Long-Term Care Insurance Act

The term "Community-Based Facility for the Elderly Covered by Public Aid Requiring Long-Term Care" as used in this Act means an Intensive Care Home for the Elderly prescribed in Article 20-5 of the Act on Social Welfare for the Elderly (limited to a facility for which the capacity of residents is twenty-nine (29) or less; the same applies hereinafter in this paragraph) that aims to provide care for bathing, bodily waste elimination, meals, etc., and other care for performing daily activities, functional training, health management, and medical care to a Person Requiring Long-Term Care who is staying in said Intensive Care Home for the Elderly (limited to a person in a condition falling under a Category of Condition of Need for Long-Term Care specified by Order of the Ministry of Health, Labour and Welfare and other persons specified by Order of the Ministry of Health, Labour and Welfare as having difficulty in performing daily activities at home; the same applies hereinafter in this paragraph and paragraph (2627)) based on a Community-Based Facility Service Plan (meaning a plan that sets out the content of services provided by a Community-Based Facility for the Elderly Covered by Public Aid Requiring Long-Term Care to a Person Requiring Long-Term Care who is staying in said facility, the personnel in charge of said services, and other matters as determined by Order of the Ministry of Health, Labour and Welfare; the same applies hereinafter in this paragraph), and the term "Daily Life Long-Term Care for a Person Admitted to a Community-Based Facility for the Elderly Covered by Public Aid Requiring Long-Term Care" means care for bathing, bodily waste elimination, meals, etc., and other care for performing daily activities, functional training, health management, and medical care that is provided to a Person Requiring Long-Term Care who is staying in a Community-Based Facility for the Elderly Covered by Public Aid Requiring Long-Term Care, based on a Community-Based Facility Service Plan.

The term "In-Home Long-Term Care Support" as used in this Act means, in order for an In-Home Person Requiring Long-Term Care (excluding a person who receives care in a residence room in a registered Fee-Based Home for the Elderly) to be able to make appropriate use, etc., of Designated In-Home Service prescribed in Article 41, paragraph (1), In-Home Service pertaining to Exceptional Allowance for In-Home Long-Term Care Service or equivalent services, Designated Community-Based Service prescribed in Article 42-2, paragraph (1), Community-Based Service pertaining to Exceptional Allowance for Community-Based Long-Term Care Service or equivalent services, In-Home Service pertaining to a project for In-Home Services, etc. in a Specified Area prescribed in Article 115-45, paragraph (3) or equivalent services, and other health and medical services or welfare services necessary for performing daily activities at home (hereinafter referred to as "Designated In-Home Service, etc." in this paragraph), to prepare, at the request of said In-Home Person Requiring Long-Term Care and in consideration of his or her mental and physical condition, the environmentexcluding a residence room in which he or she is placed, anda registered Fee-Based Home for the preferences, etc., of said In-Home Person Requiring Long-Term Care and his or her family, a planElderly) (hereinafter referred to as an "In-Home Service Plan" in this paragraph, item (iii) of paragraph (2) of that Article and the Appended Table) that sets out the types and content of the "Designated In-Home Service, etc. to be used, the personnel in charge of them, and other matters as determined by Order of the Ministry of Health, Labour and Welfare, and also to provide liaison and coordination with Designated In-Home Service Providers prescribed in Article 41, paragraph (1), Designated Community-Based Service Providers prescribed" in Article 42-2,this paragraph (1) and other persons, and ), to provide other conveniences, so as to ensure the provision of Designated In-Home Service, etc. based on said In-Home Service Plan, and, infollowing support at the case whererequest of said In-Home Person Requiring Long-Term Care requires admission to a Community-Based Facility for the Elderly Covered by Public Aid Requiring Long-Term Care, a Facility Covered by Long-Term Care Insurance or a Long-Term Care Insurance Facility in a Specified Area (hereinafter referred to as a "Community-Based Facility for the Elderly Covered by Public Aid Requiring Long-Term Care, etc." in this paragraph), to provide referral to a Community-Based Facility for the Elderly Covered by Public Aid Requiring Long-Term Care, etc. and other conveniences, and the term "In-Home Long-Term Care Support Business" means a business that provides In-Home Long-Term Care Support.

to prepare a plan (hereinafter referred to as the "In-Home Service Plan") that, taking into account the mental and physical condition and environment of said In-Home Person Requiring Long-Term Care and the wishes, etc. of said In-Home Person Requiring Long-Term Care and his or her family, sets forth the type and content of the Designated In-Home Service, etc. to be used, the persons in charge thereof, and other matters determined by Order of the Ministry of Health, Labour and Welfare;

to coordinate with the Designated In-Home Service Provider prescribed in Article 41, paragraph (1), the Designated Community-Based Service Provider prescribed in Article 42-2, paragraph (1), and other persons (referred to as "Designated In-Home Service Provider, etc." in item (ii), (a) of the following paragraph), and to provide other conveniences, in order to ensure the provision of Designated In-Home Service, etc. based on the In-Home Service Plan;

in the case where said In-Home Person Requiring Long-Term Care requires admission to a Community-Based Facility for the Elderly Covered by Public Aid Requiring Long-Term Care, a Facility Covered by Long-Term Care Insurance or a Long-Term Care Insurance Facility in a Specified Area (hereinafter referred to as "Community-Based Facility for the Elderly Covered by Public Aid Requiring Long-Term Care, etc." in this item and item (iii) of the following paragraph), to provide referral to the Community-Based Facility for the Elderly Covered by Public Aid Requiring Long-Term Care, etc. and other conveniences.

