Article 106Relationship with the Medical Care Act
第百六条（医療法との関係等）
A Long-Term Care Health Facility is not a hospital or a clinic as used in the Medical Care Act; provided, however, that the terms "hospital" and "clinic" in provisions of laws and regulations other than the same Act and orders based on it (excluding the provisions of the Health Insurance Act, the National Health Insurance Act and other laws and regulations that are specified by Cabinet Order) include a Long-Term Care Health Facility (excluding, in the provisions of laws and regulations specified by Cabinet Order, those specified by Cabinet Order).
Subsection 3 Integrated Facilities for Medical and Long-Term Care
第三款 介護医療院
Article 107Approval for Establishment
第百七条（開設許可）
A person that intends to establish an integrated facility for medical and long-term care must obtain approval of the prefectural governor pursuant to the provisions of Order of the Ministry of Health, Labour and Welfare.
介護医療院を開設しようとする者は、厚生労働省令で定めるところにより、都道府県知事の許可を受けなければならない。
When a person that has established an integrated facility for medical and long-term care intends to change the capacity of residents of said integrated facility for medical and long-term care or other particulars specified by Order of the Ministry of Health, Labour and Welfare, the same applies as in the preceding paragraph.
A prefectural governor, in a case when the application of approval as set forth in the preceding two paragraphs is filed and when it corresponds to any of the following items (with regard to the application as set forth in the preceding paragraph, item (ii) or item (iii)), may not provide approval as set forth in the preceding two paragraphs:
when a person that intends to establish said integrated facility for medical and long-term care is not a local government, a medical juridical person, a social welfare juridical person, or other person as determined by the Minister of Health, Labour and Welfare;
当該介護医療院を開設しようとする者が、地方公共団体、医療法人、社会福祉法人その他厚生労働大臣が定める者でないとき。
when said integrated facility for medical and long-term care does not have the medical care rooms, consultation rooms, treatment rooms and functional training rooms prescribed in Article 111, paragraph (1), and the facilities specified by Prefectural Ordinance, or the personnel specified by Order of the Ministry of Health, Labour and Welfare and by Prefectural Ordinance as set forth in paragraph (2) of the same Article;
when it is determined that proper management of an integrated facility for medical and long-term care cannot be conducted in accordance with the standards pertaining to facilities and management of an integrated facility for medical and long-term care as prescribed in Article 111, paragraph (3);
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;
申請者が、拘禁刑以上の刑に処せられ、その執行を終わり、又は執行を受けることがなくなるまでの者であるとき。
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;
申請者が、この法律その他国民の保健医療若しくは福祉に関する法律で政令で定めるものの規定により罰金の刑に処せられ、その執行を終わり、又は執行を受けることがなくなるまでの者であるとき。
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;
申請者が、労働に関する法律の規定であって政令で定めるものにより罰金の刑に処せられ、その執行を終わり、又は執行を受けることがなくなるまでの者であるとき。
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;
申請者が、保険料等について、当該申請をした日の前日までに、納付義務を定めた法律の規定に基づく滞納処分を受け、かつ、当該処分を受けた日から正当な理由なく三月以上の期間にわたり、当該処分を受けた日以降に納期限の到来した保険料等の全てを引き続き滞納している者であるとき。
when the applicant has had approval rescinded pursuant to the provisions of Article 114-6, paragraph (1) or Article 115-35, paragraph (6) and five years have not elapsed from the date of said rescission (including, in the case where the person whose approval was rescinded is a juridical person, a person who was an Officer of said juridical person or a manager of the integrated facility for medical and long-term care that said juridical person established within sixty days prior to the date of notification pursuant to the provisions of Article 15 of the Administrative Procedure Act pertaining to said disposition of rescission and for whom five years have not elapsed from the date of said rescission, and including, in the case where the person whose approval was rescinded is a person who is not a juridical person among the persons specified by the Minister of Health, Labour and Welfare in item (i), a person who was a manager of the integrated facility for medical and long-term care established by said person within sixty days prior to the date of said notification and for whom five years have not elapsed from the date of said rescission). However, this does not apply where the rescission of the approval falls under a rescission of the approval of an integrated facility for medical and long-term care that is specified by Order of the Ministry of Health, Labour and Welfare as one found appropriate not to be treated as the rescission of approval prescribed in the main clause of this item, in consideration of the fact that constituted the ground for the disposition of rescission of the approval, the status of efforts toward the establishment of an operational control system by the establisher of said integrated facility for medical and long-term care to prevent the occurrence of said fact, and other matters concerning the degree of responsibility that the establisher of said integrated facility for medical and long-term care had in relation to said fact;
