介護保険法
Long-Term Care Insurance Act
平成九年十二月十七日法律第百二十三号
Act No. 123 of December 17, 1997
第一章 総則 (第一条―第八条の二)
Chapter I General Provisions (Articles 1 to 8-2)
第二章 被保険者 (第九条―第十三条)
Chapter II Insured Persons (Articles 9 to 13)
第三章 介護認定審査会 (第十四条―第十七条)
Chapter III Certification Committee of Needed Long-Term Care (Articles 14 to 17)
第四章 保険給付
Chapter IV Insurance Benefits
第一節 通則 (第十八条―第二十六条)
Section 1 General Rules (Articles 18 to 26)
第二節 認定 (第二十七条―第三十九条)
Section 2 Certification (Articles 27 to 39)
第三節 介護給付 (第四十条―第五十一条の三)
Section 3 Long-Term Care Benefits (Articles 40 to 51-3)
第四節 予防給付 (第五十二条―第六十一条の三)
Section 4 Prevention Benefits (Articles 52 to 61-3)
第五節 市町村特別給付 (第六十二条)
Section 5 Municipal Special Benefits (Article 62)
第六節 保険給付の制限等 (第六十三条―第六十九条)
Section 6 Limitation on Insurance Benefits, etc. (Articles 63 to 69)
第五章 介護支援専門員並びに事業者及び施設
Chapter V Long-Term Care Support Specialists, Providers, and Facilities
第一節 介護支援専門員
Section 1 Long-Term Care Support Specialists
第一款 登録等 (第六十九条の二―第六十九条の十)
Subsection 1 Registration, etc. (Articles 69-2 to 69-10)
第二款 登録試験問題作成機関の登録、指定試験実施機関及び指定研修実施機関の指定等 (第六十九条の十一―第六十九条の三十三)
Subsection 2 Registration of an Organization that Prepares Registration Examination Questions, and Appointment of a Designated Testing Agencies and Designated Training Agency (Articles 69-11 to 69-33)
第三款 義務等 (第六十九条の三十四―第六十九条の三十九)
Subsection 3 Obligations, etc. (Articles 69-34 to 69-39)
第二節 指定居宅サービス事業者 (第七十条―第七十八条)
Section 2 Designated In-Home Service Providers (Articles 70 to 78)
第三節 指定地域密着型サービス事業者 (第七十八条の二―第七十八条の十一)
Section 3 Designated Community-Based Service Providers (Articles 78-2 to 78-11)
第四節 指定居宅介護支援事業者 (第七十九条―第八十五条)
Section 4 Designated In-Home Long-Term Care Support Providers (Articles 79 to 85)
第五節 介護保険施設
Section 5 Facilities Covered by Long-Term Care Insurance
第一款 指定介護老人福祉施設 (第八十六条―第九十三条)
Subsection 1 Designated Facilities Covered by Public Aid Providing Long-Term Care to the Elderly (Articles 86 to 93)
第二款 介護老人保健施設 (第九十四条―第百六条)
Subsection 2 Long-Term Care Health Facilities (Articles 94 to 106)
第三款 指定介護療養型医療施設 (第百七条―第百十五条)
Subsection 3 Designated Medical Long-Term Care Sanatoriums (Articles 107 to 115)
第六節 指定介護予防サービス事業者 (第百十五条の二―第百十五条の十)
Section 6 Designated Providers of Preventive Service to Long-Term Care (Articles 115-2 to 115-10)
第七節 指定地域密着型介護予防サービス事業者 (第百十五条の十一―第百十五条の十九)
Section 7 Designated Providers of Community-Based Preventive Service of Long-Term Care (Articles 115-12 to 115-19)
第八節 指定介護予防支援事業者 (第百十五条の二十―第百十五条の二十八)
Section 8 Designated Providers of Support for Prevention of Long-Term Care (Articles 115-20 to 115-28)
第九節 介護サービス情報の公表 (第百十五条の二十九―第百十五条の三十七)
Section 9 Publication of Long-Term Care Service Information (Articles 115-29 to 115-37)
第六章 地域支援事業等 (第百十五条の三十八―第百十五条の四十一)
Chapter VI Community Support Projects, etc. (Articles 115-38 to 115-41)
第七章 介護保険事業計画 (第百十六条―第百二十条)
Chapter VII Insured Long-Term Care Service Plans (Articles 116 to 120)
第八章 費用等
Chapter VIII Expenses, etc.