The term "Facility Covered by Long-Term Care Insurance" as used in this Act means a Designated Facility Covered by Public Aid Providing In this Act, "registered facility long-term care support" means to provide the following support, upon the request of a Person Requiring Long-Term Care in a registered facility (meaning a Person Requiring Long-Term Care to the Elderly prescribedwho receives care in Article 48, paragraph (1), item (ia residence room of a registered Fee-Based Home for the Elderly), a so that said Person Requiring Long-Term Care Health Facility (excluding a Long-Term Care Health Facility in a registered facility can make appropriate use, etc. of the Designated In-Home Service prescribed in Article 4941, paragraph (1), item (iii)), and or the In-Home Service pertaining to an integrated facilityExceptional Allowance for medical and long-term care (excluding an integrated facility for medical and long-term careIn-Home Long-Term Care Service or services equivalent thereto, the Designated Community-Based Service prescribed in Article 4942-2, paragraph (1), item (iv)), and or the term "Long-Term Care Insurance Facility in a Specified Area" means a Facility Covered by Public Aid Providing Long-Term Care Community-Based Service pertaining to an Exceptional Allowance for Community-Based Long-Term Care Service or services equivalent thereto, the In-Home Service pertaining to the Elderly project for In-Home Services, etc. in a Specified Area prescribed in Article 49115-45, paragraph (1), item (ii), a Long-Term Care Health Facility prescribed 3) or services equivalent thereto, and other health and medical services or welfare services necessary for leading daily life in item (iii) a residence room of that paragraph, and an integrated facility for medical a registered Fee-Based Home for the Elderly (hereinafter referred to as "Designated Registered Facility Service, etc." in this paragraph), and "registered facility long-term care prescribed in item (iv) ofsupport business" means a business that paragraphprovides registered facility long-term care support.

to hear the mental and physical condition and environment of said Person Requiring Long-Term Care in a registered facility, and other circumstances of said person, from the founder of the registered Fee-Based Home for the Elderly that said person enters, and, after taking into account those circumstances and the wishes, etc. of said Person Requiring Long-Term Care in a registered facility and his or her family, to prepare a plan (hereinafter referred to as the "registered Facility Service Plan") that sets forth the type and content of the Designated Registered Facility Service, etc. to be used, the persons in charge thereof, and other matters determined by Order of the Ministry of Health, Labour and Welfare;

to provide the following support in order to ensure the provision of Designated Registered Facility Service, etc. based on the registered Facility Service Plan:

to coordinate with the Designated In-Home Service Provider, etc. and to provide other conveniences;

to assist said Person Requiring Long-Term Care in a registered facility in participating in activities conducted by community residents, etc. (meaning community residents, etc. prescribed in Article 4, paragraph (2) of the Social Welfare Act (Act No. 45 of 1951); the same applies in item (ii), (b) of paragraph (17) of the following Article) to reduce the Condition of Need for Long-Term Care or prevent its worsening, and activities for leading an independent daily life in the community.

in the case where said Person Requiring Long-Term Care in a registered facility requires admission to a Community-Based Facility for the Elderly Covered by Public Aid Requiring Long-Term Care, etc., to provide referral to the Community-Based Facility for the Elderly Covered by Public Aid Requiring Long-Term Care, etc. and other conveniences.

The term "Facility ServiceCovered by Long-Term Care Insurance" as used in this Act means a Designated Facility Service for Covered by Public Aid Providing Long-Term Care Covered by Public Aid, to the Elderly prescribed in Article 48, paragraph (1), item (i), a Long-Term Care Health Facility Service, and service at (excluding a Long-Term Care Health Facility prescribed in Article 49, paragraph (1), item (iii)), and an integrated facility for medical and long-term care, (excluding an integrated facility for medical and the term "Facility Service Plan" means a plan for a Person Requiring long-term care prescribed in Article 49, paragraph (1), item (iv)), and the term "Long-Term Care who is staying at Insurance Facility in a Specified Area" means a Facility Covered by Public Aid Providing Long-Term Care to the Elderly, a Long-Term Care Health Facility, or an integrated facility for medical and long-term care, that sets out the content of services provided by said facilities, the personnel in a Specified Area prescribed in Article 49, paragraph (1), item (ii), a Long-Term Care Health Facility prescribed in charge item (iii) of said servicesthat paragraph, and other matters as determined by Order of the Ministry of Health, Labour and Welfarean integrated facility for medical and long-term care prescribed in item (iv) of that paragraph.

