Czech care homes want pensioners to pay for their own food and lodging

The Association of Social Services Providers of the Czech Republic has proposed that residents of care homes should cover the full cost of food and accommodation themselves, with state money used to fund only the actual care. The initiative was presented by the association's president, Jiří Horecký, and it has already sparked heated debate among other social service providers and at the Ministry of Labour and Social Affairs.

Currently the state covers part of the cost

Under the current rules, pensioners in care homes pay a top-up for food of no more than 290 crowns a day and for accommodation 335 crowns a day (380 crowns for a single room). The law also guarantees that after all payments, a person must be left with at least 15% of their pension for personal needs. According to Horecký, part of these costs is not currently covered by clients' contributions and is quietly subsidised from the budget — regardless of how much a given person actually needs that help.

The association proposes changing this logic: public money would pay only for the actual care of elderly people, while everything related to food and housing would be shifted entirely onto the residents themselves. The guaranteed minimum remainder of 15% of income would be kept, but the association also wants an analysis of whether that amount is even sufficient.

If there isn't enough money, the family gets involved

What happens if a pensioner doesn't have enough money to cover the full cost? Under the association's proposal, the difference would then be covered by their spouse or partner, or by their children. If relatives are also unable to help, the missing amount would be covered by the state through what is known as a "super-benefit" — a comprehensive social allowance.

Representatives of the association gave an illustrative example: if the monthly fee at a care home is 21,000 crowns and a person's pension is 22,000 crowns, then after deducting the guaranteed 15% (3,300 crowns), they are able to pay 18,700 crowns. The remaining 2,300 crowns would be covered from personal savings — in the association's example, the person has savings of 200,000 crowns. If there are no savings, relatives or the state step in.

"Everyone is responsible for their own housing and food"

Horecký explained the logic behind the reform as follows: "Medical and social care will always be available to a Czech citizen free of charge. But everyone is responsible for their own housing and food — either the pensioner themselves or their family." According to him, the proposal draws on the experience of Western European countries.

The idea was backed by Viktor Kubát, head of the non-profit organisation "Dohled na dosah" and of the Czech Union of Social Services: in his view, given demographic trends, the current system of paying for care is unsustainable, and the debate raised by the association needs to begin with all stakeholders involved — otherwise it will be impossible to secure long-term, sustainable funding not only for care homes but also for home care services.

The ministry is treading carefully for now

Payment rules at social care facilities are currently set by a decree of the Ministry of Labour and Social Affairs. To adopt the association's proposal, the Social Services Act itself would have to be amended — meaning the decision would depend not only on ministry officials but also on members of parliament.

Ministry spokesman Jakub Slavík called the association an important partner for dialogue, noting that the system already separates payment for care from payment for accommodation and food. At the same time, he said, the association's proposal contains elements of a far more far-reaching systemic reform — using clients' savings, involving family members, and a subsequent top-up through the benefits system — and before changing anything, the social, legal, administrative and budgetary consequences need to be carefully assessed. The key point, Slavík stressed, is that the changes must not reduce the accessibility of social services for people without their own means.

Horecký, in response, insists that such safeguards are already built into his proposal: if a person doesn't have enough money, the state will help through a targeted social benefit. Meanwhile, the ministry is already working on maximum rates for social services in 2027, taking into account both providers' costs and clients' incomes — including pension trends and care allowances.

Around Prague, based on reporting by denik.cz