Long-Term Care Insurance Act

The appointment as a service provider as set forth in Article 48, paragraph (1), item (i) is to be provided, pursuant to the provisions of Order of the Ministry of Health, Labour and Welfare, to an application filed by an establisher of an Intensive Care Home for the Elderly, among those prescribed in Article 20-5 of the Act on Social Welfare for the Elderly, with an admission capacity of said facility that is thirty (30) or more and is a number specified by Prefectural Ordinance.

A prefectural governor, in a case of an application as set forth in the preceding paragraph, when said Intensive Care Home for the Elderly corresponds to any of the following items, must not provide appointment as service provider as set forth in the main clause of Article 48, paragraph (1), item (i):

when it does not employ personnel as provided by Article 88, paragraph (1);

when it is determined that said Intensive Care Home for the Elderly cannot properly manage a Facility Covered by Public Aid Providing Long-Term Care to the Elderly in accordance with standards pertaining to facilities and management of a Designated Facility Covered by Public Aid Providing Long-Term Care to the Elderly as prescribed in Article 88, paragraph (2);

when the establisher of said Intensive Care Home for the Elderly was punished by a fine pursuant to the provisions of this Act, provided by a Cabinet Order, concerning citizens' health and medical care or public aid and execution of said penalty has not yet been completed or has not yet expired;

when the establisher of said Intensive Care Home for the Elderly was 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 establisher of said Intensive Care Home for the Elderly, with regard to the insurance premiums, burden charges, or contributions for which it bears the obligation to pay as provided by the Health Insurance Act, the Local Public Officers, etc. Mutual Aid Association Act, the Employees' Pension Insurance Act, or the Act on the Collection, etc. of Insurance Premiums of Labor Insurance, was subject, by the day before the day of making said application, to a disposition of delinquency based on the provisions of these Acts, 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, burden charges, or contributions whose due dates arrived on or after the day of receiving said disposition (limited to the insurance premiums, burden charges, or contributions for which the person subject to said disposition bears the obligation to pay under the Act that provides that the person bears the obligation to pay the insurance premiums, burden charges, or contributions pertaining to said disposition);

when the establisher of said Intensive Care Home for the Elderly is a person whose designation has been rescinded pursuant to the provisions of Article 92, paragraph (1) or Article 115-35, paragraph (6) and five years have not elapsed from the date of the 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 designation of a Designated Facility Covered by Public Aid Providing Long-Term Care to the Elderly, in consideration of the facts that were the grounds for the disposition of said rescission, the status of efforts by the establisher of said Designated Facility Covered by Public Aid Providing Long-Term Care to the Elderly 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 said Designated Facility Covered by Public Aid Providing Long-Term Care to the Elderly had in relation to said facts;

when an establisher of said Intensive Care Home for the Elderly is a person who declined the appointment as service provider pursuant to the provisions of Article 91 (excluding a person that has a reasonable basis for said decline of appointment as service provider) during the period from the date of notification pursuant to the provisions of Article 15 of the Administrative Procedure Act pertaining to the disposition of rescission of the designation pursuant to the provisions of Article 92, paragraph (1) or Article 115-35, paragraph (6) to the date of making said disposition or the date of determining not to make a disposition, and five years have not elapsed from the date of said decline of appointment as service provider;

when an establisher of said Intensive Care Home for the Elderly is a person who declined the appointment as service provider pursuant to the provisions of Article 91 (excluding a person that has a reasonable basis for said decline of appointment as service provider) during the period from the date on which an inspection pursuant to the provisions of Article 90, paragraph (1) was conducted to the expected hearing decision date (meaning the specific date, in a case when a prefectural governor has notified the establisher of said Intensive Care Home for the Elderly of a specific date within ten days from the date on which said inspection was conducted, as provided by Order of the Ministry of Health, Labour and Welfare, as the date on which it is expected to be decided, based on the result of said inspection, whether to hold a hearing on the disposition of rescission of the designation pursuant to the provisions of Article 92, paragraph (1)), and five years have not elapsed from the date of said decline of appointment as service provider;

when an establisher of said Intensive Care Home for the Elderly performs a wrongful or significantly unjustifiable act concerning In-Home Service, etc., within five years prior to an application of appointment as service provider;

when any Officer, etc., or the chairperson of an establisher of said Intensive Care Home for the Elderly corresponds to any of the following:

a person punished by imprisonment or a heavier penalty and execution of said penalty has not yet been completed or has not yet expired;

a person that corresponds to item (iii), item (iii)-2, or the preceding item;