The term "Facility Covered by Public Aid Providing Long-Term Care to the ElderlyService" as used in this Act means an Intensive Care Home for the Elderly provided in Article 20-5 of the Act on Social WelfareFacility Service for the Elderly (limited to a facility with a capacity of thirty (30) residents or more; the same applies hereinafter in this paragraph). The purpose of saidLong-Term Care Covered by Public Aid, Long-Term Care Health Facility Service, and service at an integrated facility is to provide care for bathing, bodily waste elimination, meals, etc.medical and long-term care, and for other daily activities, functional training, health management, and medical care tothe term "Facility Service Plan" means a plan for a Person Requiring Long-Term Care who is staying in said Intensive Care Home for the Elderly based onat a Facility Service Plan. The term "Facility Service for Long-Term Care Covered by Public Aid" as used in this Act means care that is provided based on a Facility Service Plan Providing Long-Term Care to the Elderly, a Long-Term Care Health Facility, or an integrated facility for bathing, bodily waste elimination, meals, etc., and for other daily activities, functional training, health management, and medical care to a Person Requiring Long-Term Care who is staying in said Facility Coveredmedical and long-term care, that sets out the content of services provided by said facilities, the personnel in charge of said services, and other matters as determined by Public Aid Providing Long-Term Care to the ElderlyOrder of the Ministry of Health, Labour and Welfare.

The term "Facility Covered by Public Aid Providing Long-Term Care Health Facilityto the Elderly" as used in this Act means a facility which has obtained permission from the prefectural governor as set forth in Article 94, paragraph (1) asan Intensive Care Home for the Elderly provided in Article 20-5 of the Act on Social Welfare for the Elderly (limited to a facility with the purposea capacity of providing, based on a Facility Service Plan, nursing, long-term care and functional training under medical management, and other necessary medical care, as well asthirty (30) residents or more; the same applies hereinafter in this paragraph). The purpose of said facility is to provide care for performing daily activities, to a Person Requiring Long-Term Care who requires support primarily to maintain and recover mental or physical functions andbathing, bodily waste elimination, meals, etc., and for other daily activities, functional training, health management, and medical care to enable him or her to live at home (limited to those specified by Order ofa Person Requiring Long-Term Care who is staying in said Intensive Care Home for the Ministry of Health, Labour and Welfare with regard to the degree of needElderly based on a Facility Service Plan. The term "Facility Service for medical treatment; hereinafter simply referred to as "Person Requiring Long-Term Care"Long-Term Care Covered by Public Aid" as used in this paragraph), and the term "Long-Term Care Health Facility Service" means nursing, long-term care and functional training under medical managementAct means care that is provided based on a Facility Service Plan for bathing, bodily waste elimination, meals, etc., and other necessary medical care, as well as care for performing daily activities, that are providedfor other daily activities, functional training, health management, and medical care to a Person Requiring Long-Term Care who is staying in a Long-Term Care Health Facility, based on a Facility Service Plansaid Facility Covered by Public Aid Providing Long-Term Care to the Elderly.

The term "integrated facility for medical and long-term careLong-Term Care Health Facility" as used in this Act means a facility which has obtained permission from the prefectural governor as set forth in Article 10794, paragraph (1) as a facility with the purpose of providing, based on a Facility Service Plan, medical care management, nursing, long-term care and functional training under medical management, and other necessary medical care, as well as care for performing daily activities, to a Person Requiring Long-Term Care who requires support primarily requires medical care over a long period to maintain and recover mental or physical functions and to enable him or her to live at home (limited to those specified by Order of the Ministry of Health, Labour and Welfare with regard to the degree of need for medical treatment; hereinafter simply referred to as "Person Requiring Long-Term Care" in this paragraph), and the term "service at an integrated facility for medical and long-term careLong-Term Care Health Facility Service" means medical care management, nursing, long-term care and functional training under medical management, and other necessary medical care, as well as care for performing daily activities, that are provided to a Person Requiring Long-Term Care who is staying in an integrated facility for medical and long-term carea Long-Term Care Health Facility, based on a Facility Service Plan.

The term "integrated facility for medical and long-term care" as used in this Act means a facility which has obtained permission from the prefectural governor as set forth in Article 107, paragraph (1) as a facility with the purpose of providing, based on a Facility Service Plan, medical care management, nursing, long-term care and functional training under medical management, and other necessary medical care, as well as care for performing daily activities, to a Person Requiring Long-Term Care who primarily requires medical care over a long period (limited to those specified by Order of the Ministry of Health, Labour and Welfare with regard to the degree of need for medical treatment; hereinafter simply referred to as "Person Requiring Long-Term Care" in this paragraph), and the term "service at an integrated facility for medical and long-term care" means medical care management, nursing, long-term care and functional training under medical management, and other necessary medical care, as well as care for performing daily activities, that are provided to a Person Requiring Long-Term Care who is staying in an integrated facility for medical and long-term care, based on a Facility Service Plan.

