Families in Serbia face an increasingly difficult choice - where and to whom to entrust the care of their children the oldest members. Incidents in nursing homes which, from time to time, are heard in the media or the negative experiences of individual users and families - often not reported to the competent authorities - with reason deepen distrust towards these institutions.
Especially when it comes to private homes, the question is - do they even have a license? Does anyone control their work? Who (doesn't) do that?
INSUFFICIENT NUMBER OF INSPECTORS
According to the Law on social protection, the inspection supervision of homes for the elderly is carried out by the ministry responsible for social protection, through the inspector of social protection. In Vojvodina, this supervision is carried out by the competent provincial authority. In addition, when taking into account previous incidents and accidents, the service is responsible for fire protection Ministry of the Interior, and for checking the correctness of food, a sanitary inspection.
The numbers are as follows: in the Annual Inspection Plan of the Social Protection Inspection of the competent Ministry for 2025, it is stated that it is implemented by a total of 20 social protection inspectors, 10 at the level of the Republic, eight at the level of the Province, and two at the level of the City of Belgrade. Then, in Serbia, there are 42 state homes and 277 licensed private institutions for housing the elderly.
Private institutions are issued a work license by the mentioned ministry. In order for the establishment to receive a permit, it must meet legal requirements, which primarily concern the location of the facility, appropriate equipment, personal and hygiene maintenance, room capacity, food, staff. Also, it must have a fire protection plan.
In addition to inspection work, since 2013, social protection inspectors of the Ministry have also been performing licensing work, and suspension and revocation of licenses are also under their jurisdiction.
In the Annual Report on the Work of the Social Protection Inspection for 2024, it is stated that only one regular inspection was carried out in that year, 83 were extraordinary, and 76 were confirmatory inspections (upon a request to determine the fulfillment of the conditions for obtaining a license).
Inspections in social protection are mainly carried out through extraordinary inspections, due to incident situations or after learning about the existence of illegal service providers - which are unregistered entities, without a work license - and upon a request to determine the fulfillment of the conditions for obtaining a license.
Thus, in January 2025, the Social Protection Inspection closed a home for the elderly in Belgrade, which was then in the process of obtaining a license. The social welfare inspector told RTS that she called the home allegedly looking for a place for her grandmother. Although it still did not have a license, the home was advertised, and at the time of the inspection, it had 25 users.
The reason for this way of functioning of inspection supervision, it can be concluded in the report, lies primarily in the insufficient number of social welfare inspectors, which is why it is not possible to ensure continuous regular inspection supervision and continuity of control.
The key deficiency in inspection supervision, according to Nadežda Satarić, a social worker from the "Strength of Friendship - Amity" citizens' association, is that there are no regular inspections without an announcement of arrival. "The inspection plan of institutions is made on an annual basis and is announced at the beginning of the year when the Social Welfare Inspection will come. This is not good because everyone will prepare for the announced inspection. Extraordinary inspections are generally carried out based on applications," she says. The institutions themselves, as he says, should once a year conduct an internal evaluation of the quality of the services provided, which includes examining the satisfaction of users, that is, their labor representatives, and write a report about it that should be available to the professional public. "I haven't noticed that it works in practice (I haven't found such a report on any website of a private home). Such bad practices leave enough room for more relaxed behavior of the owners/managers of the homes and also for the occurrence of work failures (there is no social worker, not enough caregivers, more users than the prescribed capacity...)", says Nadežda Satarić.
HOW DIFFICULT IS THE LICENSE?
The fact that inspections are carried out when an incident occurs or upon learning about illegal business is evidenced by cases that pointed to system failures. One example is from January 2025, when a fire broke out in the "Ivanović" home, in which 11 users lost their lives.
BIRN's research showed that at the end of 2018, the Directorate for Emergency Situations of the Ministry of Internal Affairs of Serbia identified a number of irregularities and deficiencies in fire protection in the "Ivanović" home, but never ordered the home to be closed. The inspection gave this house 45 days seven years ago to correct the illegalities found by the inspection. The administration of the home, however, completely ignored that order. The inspectors came for a control inspection in 2019 and found that only one of the five defects was corrected, that the mandatory internal hydrant network does not exist, and that the commission, which was hired by the owners after their license expired, falsified findings on fire protection, writes BIRN.
Despite everything, the "Ivanović" home received a new license from the Ministry of Labour, Employment, Veterans and Social Affairs in 2021, and its capacity was also increased.
A series of irregularities in the work of the homes was also shown by the extraordinary inspection of the private home for the elderly "Milidom Lux" in Mali Mokro Lug, where two users lost their lives in a fire.
Fulfilling the criteria in the field of fire protection is the most complex in the process of obtaining a license, Saša Ristović, secretary of the Association of Private Social Welfare Institutions, Homes for Adults and the Elderly, told Boom 93. He estimates that this process is the longest, and perhaps the most expensive, next to building or renovating the building.
As Nadežda Satarić explains, the licensing procedure for all social care institutions, not just private homes for the elderly, is clearly defined by law and regulations, and is available to all interested parties, not only the professional public. Otherwise, when it is obtained for the first time, the license is issued for five years, and later for six years.
She explains that the documents that regulate these issues are quite good, but that they could be improved in some parts. Such, in her opinion, is the part of the Rulebook on closer conditions and standards for the provision of social protection services that refers to personnel. It states that at least one carer is needed for every ten users with the established I and II level of support (an immobile or very difficult user who is referred for full-day assistance by another person).
"It is not specified whether this is per shift or overall. If it is understood that there is one carer in total, it is not enough because care users are worked in three shifts. This means that for a capacity of 30 users there are three carers, who need to cover three shifts for all 30 days of the month, plus they get days off and annual leave, and that is not possible. Hence the situation that in the home in Barajevo, where the fire broke out at night, there were no employees, which is unacceptable", says Nadežda Satarić.
