A care and treatment facility (zakład opiekuńczo-leczniczy, ZOL) in Poland admits a person who no longer needs hospital treatment but does need round-the-clock nursing care and has scored 40 points or fewer on the Barthel scale. Three documents are needed: an application, a referral from a doctor, and a nursing interview with a medical certificate. Treatment and nursing are funded by the National Health Fund (NFZ). The patient pays for board and lodging 250 per cent of the minimum pension, that is PLN 4,946.23 a month, but never more than 70 per cent of their income.
In short
- The referral is issued by a doctor working within the public health insurance system: the family doctor or the attending doctor in hospital. The documents are submitted directly to the chosen facility, anywhere in Poland.
- With a pension of PLN 3,000 net, the fee will be PLN 2,100 a month, and PLN 900 will remain at the patient's disposal.
- The biggest obstacle is the waiting time. Waiting times at individual facilities can be checked in the NFZ search tool.
Who a ZOL is for, and who it is not for
A ZOL is a medical long-term care facility. It admits chronically ill people who have finished hospital treatment but, because of their condition, need constant nursing, medical supervision and rehabilitation. Typical situations are the aftermath of a stroke or a hip fracture, advanced neurological diseases, tube or PEG feeding, and extensive pressure sores.
The condition is an assessment on the Barthel scale, which measures independence in ten everyday activities. A score from 0 to 40 points out of a possible 100 qualifies for a ZOL. We describe what the assessment looks like in the Barthel scale and long-term care.
A person whose main indication is advanced cancer, mental illness or addiction is not referred to the facility. For cancer patients in the final phase of the disease, a hospice is the right place. Old age alone, loneliness or a difficult housing situation are not grounds for a referral either. In those cases the right route is a social welfare home or a private care home.
ZOL, DPS and a private care home: a comparison
| Feature | ZOL or ZPO | DPS | Private care home |
|---|---|---|---|
| Who refers | a doctor, by referral | the municipality, by administrative decision | nobody, a contract is enough |
| For whom | a person scoring up to 40 points on the Barthel scale who needs medical nursing | a person needing round-the-clock care, not necessarily medical | according to the facility's offer |
| Resident's fee | up to 70 per cent of income, at most PLN 4,946.23 | up to 70 per cent of income, the rest paid by the family or the municipality | full price, PLN 5,665 on average |
| Waiting time | from a few weeks to many months | usually a few months | usually a few days |
| Nature of the stay | as long as medical indications persist | permanent | permanent or short-term |
A nursing and care facility (ZPO) works on the same rules as a ZOL. The referral, criteria and fee are identical, and the differences mainly concern how the work is organised.
How to get a referral step by step
- Ask a doctor and a nurse for a Barthel scale assessment. If the patient is in hospital, the ward does it. If at home, the family doctor and the community nurse do.
- Put together three documents: the application for a referral signed by the patient or their legal representative, the referral from the doctor, and the nursing interview with the medical certificate. The templates are annexes to a regulation of the Minister of Health and every facility has them.
- Attach a document confirming income, for example the latest pension indexation decision. The facility will calculate the fee on that basis.
- Choose a facility and submit the documents directly there. There are no catchment areas, so it can be a facility in another town or voivodeship.
- Wait for qualification. The facility's doctor assesses the documents, and the patient is either admitted or entered on the waiting list.
If the patient is unable to sign the application consciously and has no legal representative, the guardianship court rules on placement in the facility. The application to the court is made by the family or the hospital. We write about representing a person who no longer decides for themselves in the article on legal incapacitation of a senior.
How long the wait is and how to shorten the queue
Waiting times vary greatly between facilities, from a few weeks to more than a year. Current times are given by the NFZ search tool "Terminy leczenia", where you only need to enter „zakład opiekuńczo-leczniczy” and the voivodeship. It is worth checking neighbouring districts too, because the differences can amount to several months.
For a given service you can be entered on only one waiting list, so the facility has to be chosen deliberately. Some facilities run commercial places alongside the NFZ-funded ones; they are available sooner but fully paid.
The hardest period is between hospital discharge and admission to a ZOL. Families solve it in two ways: care at home with the support of a long-term care nurse, or a short stay in a private care home. If you need a place for the waiting period, describe the situation in our form and we will send you suggestions of facilities that admit bedridden people and people after a hospital stay.
How much a stay in a ZOL costs
The Act sets the fee with two thresholds. The first is 250 per cent of the minimum pension, which from 1 March 2026 is PLN 4,946.23 a month. The second is 70 per cent of the patient's monthly income within the meaning of the social assistance provisions, that is the amount after tax and contributions. The patient pays the lower of the two. With a pension of PLN 3,000 net that will be PLN 2,100, with PLN 5,000 it will be PLN 3,500, and the upper threshold only comes into play with an income above about PLN 7,066.
The family does not top up the difference. This is an important difference from a social welfare home, where after the resident's fee the spouse and children are called on to cover the cost. As part of the stay, the facility provides the care of a doctor and nurses, rehabilitation, medicines, medical supplies and tests ordered on site.
There is one loss to remember. For the duration of a stay in a ZOL or ZPO, ZUS suspends the nursing supplement, currently PLN 366.68, unless the patient stays outside the facility for more than two weeks in a month. On the other hand, the fee for a stay in a ZOL can be deducted in the annual PIT return under the rehabilitation tax relief, if the patient holds a disability certificate or a pension decision.
How long you can stay in a ZOL
The stay has no rigid limit, but it is not lifelong by design either. The patient's condition is assessed regularly on the Barthel scale. As long as the score does not exceed 40 points and medical indications persist, the stay is extended. When the patient regains fitness above that threshold, the facility prepares a discharge and the family has to plan further care. It is worth knowing this from the start and looking around for a long-term solution during the stay.
Frequently asked questions
Who issues a referral to a ZOL?
A doctor working within the public health insurance system, most often the family doctor or the attending doctor in hospital. A nursing interview and a medical certificate are attached to the referral.
How many Barthel scale points do you need to get into a ZOL?
From 0 to 40 points out of a possible 100. A score above 40 points rules out admission and is grounds for discharge from the facility.
How much does a stay in a ZOL cost in 2026?
The patient pays 70 per cent of their monthly net income, but no more than PLN 4,946.23. The costs of treatment, nursing and rehabilitation are covered by the NFZ.
Does the family pay extra for a stay in a ZOL?
No. The fee is borne solely by the patient from their own income. Unlike in a social welfare home, the rules do not provide for top-ups from a spouse or children.