a person who, with regard to insurance premiums (including National Health Insurance tax pursuant to the provisions of the Local Tax Act; hereinafter referred to as "insurance premiums, etc." in this (c)) for which the person bears the obligation to pay as provided by this Act, the National Health Insurance Act, or the National Pension Act, 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 to pay, 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 arrived on or after the day of receiving said disposition (limited to the insurance premiums, etc. for which the person subject to said disposition bears the obligation to pay under the Act that provides that the person bears the obligation to pay the insurance premiums, etc. pertaining to said disposition);

a person who, in an Intensive Care Home for the Elderly whose designation has been rescinded pursuant to the provisions of Article 92, paragraph (1) or Article 115-35, paragraph (6), was an Officer of its establisher or the head of said Intensive Care Home for the Elderly 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 (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 this item, among the rescissions of the designation of a Designated Facility Covered by Public Aid Providing Long-Term Care to the Elderly, in consideration of the facts that were the grounds for the disposition of said rescission, the status of efforts by the establisher of said Designated Facility Covered by Public Aid Providing Long-Term Care to the Elderly 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 said Designated Facility Covered by Public Aid Providing Long-Term Care to the Elderly had in relation to said facts);

a person that is or was an Officer, etc., of an establisher or the chairperson of the board of an Intensive Care Home for the Elderly that declined an appointment as service provider pursuant to the provisions of Article 91 within the period provided by item (v) (except for an Intensive Care Home for the Elderly which has a reasonable basis for said decline of appointment as service provider) within sixty days prior to the date of notification as set forth in the same item and five years have not elapsed from the date of said decline of appointment as service provider.

A prefectural governor, when he or she intends to provide appointment as service provider as set forth in Article 48, paragraph (1), item (i), 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.

Appointment as service provider as set forth in Article 48, paragraph (1), item (i), 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 (herein referred to as "Effective Period of Designation as Service Provider" in this Act), 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 renewal of appointment as service provider as set forth in paragraph (1).

An establisher of a Designated Facility Covered by Public Aid Providing Long-Term Care to the Elderly must act in compliance with the standards concerning facilities and management of a Designated Facility Covered by Public Aid Providing Long-Term Care to the Elderly as prescribed in paragraph (2) of the following Article, offer an appropriate Designated Facility Covered by Public Aid Providing Long-Term Care to the Elderly 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 Facility Covered by Public Aid Providing Long-Term Care to the Elderly by implementing self-evaluation of the quality of the Provider's own Designated Facility Covered by Public Aid Providing Long-Term Care to the Elderly and other measures.

An establisher of a Designated Facility Covered by Public Aid Providing Long-Term Care to the Elderly, when it has confirmed, through the presentation of the certificate of insured person, etc. by an Insured Person that intends to receive Designated Facility Service for Long-Term Care Covered by Public Aid, an Opinion of the Certification Committee pertaining to said Insured Person, must engage in offering said Designated Facility Service for Long-Term Care Covered by Public Aid of said Insured Person in consideration of said Opinion of the Certification Committee.

A Designated Facility Covered by Public Aid Providing Long-Term Care to the Elderly must employ the number of Long-Term Care Support Specialists or other employees that engage in said Designated Facility Service for Long-Term Care Covered by Public Aid, as determined by Prefectural Ordinance.

In addition to the provisions as prescribed in the preceding paragraph, standards concerning facilities and management of a Designated Facility Covered by Public Aid Providing Long-Term Care to the Elderly are determined by Prefectural Ordinance.

A prefecture, in establishing the Prefectural Ordinances set forth 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:

employees that engage in Designated Facility Service for Long-Term Care Covered by Public Aid and the number of said employees;

the floor area of residence rooms pertaining to a Designated Facility Covered by Public Aid Providing Long-Term Care to the Elderly;

matters concerning the operation of a Designated Facility Covered by Public Aid Providing Long-Term Care to the Elderly that are determined 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, ensuring of safety, and maintenance of confidentiality.

The Minister of Health, Labour and Welfare, when providing 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 Facility Service for Long-Term Care Covered by Public Aid), must hear the opinion of the Social Security Council in advance.

An establisher of a Designated Facility Covered by Public Aid Providing Long-Term Care to the Elderly, when declining the appointment as service provider pursuant to the provisions of Article 91, must provide coordination with establishers of other Designated Facilities Covered by Public Aid Providing Long-Term Care to the Elderly and other relevant persons, and other conveniences, to persons who received said Designated Facility Service for Long-Term Care Covered by Public Aid on the day before the start date of the prior notice period prescribed in that Article and who wish to continue to receive services equivalent to said Designated Facility Service for Long-Term Care Covered by Public Aid on or after the date of said decline of appointment as service provider, so that necessary In-Home Service, etc. are continuously provided.

An establisher of a Designated Facility Covered by Public Aid Providing Long-Term Care to the Elderly 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.