The term "Preventive Long-Term Care Support" as used in this Act means that, in order for an In-Home Person Requiring Support (excluding a person who receives support in a residence room in a registered Fee-Based Home for the Elderly) to be able to make appropriate use, etc., of Designated Preventive Long-Term Care Service prescribed in Article 53, paragraph (1), Preventive Long-Term Care Service pertaining to Exceptional Allowance for Preventive Service of Long-Term Care or equivalent services, Designated Community-Based Service for Preventive Long-Term Care prescribed in Article 54-2, paragraph (1), Community-Based Service for Preventive Long-Term Care pertaining to Exceptional Allowance for Community-Based Preventive Service of Long-Term Care or equivalent services, a Specified Comprehensive Project for Long-Term Care Prevention and Daily Life Support (limited to those conducted by a Municipality, a Designated Provider prescribed in Article 115-45-3, paragraph (1), or an entrusted party prescribed in Article 115-47, paragraph (7); the same applies hereinafter in this paragraph and Article 32, paragraph (4), item (ii)), Preventive Long-Term Care Service pertaining to a project for In-Home Services, etc. in a Specified Area prescribed in Article 115-45, paragraph (3) or equivalent services, and other health and medical services or welfare services that contribute to Prevention of Long-Term Care (hereinafter referred to as "Designated Preventive Long-Term Care Service, etc." in this paragraph and the following paragraph), a person specified by Order of the Ministry of Health, Labour and Welfare from among the staff of a community general support center prescribed in Article 115-46, paragraph (1) and the employees of the Business Office that provides Designated In-Home Long-Term Care Support prescribed in Article 46, paragraph (1) prepares, at the request of said In-Home Person Requiring Support and in consideration of his or her mental and physical condition,provides the environment in which he or she is placed, andfollowing support at the preferences, etc.,request of said In-Home Person Requiring Support and his or her family, a plan (hereinafter referred to as a "Preventive Long-Term Care Service Plan" in this paragraph, Article 115-30-2, paragraph (1), Article 115-45, paragraph (2), item (iii) and the Appended Table) that sets out the types and content of the Designated Preventive Long-Term Care Service, etc. to be used, the personnel in charge of them, and other matters as determined by Order of the Ministry of Health, Labour and Welfare, and also provides liaison and coordination with Designated Providers of Preventive Long-Term Care Service prescribed in Article 53, paragraph (1), Designated Providers of Community-Based Service for Preventive Long-Term Care prescribed in Article 54-2, paragraph (1), persons that conduct a Specified Comprehensive Project for Long-Term Care Prevention and Daily Life Support, and other persons, and other conveniences, so as to ensure the provision of the Designated Preventive Long-Term Care Service, etc. based on said Preventive Long-Term Care Service Plan, and the term "Preventive Long-Term Care Support Business" means a business that provides Preventive Long-Term Care Support.

to prepare a plan (hereinafter referred to as the "Preventive Long-Term Care Service Plan") that, taking into account the mental and physical condition and environment of said In-Home Person Requiring Support and the wishes, etc. of said In-Home Person Requiring Support and his or her family, sets forth the type and content of the Designated Preventive Long-Term Care Service, etc. to be used, the persons in charge thereof, and other matters determined by Order of the Ministry of Health, Labour and Welfare;

to coordinate with the Designated Provider of Preventive Long-Term Care Service prescribed in Article 53, paragraph (1), the Designated Provider of Community-Based Service for Preventive Long-Term Care prescribed in Article 54-2, paragraph (1), a person that conducts the Specified Comprehensive Project for Long-Term Care Prevention and Daily Life Support, and other persons (referred to as "Designated Provider of Preventive Long-Term Care Service, etc." in item (ii), (a) of the following paragraph), and to provide other conveniences, in order to ensure the provision of Designated Preventive Long-Term Care Service, etc. based on the Preventive Long-Term Care Service Plan.

In this Act, "registered facility Preventive Long-Term Care Support" means that, upon the request of a Person Requiring Support in a registered facility (meaning a Person Requiring Support who receives support in a residence room of a registered Fee-Based Home for the Elderly), those, among the staff of the Community General Support Center prescribed in Article 115-46, paragraph (1) and the employees of the Business Office that provides the Designated Registered Facility Long-Term Care Support prescribed in Article 47-2, paragraph (1), who are specified by Order of the Ministry of Health, Labour and Welfare, provide the following support so that said Person Requiring Support in a registered facility can make appropriate use, etc. of Designated Preventive Long-Term Care Service, etc., and "registered facility Preventive Long-Term Care Support Business" means a business that provides registered facility Preventive Long-Term Care Support.