第一節 費用の負担 (第百二十一条―第百四十六条)
Section 1 Imposition of Expenses (Articles 121 to 146)
第二節 財政安定化基金等 (第百四十七条―第百四十九条)
Section 2 Fiscal Stability Funds (Articles 147 to 149)
第三節 医療保険者の納付金 (第百五十条―第百五十九条)
Section 3 Levies for Medical Insurers (Articles 150 to 159)
第九章 社会保険診療報酬支払基金の介護保険関係業務 (第百六十条―第百七十五条)
Chapter IX Business Related to Insured Long-Term Care for Social Insurance Medical Fee Payment Funds (Articles 160 to 175)
第十章 国民健康保険団体連合会の介護保険事業関係業務 (第百七十六条―第百七十八条)
Chapter X Business Related to a Long-Term Care Insurance Project for the Federation of National Health Insurance Associations (Articles 176 to 178)
第十一章 介護給付費審査委員会 (第百七十九条―第百八十二条)
Chapter XI Examination Committee for Long-Term Care Benefit Expense (Articles 179 to 182)
第十二章 審査請求 (第百八十三条―第百九十六条)
Chapter XII Application for Examination (Articles 183 to 196)
第十三章 雑則 (第百九十七条―第二百四条)
Chapter XIII Miscellaneous Provisions (Articles 197 to 204)
第十四章 罰則 (第二百五条―第二百十五条)
Chapter XIV Penalty Provisions (Articles 205 to 215)
附 則
Supplementary Provisions
第一章 総則
Chapter I General Provisions
(目的)
(Purposes)
第一条 この法律は、加齢に伴って生ずる心身の変化に起因する疾病等により要介護状態となり、入浴、排せつ、食事等の介護、機能訓練並びに看護及び療養上の管理その他の医療を要する者等について、これらの者が尊厳を保持し、その有する能力に応じ自立した日常生活を営むことができるよう、必要な保健医療サービス及び福祉サービスに係る給付を行うため、国民の共同連帯の理念に基づき介護保険制度を設け、その行う保険給付等に関して必要な事項を定め、もって国民の保健医療の向上及び福祉の増進を図ることを目的とする。
Article 1 The purposes of this Act are to improve health and medical care and to enhance the welfare of citizens. With regard to people who are under condition of need for long-term care due to disease, etc., as a result of physical or emotional changes caused by aging, and who require care such as for bathing, bodily waste elimination, meals, etc., and require the functional training, nursing, management of medical treatment, and other medical care, these purposes are to be accomplished by establishing a long-term care insurance system based on the principle of the cooperation of citizens, solidarity, and determining necessary matters concerning related insurance benefits, etc., in order to provide benefits pertaining to necessary health and medical services and public aid services so that these people are able to maintain dignity and an independent daily life routine according to each person's own level of abilities.
(介護保険)
(Long-Term Care Insurance)
第二条 介護保険は、被保険者の要介護状態又は要支援状態に関し、必要な保険給付を行うものとする。
Article 2 (1) Long-Term Care Insurance shall provide necessary insurance benefits for a Condition of Need for Long-Term Care or for a Needed Support Condition of the insured person.
2 前項の保険給付は、要介護状態又は要支援状態の軽減又は悪化の防止に資するよう行われるとともに、医療との連携に十分配慮して行われなければならない。
(2) Insurance benefits as set forth in the preceding paragraph shall be provided in order to contribute to reduction or prevention of aggravation of a Condition of Need for Long-Term Care or a Needed Support Condition, and shall be provided with careful attention to cooperation with medical care.