申請者が、第百十四条の六第一項又は第百十五条の三十五第六項の規定により許可を取り消され、その取消しの日から起算して五年を経過しない者（当該許可を取り消された者が法人である場合においては、当該取消しの処分に係る行政手続法第十五条の規定による通知があった日前六十日以内に当該法人の役員又はその開設した介護医療院の管理者であった者で当該取消しの日から起算して五年を経過しないものを含み、当該許可を取り消された者が第一号の厚生労働大臣が定める者のうち法人でないものである場合においては、当該通知があった日前六十日以内に当該者の開設した介護医療院の管理者であった者で当該取消しの日から起算して五年を経過しないものを含む。）であるとき。ただし、当該許可の取消しが、介護医療院の許可の取消しのうち当該許可の取消しの処分の理由となった事実及び当該事実の発生を防止するための当該介護医療院の開設者による業務管理体制の整備についての取組の状況その他の当該事実に関して当該介護医療院の開設者が有していた責任の程度を考慮して、この号本文に規定する許可の取消しに該当しないこととすることが相当であると認められるものとして厚生労働省令で定めるものに該当する場合を除く。
when the applicant is a person that submitted a notification of abolition pursuant to the provisions of Article 113, paragraph (2) 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 approval pursuant to the provisions of Article 114-6, paragraph (1) or Article 115-35, paragraph (6) to the date on which said disposition is made or the date on which a decision not to make a disposition is made (excluding a person that has a reasonable basis for said abolition), and five years have not elapsed from the date of said notification;
申請者が、第百十四条の六第一項又は第百十五条の三十五第六項の規定による許可の取消しの処分に係る行政手続法第十五条の規定による通知があった日から当該処分をする日又は処分をしないことを決定する日までの間に第百十三条第二項の規定による廃止の届出をした者（当該廃止について相当の理由がある者を除く。）で、当該届出の日から起算して五年を経過しないものであるとき。
when the applicant is a person that submitted a notification of abolition pursuant to the provisions of Article 113, paragraph (2) during the period from the date on which an inspection pursuant to the provisions of Article 114-2, paragraph (1) was conducted to the expected hearing decision date (meaning, where the prefectural governor has, pursuant to the provisions of Order of the Ministry of Health, Labour and Welfare, notified said applicant of a specific date within 10 days from the date on which said inspection was conducted as the date on which a decision is expected to be made, based on the result of said inspection, as to whether or not to hold a hearing pertaining to a disposition of rescission of the approval pursuant to the provisions of Article 114-6, paragraph (1), said specific date) (excluding a person that has a reasonable basis for said abolition), and five years have not elapsed from the date of said notification;
申請者が、第百十四条の二第一項の規定による検査が行われた日から聴聞決定予定日（当該検査の結果に基づき第百十四条の六第一項の規定による許可の取消しの処分に係る聴聞を行うか否かの決定をすることが見込まれる日として厚生労働省令で定めるところにより都道府県知事が当該申請者に当該検査が行われた日から十日以内に特定の日を通知した場合における当該特定の日をいう。）までの間に第百十三条第二項の規定による廃止の届出をした者（当該廃止について相当の理由がある者を除く。）で、当該届出の日から起算して五年を経過しないものであるとき。
in the case where a notification of abolition pursuant to the provisions of Article 113, paragraph (2) has been submitted within the period prescribed in item (ix), 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 of the juridical person pertaining to said notification (excluding a juridical person that has a reasonable basis for said abolition) or a manager of the integrated facility for medical and long-term care that said juridical person established, or a manager of an integrated facility for medical and long-term care established by a person who is not a juridical person among the persons specified by the Minister of Health, Labour and Welfare in item (i) pertaining to said notification (excluding a person that has a reasonable basis for said abolition), 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 for approval;
申請者が、許可の申請前五年以内に居宅サービス等に関し不正又は著しく不当な行為をした者であるとき。
when the applicant is a juridical person and any of its Officers, etc. is a person who corresponds to any of the provisions of item (iv) through the preceding item;
when the applicant is a person who is not a juridical person among the persons specified by the Minister of Health, Labour and Welfare in item (i), and among the person who manages the Business Office of the applicant and the other employees specified by Cabinet Order there is a person who corresponds to any of the provisions of item (iv) through item (xii);
申請者が、第一号の厚生労働大臣が定める者のうち法人でないもので、その事業所を管理する者その他の政令で定める使用人のうちに第四号から第十二号までのいずれかに該当する者のあるものであるとき。
A prefectural governor may decline to give the approval set forth in paragraph (1) to a person who intends to establish an integrated facility for medical and long-term care for the purpose of profit.
