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Pflegepersonaluntergrenzen-Verordnung:
What hospitals need to know

The PpUGV sets out how many nursing staff must be present, at minimum, per shift in certain hospital units. What exactly it regulates, who is affected, and what happens if a unit falls short - explained concisely.

Reading time approx. 6 minutes · last updated August 2026

What is the Pflegepersonaluntergrenzen-Verordnung?

The Pflegepersonaluntergrenzen-Verordnung (PpUGV, the German nursing staffing minimums regulation) sets out, based on § 137i SGB V, how many patients a single nurse may care for, at most, per shift in certain especially care-intensive units - the so-called nursing-sensitive units. It has applied since 2019 and has since been extended to cover further units several times. Its goal is to prevent nursing shortages where they are most dangerous for patients.

The regulation covers hospitals - not outpatient care or nursing homes (more on that below).

Which units count as nursing-sensitive units?

Currently covered nursing-sensitive units include:

The PpUGV does not apply to psychiatry and psychosomatics - a separate rule applies there: Personalausstattung Psychiatrie und Psychosomatik-Richtlinie (PPP-RL, the German staffing directive for psychiatry and psychosomatics) of the Federal Joint Committee (Gemeinsamer Bundesausschuss). Both regulations pursue the same goal - a minimum level of nursing staff - but differ in detail and in how they are calculated.

How are the nursing staffing minimums calculated?

For every nursing-sensitive unit, a maximum nurse-to-patient ratio is set per shift, separately for day and night. If the number of patients per nursing staff member exceeds this value, the unit falls below the minimum.

Important: The exact ratios differ by unit and are adjusted regularly. What counts is always the current text of the regulation - when in doubt, check the version currently in force or coordinate with your state association or hospital administration.

What happens if a unit falls below the minimum?

Hospitals must report compliance with the nursing staffing minimums to the health insurers every quarter. If a unit repeatedly falls below the minimum, it risks reimbursement cuts - in extreme cases, the affected unit can be closed to further admissions until enough staff are available again. For the hospital, that is not just a financial risk but an organizational one: without an ongoing view of staffing, a looming shortfall is often only noticed once the schedule has already been published.

And what about nursing homes?

The PpUGV applies explicitly to hospitals. For inpatient elderly care a separate staffing-assessment procedure applies under § 113c SGB XI (including the so-called PeBeM procedure), which uses different criteria. If you run both - say, a hospital unit and an affiliated nursing home - treat the requirements for each facility separately.

How Presio helps you stay compliant

In Presio, you can set a staffing target per shift in place - whether that's your own target or a legal one like PpUGV or PPP-RL. The staffing row in the schedule then shows, for every day and every shift, at a glance whether the target is met - in seconds, rather than only at month-end when you check the statistics. That way a looming shortfall shows up before the schedule is published, not after.

Master data and shifts don't need to be maintained twice for that: on request, we build an interface to your hospital information system (HIS), through which this data can be imported automatically.

Frequently asked questions about the PpUGV

What is the Pflegepersonaluntergrenzen-Verordnung (PpUGV)?

The PpUGV is a regulation based on § 137i SGB V that sets a maximum ratio of patients to nursing staff per shift for certain nursing-sensitive units in hospitals - such as intensive care, geriatrics or cardiology. It has applied since 2019 and is meant to prevent nursing shortages in especially sensitive units.

Which units are covered by the nursing staffing minimums?

Among others: intensive care, cardiology, trauma surgery, general surgery, internal medicine, neurology including stroke units, geriatrics, cardiac surgery, and pediatrics including pediatric intensive care. Psychiatry and psychosomatics are covered by the PPP-RL instead.

What happens if a hospital falls below a nursing staffing minimum?

Compliance must be reported to the health insurers every quarter. Repeated shortfalls risk reimbursement cuts, and in extreme cases an admissions freeze for the affected unit until enough staff are available again.

Does the PpUGV also apply to nursing homes?

No. The PpUGV applies to hospitals. Inpatient elderly care is covered by a separate staffing-assessment procedure under § 113c SGB XI.

Staffing targets that check themselves

Presio shows target vs. actual staffing per shift at a glance - whether your own target or PpUGV. Free until October 31, 2026, no credit card required.

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This article is for general information only and does not replace legal advice. For binding information on the currently applicable ratios and your specific situation, please contact your state association, your hospital administration or legal counsel.

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