Hospital investments; application for funding

The Free State of Bavaria promotes the necessary investments of the hospitals included in its hospital plan (acute inpatient hospital care).

Description

  • Individual funding of investments (Art. 11 Bavarian Hospital Act - BayKrG).

The following investments are subsidized individually:

  • The construction of hospitals (remodeling, expansion, new construction) including the initial equipment necessarily associated therewith as well as comprehensive overall renovation measures,
  • the replacement including supplementary procurement of medium-term fixed assets (average useful life of more than 15 years),
  • the supplementary procurement of short-term assets (average useful life of more than three and up to 15 years), insofar as the supplement goes significantly beyond the usual adaptation to medical and technical developments.

The projects are funded by fixed amounts agreed with the hospital operators. Funding is provided through the Bavarian Annual Hospital Construction Programs.

  • Flat-rate funding (Art. 12 Bavarian Hospital Act - BayKrG)

    Lump-sum subsidies are granted to hospital operators for the independent replacement, including supplementary procurement, of short-term fixed assets and for smaller investments whose costs, including value-added tax, do not exceed the cost limit of one-fifth of the individual hospital's annual lump sum.
  • Funding of user charges (Art. 13 Bavarian Hospital Act - BayKrG)

    Instead of individual funding of investments, fees for the use of fixed assets may be funded if the construction or procurement of the fixed asset is impossible or less economical.
  • Subsidization of burdens from investment loans (Art. 15 Bavarian Hospital Act - BayKrG)

    If a hospital owner has taken out loans for eligible investment costs incurred prior to the hospital's inclusion in the hospital plan, the debt service burdens incurred since the hospital's inclusion in the hospital plan may be subsidized. In addition, loan burdens from investments for individual buildings (previously used for other purposes) of hospitals already included in the hospital plan are eligible for funding if they are put to acute inpatient use for the first time in line with demand and this is more economical than individual funding of investments under Art. 11 BayKrG.
  • Equity compensation (Art. 16 Bavarian Hospital Act - BayKrG)

    In connection with the withdrawal of a hospital or a dependent operating facility from the hospital plan, an equity compensation is granted. The lump-sum compensation payment per treatment place amounts to 500 euros. If appropriate evidence is provided, a higher compensation amount can also be granted - with offsetting of subsidized replacement investments.
  • Lump-sum compensation payments in the event of closure or conversion of hospitals (Art. 17 Bavarian Hospitals Act - BayKrG)

    In the event of the closure of hospitals or hospital departments or their conversion to other tasks, lump-sum compensation payments are granted to mitigate any unavoidable hardship this may cause for the hospital operator.

    In the event of closure or conversion of a hospital or dependent facility, the compensation payments amount to 12,000 euros for each treatment place that is discontinued, and in the event of closure or conversion of hospital departments, 30,000 euros for each specialty discontinued plus 6,000 euros for each treatment place discontinued in this connection.

Prerequisites

General requirements:

  • Only hospitals that are included in the hospital plan of the Free State of Bavaria or for which the hospital planning requirement for their inclusion has been established are entitled to state investment cost subsidies.
  • The granting of subsidies requires an application to be submitted by the hospital operator to the locally responsible government. It is the responsibility of the hospital owner to provide the information necessary for the assessment of the subsidy and to provide evidence upon request.
  • Subsidies are only granted to the hospital owner. The hospital owner is the person who operates the hospital.
  • The investment costs must be necessary in accordance with the hospital's mission statement in the Bavarian Hospital Plan and the principles of economy and efficiency.
  • In particular, the following costs are not subsidized
    • of outpatient or rehabilitative care,
    • the acquisition or leasing of hospitals already in operation and included in the hospital plan,
    • of land and property,
    • advance financing of the hospital operator, and
    • the hospital's own personnel.

Essential requirements for the individual types of funding:

