Specialist quota 2027: Transitional regulation of Section 113c SGB XI ends on 31.12.2026
India as a solution to the shortage of skilled workers in inpatient care
If you are responsible for inpatient care, you know the feeling: the duty roster is tight, there is a shortage of qualified specialists and, at the same time, the regulatory requirements continue to increase. Section 113c SGB XI will add another obligation from January 1, 2027, which may also cause serious concerns for your facility.
What § 113c SGB XI specifically requires
As you probably already know, Section 113c SGB XI prescribes a binding staff assessment procedure for full inpatient care facilities – the so-called PeBeM procedure. It specifies how many staff must be deployed at which qualification level.
The crucial point is that the skilled worker positions must be filled by qualified nursing staff – i.e. people with three years of training or an equivalent qualification (qualification level 3+). Nursing assistants with a one-year qualification do not count.
Transitional regulation ends on 31.12.2026
Until December 31, 2026, the transitional provision in Section 113c (3) SGB XI gave you a certain amount of leeway: positions that exceed the minimum requirements could also be filled with staff below qualification level 3. This leeway ends on December 31, 2026.
From January 1, 2027, all specialist positions provided for under PeBeM must be filled by qualified nursing staff, i.e. if you fill some of your specialist positions with nursing assistants today, you must fill these positions with qualified nursing staff by the end of 2026.
Otherwise you run the risk:
- Remuneration cuts by the cost bearers
- Bed closures by the home supervisory authority
- Complaints during quality audits by the Medical Service
- Increased liability risks if care services are not provided by qualified personnel
These are the consequences that you as a facility manager, board member or management board should already be taking into account today.
Why the domestic labor market is not the answer
We’re not telling you anything new when we say that the German labor market for nursing professionals is empty. There is no prospect of a new generation of relevant quality and quantity. People from Eastern Europe – Poland, Romania, Bosnia – were a realistic option for a long time. Today, this potential has also been largely exhausted.
India as a serious alternative
According to our recruiting experience, India is a realistic alternative.
- Indian nurses complete a four-year university course (B.Sc. Nursing) – not a short course, but an academically sound degree.
- Once they have been recognized in Germany, they are considered fully qualified nursing staff within the meaning of Section 113c – and therefore count directly towards the quota of qualified staff.
- India is multilingual. This structurally facilitates the acquisition of German – anyone who switches between several languages from childhood learns another one faster and more confidently. Language level B 2 is reached faster than average.
- Experience has shown that Indian workers are highly motivated to stay in Germany permanently, hence the retention rate so far.
What a serious recruitment process must achieve
It realistically takes 12 to 18 months from the first contact to the first working day of a nurse from India. This includes pre-selection, language preparation, visa procedure, recognition process and induction.
Two aspects in particular are crucial here: Language and recognition.
Language skills and dialect
A specialist who is B2-certified but does not understand the local dialect has a communication problem in everyday life. “Grüß Gott” instead of “Servus” or “Guten Morgen” doesn’t just affect the quality of the relationship – it can also quickly become a question of patient safety.
We therefore prepare our candidates specifically for the regional context of your institution. This is a step that many recruiters skip.
Recognition procedure
Professional recognition is the linchpin. Only after passing the equivalence test or knowledge test does a nurse receive the German professional certificate – and thus counts as a specialist within the meaning of Section 113c. How high the recognition rate is depends directly on the quality of the pre-selection.
Our recognition rate is 100%. This is no coincidence, but the result of a rigorous pre-selection process that we carry out with our teams or with you on site in India. We have been working in India for over 20 years and know the market, the training institutions and the specific characteristics of candidates.
Conclusion
The transitional period under Section 113c (3) SGB XI for inpatient care is coming to an end – it will be difficult to meet the skilled worker quota by the beginning of 2027 without recruiting internationally. Recruitment from India is not an emergency solution, but a sensible personnel strategy.
We recruit Indian nurses who can be immediately deployed as registered nurses in your facility after recognition – fully compliant with all German qualification requirements. You can find more information here.
Do you still have doubts or questions? Feel free to contact us for a non-binding discussion.