3 第一項の保険給付は、被保険者の心身の状況、その置かれている環境等に応じて、被保険者の選択に基づき、適切な保健医療サービス及び福祉サービスが、多様な事業者又は施設から、総合的かつ効率的に提供されるよう配慮して行われなければならない。
(3) Insurance benefits as set forth in paragraph (1) shall be provided in consideration of the appropriate health and medical services and public aid services that are offered by diverse providers and facilities comprehensively and effectively, according to the physical and mental conditions of the insured person, said person's environment, etc., and based on the preferences of the insured person.
4 第一項の保険給付の内容及び水準は、被保険者が要介護状態となった場合においても、可能な限り、その居宅において、その有する能力に応じ自立した日常生活を営むことができるように配慮されなければならない。
(4) With regard to the contents and level of insurance benefits as set forth in paragraph (1), it shall be considered that said person is able to live an independent daily life according to that person's own abilities in his or her home as much as possible, although said insured person becomes in a Condition of Need for Long-Term Care.
(保険者)
(Insurers)
第三条 市町村及び特別区は、この法律の定めるところにより、介護保険を行うものとする。
Article 3 (1) Municipalities and special city wards shall provide Long-Term Care Insurance pursuant to the provisions of this Act.
2 市町村及び特別区は、介護保険に関する収入及び支出について、政令で定めるところにより、特別会計を設けなければならない。
(2) Municipalities and special city wards shall establish a special account for income and expenses regarding Long-Term Care Insurance pursuant to the provisions of Cabinet Orders.
(国民の努力及び義務)
(Citizen's Efforts and Obligations)
第四条 国民は、自ら要介護状態となることを予防するため、加齢に伴って生ずる心身の変化を自覚して常に健康の保持増進に努めるとともに、要介護状態となった場合においても、進んでリハビリテーションその他の適切な保健医療サービス及び福祉サービスを利用することにより、その有する能力の維持向上に努めるものとする。
Article 4 (1) A citizen shall be aware of his or her physical and mental changes due to aging and shall always strive to maintain and enhance good health in order to prevent becoming in a Condition of Need for Long-Term Care. In a case of becoming in a Condition of Need for Long-Term Care, a citizen shall strive to maintain and improve his or her existing abilities through the willing use of rehabilitation and other appropriate health and medical services and public aid services.
2 国民は、共同連帯の理念に基づき、介護保険事業に要する費用を公平に負担するものとする。
(2) Citizens shall be equally subjected to the expenses necessary for an Insured Long-Term Care Project, based on the principle of cooperation and solidarity.
(国及び都道府県の責務)
(Responsibilities of the National and Prefectural Governments)
第五条 国は、介護保険事業の運営が健全かつ円滑に行われるよう保健医療サービス及び福祉サービスを提供する体制の確保に関する施策その他の必要な各般の措置を講じなければならない。
Article 5 (1) The national government shall undertake measures to ensure the system of providing health and medical services and public aid services, and every other necessary action for the healthy and efficient operation of an Insured Long-Term Care Project.
2 都道府県は、介護保険事業の運営が健全かつ円滑に行われるように、必要な助言及び適切な援助をしなければならない。
(2) Prefectural governments shall provide necessary advice and appropriate support for the healthy and efficient operation of an Insured Long-Term Care Project.
(医療保険者の協力)
(Cooperation of Medical Insurers)
第六条 医療保険者は、介護保険事業が健全かつ円滑に行われるよう協力しなければならない。
Article 6 Medical insurers shall cooperate for the healthy and efficient operation of an Insured Long-Term Care Project.
