LTC System in Austria

The scope of long-term care facilities includes the care and support of individuals who require assistance with daily living activities. Long-term care in Austria is organized through a combination of financial benefits and publicly organized services. The primary financial benefit is the Pflegegeld (care allowance), which is granted without an income test and is divided into seven levels based on the individual's care needs. This system allows for flexibility in choosing between formal and informal care services.

Austria has approximately 900 nursing homes, operated by both public and private providers. Slightly more than 400 of these are public institutions run by federal states, municipalities, or social organizations. Around 500 nursing homes are operated by private organizations.

In Austria, legislation regarding long-term care is regulated at both federal and state levels. The Bundespflegegeldgesetz (Federal Care Allowance Act) governs entitlement to care allowance, while regional laws (e.g., Steiermärkisches Sozialhilfegesetz or Pflegeheimgesetze) regulate long-term care facilities. Since 2012, care allowance has been the sole responsibility of the federal government. This ensures a standardized approach across the country and provides a unified framework for care services.

Admission to a nursing home is determined by care needs, which are generally assessed through the federal care allowance system, ranging from level 1 to level 7. These levels determine the amount of care allowance, which ranges from €200.80 at level 1 to €2,156.60 at level 7 (as of January 2025). For residential care, level 4 is typically the minimum requirement unless a higher need is demonstrated through specific medical documentation. A formal application process, including medical and financial documentation, is mandatory. There is no income test, meaning eligibility is not dependent on income or assets.

Austria offers both formal and informal care options:

Informal care is the most preferred form of care among older adults in Austria. This preference is mainly due to the cultural value placed on family care and the flexibility it offers. The care allowance supports this by providing financial aid that can compensate informal caregivers.

Long-term care in Austria is primarily funded through public expenditures. The care allowance is financed by the federal government, while additional services are often subsidized by regional governments. The care allowance is intended for care-related expenses and can be used to pay for services from public or private providers or to compensate informal caregivers. For those receiving long-term care services, an income-based co-payment is required. If personal income is insufficient to cover care costs, social assistance covers the remaining expenses, often through mixed funding mechanisms involving federal and regional resources. Additionally, the Pflegefonds (Care Fund), supported by contributions from the federal and state governments, helps provide care services. Since 2018, personal assets of individuals and their relatives can no longer be used to finance long-term care (abolition of care recourse). Nursing home costs typically consist of two components, which vary by facility: accommodation costs, covering housing-related expenses, and care fees, covering nursing and support services.

The increasing elderly population is expected to lead to higher public expenditures on long-term care, with forecasts predicting a significant rise by 2070.