You want to hire a nurse from Bosnia and Herzegovina whose qualification is to be recognised in Germany. Almost every job advertisement for qualified nurses asks for B2, but the Pflegeberufegesetz (Nursing Professions Act, PflBG) does not. Which language certificate counts and when it has to be submitted is determined by the authority in your federal state, and this decides when you schedule the language course. At MioTalent we place nurses from abroad with German care organisations, and we settle this question before we present candidates.
For nurses from abroad, the law requires German but names no level
Anyone who wants to use the professional title Pflegefachfrau or Pflegefachmann (registered nurse) in Germany needs a licence to do so. This is laid down in Section 1 PflBG. Section 2 sets out the requirements: the prescribed training with a passed examination, reliability, health suitability and, as the fourth condition, “die für die Ausübung des Berufs erforderlichen Kenntnisse der deutschen Sprache” (the knowledge of German required to practise the profession). The law does not name a level such as B1 or B2.
The figure you plan by is therefore not in the law. According to a press release of the Federal Employment Agency (Bundesagentur für Arbeit, BA) for International Nurses Day 2026 (Tag der Pflege), 353,000 employees with foreign citizenship work in nursing occupations, around 20 percent of all employees there. Ten years earlier, according to the BA, the share was around seven percent. Among the three largest groups, the BA names nurses from Bosnia and Herzegovina. For many organisations, the language question is therefore part of everyday workforce planning.
The B2 level comes from a resolution of the health ministers
In June 2019 in Leipzig, the 92nd Conference of Health Ministers (Gesundheitsministerkonferenz) adopted key points (Eckpunkte) on how the federal states test the necessary German skills in the health professions. For all of these professions except speech therapy, the key points set level B2 of the Common European Framework of Reference for Languages, and C2 for speech therapy. The key points do not provide for anything below B2 for nursing. What can differ between the federal states is which certificate counts as proof, who conducts the test and when the proof has to be submitted.
The key points are an agreement among the federal states on how to fill the open term in the Pflegeberufegesetz. Each state has to implement them itself. The key points also allow the states to determine who conducts the language test: the authority that grants the licence, a professional chamber, a comparable professional body or another authorised body. What is binding for your case is therefore the information from the competent recognition authority.
The key points also name cases in which the proof is generally deemed to have been provided. These include the successful completion of a programme for recruiting foreign skilled workers in health professions that is run, supported or recognised by a federal or state authority and that includes a job-related German course at least at level B2. If your candidate comes through such a programme, ask the authority whether completing this programme is sufficient as proof of language skills.
Each federal state decides which certificates count
The Hessisches Landesamt für Gesundheit und Pflege (Hessian State Office for Health and Care) accepts a long list of language certificates, for example telc Deutsch B2 Pflege or the Goethe-Zertifikat B2. The Fachsprachenprüfung Pflege (specialist language examination for nursing) of digiFORT gGmbH is also on the list. For Hesse, your candidate can therefore choose between several examinations.
In Rhineland-Palatinate, the Landespflegekammer (State Chamber of Nursing) has offered its own Fachsprachprüfung B2 Pflege (specialist language examination B2 for nursing) since 2024, which counts as proof. The examination simulates conversations with a person receiving care and with a supervisor; in the written part it requires a nursing report. Only the nurse herself may register; an authorised representative cannot do this for her. If she completed her training outside the EU, she also needs a Feststellungsbescheid (recognition decision) to register. This is the decision with which a German recognition authority communicates the result of the equivalence assessment.
Where a specialist language examination is only possible after the Feststellungsbescheid, the language proof moves to the end of the procedure. The two states therefore take different routes. Whether a certificate is sufficient is decided by the authority of the state in which your candidate applies for the licence. We read the requirements of each state individually; the binding information for your case comes from the authority.
In Hesse the proof is only due for the licence, but your candidate needs German earlier
According to the Hessian State Office, the language proof does not yet have to be available when the application is submitted. It must be available at the latest when the Berufserlaubnis (licence to practise) is granted. Other states may regulate this differently. In the recognition procedure, the authority examines whether the foreign qualification is equivalent. What is recognised is the qualification, not the person.
If the authority finds differences, your candidate can compensate for them with an Anpassungslehrgang (adaptation course) or a Kenntnisprüfung (knowledge test). According to the Hessian State Office, she also needs sufficient language skills for this. Anyone who plans the language course for the period after the knowledge test is planning too late.
The order is fixed. We go through it with you.
- Together with you, we identify the competent recognition authority. The Anerkennungs-Finder (recognition finder) of the portal Anerkennung in Deutschland shows it.
- You ask the authority in writing which level is required, which certificates are accepted, whether a specialist language examination is necessary and by when the proof has to be submitted. We prepare the questions with you.
- Only with this answer does your candidate register for the language course and the examination.
- We coordinate the timetable for the course with you so that it ends before an adaptation course or a knowledge test.
We settle the language question before we present candidates to you
A certificate that your authority does not accept costs time in which your position stays vacant. That is why we check the published requirements of your federal state before we present candidates and compare them with the language level of each applicant. If a certificate that your state accepts is already available, it belongs to step 4 of our procedure, the collection and legalisation of documents. An examination that is only possible after the Feststellungsbescheid follows after step 5, the submission to the German authorities, and the time it takes is added.
The certificate is a condition set by the authority. Whether your new employee copes on the phone at night with a relative is a different question. You answer it during induction, and our article on the language barrier has more on this.
From the requirements analysis to arrival, we expect around 4 months. If your candidate’s qualification first has to be recognised, the time for the adaptation course or knowledge test is added. What this means for your organisation is described in our article on the knowledge test in nursing, and why a condition tends to be the rule is explained in our article on recognition in nursing.
Free initial consultation — we will call you back, when suits you? In 15 minutes we talk about your open nursing position and about which questions you should put to your state authority before the selection.
Information for orientation only, not legal advice.
Sources
- Federal Ministry of Justice: Pflegeberufegesetz, Sections 1 and 2. 2026. https://www.gesetze-im-internet.de/pflbg/__2.html (retrieved 04.10.2026).
- Conference of Health Ministers (Gesundheitsministerkonferenz): Beschluss der 92. GMK am 05./06. Juni 2019, TOP 8.6, Eckpunkte zur Überprüfung der Deutschkenntnisse in den Gesundheitsfachberufen. 2019. https://www.deutsch-am-arbeitsplatz.de/fileadmin/user_upload/PDF/02_News/8.6_B_P.pdf (retrieved 04.10.2026).
- Hessisches Landesamt für Gesundheit und Pflege: Anerkennung internationaler Pflegeabschlüsse – Antrag und Anerkennungsverfahren. n.d. https://hlfgp.hessen.de/pflegefachberufe/auslaendische-abschluesse-pflege-antrag-und-anerkennungsverfahren (retrieved 04.10.2026).
- Landespflegekammer Rheinland-Pfalz: Fachsprachprüfung. n.d. https://pflegekammer-rlp.de/pflege-als-heilberuf/fachsprachpruefung/ (retrieved 04.10.2026).
- Federal Employment Agency: Tag der Pflege – jede fünfte Pflegekraft hat ausländische Staatsangehörigkeit. Press release 16. 2026. https://www.arbeitsagentur.de/presse/2026-16-tag-der-pflege-jede-fuenfte-pflegekraft-hat-auslaendische-staatsangehoerigkeit (retrieved 04.10.2026).