to hear the mental and physical condition and environment of said Person Requiring Support in a registered facility, and other circumstances of said person, from the founder of the registered Fee-Based Home for the Elderly that said person enters, and, after taking into account those circumstances and the wishes, etc. of said Person Requiring Support in a registered facility and his or her family, to prepare a plan (hereinafter referred to as the "registered facility Preventive Long-Term Care Service plan") that sets forth the type and content of the Designated Preventive Long-Term Care Service, etc. to be used, the persons in charge thereof, and other matters determined by Order of the Ministry of Health, Labour and Welfare;

to provide the following support in order to ensure the provision of Designated Preventive Long-Term Care Service, etc. based on the registered facility Preventive Long-Term Care Service plan:

to coordinate with the Designated Provider of Preventive Long-Term Care Service, etc. and to provide other conveniences;

to assist said Person Requiring Support in a registered facility in participating in activities conducted by community residents, etc. to prevent the Condition of Need for Long-Term Care, or to reduce the Condition of Need for Long-Term Care, etc. or prevent its worsening, and activities for leading an independent daily life in the community.

When a Designated In-Home Service Provider prescribed in Article 41, paragraph (1); a Designated Community-Based Service Provider prescribed in Article 42-2, paragraph (1); a Designated In-Home Long-Term Care Support Provider prescribed in Article 46, paragraph (1); a Designated Registered Facility Long-Term Care Support Provider prescribed in Article 47-2, paragraph (1); a Facility Covered by Long-Term Care Insurance; a Designated Provider of Preventive Long-Term Care Service prescribed in Article 53, paragraph (1); a Designated Provider of Community-Based Service for Preventive Long-Term Care prescribed in Article 54-2, paragraph (1); a Designated Preventive Long-Term Care Support Provider prescribed in Article 58, paragraph (1); or a Designated Registered Facility Preventive Long-Term Care Support Provider prescribed in Article 5859-2, paragraph (1) (hereinafter referred to as a "Designated In-Home Service Provider, etc." in this paragraph) receives a payment pursuant to the provisions of Article 41, paragraph (6), Article 42-2, paragraph (6), Article 46, paragraph (4), Article 47-2, paragraph (4), Article 48, paragraph (4), Article 51-3, paragraph (4), Article 53, paragraph (4), Article 54-2, paragraph (6), Article 58, paragraph (4), Article 59-2, paragraph (4), or Article 61-3, paragraph (4) by deception or other wrongful act, a Municipality may collect from said Designated In-Home Service Provider, etc. the amount to be returned with regard to the amount paid, and may also collect the amount obtained by multiplying the amount to be returned by 40 percent.

A Municipality may, when it determines necessity with regard to an insurance benefit, demand or request submission or presentation of documents and other items, or direct its personnel to ask questions and inquiries to a person that receives said insurance benefit, a person that is in charge of In-Home Service, etc. pertaining to said insurance benefit (which means In-Home Service (including equivalent services), Community-Based Service (including equivalent services), In-Home Long-Term Care Support (including equivalent services), registered facility long-term care support (including equivalent services), Facility Service, Preventive Long-Term Care Service (including equivalent services), Community-Based Service for Preventive Long-Term Care (including equivalent services), Preventive Long-Term Care Support (including equivalent services), or a registered facility Preventive Long-Term Care Support (including equivalent services); the same applies hereinafter) , or a person that provides a house modification for in-home careHome Modification as prescribed in Article 45, paragraph (1) which pertains to an insurance benefit, or a person that was said person (hereinafter referred to as "Person, etc., Subject to Inquiry" in Article 24-2, paragraph (1), item (i)).

affairs pertaining to an inspection pursuant to the provisions of Article 27, paragraph (2) (including a case when applied mutatis mutandis pursuant to Article 28, paragraph (4), Article 29, paragraph (2), Article 30, paragraph (2), Article 31, paragraph (23), and Article 32, paragraph (2) (including a case when applied mutatis mutandis pursuant to Article 33, paragraph (4), Article 33-2, paragraph (2), Article 33-3, paragraph (2), and Article 34, paragraph (23)));

An Insured Person that intends to obtain a Certification of Needed Long-Term Care, pursuant to the provisions of Order of the Ministry of Health, Labour and Welfare, must submit to a Municipality a writtenan application with the Certificate of Insured Person attached. In this case, said Insured Person, pursuant to the provisions of Order of the Ministry of Health, Labour and Welfare, may have a provider or facility listed in the following items implement the procedures pertaining to said application on behalf of said Insured Person.

a Community-Based Designated Registered Facility for the Elderly Covered by Public Aid Requiring Long-Term CareLong-Term Care Support Provider prescribed in Article 47-2, paragraph (1);

a Community-Based Facility for the Elderly Covered by Public Aid Requiring Long-Term Care Insurance;

a Long-Term Care Insurance Facility in a Specified AreaCovered by Long-Term Care Insurance;

a Designated Provider of Preventive Long-Term Care Service prescribedInsurance Facility in Article 53, paragraph (1) that provides Daily Preventive Long-Term Care Admitted to a Specified FacilityArea;

a Designated Provider of Community-Based Service for Preventive Long-Term Care Service prescribed in Article 54-253, paragraph (1) that provides MultifunctionalDaily Preventive Long-Term Care in a Small Group Home or Preventive Long-Term Care forAdmitted to a Dementia Patient in Communal LivingSpecified Facility;

a Designated Provider of Community-Based Service for Preventive Long-Term Care prescribed in Article 54-2, paragraph (1) that provides Multifunctional Preventive Long-Term Care in a Small Group Home or Preventive Long-Term Care for a Dementia Patient in Communal Living;

