Long-Term Care Insurance Act

A person that intends to establish a Long-Term Care Health Facility must obtain approval of the prefectural governor pursuant to the provisions of Order of the Ministry of Health, Labour, and Welfare.

The provisions of the preceding paragraph apply to when a person that established a Long-Term Care Health Facility intends to change the fixed limit of the number of persons who may be admitted to said Long-Term Care Health Facility and other matters as determined by Order of the Ministry of Health, Labour and Welfare.

A prefectural governor, in a case when the application of approval as set forth in the preceding two paragraphs is filed and when it corresponds to any of the following items (with regard to the application as set forth in the preceding paragraph, item (ii) or item (iii)), may not provide approval as set forth in the preceding two paragraphs:

when a person that intends to establish said Long-Term Care Health Facility is not a local government, a medical juridical person, a social welfare juridical person, or other person as determined by the Minister of Health, Labour, and Welfare;

when said Long-Term Care Health Facility does not possess the medical care rooms, consultation rooms and functional training rooms, and the facilities determined by Prefectural Ordinance as prescribed in Article 97, paragraph (1), or the number of personnel determined by Order of the Ministry of Health, Labour and Welfare and by Prefectural Ordinance as prescribed in paragraph (2) of the same Article;

when it is determined that the Long-Term Care Health Facility cannot properly manage the Long-Term Care Health Facility in accordance with standards pertaining to facilities and management as prescribed in Article 97, paragraph (3);

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 health and medical care or public aid for citizens as determined by a Cabinet Order and 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 approval has been rescinded pursuant to the provisions of Article 104, 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 approval has been rescinded is a juridical person, including a person who was an Officer of said juridical person or a manager of the Long-Term Care Health Facility established by it 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 approval has been rescinded is a person specified by the Minister of Health, Labour and Welfare under item (i) that is not a juridical person, including a person who was a manager of the Long-Term Care Health Facility established by said person 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 approval 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 approval prescribed in the main clause of this item, among the rescissions of the approval of a Long-Term Care Health Facility, in consideration of the facts that were the grounds for the disposition of said rescission, the status of efforts by the Establisher of a Long-Term Care Health Facility toward the establishment of an operational control system to prevent the occurrence of said facts, and other matters on the degree of responsibility that the Establisher of a Long-Term Care Health Facility had in relation to said facts;

when the applicant has provided notification of abolishment pursuant to the provisions of Article 99, paragraph (2) (except for a person that has a reasonable basis for said abolishment) 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 approval pursuant to the provisions of Article 104, 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 from the date of said notification;

when the applicant is a person who has provided notification of abolishment pursuant to the provisions of Article 99, paragraph (2) (except for a person that has a reasonable basis for said abolishment) during the period from the date on which an inspection pursuant to the provisions of Article 100, paragraph (1) was conducted to the expected hearing decision date (meaning, in the case where the prefectural governor 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 approval pursuant to the provisions of Article 104, paragraph (1), said specific date), and five years have not elapsed from the date of said notification;

in a case when notification of abolishment pursuant to the provisions of Article 99, paragraph (2) has been provided within the period provided by item (vii), when the applicant is a person who, within sixty days prior to the date of notification as set forth in the same item, was an Officer of the juridical person pertaining to said notification (except for a juridical person that has a reasonable basis for said abolishment) or a manager of the Long-Term Care Health Facility established by it, or a manager of the Long-Term Care Health Facility established by a person specified by the Minister of Health, Labour and Welfare under item (i) that is not a juridical person pertaining to said notification (except for a person that has a reasonable basis for said abolishment), 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 an application of approval;

when the applicant is a juridical person and any said Officer, etc., corresponds to any provision of item (iv) to the preceding item;

when the applicant is not a juridical person among those who are provided by the Minister of Health, Labour, and Welfare as set forth in item (i), and any person that manages said Business Office and other employees provided by a Cabinet Order corresponds to any of item (iv) to item (ix).

A prefectural governor may determine not to provide approval as set forth in paragraph (1) to a person that intends to establish a Long-Term Care Health Facility for the purpose of profit.