  • Individual funding of investments (Art. 11 Bavarian Hospital Act - BayKrG).
    • The prerequisite for individual funding is the inclusion of the measure in the annual hospital construction program and the implementation of a technical review procedure. In addition, the cost limit for lump-sum funding must be exceeded (Art. 12 Para. 1 No. 2 BayKrG).
    • The annual hospital construction program is drawn up jointly each year by the State Ministry of Health and Care and the State Ministry of Finance and the Home Office. At the same time, so-called "advance decisions" are made for the annual hospital construction programs of the following three years.
    • As part of the technical review process, a check is made to ensure that the project meets the needs of hospital planning, that it complies with the principles of economy and efficiency, taking into account operating costs, and that overall financing is secured.
    • Projects with eligible costs that exceed the cost limit for lump-sum funding pursuant to Art. 12 (1) No. 2 BayKrG, but do not exceed an amount of EUR 2 million, are not included individually in the annual hospital construction program, but are funded independently by the governments in a simplified procedure within the framework of the government quotas made available to them by the State Ministry of Finance and Home Affairs.
    • The project may not be started before the initial approval. The locally responsible government can agree to an early start of the measure if the project is financially secured in an annual hospital construction program or government contingent, the technical review procedure has been completed and the hospital operator has declared its agreement to assume the pre-financing costs.
  • Flat-rate funding (Art. 12 Bavarian Hospital Act - BayKrG)
    • The hospital operator manages the lump-sum subsidies on its own responsibility within the scope of the earmarking for acute inpatient hospital care, taking into account its remit in the hospital plan and the principles of efficiency and economy.
    • The formation of funds reserves of more than three times the annual amount must be reported and leads to a corresponding reduction in the lump sum in the following year, insofar as the subsidies are not demonstrably required for concretely foreseeable investments.
  • Funding of user charges (Art. 13 Bavarian Hospital Act - BayKrG)
    • Instead of individual subsidies, fees for the use of fixed assets can be subsidized if there are circumstances that speak in favor of hospital operation within the framework of a user relationship in the individual case. In addition, there must be an interest in hospital planning and the consent of the locally responsible government to the conclusion of the utilization agreement, and a technical review procedure must have been carried out. The project may not be started before the initial approval. In principle, approval for the early start of the project is possible after completion of the technical review procedure.
    • The fees for the use of fixed assets, the production or procurement of which would have to be financed from the lump sums pursuant to Art. 12 BayKrG, must be financed from the lump sums. The financing of the user charges must be in line with economic management.
  • Funding of charges from investment loans (Art. 15 Bavarian Hospital Act - BayKrG)
    • The use of the loans must have been necessary with reasonable use of the assets of the hospital operator or other natural or legal persons who can directly or indirectly exercise a controlling influence over it. Only costs that were necessary for an efficient and economical hospital at the time they were incurred will be considered. Loans to redeem equity and increased burdens from a debt restructuring are generally not eligible for consideration.
  • Equity compensation (Art. 16 Bavarian Hospital Act - BayKrG)
    • The hospital or dependent operating facility must be removed from the hospital plan. The mere relocation of a hospital operation to a replacement facility or a change of sponsor does not trigger an entitlement.
    • At the start of the subsidy, eligible assets purchased with the hospital's own funds must have existed and their regular useful life had not yet expired at that time.
  • Lump-sum compensation payments in the event of hospital closure or conversion (Art. 17 Bavarian Hospital Act - BayKrG)
    • The entitlement requires that
      • the dismantled treatment places are not relocated to another hospital or the dismantled specialty is not rebuilt at another hospital,
      • the closure or conversion is not handled as part of insolvency proceedings.
    • The reduction of individual treatment places is not facilitated by lump-sum compensation payments, but by a two-year phase-out provision in the granting of the annual lump-sum payment (Art. 12 Para. 2 BayKrG).

Procedure

Applications for funding must be submitted to the locally responsible government.

Deadlines

The deadlines set by the locally responsible government apply to individual funding under Art. 11 BayKrG.

Processing time

The processing time depends on the submission of complete application documents by the hospital operator, the size and complexity of the measure, and the number of applications currently being processed by the locally responsible government.

Required documents

  • The necessary documents are requested by the locally competent government on a case-by-case basis.

    In principle, they result from the Bavarian Hospital Act, the Ordinance on the Implementation of the Bavarian Hospital Act and the administrative regulations issued in this regard.

Forms

  • Prefillable Form, Bavaria-wide: Krankenhausförderung - Auszahlungsantrag über Förderleistungen nach Art. 11 BayKrG
    Please note

    This form has to be signed and sent to the responsible authority. You can sign the form manually and send it by email/fax or sign the form electronically with your qualified electronic signature an send it by (secure) email. If the responsible authority has set up a De-Mail account, you can also send the form by De-Mail using an sender-confirmed message.

Remedy

Administrative court action

Status: 08.03.2022

Responsible for editing: Bayerisches Staatsministerium der Finanzen und für Heimat

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  • Online transactions, Bavaria-wide
  • Online transactions, locally limited
  • Prefillable Form, Bavaria-wide
  • Legal bases, Bavaria-wide
  • Legal bases, locally limited
  • Fees, Bavaria-wide
  • Fees, locally limited
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Sachgebiet 12.2 - Kommunales Finanzwesen, Kommunale Förderungen; Oberversicherungsamt Südbayern

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