In a case when an application for the approval set forth in paragraph (1) or the approval set forth in paragraph (2) (limited to those pertaining to an increase in the maximum number of persons who may be admitted to the facility; hereinafter the same applies in this paragraph and the following paragraph) is filed, the prefectural governor, when it is determined that the total number of the maximum number of persons who may be admitted to integrated facilities for medical and long-term care in the area (which means an area specified by said prefecture pursuant to the provisions of Article 118, paragraph (2), item (i)) including the location of the facility pertaining to said application has already reached the total number of the required number of persons who may be admitted to integrated facilities for medical and long-term care in the area as prescribed in the Prefectural Insured Long-Term Care Support Project Plan specified by said prefecture pursuant to the provisions of paragraph (1) of the same Article, or will exceed said total number by the establishment of the facility pertaining to said application or the increase in the maximum number of persons who may be admitted to the facility, or when it is determined that it is likely to cause problems with the accomplishment of said Prefectural Insured Long-Term Care Support Project Plan, may decline to give the approval set forth in paragraph (1) or the approval set forth in paragraph (2).
都道府県知事は、第一項の許可又は第二項の許可（入所定員の増加に係るものに限る。以下この項及び次項において同じ。）の申請があった場合において、当該申請に係る施設の所在地を含む区域（第百十八条第二項第一号の規定により当該都道府県が定める区域とする。）における介護医療院の入所定員の総数が、同条第一項の規定により当該都道府県が定める都道府県介護保険事業支援計画において定めるその区域の介護医療院の必要入所定員総数に既に達しているか、又は当該申請に係る施設の開設若しくは入所定員の増加によってこれを超えることになると認めるとき、その他の当該都道府県介護保険事業支援計画の達成に支障を生ずるおそれがあると認めるときは、第一項の許可又は第二項の許可を与えないことができる。
A prefectural governor, when he or she intends to give the approval set forth in paragraph (1) or the approval set forth in paragraph (2), must provide notice of matters specified 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.
都道府県知事は、第一項の許可又は第二項の許可をしようとするときは、関係市町村長に対し、厚生労働省令で定める事項を通知し、相当の期間を指定して、当該関係市町村の第百十七条第一項に規定する市町村介護保険事業計画との調整を図る見地からの意見を求めなければならない。
Article 108Renewal of Approval
第百八条（許可の更新）
Approval as set forth in paragraph (1) of the preceding Article, if it is not renewed within a period of six years, ceases to be effective when said period expires.
前条第一項の許可は、六年ごとにその更新を受けなければ、その期間の経過によって、その効力を失う。
In a case of application for renewal as set forth in the preceding paragraph, when a final determination of the application does not occur prior to the expiry of the period as set forth in the same paragraph (hereinafter referred to as "Effective Period of Approval" in this Article), the prior approval remains in force after expiry of the Effective Period of Approval until a determination is reached regarding said application.
In a case as set forth in the preceding paragraph, when the approval is renewed, said Effective Period of Approval is to be from the date following the date of expiry of the prior Effective Period of Approval.
