Long-Term Care Insurance Act

An appointment as service provider as set forth in the main clause of Article 54-2, paragraph (1) is to be made, pursuant to the provisions of Order of the Ministry of Health, Labour and Welfare, upon application of a person that conducts a Community-Based Preventive Long-Term Care Business, for each type of Community-Based Service for Preventive Long-Term Care and each Business Office that conducts a Community-Based Preventive Long-Term Care Business pertaining to the type of said Community-Based Service for Preventive Long-Term Care (hereinafter referred to as "Business Office" in this Section), and is to have effect with regard to payment of an allowance for Community-Based Service for Preventive Long-Term Care and an exceptional allowance for Community-Based Service for Preventive Long-Term Care to an Insured Person of Long-Term Care Insurance (in the case of the appointment pertaining to Specified Community-Based Service for Preventive Long-Term Care, including an Insured In-Home Person Requiring Support to Whom the Domicile Exception Applies who has Admission, etc. to a Facility Subject to Domicile Exception located within the area of said Municipality) provided by a Municipality of which the mayor of the Municipality who makes said appointment is the head.

A mayor of a Municipality, in a case of an application as set forth in the preceding paragraph, when the application corresponds to any of the following items, may not provide appointment as service provider as set forth in the main clause of Article 54-2, paragraph (1):

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

when knowledge, skill and number of employees of the Business Office pertaining to said application do not meet the standards specified by Municipal Ordinance as set forth in Article 115-14, paragraph (1) or the fixed minimum number of employees specified by Municipal Ordinance as set forth in the same paragraph, or the standards concerning employees that engage in Designated Community-Based Service for Preventive Long-Term Care as prescribed in paragraph (5) of the same Article;

when it is determined that the applicant cannot properly operate a Community-Based Preventive Long-Term Care Business in accordance with the standards concerning effective methods of support for Prevention of Long-Term Care pertaining to Designated Community-Based Service for Preventive Long-Term Care or the standards concerning facilities and management of the business of Designated Community-Based Service for Preventive Long-Term Care as prescribed in Article 115-14, paragraph (2) or paragraph (5);

when the Business Office pertaining to said application is located outside the area of said Municipality and the consent of the mayor of the Municipality of said location has not yet obtained;

when the applicant is punished by imprisonment or a severer punishment and execution of said punishment has not yet 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 arrived on or after the day of receiving said disposition;

when the applicant (excluding an applicant for designation pertaining to Preventive Long-Term Care for a Dementia Patient in Communal Living) is a person whose designation (excluding designation pertaining to Preventive Long-Term Care for a Dementia Patient in Communal Living) has been rescinded pursuant to the provisions of Article 115-19 (excluding items (ii) through (v)) 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 that 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 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 that 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 Provider of Community-Based Service for Preventive Long-Term Care, in consideration of the facts that were the grounds for the disposition of said rescission, the status of efforts by said Designated Provider of Community-Based Service for Preventive Long-Term Care 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 Provider of Community-Based Service for Preventive Long-Term Care had in relation to said facts;

when the applicant (limited to an applicant for designation pertaining to Preventive Long-Term Care for a Dementia Patient in Communal Living) is a person whose designation (limited to designation pertaining to Preventive Long-Term Care for a Dementia Patient in Communal Living) has been rescinded pursuant to the provisions of Article 115-19 (excluding items (ii) through (v)) 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 that 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 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 that 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 Provider of Community-Based Service for Preventive Long-Term Care, in consideration of the facts that were the grounds for the disposition of said rescission, the status of efforts by said Designated Provider of Community-Based Service for Preventive Long-Term Care 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 Provider of Community-Based Service for Preventive Long-Term Care had in relation to said facts;

when a person that has a close relationship with the applicant is a person whose designation has been rescinded pursuant to the provisions of Article 115-19 (excluding items (ii) through (v)) 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 Provider of Community-Based Service for Preventive Long-Term Care, in consideration of the facts that were the grounds for the disposition of said rescission, the status of efforts by said Designated Provider of Community-Based Service for Preventive Long-Term Care 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 Provider of Community-Based Service for Preventive Long-Term Care had in relation to said facts;

when the applicant is a person that provided notification of abolishment of business pursuant to the provisions of Article 115-15, paragraph (2) 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 115-19 (except for items (ii) through (v)) to the date when said disposition is made or the date when it is determined not to make a disposition (except for a person that has a reasonable basis for abolishment of said business), and five years have not elapsed from the date of said notification;