(定義)
(Definitions)
第七条 この法律において「要介護状態」とは、身体上又は精神上の障害があるために、入浴、排せつ、食事等の日常生活における基本的な動作の全部又は一部について、厚生労働省令で定める期間にわたり継続して、常時介護を要すると見込まれる状態であって、その介護の必要の程度に応じて厚生労働省令で定める区分(以下「要介護状態区分」という。)のいずれかに該当するもの(要支援状態に該当するものを除く。)をいう。
Article 7 (1) The term "Condition of Need for Long-Term Care" as used in this Act means a condition assumed to require care on a continual and steady basis for the whole or a part of basic movements in daily activities such as bathing, bodily waste elimination, meals, etc., due to physical or mental problems during the period specified by an Ordinance of the Ministry of Health, Labour, and Welfare, and said condition shall conforms to any of the categories stipulated by an Ordinance of the Ministry of Health, Labour, and Welfare according to the degree of needed care (herein referred to as a "Category of Condition of Need for Long-Term Care") (except when said condition is subject to a Needed Support Condition).
2 この法律において「要支援状態」とは、身体上若しくは精神上の障害があるために入浴、排せつ、食事等の日常生活における基本的な動作の全部若しくは一部について厚生労働省令で定める期間にわたり継続して常時介護を要する状態の軽減若しくは悪化の防止に特に資する支援を要すると見込まれ、又は身体上若しくは精神上の障害があるために厚生労働省令で定める期間にわたり継続して日常生活を営むのに支障があると見込まれる状態であって、支援の必要の程度に応じて厚生労働省令で定める区分(以下「要支援状態区分」という。)のいずれかに該当するものをいう。
(2) The term "Needed Support Condition" as used in this Act means a condition assumed to require care on a continual and steady basis during the period specified by an Ordinance of the Ministry of Health, Labour, and Welfare that especially contributes to the reduction or prevention of the aggravation of the condition requiring care for the whole or a part of basic movements in daily activities such as bathing, bodily waste elimination, meals, etc., due to physical or mental problems, or a condition assumed to cause continual difficulties in performing daily activities due to physical or mental problems during the period specified by an Ordinance of the Ministry of Health, Labour, and Welfare, and said condition shall conforms to any category as stipulated by an Ordinance of the Ministry of Health, Labour, and Welfare according to the degree of needed support (herein referred to as "Category of Needed Support Condition").
3 この法律において「要介護者」とは、次の各号のいずれかに該当する者をいう。
(3) The term "Person Requiring Long-Term Care" as used in this Act means a person defined by any of the following items:
一 要介護状態にある六十五歳以上の者
(i) a person that is in a Condition of Need for Long-Term Care and is the age of 65 or older;
二 要介護状態にある四十歳以上六十五歳未満の者であって、その要介護状態の原因である身体上又は精神上の障害が加齢に伴って生ずる心身の変化に起因する疾病であって政令で定めるもの(以下「特定疾病」という。)によって生じたものであるもの
(ii) a person that is in a Condition of Need for Long-Term Care and is the age of 40 to less than the age of 65, and the physical or mental problems that are the causes of said Condition of Need for Long-Term Care are a result of diseases that are caused by the physical or mental changes due to aging, specified by a Cabinet Order (herein referred to as "Specified Disease").
4 この法律において「要支援者」とは、次の各号のいずれかに該当する者をいう。
(4) The term "Person Requiring Support" as used in this Act means a person defined by any of the following items:
一 要支援状態にある六十五歳以上の者
(i) a person that is in a Needed Support Condition and is the age of 65 or older;
二 要支援状態にある四十歳以上六十五歳未満の者であって、その要支援状態の原因である身体上又は精神上の障害が特定疾病によって生じたものであるもの
(ii) a person that is in a Needed Support Condition and is the age of 40 to less than the age of 65, and the physical or mental problems that are the cause of said Needed Support Condition are caused by a Specified Disease.
