Long-Term Care Insurance Act

An appointment as service provider as set forth in Article 46, paragraph (1) is determined pursuant to the provisions of Order of the Ministry of Health, Labour, and Welfare, by the application of a Person that operates an In-Home Long-Term Care Support Business, and by type of In-Home Service and provider that operates In-Home Long-Term Care Support Business pertaining to the type of said In-Home Service (hereinafter referred to simply as "Business Office" in this Section).

A mayor of a Municipality, in a case of an application as set forth in the preceding paragraph, when it corresponds to any of the following items, must not provide appointment as service provider as set forth in Article 46, paragraph (1):

when the applicant is not a person specified by Municipal Ordinance;

when the number of Long-Term Care Support Specialists of the Business Office pertaining to said application does not meet the number of employees determined by Municipal Ordinance as set forth in Article 81, paragraph (1);

when it is determined that the applicant cannot perform proper In-Home Long-Term Care Support Business in accordance with standards pertaining to Management of a Designated In-Home Long-Term Care Support Business as prescribed in Article 81, paragraph (2);

when the applicant is punished by imprisonment or a more severe penalty and said execution of the penalty has not been completed or has not yet expired;

when the applicant is punished by a fine pursuant to the provisions of this Act or another Act pertaining to citizens' health and medical care and public aid as determined by a Cabinet Order and the execution of said penalty has not yet been completed or has not yet expired;

when the applicant is punished by a fine pursuant to the provisions of laws concerning labor specified by Cabinet Order and execution of said penalty has not yet been completed or has not yet expired;

when the applicant, with regard to insurance premiums, etc., was subject, by the day before the day of making said application, to a disposition of delinquency based on the provisions of the Act that provides for the obligation of payment, and has continued, for a period of three months or more from the day of receiving said disposition without a justifiable reason, to be delinquent in all of the insurance premiums, etc. whose due dates of payment arrived on or after the day of receiving said disposition;

when the applicant is a person whose designation has been rescinded pursuant to the provisions of Article 84, paragraph (1) or Article 115-35, paragraph (6) and five years have not elapsed from the date of said rescission (in a case when a person whose designation has been rescinded is a juridical person, including a person who was an Officer, etc., of said juridical person within sixty days prior to the date of notification pursuant to the provisions of Article 15 of the Administrative Procedure Act pertaining to the disposition of said rescission and five years have not elapsed from the date of said rescission, and in a case when a person whose designation has been rescinded is a Business Office that is not a juridical person, including a person who was a manager of said Business Office within sixty days prior to the date of said notification and five years have not elapsed from the date of said rescission), however, excluding a case in which the rescission of said designation falls under one that is specified by Order of the Ministry of Health, Labour and Welfare as being appropriate to treat as not falling under the rescission of the designation prescribed in the main clause of this item, among the rescissions of the appointment as service provider of a Designated In-Home Long-Term Care Support Provider, in consideration of the facts that were the grounds for the disposition of said rescission, the status of efforts by said Designated In-Home Long-Term Care Support Provider toward the establishment of an operational control system to prevent the occurrence of said facts, and other matters on the degree of responsibility that said Designated In-Home Long-Term Care Support Provider had in relation to said facts;

when a person who has a close relationship with the applicant has had a designation rescinded pursuant to the provisions of Article 84, paragraph (1) or Article 115-35, paragraph (6) and five years have not elapsed from the date of said rescission, however, excluding a case in which the rescission of said designation falls under one that is specified by Order of the Ministry of Health, Labour and Welfare as being appropriate to treat as not falling under the rescission of the designation prescribed in the main clause of this item, among the rescissions of the appointment as service provider of a Designated In-Home Long-Term Care Support Provider, in consideration of the facts that were the grounds for the disposition of said rescission, the status of efforts by said Designated In-Home Long-Term Care Support Provider toward the establishment of an operational control system to prevent the occurrence of said facts, and other matters on the degree of responsibility that said Designated In-Home Long-Term Care Support Provider had in relation to said facts;

when the applicant has provided notification of abolishment of business pursuant to the provisions of Article 82, paragraph (2) (except for a person that has a reasonable basis for said abolishment of business) from the date of notification pursuant to the provisions of Article 15 of the Administrative Procedure Act pertaining to a disposition of rescission of the designation pursuant to the provisions of Article 84, paragraph (1) or Article 115-35, paragraph (6) to the date on which said disposition is made or the date on which it is determined not to make a disposition, and five years have not elapsed yet from the date of said notification;

when the applicant is a person who has provided notification of abolishment of business pursuant to the provisions of Article 82, paragraph (2) (except for a person that has a reasonable basis for said abolishment of business) during the period from the date on which an inspection pursuant to the provisions of Article 83, paragraph (1) was conducted to the expected hearing decision date (meaning, in the case where the mayor of the Municipality has notified said applicant of a specific date within ten days from the date on which said inspection was conducted, pursuant to the provisions of Order of the Ministry of Health, Labour and Welfare, as the date on which it is expected to be decided, based on the results of said inspection, whether or not to hold a hearing concerning the disposition of rescission of the designation pursuant to the provisions of Article 84, paragraph (1), said specific date), and five years have not elapsed from the date of said notification;

