Krankenhausinvestitionen; Beantragung einer Förderung

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

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

The following investments are funded individually:

• The construction of hospitals (conversion, extension, new construction) including the necessary initial equipment as well as comprehensive overall refurbishment measures,

• the replacement, including the supplementary procurement of medium-term fixed assets (average useful life of more than 15 years),

• the supplementary procurement of short-term fixed assets (average useful life of more than three and up to 15 years), insofar as the addition 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 via the Bavarian annual hospital construction programs.

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

  Flat-rate subsidies are granted to hospital operators for the independent replacement, including the supplementary procurement of short-term fixed assets, as well as for smaller investments whose costs, including VAT, do not exceed the cost limit of one fifth of the annual flat rate of the individual hospital.
  

• Promotion of user fees (Art. 13 Bavarian Hospital Act - BayKrG)

  Instead of individual funding for investments, fees for the use of fixed assets can be funded if the construction or procurement of the fixed asset is impossible or less economical.
  

• Funding of charges from investment loans (Art. 15 Bavarian Hospital Act - BayKrG)

  If a hospital operator has taken out loans for eligible investment costs incurred before the hospital was included in the hospital plan, the debt service charges incurred since inclusion in the hospital plan can 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 these are used for the first time for acute inpatient care in line with demand and this is more economical than individual funding of investments in accordance with 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, equity compensation is granted. The lump-sum compensation payment per treatment place is 500 euros. If appropriate evidence is provided, a higher compensation amount can also be granted - taking into account subsidized replacement investments.
  

• Lump-sum compensation payments in the event of closure or conversion of hospitals (Art. 17 Bavarian Hospital 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 in order to mitigate the unavoidable hardship for the hospital operator.
  
  In the event of the closure or conversion of a hospital or dependent operating facility, the compensation payments amount to EUR 12,000 for each treatment place that is discontinued and, in the event of the closure or conversion of hospital departments, EUR 30,000 for each discontinued specialty plus EUR 6,000 for each treatment place that is discontinued in this context.

• 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.

General requirements:

• Only hospitals that are included in the hospital plan of the Free State of Bavaria or for which the hospital planning requirements for their admission have been determined are entitled to state investment cost support.
• The granting of subsidies requires the hospital operator to submit an application to the local government. It is the responsibility of the hospital operator to provide the information required to assess the funding and to provide evidence upon request.
• Subsidies are only granted to the hospital operator. The hospital operator is the operator of the hospital.
• The investment costs must be necessary in accordance with the hospital's mission in the Bavarian Hospital Plan and the principles of economy and efficiency.
• In particular, the costs of
  • outpatient or rehabilitative care,
  • the acquisition or rental of hospitals already in operation and included in the hospital plan,
  • of land and property,
  • pre-financing of the hospital operator and
  • the hospital operator's own staff.

Essential requirements for the individual types of funding:

• Individual funding for 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 process. In addition, the cost limit for flat-rate funding must be exceeded (Art. 12 Para. 1 No. 2 BayKrG).
  • The annual hospital construction program is jointly drawn up each year by the State Ministry of Health and Care and the State Ministry of Finance and Home Affairs. So-called "advance determinations" are also made for the annual hospital construction programs of the following four years.
  • As part of the technical review process, it is checked whether the project is in line with demand in the context of hospital planning, whether it complies with the principles of economy and efficiency, including operating costs, and whether the overall financing is secured.
  • Projects with eligible costs that exceed the cost limit for flat-rate funding in accordance with Art. 12 Para. 1 No. 2 BayKrG, but do not exceed an amount of EUR 2.5 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 initial approval has been granted. The locally responsible government may approve an early start to the project if the project is financially secured in an annual hospital construction program or government quota, the technical review process has been completed and the hospital operator has agreed to assume the pre-financing costs.
  • From an expected funding amount of more than EUR 500,000, the hospital operator will be required to provide security in accordance with Art. 18 Para. 3 BayKrG in conjunction with the Guarantee Guidelines (AbR) for a possible claim for repayment before the funding is paid out, unless there is an exemption from the obligation to provide security in accordance with No. 1.2 AbR.
    
• Flat-rate funding (Art. 12 Bavarian Hospital Act - BayKrG)
  • The hospital operator is responsible for managing the lump-sum funding within the scope of the earmarking for acute inpatient hospital care, taking into account its tasks in the hospital plan and the principles of efficiency and economy.
  • The creation of fund 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, unless the funding is demonstrably required for specific foreseeable investments.
    
• Promotion of user fees (Art. 13 Bavarian Hospital Act - BayKrG)
  • Instead of individual funding, fees for the use of fixed assets can be funded if there are circumstances in the individual case that speak in favor of hospital operation within the framework of a usage relationship. In addition, there must be an interest in hospital planning and the approval of the local government responsible for concluding the usage agreement and a technical review procedure must have been carried out. The project may not be started before initial approval has been granted. Approval for early commencement of the project is generally possible once the technical review procedure has been completed.
  • The fee for the use of fixed assets whose production or procurement would have to be financed from the lump sums in accordance with Art. 12 BayKrG must be financed from the lump sums. The financing of the usage fees must correspond to economic management.
    
• Funding of charges from investment loans (Art. 15 Bavarian Hospital Act - BayKrG)
  • The utilization 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 are taken into account. Loans to redeem equity and increased charges from debt rescheduling are generally not eligible.
    
• 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 new replacement building or a change of ownership does not trigger an entitlement.
  • At the start of the subsidy, eligible fixed assets procured with own funds must have been available whose regular useful life had not yet expired at that time.
    
• Lump-sum compensation payments for the closure or conversion of hospitals (Art. 17 Bavarian Hospital Act - BayKrG)
  • The entitlement requires that
    • the reduced treatment places are not relocated to another hospital or the reduced specialty is not newly established at another hospital,
    • the closure or conversion is not carried out 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 when granting the annual lump sum (Art. 12 para. 2 BayKrG).

Applications for funding must be submitted to the responsible local government.
The State Office of Finance (State Debt Administration) is responsible for any necessary collateralization of funding.

Online procedure

Applications can be submitted online. They are displayed in the BayernPortal under "Online procedure" when you select the town or zip code of the location of the hospital or business premises.

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

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