The provisions of the preceding Article apply mutatis mutandis to renewal of approval as set forth in paragraph (1).
An establisher of an integrated facility for medical and long-term care must have a physician approved by the prefectural governor manage said integrated facility for medical and long-term care.
介護医療院の開設者は、都道府県知事の承認を受けた医師に当該介護医療院を管理させなければならない。
Notwithstanding the provisions of the preceding paragraph, an establisher of an integrated facility for medical and long-term care may obtain approval of the prefectural governor and have a person other than a physician manage said integrated facility for medical and long-term care.
An establisher of an integrated facility for medical and long-term care must endeavor to provide appropriate service at an integrated facility for medical and long-term care, in accordance with the standards concerning facilities and management of an integrated facility for medical and long-term care as prescribed in paragraph (3) of the following Article, according to the mental and physical condition, etc., of a Person Requiring Long-Term Care, and to always provide said service from the viewpoint of the person that receives service at an integrated facility for medical and long-term care, by implementing self-evaluation of the quality of the service at an integrated facility for medical and long-term care that the establisher provides and by other measures.
An establisher of an integrated facility for medical and long-term care, when an Opinion of the Certification Committee is entered on the certificate of insured person that is presented by an Insured Person that intends to receive service at an integrated facility for medical and long-term care, must endeavor to provide said service at an integrated facility for medical and long-term care to said Insured Person in consideration of said Opinion of the Certification Committee.
第百十一条
An integrated facility for medical and long-term care must have medical care rooms, consultation rooms, treatment rooms and functional training rooms pursuant to the provisions of Order of the Ministry of Health, Labour and Welfare, as well as facilities specified by Prefectural Ordinance.
介護医療院は、厚生労働省令で定めるところにより療養室、診察室、処置室及び機能訓練室を有するほか、都道府県の条例で定める施設を有しなければならない。
An integrated facility for medical and long-term care must have physicians and nurses in the number specified by Order of the Ministry of Health, Labour and Welfare, as well as Long-Term Care Support Specialists and employees that engage in care and other duties in the number specified by Prefectural Ordinance.
In addition to what is prescribed in the preceding two paragraphs, the standards concerning facilities and management of an integrated facility for medical and long-term care are specified by Prefectural Ordinance.
A prefecture, in establishing the Prefectural Ordinance set forth in the preceding three paragraphs, is to establish the following matters in accordance with the standards specified by Order of the Ministry of Health, Labour and Welfare, and is to take into consideration the standards specified by Order of the Ministry of Health, Labour and Welfare for other matters:
都道府県が前三項の条例を定めるに当たっては、次に掲げる事項については厚生労働省令で定める基準に従い定めるものとし、その他の事項については厚生労働省令で定める基準を参酌するものとする。
Long-Term Care Support Specialists and employees that engage in care and other duties, and their number;
介護支援専門員及び介護その他の業務に従事する従業者並びにそれらの員数
matters concerning the management of an integrated facility for medical and long-term care that are specified by Order of the Ministry of Health, Labour and Welfare as being closely related to the appropriate use of services by Persons Requiring Long-Term Care who are admitted, appropriate treatment, ensuring of safety, and maintaining of confidentiality.
The Minister of Health, Labour and Welfare, when intending to provide the standards specified by Order of the Ministry of Health, Labour and Welfare as prescribed in the preceding paragraph (limited to the part pertaining to the handling of service at an integrated facility for medical and long-term care), must hear the opinion of the Social Security Council in advance.
An establisher of an integrated facility for medical and long-term care, when it has submitted a notification of abolition or suspension pursuant to the provisions of Article 113, paragraph (2), must provide convenience, such as coordination with the establishers of other integrated facilities for medical and long-term care and other persons concerned, to persons who were receiving said service at an integrated facility for medical and long-term care on the day before the date of said notification and who wish to continue to be provided with service equivalent to said service at an integrated facility for medical and long-term care on or after the date of said abolition or suspension, so that necessary In-Home Service, etc. is continuously provided.
An establisher of an integrated facility for medical and long-term care 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 its duties for a Person Requiring Long-Term Care.