Long-Term Care Insurance Act

The designation under Article 58, paragraph (1) is made, as provided by Order of the Ministry of Health, Labour and Welfare, upon application by the founder of a community general support center prescribed in Article 115-46, paragraph (1) or a Designated In-Home Long-Term Care Support Provider, for each Business Office that conducts the Preventive Long-Term Care Support Business (hereinafter referred to as "Business Office" in this Section), and is effective with regard to the payment of the Allowance for Preventive Long-Term Care Service Plan and the Exceptional Allowance for Preventive Long-Term Care Service Plan to Insured Persons of Long-Term Care Insurance provided by the Municipality of which the mayor who makes said designation is the head (excluding Insured In-Home Persons Requiring Support to Whom the Domicile Exception Applies under the Long-Term Care Insurance provided by said Municipality, and including Insured In-Home Persons Requiring Support to Whom the Domicile Exception Applies who are undergoing Admission, etc. to a Facility Subject to Domicile Exception located within the area of said Municipality).

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 the main clause of Article 58, paragraph (1):

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

when the knowledge and skill of the employees of the Business Office pertaining to said application, and the number of its personnel, do not meet the standards as determined by Municipal Ordinance as set forth in Article 115-24, paragraph (1) and the number of employees as determined by Municipal Ordinance as prescribed in the same paragraph;

when it is determined that the applicant cannot appropriately operate the Preventive Long-Term Care Support Business in accordance with the standards concerning effective support methods for Prevention of Long-Term Care pertaining to Designated Preventive Long-Term Care Support or the standards concerning management of the business of Designated Preventive Long-Term Care Support as prescribed in Article 115-24, paragraph (2);

when the applicant is punished by imprisonment or a more severe penalty and execution of said 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 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;

when the applicant is a person whose designation has been rescinded pursuant to the provisions of Article 115-29 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 designation of a Designated Preventive 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 Preventive 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 Preventive Long-Term Care Support Provider had in relation to said facts;

when a person who has a close relationship with the applicant has had the designation rescinded pursuant to the provisions of Article 115-29 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 designation of a Designated Preventive 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 Preventive 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 Preventive Long-Term Care Support Provider had in relation to said facts;

when the applicant is a person who has provided notification of abolishment of business pursuant to the provisions of Article 115-25, paragraph (2) (except for a person that has a reasonable basis for abolishment of said business) during the period from the date of notification pursuant to the provisions of Article 15 of the Administrative Procedure Act pertaining to rescission of the designation pursuant to the provisions of Article 115-29 to the date of making said disposition or the date of determining not to make the disposition, and five years have not elapsed from the date of said notification of abolishment;

when the applicant is a person who has provided notification of abolishment of business pursuant to the provisions of Article 115-25, paragraph (2) (excluding a person who 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 115-27, paragraph (1) was conducted to the expected hearing decision date (meaning, in the case where the mayor of the Municipality, as provided by Order of the Ministry of Health, Labour and Welfare, has notified said applicant of a specific date within ten days from the date on which said inspection was conducted as the date on which it is expected to be decided, based on the result of said inspection, whether or not to hold a hearing concerning the disposition of rescission of the designation pursuant to the provisions of Article 115-29, said specific date), and five years have not elapsed from the date of said notification;

in the case where notification of abolishment of business pursuant to the provisions of Article 115-25, paragraph (2) has been provided during the period prescribed in item (vi), when the applicant is a person who, within sixty days before the date of notification as set forth in the same item, was an Officer, etc., of a 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 a 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 an application of appointment as service provider;

when the applicant is a juridical person and any of its Officers, etc., is a person who falls under any of item (iii)-2 through item (v) or item (vi) through the preceding item;

when the applicant is a Business Office that is not a juridical person and the manager of the Business Office is a person who falls under any of item (iii)-2 through item (v) or item (vi) through item (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 specified by Order of the Ministry of Health, Labour and Welfare.

A mayor of a Municipality, when intending to designate an appointment as service provider as set forth in the main clause of Article 58, paragraph (1), must take necessary measures in advance in order to reflect the opinion of relevant persons and those of Insured Persons by Long-Term Care Insurance provided by said Municipality.

A Designated Provider of Support for Prevention of Long-Term Care must act in compliance with the standards concerning effective support methods for Prevention of Long-Term Care pertaining to Designated Support for Prevention of Long-Term Care and standards concerning management of the business of Designated Support for Prevention of Long-Term Care as prescribed in paragraph (2) of the following Article, offer appropriate Designated Support for Prevention of Long-Term Care 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 Support for Prevention of Long-Term Care by implementing self-evaluation of the quality of the Provider's own Designated Support for Prevention of Long-Term Care and other measures.

A Designated Preventive Long-Term Care Support Provider, when it has confirmed, through the presentation of the certificate of insured person, etc. by an Insured Person that intends to receive Designated Preventive Long-Term Care Support, the Opinion of the Certification Committee pertaining to said Insured Person, must endeavor to provide said Designated Preventive Long-Term Care Support to said Insured Person in consideration of said Opinion of the Certification Committee.

A Designated Preventive Long-Term Care Support Provider that is the founder of a community general support center prescribed in Article 115-46, paragraph (1) may, as provided by Order of the Ministry of Health, Labour and Welfare, entrust a part of the Designated Preventive Long-Term Care Support to a person specified by Order of the Ministry of Health, Labour and Welfare.

A Designated Preventive Long-Term Care Support Provider must employ the number of employees that engage in said Designated Preventive Long-Term Care Support, as determined by Municipal Ordinance in accordance with the standards as determined by Municipal Ordinance, at each Business Office pertaining to said appointment as service provider.

In addition to the provisions in the preceding paragraph, standards concerning effective support methods for Prevention of Long-Term Care pertaining to Designated Preventive Long-Term Care Support and standards concerning management of the business of Designated Preventive Long-Term Care Support are prescribed by Municipal Ordinance.

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

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

matters concerning the operation of the business of Designated Preventive Long-Term Care Support 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 Support who use them, appropriate treatment and ensuring safety, and maintaining confidentiality, etc.

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

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

A Designated Preventive Long-Term Care Support Provider must respect the personality of a Person Requiring Support, act in compliance with this Act or an order based on this Act, and faithfully perform its duties for a Person Requiring Support.