## Facts

- The German federal legislature enacted the Geriatric Nursing Act (2000) to create nationwide minimum standards for geriatric-nursing training, examinations, licensing, and title protection.
- Before enactment, the German states regulated geriatric-nursing training in differing ways, producing nonuniform curricula and qualifications.
- Bavaria filed an abstract review petition seeking a declaration that the federal statute was unconstitutional for lack of federal legislative competence.
- The constitutional dispute centered on whether geriatric nursing falls within federal concurrent power over admission to “medical and other healing professions,” and whether federal regulation was constitutionally “necessary” rather than left to the states.
- The case was heard directly by the German Federal Constitutional Court without prior lower-court proceedings.

## Issues

1. Whether the profession of geriatric nurse qualifies as an “other healing profession,” bringing the statute within federal concurrent legislative competence over professional admission and related regulation.
2. Whether the statute satisfied the constitutional “necessity” requirement limiting federal use of concurrent powers—i.e., whether federal regulation was required to secure equivalent living conditions or preserve legal or economic unity.
3. Whether the necessity determination is fully subject to constitutional review or largely committed to legislative discretion.

## Decision

- The court held that geriatric nursing is an “other healing profession,” permitting federal regulation of admission-related matters such as training, examinations, and licensing.
- The court distinguished geriatric nurses from geriatric nursing assistants, finding the latter category did not, as such, fall within the same competence label.
- The court held that the constitutional necessity requirement is justiciable and subject to full constitutional review, not insulated by a political-discretion doctrine.
- The court upheld the statute’s core provisions establishing nationwide minimum standards for training and admission to the geriatric-nurse profession.
- The court invalidated certain provisions that regulated matters beyond what was necessary for the identified federal interests, leaving most of the statute in effect.

## Legal Principles

- A constitutional competence label covering “admission to medical and other healing professions” extends beyond formal licensing to closely connected training and examination rules.
- Legislative competence categories may be applied dynamically; the legislature may shape professional profiles in response to contemporary public-health and care needs within constitutional limits.
- The constitutional “necessity” limit on concurrent legislative power is enforceable by courts; the legislature must substantiate why federal regulation is required rather than state regulation.
- Uniform federal law is not, by itself, sufficient to satisfy the necessity requirement; the constitution requires a demonstrated risk or reality of serious divergence affecting equivalent living conditions or legal/economic unity.
- Federal regulation must be confined to what is necessary to achieve constitutionally recognized integrative interests; provisions exceeding that scope are unconstitutional even if the statute’s core is valid.

## Conclusion

The court sustained federal authority to standardize admission-related regulation for geriatric nurses and confirmed that the necessity requirement meaningfully constrains concurrent federal powers through judicial review, while striking discrete statutory provisions that went beyond what the constitution permitted as necessary for nationwide objectives.


Geriatric Nursing Act Case (Altenpflegegesetz-Entscheidung), 106 BVerfGE 62 (BVerfG 2002)