in a case when notification of abolishment of business pursuant to the provisions of Article 82, paragraph (2) has been provided within the period provided by item (vi), when the applicant is a person who was, within sixty days prior to the date of notification as set forth in the same item, an Officer, etc., of the juridical person pertaining to said notification (except for a juridical person that has a reasonable basis for said abolishment of business) or a manager of the Business Office that is not a juridical person pertaining to said notification (except for one that has a reasonable basis for said abolishment of business), and five years have not elapsed from the date of said notification;

when the applicant performs a wrongful or significantly unjustifiable act pertaining to In-Home Service, etc., within five years prior to said application of appointment as service provider;

when the applicant is a juridical person and any Officer, etc., of said juridical person corresponds to any of items (iii)-2 through (v) or items (vi) through the preceding item;

when the applicant is a Business Office that is not a juridical person and the manager thereof is a person who corresponds to any of items (iii)-2 through (v) or items (vi) through (vii).

A Municipality, in establishing the Municipal Ordinance set forth in item (i) of the preceding paragraph, is to establish it in accordance with the standards determined by Order of the Ministry of Health, Labour and Welfare.

An appointment as service provider as set forth in Article 46, paragraph (1), if it is not renewed within a period of six years, ceases to be effective when said period expires.

In a case of application for renewal as set forth in the preceding paragraph, when a final determination of the application does not occur prior to the expiry of the period as set forth in the same paragraph (herein referred to as "Effective Period of Designation as Service Provider" in this Article), the prior appointment as service provider remains effective after expiry of the Effective Period of Designation as Service Provider until a determination is reached regarding said application.

In a case as set forth in the preceding paragraph, when the appointment as service provider is renewed, said Effective Period of Designation as Service Provider is to be from the date following the date of expiry of the prior Effective Period of Designation as Service Provider.

The provisions of the preceding Article apply mutatis mutandis to a renewal of appointment as service provider as set forth in paragraph (1).

A Designated In-Home Long-Term Care Support Provider must act in compliance with the standards concerning Management of a Designated In-Home Long-Term Care Support Business as prescribed in paragraph (2) of the following Article, offer appropriate Designated In-Home Long-Term Care Support according to the mental and physical condition, etc., of a Person Requiring Long-Term Care, and always engage in offering said services from the viewpoint of the person that receives Designated Community-Based Service by implementing self-evaluation of the quality of the Provider's own Designated Community-Based Service and other measures.

A Designated In-Home Long-Term Care Support Provider, when an Opinion of the Certification Committee is entered on the Certificate of Insured Person that is presented by an Insured Person that intends to receive Designated In-Home Long-Term Care Support, must engage in offering said Designated Community-Based Service of said Insured Person in consideration of said Opinion of the Certification Committee.

A Designated In-Home Long-Term Care Support Provider must employ the number of Long-Term Care Support Specialists as determined by Municipal Ordinance for each Business Office pertaining to said appointment as service provider.

In addition to the provisions in the preceding paragraph, standards concerning Management of a Designated In-Home Long-Term Care Support Business are prescribed by Municipal Ordinance.

A Municipality, in establishing the Municipal Ordinances referred to in the preceding two paragraphs, is to establish the following matters in accordance with the standards determined by Order of the Ministry of Health, Labour and Welfare, and is to take into consideration the standards determined by Order of the Ministry of Health, Labour and Welfare for other matters:

the standards concerning employees that engage in Designated In-Home Long-Term Care Support and the number of said employees;

matters concerning the management of a Designated In-Home Long-Term Care Support Business that are specified by Order of the Ministry of Health, Labour and Welfare as being closely related to the appropriate use of services by Persons Requiring Long-Term Care who use them, appropriate treatment and ensuring of safety, and maintenance of confidentiality, etc.

The Minister of Health, Labour and Welfare, when intending to establish the standards determined by Order of the Ministry of Health, Labour and Welfare prescribed in the preceding paragraph (limited to the part concerning the handling of Designated In-Home Long-Term Care Support), must hear the opinion of the Social Security Council in advance.

A Designated In-Home Long-Term Care Support Provider, when it has provided notification of abolishment or suspension of business pursuant to the provisions of paragraph (2) of the following Article, must provide coordination with other Designated In-Home Long-Term Care Support Providers and other relevant persons, and provide other conveniences, to a person who received said Designated In-Home Long-Term Care Support within one month before the date of said notification and who wishes to continue to be provided with services equivalent to said Designated In-Home Long-Term Care Support on or after the date of said abolishment or suspension of business, so that necessary In-Home Service, etc. are provided continuously.

A Designated In-Home Long-Term Care Support Provider must respect the personality of a Person Requiring Long-Term Care, act in compliance with this Act or an Order based on this Act, and faithfully perform said duty for a Person Requiring Long-Term Care.