Trained as a Nurse Abroad? Hesse Also Moved This to One Office, in 2023
Nursing (Pflegefachfrau, Pflegefachmann, Pflegefachperson) is a legally regulated profession in Germany, so recognition of a foreign qualification is a genuine requirement before you can work under that title, in Frankfurt exactly as everywhere else. Since January 1, 2023, the Hessisches Landesamt für Gesundheit und Pflege (HLfGP) has handled this for the whole state, a newly formed authority that folded the former Hessisches Landesprüfungs- und Untersuchungsamt (HLPUG) together with health-profession functions that used to sit with the Regierungspräsidien in Darmstadt and Gießen. HLfGP is headquartered in Darmstadt but keeps a branch office in Frankfurt itself. To apply, you need proof of a genuine connection to Hesse (residence, employment, or a confirmed placement through a recognition counseling service), a German-language CV, your diploma and training records with a certified German translation, documentation of your training's duration and curriculum hours, and, eventually, a B2 German certificate. HLfGP compares your training to the German reference qualification and the outcome is one of three: direct recognition, an Anpassungslehrgang (a roughly 200-hour, five-module supervised adaptation course plus practical placement, closed out with a final Fachgespräch), or a Kenntnisprüfung (a practical exam with real patients plus a 45- to 60-minute oral exam across five competency areas). Unlike Bavaria's equivalent office, HLfGP doesn't publish a standard processing-time figure, so the realistic move is to ask HLfGP directly, or a counseling service such as PQZ Hessen or the IQ Netzwerk, for a case-specific estimate rather than assume a fixed number of months. Fees run 110 euros for the application review, 110 euros for professional license issuance, or 165 euros total if your qualification is already EU/EEA/Swiss-harmonized. One genuinely useful Frankfurt-specific detail: if an Anpassungslehrgang is ordered, you don't have to leave the city for it, a Ludwig Fresenius Schulen location in Frankfurt am Main runs the course itself, 176 instructional units split across nursing process and diagnostics, communication and counseling, interprofessional collaboration, and legal and ethical foundations.
The Official Rule
Nursing is a genuinely different situation from many other professions covered on this site: Pflegefachfrau, Pflegefachmann, and Pflegefachperson (nurse, in its gender-neutral German forms) are legally regulated professions in Germany, which means formal recognition of your foreign qualification isn’t optional if you want to work under that title. There’s no equivalent of an unregulated field where you can work first and sort out the paperwork later, here the recognition procedure is the gate itself.
Since January 1, 2023, the Hessisches Landesamt für Gesundheit und Pflege (HLfGP) has been the responsible authority for this across the entire state of Hesse. HLfGP itself is a new organization, formed by folding the former Hessisches Landesprüfungs- und Untersuchungsamt (HLPUG) together with health-profession functions that used to sit separately with the Regierungspräsidien in Darmstadt and Gießen. It’s headquartered in Darmstadt, with additional branch offices in Frankfurt, Gießen, and Dillenburg, meaning the office handling your file has an actual local presence in Frankfurt, not just Darmstadt.
To start, you need proof of a genuine connection to Hesse (residence, employment, or a confirmed placement arranged through a recognition counseling service), a CV in German, identity documents, your diploma and training records with a certified German translation, and documentation showing your training’s duration, curriculum hours, and practical placements. HLfGP then compares your training against the current German reference qualification.
| Outcome | What it means |
|---|---|
| Direct recognition | No substantial differences found, your training is recognized as equal |
| Anpassungslehrgang | Roughly 200 hours of theory across 5 modules plus supervised practical placement, closed out with a final Fachgespräch |
| Kenntnisprüfung | A practical exam with real patients plus a 45- to 60-minute oral exam across 5 competency areas |
B2-level German (telc Deutsch B2, Goethe-Zertifikat B2, TestDaF level 3, or a specialized nursing-language test) is required before you can hold the final professional license, though it can be submitted after the initial application. Translations count only if they come from a translator who is publicly appointed or sworn in, in Germany or abroad, a genuinely easy detail to miss until an application gets sent back for exactly this reason.
| Item | Fee |
|---|---|
| Application review and equivalence determination | €110 |
| Professional license issuance | €110 |
| EU/EEA/Swiss harmonized qualifications (combined) | €165 |
One thing worth knowing before you plan around a specific timeline: unlike Bavaria’s equivalent office, HLfGP does not publish a standard processing-time figure for the initial review. Rather than assume a fixed number of months, contact HLfGP directly, or a recognition counselor, for a realistic estimate based on your specific documents and qualification type.
Completing an Anpassungslehrgang Without Leaving Frankfurt
If your file comes back needing a compensation measure, the practical question is where you’ll actually complete it. Here, Frankfurt has a genuine advantage: a Ludwig Fresenius Schulen location in Frankfurt am Main runs the Anpassungslehrgang itself, so an ordered adaptation course doesn’t force a move to another city or region.
| Competency area | Instructional units |
|---|---|
| Nursing process and diagnostics | 56 |
| Communication and counseling | 48 |
| Interprofessional collaboration | 40 |
| Legal and ethical foundations | 32 |
The course runs in block weeks combining classroom theory with supervised practical placements in hospitals, care homes, or ambulatory services, and closes with a final assessment discussion (Fachgespräch). Entry requires HLfGP’s approval letter confirming the compensation measure and a completed foreign nursing qualification; sources describe the German level needed to start anywhere from B1 to B2, but B2 is the level that actually matters for the final license regardless of where the course begins.
