Frequently asked questions about HKZ
HKZ raises many questions: is it mandatory, what does it cost, how long does it take? This page answers the most frequently asked questions. You can find more background on the quality mark on the HKZ hub. A full overview of schemes is on a separate page. Official information about the standards is available at hkz.nl and NEN .
Is HKZ mandatory?
No. HKZ is not mandatory by law. There is no law that says your organisation must have HKZ.
In practice, it feels different. Care purchasers (Wlz procurement), health insurers (Zvw contracts) and municipalities (Wmo and Jeugdwet, the Dutch Youth Act) include quality requirements in their purchasing policy. HKZ is a commonly named choice in this. Without a recognised quality mark, you sometimes drop out of those procurement rounds straight away.
The difference: it is not a law, but a market requirement. Read more about when HKZ is a purchasing requirement on who is HKZ for?.
What is the difference between HKZ and ISO 9001?
HKZ is built on ISO 9001. The HKZ schemes take over all ISO 9001 requirements in full and add a care-specific layer: client safety, record keeping, medication safety and links to care legislation.
If you achieve HKZ, you also meet ISO 9001 at its core. The reverse does not apply: if you only have ISO 9001, you do not automatically meet the care-specific HKZ requirements.
ISO 9001 is internationally recognised and applies across sectors. HKZ is recognised only in the Netherlands and is specific to care and welfare. The full picture is on HKZ vs ISO 9001.
How many HKZ schemes are there?
There are more than 30 HKZ schemes. Each scheme is aimed at a specific sector or target group in care. Examples are HKZ 144 VVT (nursing, residential care and home care), HKZ 129 GGZ (mental health care), HKZ 118 Gehandicaptenzorg (disability care), HKZ 142 Jeugdzorg (youth care) and HKZ 165 Care & Welfare (generic).
There is also a scheme for small organisations (HKZ 143 Small Organisations) and schemes for self-employed care workers (HKZ 166 and 167). A full overview is on schemes by sector.
What does HKZ cost?
The costs depend on your size and the scheme you choose. As an indication:
| Organisation size | Indicative cost, first year |
|---|---|
| Self-employed / very small | €2,000 - €5,000 |
| Small (up to 50 employees) | €4,000 - €9,000 |
| Medium (50-250 employees) | €9,000 - €18,000 |
| Large (250+) | €18,000+ |
These are indications, including support and the certification audit. The costs are also determined by the certification body you choose, so always request several quotes. The full cost overview, including annual costs after certification, is on costs and timeline.
How long is an HKZ certificate valid?
An HKZ certificate is valid for 3 years. During those 3 years the auditor visits every year for an annual surveillance audit. After 3 years a recertification follows, in which the full audit process is run through again.
Make sure your system keeps running through the whole cycle: keep reporting incidents, carry out a management review every year and maintain your documentation. You can read more about the audit cycle on the audit process.
Can a small organisation get HKZ?
Yes. For small care providers there is HKZ Small Organisations (HKZ 143), the HKZ standard for organisations with up to 10 FTE. Every employee counts, including management and hired staff. If you are above that, choose a different scheme.
The certificate carries the same value as a regular HKZ certificate. Purchasers recognise it as proof of quality. The costs are considerably lower: an indication of €2,000 to €5,000 for the first year.
Who issues the HKZ quality mark?
HKZ does not issue certificates. Independent, accredited certification bodies (CBs) do that. They are accredited by the Dutch Accreditation Council (Raad voor Accreditatie) (RvA) and must have a contract with HKZ for the scheme they audit.
Well-known CBs are Kiwa, DEKRA, DNV, TÜV, Lloyd’s Register and CIIO. Not every CB is accredited for every scheme, so always check this on hkz.nl . A full overview is on certification bodies.
Does HKZ also cover information security?
No. HKZ safeguards the quality of your care, but information security falls outside its scope. For that there is NEN 7510, the Dutch standard for information security in care.
If you work with patient data, you need both in most cases: HKZ for your care quality, NEN 7510 for the protection of that data. The two standards combine well in one management system. Read more on HKZ and NEN 7510.
What is HKZ 165?
HKZ 165 is the generic, cross-sector HKZ standard for care and welfare. Unlike schemes such as HKZ 144 VVT or HKZ 129 GGZ, HKZ 165 is not aimed at one specific sector. It is a broad standard that can be used by organisations that operate in several care sectors or for which no separate sector scheme exists.
The current edition is HKZ 165:2024+C1:2025. The older HKZ 165:2018 remains valid until 1 March 2027. In September 2024, the theme of climate change was added, in line with international ISO amendments. More information about this and other schemes is on schemes by sector.
Do I still need a written care agreement?
Not as an HKZ requirement any more. Since 2025, HKZ has dropped the requirement for a signed written care agreement under HKZ 144 VVT and HKZ 118 Gehandicaptenzorg . This follows from the Ontregel de Zorg programme (a programme to cut unnecessary bureaucracy in care).
Note: financiers and supervisory bodies may still ask for a written agreement, even though HKZ no longer requires one. Check the requirements of your specific client or financier.
Is your question not listed here? Then look at hkz.nl or contact one of the certification bodies for a free orientation meeting.