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Drafting general terms and conditions for home care involves establishing the fixed provisions of your care provision: the care agreement, the relationship to the WGBO, the form of financing (PGB, ZVW, Wlz, or private), cancellation, liability, the complaints procedure under the Wkkgz, privacy under the GDPR, and payment. The key lies in provisions that are enforceable *and* remain within mandatory healthcare law and consumer law. Below is the structure and the pitfalls.
The short answer
- Scope: to which care and which clients the conditions apply.
- Care Agreement and WGBO: commencement, amendment, termination and client rights.
- Funding: separate provisions for PGB, ZVW, Wlz and private care.
- Cancellation, liability and payment: terms, limits and consequences.
- Complaints and privacy: Wkkgz route and GDPR processing.
Drafting general terms and conditions for home care: where do you start?
Start with the scope. Define which forms of care the conditions apply to and which clients. A home care organization often provides multiple types of care simultaneously—district nursing under the Health Insurance Act (ZVW), care from a Personal Budget (PGB), sometimes Long-Term Care Act (Wlz) care, and additionally private supplementary services. Each form has its own funding and rules. Make this distinction clear immediately; otherwise, confusion will arise regarding who pays for what.
The care agreement and the WGBO
The conditions must align with the individual care agreement. Include:
- Commencement and care plan: how care starts and how the care plan is established and updated.
- Modification: how the scope or nature of the care is adjusted and who is authorized to do so.
- Termination: notice periods for the client and the organization, and the grounds on which the organization may terminate (with due observance of the duty of care).
- WGBO rights: duty to inform, consent requirement, record keeping, and right of access. You specify these rights; you cannot restrict them to the detriment of the client.
Please note regarding termination: a healthcare provider cannot simply terminate a treatment agreement unilaterally. Serious reasons and due diligence requirements apply. A termination clause that is too broad will not hold up.
Funding: PGB, ZVW, Wlz and private
This is the most underestimated part. The form of financing determines the contractual relationship:
- PGB: the budget holder contracts the care provider directly. Care agreements must meet the requirements of the SVB. Payment arrangements are made via the budget.
- ZVW (district nursing): the health insurer funds; the district nurse determines the indication. In principle, the client does not pay themselves, so payment provisions here primarily relate to supplementary, non-reimbursed care.
- Wlz: funding via the healthcare office, with any personal contribution via the CAK.
- Private individual: the client pays directly. Payment, collection, and cancellation provisions apply most strictly here, as does consumer law.
Cancellation, liability and payment
Three provisions that often lead to discussion:
- Cancellation. Apply a reasonable cancellation period (e.g., 24 hours) and a proportionate fee. An unreasonably high cancellation fee charged to a consumer is a grey-list clause and can be annulled.
- Liability. You may limit liability, but not exclude it without limit. For example, limit it to the amount paid out by the insurer and exclude indirect damages — but take into account the limits of consumer law and intent or gross negligence, which you can never exclude.
- Payment. Specify the payment term, collection process, and consequences of non-payment, especially for private healthcare and personal contributions. For consumers, statutory collection costs and the fourteen-day notice apply.
Complaints procedure (Wkkgz) and privacy (GDPR)
The Wkkgz obliges every healthcare provider to have a complaints procedure with a complaints officer and to be affiliated with a recognized dispute resolution body. Refer to this procedure and the dispute resolution body with which you are affiliated in the terms and conditions. You may not restrict the statutory route.
Regarding privacy , health data is considered special personal data. The privacy provision must align with your processing register, retention periods, and any data processing agreements (for example, with an EHR vendor). Where possible, refer to a separate privacy statement instead of cramming all the details into the terms and conditions.
A practical example
A home care organization drafted a single set of terms and conditions for both ZVW district nursing and private care, without distinction. A private client disputed an invoice, arguing that “the health insurer pays anyway.” Because the terms and conditions did not clearly distinguish which care was private, collection took unnecessary time. After splitting the financing provisions, it was clear to every client who would receive the bill.
Honest recommendation
You can draft a simple set of conditions for a single form of financing—for example, private care only—yourself, using a solid foundation and this framework. You do not need a lawyer for this; just ensure that you demonstrably provide the conditions in advance and do not include unreasonable cancellation or liability clauses.
Do have it legally drafted or reviewed if you work with multiple forms of financing simultaneously (PGB, ZVW, Wlz, private), if you wish to limit liability, or if you want termination clauses that respect the duty of care and the WGBO. That is precisely where self-written terms and conditions fail.
Read more: general terms and conditions for home care, what are general terms and conditions for home care and having general terms and conditions for home care drawn up.
Frequently Asked Questions
Document the fixed provisions of your care provision: scope, care agreement and WGBO rights, form of financing (PGB, ZVW, Wlz, private), cancellation, liability, complaints procedure under the Wkkgz, privacy under the GDPR, and payment. Ensure that the provisions are enforceable and remain within mandatory healthcare and consumer law.
The form of financing (who pays), the complaints procedure under the Wkkgz, the privacy provision under the GDPR, and the termination arrangement that respects the duty of care. It is precisely these topics that are often forgotten or formulated too generally, resulting in disputes or provisions that are voidable.
Limiting liability is permitted, but excluding it completely is not. For example, you can limit liability to the amount paid out by your insurer and exclude indirect damages. You can never exclude intent and gross negligence, and additional limits under consumer law apply to consumers.
With a reasonable cancellation period and proportionate compensation, for example, cancelling up to 24 hours in advance free of charge. An unreasonably high cancellation fee charged to a consumer is on the grey list and can be annulled. Clearly define the provision and provide the terms and conditions in advance.
Yes. With a PGB, the budget holder contracts directly and SVB requirements apply; with ZVW district nursing, the health insurer funds the service and, in principle, the client does not pay themselves. Payment and cancellation provisions primarily relate to private and non-reimbursed care. Make that distinction explicit.
Refer to your complaints procedure with a complaints officer and to the recognized dispute resolution body with which you are affiliated, as required by the Wkkgz. The procedure itself can be a separate document; include the reference and the contact route in the terms and conditions. Restricting the statutory route is not permitted.
Only if the client has received them before or at the conclusion of the care agreement (provision) and the provisions are not unreasonably burdensome. Provide them demonstrably, for example as an attachment to the agreement. Without timely provision, the client may invalidate provisions.