5 この法律において「介護支援専門員」とは、要介護者又は要支援者(以下「要介護者等」という。)からの相談に応じ、及び要介護者等がその心身の状況等に応じ適切な居宅サービス、地域密着型サービス、施設サービス、介護予防サービス又は地域密着型介護予防サービスを利用できるよう市町村、居宅サービス事業を行う者、地域密着型サービス事業を行う者、介護保険施設、介護予防サービス事業を行う者、地域密着型介護予防サービス事業を行う者等との連絡調整等を行う者であって、要介護者等が自立した日常生活を営むのに必要な援助に関する専門的知識及び技術を有するものとして第六十九条の七第一項の介護支援専門員証の交付を受けたものをいう。
(5) The term "Long-Term Care Support Specialist" as used in this Act means a person that provides consultation to a Person Requiring Long-Term Care or to a Person Requiring Support (herein referred to as a "Person Requiring Long-Term Care, etc.") and communicates with and coordinates Municipalities, a person performing In-Home Services, a person performing Community-Based Service Business, a Facility Covered by Long-Term Care Insurance, a person performing Preventive Long-Term Care Service Business, a person performing Community-Based Preventive Long-Term Care, etc., in order for a Person Requiring Long-Term Care, etc., to be able to use appropriate In-Home Service, Community-Based Service, Facility Service, Preventive Long-Term Care Service, and Community-Based Service for Preventive Long-Term Care according to the mental and physical conditions, etc., of a Person Requiring Long-Term Care, etc., and who received Long-Term Care Support Specialist Certification as set forth in Article 69-7, paragraph (1) as a person possessing professional knowledge and skills regarding necessary support for a Person Requiring Long-Term Care, etc., to live an independent daily life.
6 この法律において「医療保険各法」とは、次に掲げる法律をいう。
(6) The term "Medical Insurance Acts" as used in this Act means the following acts:
一 健康保険法(大正十一年法律第七十号)
(i) Health Insurance Act (Act No. 70 of 1992);
二 船員保険法(昭和十四年法律第七十三号)
(ii) Seaman's Insurance Act (Act No. 73 of 1939);
三 国民健康保険法(昭和三十三年法律第百九十二号)
(iii) National Health Insurance Act (Act No. 192 of 1958);
四 国家公務員共済組合法(昭和三十三年法律第百二十八号)
(iv) National Public Servants Mutual Aid Association Act (Act No. 128 of 1958);
五 地方公務員等共済組合法(昭和三十七年法律第百五十二号)
(v) Local Public Service Mutual Aid Association Act (Act No. 152 of 1962);
六 私立学校教職員共済法(昭和二十八年法律第二百四十五号)
(vi) Private School Personnel Mutual Aid Association Act (Act No. 245 of 1953).
7 この法律において「医療保険者」とは、医療保険各法の規定により医療に関する給付を行う政府、健康保険組合、市町村(特別区を含む。)、国民健康保険組合、共済組合又は日本私立学校振興・共済事業団をいう。
(7) The term "Medical Insurers" as used in this Act means the national government, health insurance societies, municipalities (including special city wards), National Health Insurance Society, mutual aid associations, or Promotion and Mutual Aid Society for Private Schools of Japan that provide medical benefits pursuant to the provisions of Medical Insurance Acts.
