance enhancements are also provided for home care of dementia patients.
Inpatient services
In the area of inpatient care, care benefits only in care level III to an increase in benefits to € 1,555 in normal cases and in cases of hardship to € 1,918.
Family Care Act (FamPflegeZG) 2012
According to the new Nursing Law, since January 1, 2012, employees who wish to care for dependents can reduce their working time to a maximum of 50% for a maximum period of two years, with a salary of 75% Of the last gross income. In order to compensate for this reduction in working time, the employees have to return to full working hours, but in this case only 75% of their salary is paid until the value balance is balanced again. With a salary of 75% of the last gross income in this case. In order to compensate for this reduction in working time, the employees have to work fully again, but in this case only 75% of their salary is paid until the value balance is balanced again. With a salary of 75% of the last gross income in this case. In order to compensate for this reduction in working time, the employees have to work fully again, but in this case only 75% of their salary is paid until the value balance is balanced again..
In order to receive benefits from the long-term care insurance, an application must be submitted. Formal declarations, which express the performance motto, are also considered as an application. Any change in the need for long-term care requires a renewed application for changes to benefits from the long-term care insurance, provided that additional benefits are sought. The same also applies to the purchase of other services or aids..
The following are eligible for the application: - in the case of private long-term care insurance: the policyholder or his authorized representative. - in the social long-term care insurance: the insured person (if he has reached the age of 15, otherwise his legal representative), or a person authorized by them.
Applications for benefits from the long-term care insurance can also be made informally (via telephone, fax, mail). Application forms are not required, although useful. For this reason, the nursing fund or the institution of private long-term care insurance sends an application form after receiving the first (informal) notification. However, the application is already deemed to have been submitted by the first, possibly telephone, message. Concrete care services need not yet be defined at this time. It suffices to state the need for care services in general. As soon as the application has been approved in a positive way, the person in need of care is to specify which benefits he claims.
Applications for benefits from the long-term care insurance can also be made informally (via telephone, fax, mail). Application forms are not required, although useful. For this reason, the nursing fund or the institution of private long-term care insurance sends an application form after receiving the first (informal) notification. However, the application is already deemed to have been submitted by the first, possibly telephone call or message. Concrete care services need not be defined at this time. It suffices to state the need for care services in general. As soon as the application has been approved positive, the person in need of care has to specify which benefits he claims.
If the need for care has increased, an upgrading and re-assessment can be sought. As with the initial application, this is initially formless. The person entitled to care or an authorized person is entitled to apply. A change or a change of the type of service (eg from home care to inpatient care) is in principle not a reason for a new review. However, if the need for care has changed accordingly, an application for upgrading should be made.
You can obtain support from the relevant nursing care fund, the providers of private long-term care insurance, and care givers like PFlegewunder.
Under certain circumstances, it is possible to employ a caregiver from Eastern Europe in a household in Germany.
However, there are also illegal forms of employment which can lead to a postpayment of social insurance contributions or even a high fine or an indication of tax evasion and the withholding of social contributions. Therefore, the legal structure of the employment relationship is decisive.
In principle, there are 3 alternatives for the employment of an Eastern European nurse: :
- direct employment relationship
- through the intermediary of the employment office (zentrale Auslandsvermittlung der Arbeitsagentur (Employment Agency)
- through private mediation agencies
Families can also directly hire caregivers or household help from Eastern Europe. A private employer-employee contract is legally possible with the free movement of workers within the EU, which entered into force on 1 May 2011 (initially in Poland, the Czech Republic, Slovakia, Hungary, Slovenia, Estonia, Latvia, Lithuania).
The difficulty:
You as a family provide the help and become an regular employer with all duties connected with it. For example, you have to register a company, apply for a company number, transfer social insurance contributions (health / pension / accident insurance, unemployment insurance), take out occupational liability insurance, and register assistance with the employer's liability insurance association. The employment contract must state the content of the activity and must comply with German labor law. The 38.5-hour week, for example, must be adhered to. No immoral wages may be paid and in case of illness of the nurse the payment has to be paid in full for the time.
If private contacts are lacking, the Central Office of the Arbeitsagentur (ZAV) will assist in arranging a budgetary aid. The ZAV provides budget support and offers advice and information material.
Attention: The ZAV provides only household help, no nurses in private households. These may only be used in the field of basic care (eg to provide food or help with personal care).
The difficulty:
The procedure through the ZAV has lasted at least five weeks and for each nurese change you have to pass all the burocracy.
Here, too, two alternatives are possible, a so-called employee variant and a self-employed variant. Both lead to a legal employment if you take care that the the social insurance is paid by the care giver.
In the case one, the mediated caregiver is employed by a foreign company and will be sent to your home by our agency. With our agency, you only conclude a mediation contract, while you conclude with the company abroad for the care labor force. The contract contains clear rules on working hours and leave entitlements, which are in conformity with labor law. Payment is made to the sending company, who officially contract the nurse in their home land.
In addition, the foreign company also bears the social security contributions. Households may be subject to the payment of social security contributions or even high fines or an indication of tax evasion and withholding of social security contributions. The sending certificate A1 serves as proof of this. It is proof that the nurse is covered by social insurance abroad. The difficulty:
The 38.5-hour week is also valid for foreign workers in Germany. Direct instructions can officially only been made by the foreign company the nurse is contracted.
In this alternative, the agency will provide you with a self-sufficient caregiver who has to register a business in her home country.
Legal pitfalls: A service contract is concluded, not a contract of employment!
The biggest problem according to the legal opinion of many experts, false self-employment could already been given when the care giver lives in the household of the employer. This can be prevented when the care giver has several employers over the time.
The contracts take care of the risk of false self-employment and of course all our nurses have several empoyers over the year, so that they could not be subject to false self-employment. The social security payments are as well proofed as for the employer alternative.
Due to the company who hired the nurse in their homeland the employer alternative is more expensive.
We offer employed as well as self-employed nurses and let the customer decide which version he prefers.
