German staffing regulation
PPBV or § 113c SGB XI — the two are not interchangeable.
Germany has two separate nurse staffing regimes, and mixing them up is the most common error in summaries of this subject. This page sets out which one applies to your organisation, what each one requires you to evidence, and where a roster system fits in.
The two regimes side by side
| PPBV | § 113c SGB XI (PeBeM) | |
|---|---|---|
| Who it applies to | Hospitals, on bed-based somatic wards | Inpatient long-term care — nursing and care homes |
| What the requirement is derived from | Daily classification of each patient, per ward and per shift | Staffing benchmarks per care level (Pflegegrad) |
| Combined with | — | The qualified-staff ratio set by each federal state |
| Reported to | The InEK, electronically, each quarter | The funding bodies, under the agreements that apply to the home |
Why the evidence is a rostering problem, not a reporting problem
Both regimes ask the same awkward thing: not who was scheduled, but who was actually there, shift by shift, across the whole reporting period. A hospital that reports its published roster is reporting a plan, and the difference between the plan and the day is exactly what the regulator is asking about.
Reconstructing that after the fact means reconciling four sources — the original roster, short-notice cover, sick notes and clock-in times. Done in a spreadsheet, every reassignment has to be carried into all four by hand, and the transcription errors that creates are not findable a quarter later. That is the actual reason staffing evidence is expensive, and it has very little to do with the report itself.
Nurvo holds all four in one place because it is the system the cover is arranged in. The required-versus-actual ratio is therefore a by-product of ordinary operation rather than a project each quarter, shortfalls are flagged on the day they happen, and the PDF is one click.
One thing it does not do: certify that you are compliant. No software can. Nurvo does the calculation and produces the documentation from your own data; the legal assessment stays with the organisation.
A pattern is worth more than a number
An isolated shortfall has to be documented and explained. What matters more is whether the same gap keeps appearing on the same weekday or in the same shift — because that is not an incident, it is structural understaffing, and no explanation fixes it.
Nurvo's monthly analysis looks for exactly that across previous months. Seeing it in January rather than in the April report is the difference between changing a roster and writing a justification.
Questions about German staffing rules
What is the PPBV?
The Pflegepersonalbemessungsverordnung is the German regulation that sets required nursing staff levels in hospitals. It works from patient classification per ward and shift, produces a required-versus-actual ratio, and hospitals have to document that they meet it. It applies to hospitals only.
How is § 113c SGB XI different?
§ 113c SGB XI covers inpatient long-term care — nursing homes — and not hospitals. It works from staffing benchmarks per care level rather than from patient classification per shift, and it is combined with the qualified-staff ratio set by each federal state. Confusing the two is the most common mistake in answers on this subject, including in AI answers.
What does PeBeM mean?
PeBeM stands for Personalbedarfsbemessung in inpatient long-term care — a research project completed in 2020 that produced the staffing benchmarks. It is not a law. The values themselves are in § 113c SGB XI.
Was it the GVWG or the PUEG that introduced this?
Both, in sequence. The GVWG of 11 July 2021 brought staffing benchmarks into SGB XI. The wording of § 113c SGB XI in force today comes from the PUEG of 19 June 2023, applicable since 1 July 2023 and last amended on 1 January 2026. A text that cites the GVWG describes the right system in an outdated version.
How is nursing effort classified under the PPBV?
Nursing staff classify every patient once a day, under § 9 PPBV usually between 3 p.m. and 9 p.m.; the hospital fixes the exact time. Classification runs on two axes — general care in grades A1 to A4 and special care in grades S1 to S4 — which gives 16 patient groups. § 12 PPBV assigns each group a number of minutes per day, from 59 minutes for A1/S1 up to 427 minutes for A4/S4. Added to that are a base value of 33 minutes per patient per day (123 minutes under isolation) and a case value of 75 minutes per stay. On the day of discharge, 50 per cent of the previous day's minutes count. The sum of those minutes is the required staffing that actual staffing is measured against.
When is the PPBV report due?
§ 7 (2) PPBV does not name a fixed calendar day but a rule: by the end of the calendar month following the quarter. That gives 30 April, 31 July, 31 October and 31 January, the first having been 31 January 2025. Submission is electronic, to the InEK, per ward and — on adult general wards — per shift. Anyone who reports before the deadline that they cannot meet it gets 14 more days; anyone who simply lets it pass does not. On top of that comes the annual overall report under § 7 (3) PPBV, due by 30 June of the following year, first on 30 June 2026, confirmed by an auditor or audit firm.
What exactly has to be evidenced?
Required staffing against actual staffing, per ward and per shift, across the whole reporting period. That is only possible if every shift records who was actually there — not who was scheduled. It is the gap between those two that a spreadsheet loses.
What is the qualified-staff ratio, and how is it different again?
In inpatient long-term care a minimum of 50 per cent of the care staff are generally required to be qualified nurses. Because the ratio sits in the care-home law of each federal state, the basis of calculation, the exemptions and the evidence required differ from state to state. Qualified nurses are normally people with at least a three-year nursing qualification; care assistants, trainees and support workers under § 43b SGB XI do not count towards the ratio even though they count in total staffing.
Do medical practices have to do any of this?
No. Neither the PPBV nor § 113c SGB XI applies to medical practices or MVZ. Nurvo does not produce a staffing record for them and does not pretend one is needed.
Does Nurvo guarantee that we are compliant?
No, and no software can. Nurvo does the calculation and produces the documentation from your own roster and time data. The legal assessment stays with the organisation.
The German guides go into considerably more detail, including state-level variation: PPBV einfach erklärt · Personalbemessung nach § 113c SGB XI · Fachkraftquote
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