A Municipality, when providing a Certification of Needed Long-Term Care based on the results of an examination and judgment of a Certification Committee as notified pursuant to the provisions of the first sentence of paragraph (5), must notify the Insured Person pertaining to said Certification of Needed Long-Term Care of said result. In this case, the Municipality shall enter the following items on notify said Insured Person, pursuant to the Certificateprovisions of Insured PersonOrder of said Insured Person and return the Certificatethe Ministry of Health, Labour and Welfare, of Insured Person to the Insured Personfollowing items:

A Municipality, when it determined the Insured Person pertaining to the application as set forth in paragraph (1) fails to be qualified as a Person Requiring Long-Term Care based on the results of an examination and judgment of a Certification Committee as notified pursuant to the provisions of the first sentence of paragraph (5), is to notify said Insured Person of that effect, indicating , pursuant to the reason(s), and return provisions of Order of the CertificateMinistry of Insured Person Health, Labour and Welfare, of said Insured Personthat effect, indicating the reason(s).

A Municipality may entrust an investigation as set forth in the preceding Article, paragraph (2), as applied mutatis mutandis pursuant to the preceding paragraph, to a Designated In-Home Long-Term Care Support Provider as prescribed in Article 46, paragraph (1), a Designated Registered Facility Long-Term Care Support Provider as prescribed in Article 47-2, paragraph (1), a Community-Based Facility for the Elderly Covered by Public Aid Requiring Long-Term Care, a Facility Covered by Long-Term Care Insurance, other providers or facilities as determined by Order of the Ministry of Health, Labour, and Welfare (herein referred to as "Designated In-Home Long-Term Care Support Provider, etc." in this Article), or to a Long-Term Care Support Specialist as determined by Order of the Ministry of Health, Labour, and Welfare.

A Municipality, when it is determined that an Insured Person that was issued a Certification of Needed Long-Term Care, qualifies for a Category of Condition of Need for Long-Term Care other than the Category of Condition of Need for Long-Term Care pertaining to said Certification of Needed Long-Term Care due to a lowering of the degree of necessity of long-term care, may certify a change of Category of Condition of Need for Long-Term Care. In this case, the Municipality is to request the Insured Person pertaining, when it determines it necessary with regard to said changethe qualification of certification to submit said Certificate ofan Insured Person, shall enter the Category of Condition of Need for Long-Term Care pertainingmay, pursuant to said change of certification and the opinionprovisions of the Certification Committee pursuant to the provisionsOrder of the second sentenceMinistry of Article 27, paragraph (5) as applied mutatis mutandis pursuant toHealth, Labour and Welfare, request the following paragraph (limited to those changesInsured Person pertaining to matters listed in item (ii)said change of the same paragraph), and then returnCertification to submit said Certificate of Insured Person to the Insured Person.

The provisions of Article 27, paragraphs (2) to (6), the first sentence of paragraph (7), and Article 28, paragraphs (5) to (8) apply mutatis mutandis to a Certification of Change of Category of Condition of Need for Long-Term Care as prescribed in the preceding paragraph. In this case, the necessary technical replacement of the terms of these provisions shall be provided by a Cabinet Order.

When an Insured Person that was issued a Certification of Needed Long-Term Care is subject to any of the following items, a Municipality may rescind said Certification of Needed Long-Term Care. In this case, the Municipality, when it determines it necessary with regard to the qualification of an Insured Person, may, pursuant to the provisions of Order of the Ministry of Health, Labour, and Welfare, the Municipality is to request the Insured Person pertaining to said rescission to submit said Certificate of Insured Person, delete the entry of matters listed in each item of Article 27, paragraph (7), and return the Certificate of Insured Person to the Insured Person:

when the Insured Person fails to comply with an investigation pursuant to the provisions of Article 27, paragraph (2) as applied mutatis mutandis pursuant to the preceding Article, paragraph (2) and the following, or Article 27, paragraph (2) as applied mutatis mutandis pursuant to paragraph (3) (in a case when said investigation is entrusted pursuant to the provisions of Article 24-2, paragraph (1), item (ii), Article 28, paragraph (5) as applied mutatis mutandis pursuant to Article 24-2, paragraph (1), item (iithe preceding Article, paragraph (2), the precedingor Article 28, paragraph (2), or the following 5) as applied mutatis mutandis pursuant to paragraph (3), including an investigation pertaining to said entrustment) without a justifiable reason, or when the Insured Person fails to act in compliance with an order for diagnosis pursuant to the provisions of the proviso of Article 27, paragraph (3) as applied mutatis mutandis pursuant to the preceding Article, paragraph (2), andor the following proviso of Article 27, paragraph (3) as applied mutatis mutandis pursuant to paragraph (3).

