Named as Ines Andrea R., the 52-year-old suspect is charged with four counts of murder and three counts of attempted murder following the bloodbath at the Thusnelda-von-Saldern-Haus facility in Potsdam, Brandenburg, in April.
The victims, two women and two men aged between 31 and 56, were found dead in their rooms after being stabbed with a knife, with police saying they had been subjected to “intense, extreme violence”.
Ines Andrea R. is also accused of trying to kill two further residents and of seriously injuring another, a woman aged 43.
She was detained immediately after the incident and placed in urgent psychiatric care due to what prosecutors described as “pertinent evidence” of severe mental illness.
Around 100 police officers were involved in recovering evidence at the scene.
The Thusnelda-von-Saldern-Haus, run by the Lutheran Church’s social welfare service, specialises in helping those with physical and mental disabilities, including blind, deaf and severely autistic patients.
It offers live-in care as well as schools and workshops.
Around 65 people live at the residence, which employs more than 80 people.
Germany has seen a number of high-profile murder cases from care facilities.
In the most prominent trial, nurse Niels Högel was sentenced in 2019 to life in prison for murdering 85 patients in his care.
Högel, believed to be Germany’s most prolific serial killer, murdered patients with lethal injections between 2000 and 2005, before he was eventually caught in the act.
Last year, a Polish healthcare worker was sentenced to life in prison in Munich for killing at least three people with insulin.