The average monthly out-of-pocket costs for nursing home residents in Germany have risen to 3,108 euros as of July 2025, marking an increase of 124 euros since January and 237 euros since July 2024, covering care, accommodation, meals, investments, and training levies.

While statutory long-term care insurance covers part of these expenses, residents are often required to pay significant additional costs, which continue to climb despite relief allowances introduced since 2022 that reduce personal contributions initially by 15%.

The German federal and state governments are working on comprehensive reforms, with a dedicated working group expected to deliver proposals by the end of 2025 aimed at preventing nursing care from becoming a poverty risk.

Experts and advocacy groups, including Ulrike Elsner and Mara Schäfke, emphasize that rising costs are unsustainable for residents and call for state responsibility in covering investment and training costs to reduce personal contributions.

Various reform ideas are on the table, such as capping personal contributions based on financial capability, increasing taxpayer funding, and restructuring the insurance system to cover all care costs, with some proposals suggesting a national cap or exemption of certain costs.

The Federal Audit Office reports that 30% of nursing insurance expenditures are allocated to full-time nursing home care, despite only 12.6% of those in need utilizing such services, highlighting systemic funding issues.

Consumer advocates warn that without reforms, the risk of poverty for those needing nursing care will increase, urging for a fair financing system that ensures dignified living conditions.

Residents can seek financial assistance through Wohngeld or social welfare if they face difficulties affording care, but many rely on personal savings or parental support laws, especially given the short average stay in care homes.

Health Minister Nina Warken stresses the importance of stabilizing the nursing care insurance system, which is projected to face a deficit this year, and advocates for reimbursement of COVID-19 expenses and support for family caregivers.

Immediate relief measures, such as covering investment costs, could reduce residents' monthly expenses by around 507 euros, easing the financial burden.

Experts are calling for urgent political action to fulfill financial obligations related to investments and staff training, which could significantly lower costs for residents.

Some states, like Schleswig-Holstein and North Rhine-Westphalia, offer Pflegewohngeld to help cover investment costs, and advocates suggest that full state funding of investments could further reduce costs.

The need for systemic reform is underscored by reports that a disproportionate share of nursing insurance funds is spent on full-time care, despite a smaller percentage of care recipients utilizing these services.