The provisions of Article 27, paragraphs (2) to (4), the first sentence A Municipality, when it has made a rescission of Certification of paragraph (5), paragraph (6), the first sentenceNeeded Long-Term Care pursuant to the provisions of the preceding paragraph (7), and Article 28, paragraphs (5) limited to the part pertaining to item (ii)), is to (8) apply mutatis mutandis notify the Insured Person pertaining to asaid rescission of a Certification of Needed Long-Term Care pursuant to the provisions of the preceding paragraph, item (i). In this case,that fact, pursuant to the necessary technical replacementprovisions of Order of the termsMinistry of these provisions shall be provided by a Cabinet OrderHealth, Labour and Welfare.

The provisions of Article 27, paragraphs (2) to (4), the first sentence of paragraph (5), paragraph (6), the first sentence of paragraph (7), and Article 28, paragraphs (5) to (8) apply mutatis mutandis to a rescission of Certification of Needed Long-Term Care pursuant to the provisions of paragraph (1) (limited to the part pertaining to item (i)). In this case, the necessary technical replacement of the terms of these provisions shall be provided by a Cabinet Order.

An Insured Person that intends to receive a Certification of Needed Support, pursuant to the provisions of Order of the Ministry of Health, Labour and Welfare, must submit to a Municipality a writtenan application with the Certificate of Insured Person attached. In this case, said Insured Person may, pursuant to the provisions of Order of the Ministry of Health, Labour and Welfare, have a provider or facility listed in the items of Article 27, paragraph (1) perform the procedures pertaining to said application on behalf of the Insured Person.

A Municipality, when providing Certification of Needed Support based on the results of an examination and judgment of a Certification Committee that is notified pursuant to the provisions of the first sentence of paragraph (4), is to notify the Insured Person pertaining to said Certification of Needed Support of said result. In this case, a Municipality shall enter the following items on notify said Insured Person, pursuant to the Certificateprovisions of Insured PersonOrder of said Insured Person and return the Certificatethe Ministry of Health, Labour and Welfare, of Insured Person to the Insured Personfollowing items:

A Municipality, when it is determined that the Insured Person predating pertaining to the application as set forth in paragraph (1) fails to qualify the as a Person Requiring Support based on the results of an examination and judgment of a Certification Committee that is notified pursuant to the provisions of the first sentence of paragraph (4), is to notify said Insured Person pertaining of, pursuant to the results, indicating provisions of Order of the reasons, and return the Certificate of Insured Person to said Insured PersonMinistry of Health, Labour and Welfare, of that fact, indicating the reasons.

A Municipality, when it is determined that an Insured Person that has been issued a Certification of Needed Support qualifies for a Category of Needed Support Condition other than the Category of Needed Support Condition pertaining to said Certification of Needed Support due to a lowering of the degree of Needed Support Condition, may certify a change of Category of Needed Support Condition. In this case, the Municipality is to request the Insured Person pertaining, when it is determined to said change of certification to submit said Certificatebe necessary regarding the qualification of an Insured Person, shall enter the Category of Needed Support Condition pertainingmay, pursuant to said change of certification and the opinionprovisions of the Certification Committee pursuant to the provisionsOrder of the second sentenceMinistry of Article 32, paragraph (4) as applied mutatis mutandis pursuant toHealth, Labour and Welfare, request the following paragraph (limited to thoseInsured Person pertaining to matters listed in item (ii)said change of the same paragraph), and then return theCertification to submit said Certificate of Insured Person to the Insured Person.

The provisions of Article 28, paragraph (5) to paragraph (8), and Article 32, paragraph (2) to paragraph (5), and the first sentence of paragraph (6),6) apply mutatis mutandis to a certificationCertification of Changechange of Category of Needed Support Condition as prescribed in the preceding paragraph. In this case, the necessary technical replacement of terms of these provisions is specified by a Cabinet Order.

When an Insured Person to whom has been issued a Certification of Needed Support is subject to any of the following items, a Municipality may rescind said Certification of Needed Support. In this case, the Municipality, when it is determined to be necessary regarding the qualification of an Insured Person, may, pursuant to the provisions of Order of the Ministry of Health, Labour, and Welfare, is to request the Insured Person pertaining to said rescission to submit said Certificate of Insured Person, delete the entry of matters listed in the each item of Article 32, paragraph (6), and return the Certificate of Insured Person to the Insured Person. These items are:.

when the Insured Person fails to qualify aftercomply with an investigation pursuant to the provisions of Article 27, paragraph (2) as applied mutatis mutandis pursuant to the provisions of Article 32, paragraph (2) as applied mutatis mutandis pursuant to the preceding Article, paragraph (2), or the followingArticle 27, paragraph (in a case when said investigation is entrusted2) as applied mutatis mutandis pursuant to the provisions of Article 2832, paragraph (52) as applied mutatis mutandis pursuant to paragraph (3) (in a case when said investigation is entrusted pursuant to the provisions of Article 24-2, paragraph (1), item (ii) or , Article 28, paragraph (2) of 5) as applied mutatis mutandis pursuant to the preceding Article , paragraph (2), or the followingArticle 28, paragraph (5) as applied mutatis mutandis pursuant to paragraph (3), including an investigation pertaining to said entrustment) without a justifiable reason, or when the Insured Person fails to act in compliance with an order for diagnosis pursuant to the provisions of the proviso of Article 27, paragraph (3) as applied mutatis mutandis pursuant to the provisions of Article 32, paragraph (2) as applied mutatis mutandis pursuant to the following paragraph (3).

