Date 2023.05.31

The coronavirus pandemic burdened long-term care facilities in Germany. In order to cushion the impact of the pandemic, the long-term care insurance funds paid an additional amount of more than €7 billion via the rescue package for long-term care. Our audit findings show: The underlying payment procedure was prone to abuse – and subsequent checks are not yet adequate.

The coronavirus pandemic led to additional expenditure and revenue shortfalls in long-term care facilities in Germany. Therefore, the long-term care insurance funds provided long-term care facilities with a rescue package for long-term care. Via this rescue package, an additional amount of more than €7 billion was paid to long-term care facilities.

We reviewed the procedure of paying and verifying support from the rescue package for long-term care. We developed the following key findings:

• No consistent processing specifications: The long-term care insurance funds processed the applications differently. Some long-term care insurance funds issued notices of award including instructions on legal remedies, others just paid the money. This led to uncertainties and a different treatment of long-term care facilities.
• Short disbursement period: Because of the short disbursement period of 14 days, the time frame was not long enough to check applications on a larger scale – at least for plausibility – before paying the grants.
• Verification in 10 per cent of the cases only: The grants were paid on a provisional basis subject to a possible verification procedure. However, this subsequent check had to be carried out in 10 per cent of the long-term care facilities only. The checks made so far showed a high level of failure and resulted in substantial recovery claims.
• Limited options for verification: Even in subsequent checks, the long-term care insurance funds often could only inadequately verify eligibility. For example, long-term care facilities did not always have to submit supporting documents. Furthermore, the long-term care insurance funds were often not even able to assess the documents with regard to content. As a result, checks were often ineffective.

More cases need to be verified

The high level of undue payments identified so far shows the importance of preliminary assessments and subsequent checks. We suspect a high number of undue payments which have not been identified. Therefore, we consider a significant increase in verifying eligibility to be urgently required – more than the 10 per cent of cases verified so far.

In future, the disbursement period should be long enough for the long-term care insurance funds to adequately assess the applications. Furthermore, future grants should, in principle, not be paid without verifiable supporting documents. In addition to that, we consider consistent processing of applications carried out by the long-term care insurance funds to be urgently required.