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Becoming self-employed and opening your own care service – how it works

The most important facts in brief

Your professional qualifications are the most important requirement if you want to set up a care service.

Approval from the health and care insurance companies is also crucial.

Start-ups in the care sector require a structured concept. A business plan is therefore important.

As a care service manager, you have to keep double-entry accounts.

What do you need to open a care service?

In addition to your social skills and a certain passion for working in elderly care, there are professional requirements and licenses that you need before you can set up a care service.

Legal background: According to § 71 of the German Social Security Code (SGB), only trained nursing staff with appropriate additional qualifications may open an outpatient nursing service.

These are the most important requirements:

  • You must be a care professional with an additional qualification to be allowed to manage an outpatient care service (§ 71 SGB XI). You can train to become a healthcare and nursing assistant, a pediatric nurse or a geriatric nurse.
  • You must have worked full-time in the nursing profession for at least two years in the last five years (collect evidence).
  • Further training as a nursing service manager (PDL).

Opening a nursing service without a PDL – is that possible?

Recognized PDL training courses comprise approx. 460 teaching hours. If you do not have the opportunity to acquire the specialist knowledge yourself, you must employ a full-time nurse with PDL training. This is because it is not legally permitted to set up a care service without a PDL .

Opening a care service: Calculate costs and create a business plan

To start your own business successfully, it is important that you write a business plan . Design your personal concept for the care service, calculate costs and carry out a market and location analysis.

The most important contents of your business plan

  1. Business model and strategy
  2. Services: Basics or special services such as palliative care
  3. Location selection in line with the market analysis
  4. Determine the right legal form

With structure in care!

Digitale Gründung is happy to support you during your start-up phase

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Setting up a care service in Germany: What legal form is required?

Many founders opt for the sole proprietorship, as this form allows them to go through a relatively simple process and make decisions on their own. However, if you are planning to employ additional care staff, it is advisable to set up a GmbH or UG due to the liability involved.

Need help deciding? Digitale Gründung puts you in touch with experts, lawyers and tax advisors as a one-stop solution. 100% digital and uncomplicated.

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Opening an outpatient care service: Formalities at a glance

  • Further training as a nursing service manager or PDL
  • Application for approval from the responsible care insurance fund
  • Quality audits by experts from the Medical Service of the Health Insurance Funds (MDK) -> Report to the state associations of the long-term care insurance funds
  • Legal framework conditions: Comply with quality criteria for outpatient care services

Important guidelines and laws:

  1. Framework agreements and federal recommendations for the provision of home nursing care in accordance with Section 132 a SGB V
  2. Care Quality Assurance Act
  3. Federal Social Assistance Act
  4. Framework agreements and federal recommendations on nursing care in accordance with Section 75 SGB XI
  5. Training and examination regulations for nursing professions
  6. Infection Protection Act
  • Choose legal form
  • Commercial register entry
  • Business registration
  • Notification to the responsible health authority
  • Membership of the IHK
  • Register with the employers’ liability insurance association
  • Optional: Become a member of the German Federal Association of Private Providers of Social Services

Setting up a care service: Managing costs and income correctly

As a care service provider, you are generally obliged to keep double-entry accounts . This includes preparing a balance sheet and a profit and loss account. If you set up a care service with less than € 250,000 turnover per year and fewer than seven full-time employees, only a revenue-surplus statement is relevant.

Worried about losing track of things? Digitale Gründung is your strong partner in the start-up phase. Simply choose a one-stop solution and benefit from a structured foundation.


Demographic change proves it: good care facilities and skilled workers are more in demand than ever. Would you like to accompany older people in their final years? In this article, you can find out which requirements are important if you want to open a care service and what costs you can expect.

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