The provisions of Article 28, paragraph (5) to paragraph (8), Article 32, paragraph (2), paragraph (3),A Municipality, when it has made a rescission of Certification of Needed Support pursuant to the first sentenceprovisions of paragraph (4),the preceding paragraph (5), andlimited to the first sentence of paragraph (6) apply mutatis mutandis part pertaining to item (ii)), is to notify the Insured Person pertaining to asaid rescission of Certification of Needed Support pursuant to the provisions of the preceding paragraph, item (i). In this case,that fact, pursuant to the necessary technical replacementprovisions of terms for these provisions is specified by a Cabinet OrderOrder of the Ministry of Health, Labour and Welfare.

The provisions of Article 28, paragraph (5) to paragraph (8), Article 32, paragraph (2), paragraph (3), the first sentence of paragraph (4), paragraph (5), and the first sentence of paragraph (6) apply mutatis mutandis to a rescission of Certification of Needed Support pursuant to the provisions of paragraph (1) (limited to the part pertaining to item (i)). In this case, the necessary technical replacement of terms for these provisions is specified by a Cabinet Order.

A Municipality, when a notification was issued pursuant to the provisions of the preceding paragraph, may deem that the Insured Person pertaining to said notification has submitted an application as set forth in Article 32, paragraph (1), the Municipality requested the Certification Committee to conduct an examination or issue a judgment pursuant to the provisions of paragraph (3) of the same Article and the Municipality received a notification by the Certification Committee pursuant to the provisions of paragraph (4) of the same Article, and may issue the Insured Person a Certification of Needed Support. In this case, the Municipality is to notify said Insured Person , pursuant to the provisions of Order of the Ministry of Health, Labour and Welfare, that a Certification of Needed Support is provided, enter and of the matters listed in each item of paragraph (6) of the same Article on the Certificate of Insured Person of said Insured Person, and return the Certificate of Insured Person to the Insured Person.

A Municipality, when a notification is issued pursuant to the provisions of the preceding paragraph, may deem that the Insured Person pertaining to said notification submitted an application as set forth in Article 27, paragraph (1), the Municipality requested the Certification Committee for a judgment or to conduct an examination pursuant to the provisions of paragraph (4) of the same Article, and the Municipality is provided a notification of the Certification Committee pursuant to the provisions of paragraph (5) of the same Article, and may issue the Insured Person a Certification of Needed Long-Term Care. In this case, the Municipality is to notify said Insured Person , pursuant to the provisions of Order of the Ministry of Health, Labour and Welfare, that a Certification of Needed Long-Term Care is provided, enter and of the matters listed in each item of paragraph (7) of the same Article on the Certificate of Insured Person of said Insured Person, and return the Certificate of Insured Person to the Insured Person.

A Certification Committee, when it is determined that an Insured Person that is the subject of a requested examination or judgment pursuant to the provisions of Article 27, paragraph (4) as applied mutatis mutandis pursuant to Article 31, paragraph (2) is certified3) qualifies as a Person Requiring Support although said Insured Person fails to qualify as a Person Requiring Long-Term Care, may notify said result to the Municipality, notwithstanding the provision of Article 27, paragraph (5) as applied mutatis mutandis pursuant to Article 31, paragraph (23).

A Municipality, when a notification is issued pursuant to the provisions of the preceding paragraph, may deem that the Insured Person pertaining to said notification submitted an application as set forth in Article 32, paragraph (1), the Municipality requested the Certification Committee for an examination or judgment pursuant to the provisions of paragraph (3) of the same Article, and the Municipality received a notification of the Certification Committee pursuant to the provisions of paragraph (4) of the same Article, and may issue said Insured Person a Certification of Needed Support. In this case, the Municipality is to notify the Insured Person pertaining to said notification, pursuant to the provisions of Order of the Ministry of Health, Labour, and Welfare, is to request to Insured Person pertaining to said notification to submit such Insured Person's Certificatethat a Certification of Needed Support is provided and of Insured Person, enter the matters listed in each item of paragraph (6) of the same Article, and return the Certificate of Insured Person to the Insured Person.

In the case referred to in the preceding paragraph, the Municipality, when it is determined to be necessary regarding the qualification of an Insured Person, may request the Insured Person prescribed in that paragraph to submit the Certificate of Insured Person, pursuant to the provisions of Order of the Ministry of Health, Labour and Welfare.