Photo by Pavel Danilyuk on Pexels
Separately, if your path runs through a Kenntnisprüfung instead, providers in the wider Frankfurt/Rhine-Main area, including a state-recognized nursing school in nearby Neu-Isenburg, run dedicated preparation courses for that exam, worth checking regardless of which compensation measure your file ends up needing.
What You’ll Need
- Proof of a genuine connection to Hesse: residence, employment, or a confirmed placement through a recognition counseling service.
- A CV written in German, plus identity documents and, if applicable, documentation of any legal name change.
- Your original diploma and training certificate, with a certified German translation from a publicly appointed or sworn translator.
- Training records showing the duration of your training, curriculum subjects and hours, and details of your practical placements.
- Documentation of relevant professional experience, if you have any.
- A B2 German language certificate (telc, Goethe-Zertifikat, TestDaF, or a specialized nursing-language test); this can follow after your initial application.
Step by Step
- Confirm your connection to Hesse (residence, employment offer, or a counseling-service placement) before assembling your file, HLfGP requires this as a starting condition.
- Gather your diploma, training records, and CV, and have your documents translated by a publicly appointed or sworn translator, ordinary translations are not accepted.
- Submit your application to HLfGP (Dezernat IV 3 Pflegeberufe) with your complete document set; if anything is missing, expect a request for supplementary material before the substantive review begins.
- If HLfGP orders an Anpassungslehrgang, check whether the Frankfurt am Main location of Ludwig Fresenius Schulen fits your situation, so the compensation measure doesn’t require relocating.
- If HLfGP orders a Kenntnisprüfung instead, look into dedicated exam-preparation providers in the Frankfurt/Rhine-Main area.
- Start B2 German study as early as realistically possible, and consider contacting PQZ Hessen or the IQ Qualifizierungsbegleitung Pflege program for Rhine-Main applicants if you want structured guidance alongside HLfGP’s own process.
Compliance Note
This page explains the general framework around nursing qualification recognition through the Hessisches Landesamt für Gesundheit und Pflege, current as of mid-2026. It is not legal or immigration advice, and specific requirements, fees, and processing times can vary by individual case and may change. For your specific situation, confirm current requirements directly with HLfGP or a qualified recognition counselor.
FAQ & Common Pitfalls
Why did this move from the Regierungspräsidien to a dedicated state office?
HLfGP was created effective January 1, 2023, by combining the former Hessisches Landesprüfungs- und Untersuchungsamt im Gesundheitswesen (HLPUG) with health-profession functions that used to sit separately with the Regierungspräsidien in Darmstadt and Gießen. The stated goal was a more efficient, more consistent state health administration, partly informed by lessons from the pandemic years, and nursing qualification recognition was one of the functions folded into the new authority. In practice, this mirrors what Bavaria did with its own Bayerisches Landesamt für Pflege the same year, though the two states built genuinely different organizations to get there, HLfGP is a broader health-administration body, not a nursing-only office.
What actually happens during an Anpassungslehrgang, and can it really be done in Frankfurt?
Yes. A Ludwig Fresenius Schulen location in Frankfurt am Main runs the course itself, so a compensation measure ordered by HLfGP doesn't force a move to another city. The program runs in block weeks combining theory and supervised practice, roughly 176 instructional units in total, split across four areas: nursing process and diagnostics (56 units), communication and counseling (48 units), interprofessional collaboration (40 units), and legal and ethical foundations (32 units). It closes with a final assessment discussion (Fachgespräch); passing it is what lets you actually apply for your professional license. Entry requires a completed foreign nursing qualification, an approval letter from HLfGP, and German at least at B1 to B2 level depending on the provider, sources differ slightly on the exact starting threshold, but B2 is firmly required to hold the final license regardless.
Can we work in Germany at all while recognition is still pending?
This is federal law, so it works the same way in Frankfurt as anywhere else in Germany. If you trained in the EU, EEA, or Switzerland, a formal partial practice permit (Erlaubnis zur partiellen Berufsausübung, under Section 48a of the Pflegeberufegesetz) can let you work under supervision once HLfGP has issued a decision citing a compensation measure, it isn't available the moment you file. If you trained in a third country, that specific permit route isn't open to you; in practice, third-country applicants typically work as an unlicensed nursing assistant (Hilfskraft) during an Anpassungslehrgang, sometimes with a wage subsidy offsetting the lower pay, rather than under a dedicated temporary professional permit.
Do our diplomas and training records need to be translated, and by whom?
Yes, and HLfGP is explicit about this: only translations produced by a translator who is publicly appointed or sworn in, in Germany or abroad, are accepted. A translation from a bilingual friend or a general agency without that specific status genuinely won't satisfy the requirement. See our separate guide on finding a sworn or certified translator in Frankfurt for how to actually verify someone's status before paying for a translation.
Is there help figuring out whether we're headed for an Anpassungslehrgang or a Kenntnisprüfung?
Yes. PQZ Hessen, the Pflegequalifizierungszentrum based in Marburg, coordinates with HLfGP and provides guidance on both pathways statewide, and the IQ Qualifizierungsbegleitung Pflege program specifically supports applicants in the Rhine-Main and South Hesse region, which includes Frankfurt, through the recognition procedure. Neither service issues the recognition decision itself, that stays with HLfGP, but both can help you prepare a stronger, more complete application before you submit it.