in the case where a notification of abolishment of business pursuant to the provisions of Article 115-15, paragraph (2) has been submitted within the period prescribed in the preceding item, when the applicant is a person that was, within sixty days prior to the date of notification set forth in the same item, 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 is a person that performed 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 (excluding an applicant for designation pertaining to Preventive Long-Term Care for a Dementia Patient in Communal Living) is a juridical person and any of its Officers, etc. is a person who corresponds to any of item (iv)-2 through item (vi) or the preceding three items;

when the applicant (limited to an applicant for designation pertaining to Preventive Long-Term Care for a Dementia Patient in Communal Living) is a juridical person and any of its Officers, etc. is a person who corresponds to any of item (iv)-2 through item (v)-3, item (vi)-2, or item (vii) through item (viii);

when the applicant (excluding an applicant for designation pertaining to Preventive Long-Term Care for a Dementia Patient in Communal Living) 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 (iv)-2 through item (vi) or item (vii) through item (viii);

when the applicant (limited to an applicant for designation pertaining to Preventive Long-Term Care for a Dementia Patient in Communal Living) 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 (iv)-2 through item (v)-3, item (vi)-2, or item (vii) through item (viii).

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, in a case when an application as set forth in paragraph (1) is filed and the application corresponds to any of the following items, may determine not to provide an appointment as service provider as set forth in the main clause of Article 54-2, paragraph (1):

when the applicant (excluding an applicant for designation pertaining to Preventive Long-Term Care for a Dementia Patient in Communal Living) is a person whose designation (excluding designation pertaining to Preventive Long-Term Care for a Dementia Patient in Communal Living) has been rescinded pursuant to the provisions of Article 115-19, item (ii) through item (v) 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);

when the applicant (limited to an applicant for designation pertaining to Preventive Long-Term Care for a Dementia Patient in Communal Living) is a person whose designation (limited to designation pertaining to Preventive Long-Term Care for a Dementia Patient in Communal Living) has been rescinded pursuant to the provisions of Article 115-19, item (ii) through item (v) 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);

when a person who has a close relationship with the applicant has had the appointment as service provider rescinded pursuant to the provisions of Article 115-19, item (ii) to item (v) and five years have not elapsed from the date of said rescission;

when the applicant is a person who has provided notification of abolishment of business pursuant to the provisions of Article 115-15, paragraph (2) (except for a person that has a reasonable basis for said abolishment of business) during the period 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 115-19, items (ii) to (v) 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 115-15, 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 115-17, 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 115-19, 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 115-15, paragraph (2) has been provided during the period prescribed in item (ii), 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 (excluding an applicant for designation pertaining to Preventive Long-Term Care for a Dementia Patient in Communal Living) is a juridical person and any of its Officers, etc., is a person who falls under item (i) or any of the preceding three items;

when the applicant (limited to an applicant for designation pertaining to Preventive Long-Term Care for a Dementia Patient in Communal Living) is a juridical person and any of its Officers, etc., is a person who falls under item (i)-2 or any of item (ii) through item (ii)-3;

when the applicant (excluding an applicant for designation pertaining to Preventive Long-Term Care for a Dementia Patient in Communal Living) is a Business Office that is not a juridical person and the manager of the Business Office is a person who falls under item (i) or any of item (ii) through item (ii)-3;

when the applicant (limited to an applicant for designation pertaining to Preventive Long-Term Care for a Dementia Patient in Communal Living) is a Business Office that is not a juridical person and the manager of the Business Office is a person who falls under item (i)-2 or any of item (ii) through item (ii)-3.

A mayor of a Municipality, when intending to designate an appointment as service provider as set forth in the main clause of Article 54-2, paragraph (1), must endeavor to take necessary measures in advance in order to reflect opinions of Insured Persons of Long-Term Care Insurance provided by said Municipality and other relevant persons.

A mayor of a Municipality, when providing an appointment as service provider as set forth in the main clause of Article 54-2, paragraph (1), may add a provision that is determined to be necessary for ensuring appropriate operation of said business.

The provisions of Article 78-2, paragraph (9) to paragraph (11) apply mutatis mutandis to appointment as service provider as set forth in the main clause of Article 54-2, paragraph (1). In this case, necessary technical replacement of terms is provided by a Cabinet Order.