In a case when an approval as set forth in paragraph (1) and an approval as set forth in paragraph (2) (limited to those pertaining to increase of the maximum number of persons who may be admitted to the facility; hereinafter the same applies in this paragraph and the following paragraph) is applied, the prefectural governor, when it is determined that total number of maximum number of persons who may be admitted to Long-Term Care Health Facility in the area (which means an area provided by said prefecture pursuant to the provisions of Article 118, paragraph (2), item (i)) including the location of facility pertaining to said application has already reached the total number of necessary number of persons who may be admitted to the Long-Term Care Health Facility in the area as prescribed by the Prefectural Insured Long-Term Care Support Project Plan provided by said prefecture pursuant to the provisions of paragraph (1) of the same Article, or will exceed said total number by establishment of the facility pertaining to said application or increase the maximum number of persons who may be admitted to the facility, or when it is determined that it is likely to cause problems with accomplishment of said Prefectural Insured Long-Term Care Support Project Plan, may not provide an approval as set forth in paragraph (1) or an approval as set forth in paragraph (2).

A prefectural governor, when he or she intends to provide an approval as set forth in paragraph (1) or an approval as set forth in paragraph (2), must provide notice of matters as determined by Order of the Ministry of Health, Labour, and Welfare to the mayor of the relevant Municipality, specify a reasonable period, and request opinions from the perspective of coordination with the Municipal Insured Long-Term Care Service Plan as prescribed in Article 117, paragraph (1) of said relevant Municipality.

Approval as set forth in paragraph (1) of the preceding Article, if it is not renewed within a period of six years, ceases to be effective when said period expires.

In a case of application of 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 (hereinafter referred to as "Effective Period of Approval" in this Article), the prior approval remains effective after expiry of the Effective Period of Approval until a determination is reached regarding said application.

In a case as set forth in the preceding paragraph, when the approval is renewed, said Effective Period of Approval is to be from the date following the date of expiry of the prior Effective Period of Approval.

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

An Establisher of a Long-Term Care Health Facility must employ physicians approved by the prefectural governor to manage said Long-Term Care Health Facility.

Notwithstanding the provisions of the preceding paragraph, an Establisher of a Long-Term Care Health Facility may obtain approval of the prefectural governor and direct a person other than a physician to manage said Long-Term Care Health Facility.

An Establisher of a Long-Term Care Health Facility must act in compliance with the standards concerning facilities and management of a Long-Term Care Health Facility as prescribed in paragraph (3) of the following Article, offer appropriate Long-Term Care Health Facility Service 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 Long-Term Care Health Facility Service by implementing self-evaluation of the quality of the Provider's own Long-Term Care Health Facility Service and other measures.

An Establisher of a Long-Term Care Health Facility, 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 Long-Term Care Health Facility Service, must engage in offering said Long-Term Care Health Facility Service of said Insured Person in consideration of said Opinion of the Certification Committee.

A Long-Term Care Health Facility must have, pursuant to the provisions of Order of the Ministry of Health, Labour and Welfare, a medical care room, consultation room and functional training room, in addition to the facilities determined by Prefectural Ordinance.

A Long-Term Care Health Facility must employ physicians and nurses in the number determined by Order of the Ministry of Health, Labour and Welfare, and also Long-Term Care Support Specialists and employees that engage in long-term care or other operations in the number determined by Prefectural Ordinance.

In addition to the provisions as prescribed in the preceding two paragraphs, standards concerning facilities and management of a Long-Term Care Health Facility are to be provided by Prefectural Ordinance.

A prefecture, in establishing the Prefectural Ordinances referred to in the preceding three 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:

Long-Term Care Support Specialists and employees that engage in long-term care or other operations, and the number thereof;

matters concerning the management of a Long-Term Care Health Facility 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 are admitted, appropriate treatment and ensuring of safety, and maintenance of confidentiality.

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 a Long-Term Care Health Facility Service), must hear the opinion of the Social Security Council in advance.

An Establisher of a Long-Term Care Health Facility, when it has provided notification of abolishment or suspension pursuant to the provisions of Article 99, paragraph (2), must provide coordination with Establishers of other Long-Term Care Health Facilities and other relevant persons, and provide other conveniences, to a person who was receiving said Long-Term Care Health Facility Service on the day before the date of said notification and who wishes to continue to be provided with services equivalent to said Long-Term Care Health Facility Service on or after the date of said abolishment or suspension, so that necessary In-Home Service, etc. are provided continuously.

An Establisher of a Long-Term Care Health Facility 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.