German nursing home costs rise to 3,364 monthly as staff pay rules drive increase

The average out-of-pocket cost for residents in German nursing homes has risen to €3,364 per month as of July 1, 2026, according to a new analysis by the Association of Substitute Health Insurance Funds (vdek). This represents an increase of €119 from the beginning of the year and €256 from July 1, 2025.
The rise in costs is primarily driven by increased personnel expenses, as nursing homes are now required to pay their staff according to tariff or similar agreements. "There was a need to catch up, and it is right that nursing staff are well paid. But it cannot be that this leads to ever-increasing burdens on those in need of care," said Ulrike Elsner, CEO of the vdek.
Regional differences in nursing home costs are significant. Bremen and Saarland are the most expensive regions, with average monthly costs of €3,761 and €3,695, respectively. In contrast, Sachsen-Anhalt has the lowest average cost at €2,891 per month.
The total cost for nursing home residents includes not only the cost of care but also expenses for accommodation, food, investments in facilities, and training costs for nursing staff. The base value for care costs alone has risen to €2,088 per month, an increase of €226 from July 2025.
The cost of accommodation and food has also increased, with residents now paying an average of €1,086 per month, up €50 from July 2025.
The German government is currently working on a nursing care reform, but financial constraints are leading to a reduction in relief payments for nursing home residents. The reform aims to achieve a fair distribution of costs and balanced co-payments. Currently, the co-payment for care is reduced by 15% in the first year, 30% in the second year, 50% in the third year, and 75% from the fourth year onwards. However, the coalition government is considering extending the periods between these reductions from 12 to 18 months.
The analysis by the vdek is based on remuneration agreements between nursing homes and care insurance funds in all German states. The association includes major health insurance providers such as Techniker Krankenkasse, Barmer, and DAK-Gesundheit.
In response to the rising costs, the vdek is advocating for a more equitable distribution of costs and a cap on future increases. "It is crucial that we find a balance between fair wages for nursing staff and affordable care for those in need," Elsner added.
In Berlin and Brandenburg, the out-of-pocket costs for nursing home residents have increased by around €300 per month. In Berlin, the average cost is now €3,749 per month, while in Brandenburg it is €3,476 per month.
The analysis by the vdek is based on remuneration agreements between nursing homes and care insurance funds in all German states. The association includes major health insurance providers such as Techniker Krankenkasse, Barmer, and DAK-Gesundheit.
In Mecklenburg-Vorpommern, the average out-of-pocket cost for the first year in a nursing home is €3,032 per month, an increase of €280 from the previous year. This increase is above the national average.
The vdek is calling for the states to take over the full cost of investments and training for nursing staff, which would reduce the financial burden on residents by around €650 per month.
The German government is considering changes to the rules on financial contributions from adult children of nursing home residents. Currently, adult children with an annual gross income of more than €100,000 are required to contribute to the cost of their parents' care.
The analysis by the vdek provides a comprehensive overview of the current state of nursing home costs in Germany and highlights the need for reform to ensure that care remains affordable for all residents.
Follow us for live European news
- 5
- 2
- 2
- 1
- 1
- 1
- 1
- 1
- 1
- 1
1 further source not geolocated