She also referred to the article of the Rulebook that refers to the location of the facility, in which, among other things, it is stated that the facility where services are provided to users is located in a populated place.
"It is necessary to specify what is meant by a populated place. The home in Barajevo was in a village on a meadow with an approach muddy, dirt road. And in the same article it is written: 'For the sake of the smooth use of services and services in the community, the facility should be in a place accessible to public transport.' Does the dirt road meet that criterion? I think that this part of the Ordinance should be defined more precisely. It was written that the home is near the market, the church, and that there is regular public transport that can be used by those who do not come by car. Today, it is different.
From 2004 to 2024, the inspection issued 157 work bans to institutions for the accommodation of the elderly, two of which were issued in the previous year, in 2024, to the Home for the Accommodation of the Elderly "Rose of Friendship" Meljak and the Home for Adults, the Elderly and Persons with Special Needs "Naš drugi dom" Novi Sad.
And the tragedy in Barajevo increased the number of extraordinary inspections. As the ministry announced in February, after that, the social protection inspection carried out 16 extraordinary inspections and closed five facilities where home accommodation services were provided. We asked the ministry for data on the number of closed facilities and the most common reasons for revoking the license, but we did not receive any answers until the text was published.
NO ONE IS ALLOWED TO REPORT
photo: pexels...
Homes that operate without a license represent a special problem. The case of a fire in a building where elderly people were housed in the Vojka settlement, when two people died, resonated with the public. Two people were then arrested on the suspicion that they founded an association in violation of the regulations and without a license to provide social welfare services and admitted a larger number of people than the facility's capacity to the accommodation facility of that association.
In February of this year, during an extraordinary, unannounced inspection of a building in Arandjelovac, for which there was a report that it provides residential care services for adults and the elderly, the social protection inspectors, as officials on duty, were attacked by the owner of the building and his father, endangering their safety, the ministry announced.
As stated in the announcement, the Ministry issued decisions banning the work of unregistered entities at the same address in Arandjelovac on three occasions, in 2008, 2014 and 2018.
Precisely because they are not in the register of private institutions, they remain under the radar of the inspectorate, and they are found out based on reports from citizens or after incident situations.
Saša Ristović states that the Association of Private Institutions of Social Protection actively cooperates with the Ministry to suppress illegal facilities of this type. "We are working intensively on this and we always remind all colleagues who are members of our Association that if they hear about such facilities in their area - to let us know", says Ristović.
However, Nadežda Satarić states that the inspection of the Ministry of Social Affairs is not competent for illegal homes because they are not licensed. "They function as hostels or some other legal entities, so they belong under the jurisdiction of other authorities. The social protection inspection can enter them only if it is known that some vulnerable people lived there and used the services, whose lives were put in danger or who died in a fire", explains Nadežda Satarić.
According to her, no one knows how many such illegal facilities there are in Serbia.
"The alarm is raised only in cases where there is an excess or a fire in such a building, and everything else remains under the radar. Today, none of the citizens or neighbors are interested in what is happening in someone else's yard. Who is allowed to report when they do not know who is behind the work?", our interlocutor points out.
Prepares food for whoever arrives.
Boom 93 conducted a survey on nursing home experiences. Citizens whose family members stayed in homes in Belgrade, Leskovac, Požarevac, Kikinda, Smederevo, Zrenjanin and Vrnjačka Banja took part in the survey. All private institutions mentioned by the surveyed citizens were found in the register of the Ministry of Labour, Employment, Veterans and Social Affairs, which means that they all operate with a license. About half of the respondents are satisfied.
"There is a huge number of private homes in Serbia, according to the data from the beginning of this year. I have been in about 10 percent of them and I have completely different experiences and impressions. Some have excellent conditions, dedicated staff, users and relatives are satisfied with the service, and there are, even more, those where the situation is not satisfactory and where I would not recommend anyone to place their loved one. As an association, we are mostly contacted by relatives who are dissatisfied with the housing conditions of their loved ones and the services they receive in the homes. They complain about the services unfriendly staff, lack of staff, bad and monotonous food, especially for dinner and breakfast, expensive health services, because they have to pay almost everything afterwards, in addition to the regular price of the home", says Nadežda Satarić.
Given that these were licensed private institutions, some of the experiences reported by users in the Boom 93 survey are worrisome.
There were also several objections to the diet of the users.
"There is no separate area for eating, there is a corridor where cooking and eating are done, they pickle cabbage themselves. The food is prepared by those passing by, not professional chefs," read one of the answers.
Another respondent mentioned complaints about too small portions, as well as that they rarely have meat. "It's a female user who really lost weight there. Dinner ends at 18 p.m., so she's hungry. Maybe that's okay under those conditions," says this respondent.
One of the respondents said that they could not find out about the diet from the user himself, since it was a difficult mobility and old person with advanced dementia, but her appearance indicated problems: "The appearance and general condition that resembled starvation and insufficient fluid intake. This was confirmed by a medical examination and laboratory analysis. The person must have lost about 20 kg in three months, maybe more. We had no information, but it was visible. It was scary to see."
Problems also exist when it comes to rooms in certain homes. Thus, one of the respondents states that the users "stay in crowded rooms and corridors".
Some family members did not even have the opportunity to see what the rooms where the users are housed look like.
"We never saw the room. It wasn't allowed. Visits were only when we announced ourselves and in the corridor next to the door, and when the weather was warmer, in the yard. I'm a sister and I didn't have custody, but I think that was the rule for everyone. The staff didn't give real information, so we stopped asking. We tried with the owner and nothing," reads one of the answers.
Mentor: Filip Mirilović