8 この法律において「医療保険加入者」とは、次に掲げる者をいう。
(8) The term "Medical Insurance Subscriber" as used in this Act means the following persons:
一 健康保険法の規定による被保険者。ただし、同法第三条第二項の規定による日雇特例被保険者を除く。
(i) an insured person pursuant to the provisions of the Health Insurance Act, however, provided that it shall not apply to specially-insured day laborers pursuant to the provision of Article 3, paragraph (2) of the same Act;
二 船員保険法の規定による被保険者
(ii) an insured person pursuant to the provisions of the Seaman's Insurance Act;
三 国民健康保険法の規定による被保険者
(iii) an insured person pursuant to the provisions of the National Health Insurance Act;
四 国家公務員共済組合法又は地方公務員等共済組合法に基づく共済組合の組合員
(iv) a member of a mutual aid association pursuant to the National Public Servants Mutual Aid Association Law or the Local Public Care Service Mutual Aid Association Act;
五 私立学校教職員共済法の規定による私立学校教職員共済制度の加入者
(v) a subscriber to a Private School Personnel Mutual Aid System pursuant to the provisions of the Private School Personnel Mutual Aid Association Act;
六 健康保険法船員保険法国家公務員共済組合法(他の法律において準用する場合を含む。)又は地方公務員等共済組合法の規定による被扶養者。ただし、健康保険法第三条第二項の規定による日雇特例被保険者の同法の規定による被扶養者を除く。
(vi) an insured person's dependent pursuant to the provisions of the Health Insurance Act, Seaman's Insurance Act, National Public Servants Mutual Aid Association Law (including cases when applied mutatis mutandis pursuant to other Acts), or the Local Public Care Service Mutual Aid Association Act, however, provided that it shall not apply to a dependent pursuant to the provisions of Article 3, paragraph (2) of the Health Insurance Act of a specially-insured day laborer pursuant to the provisions of the same Act;
七 健康保険法第百二十六条の規定により日雇特例被保険者手帳の交付を受け、その手帳に健康保険印紙をはり付けるべき余白がなくなるに至るまでの間にある者及び同法の規定によるその者の被扶養者。ただし、同法第三条第二項ただし書の規定による承認を受けて同項の規定による日雇特例被保険者とならない期間内にある者及び同法第百二十六条第三項の規定により当該日雇特例被保険者手帳を返納した者並びに同法の規定によるその者の被扶養者を除く。
(vii) a person that received a specially-insured day laborer certificate book pursuant to the provisions of Article 126 of the Health Insurance Act and within a certain period until the term when all of the blank space for stamps for proof of health insurance of said certificate book are filled, and said dependent pursuant to the provisions of the same Act, however, provided that it shall not apply to a person that is within the period when said person is not a specially-insured day laborer pursuant to the provision of Article 3, paragraph (2) of the same Act with the approval pursuant to the proviso of the same paragraph, and a person that has returned said specially-insured day laborer certificate book pursuant to the provisions of Article 126, paragraph (3) of the same Act, and said dependent pursuant to the provisions of the same Act.
第八条 この法律において「居宅サービス」とは、訪問介護、訪問入浴介護、訪問看護、訪問リハビリテーション、居宅療養管理指導、通所介護、通所リハビリテーション、短期入所生活介護、短期入所療養介護、特定施設入居者生活介護、福祉用具貸与及び特定福祉用具販売をいい、「居宅サービス事業」とは、居宅サービスを行う事業をいう。
Article 8 (1) The term "In-Home Service" as used in this Act means Home-Visit Long-Term Care, Home-Visit Bathing Long-Term Care, Home-Visit Nursing, Home-Visit Rehabilitation, Guidance for Management of In-Home Medical Long-Term Care, Outpatient Day Long-Term Care, Outpatient Rehabilitation, Short-Term Admission for Daily Life Long-Term Care, Short-Term Admission for Recuperation, Daily Life Long-Term Care Admitted to a Specified Facility, Rental Service of Equipment for Long-Term Care Covered by Public Aid, and Sale of Specified Equipment Covered by Public Aid. The term "In-Home Service Business" as used in this Act means business performing In-Home Service.
2 この法律において「訪問介護」とは、要介護者であって、居宅(老人福祉法(昭和三十八年法律第百三十三号)第二十条の六に規定する軽費老人ホーム、同法第二十九条第一項に規定する有料老人ホーム(第十一項及び第十九項において「有料老人ホーム」という。)その他の厚生労働省令で定める施設における居室を含む。以下同じ。)において介護を受けるもの(以下「居宅要介護者」という。)について、その者の居宅において介護福祉士その他政令で定める者により行われる入浴、排せつ、食事等の介護その他の日常生活上の世話であって、厚生労働省令で定めるもの(夜間対応型訪問介護に該当するものを除く。)をいう。
(2) The term "Home-Visit Long-Term Care" as used in this Act means care service that is for bathing, bodily waste elimination, meals, etc., and for other daily activities provided by long-term care public aid workers and other persons who determined by an Ordinance of the Ministry of Health, Labour, and Welfare (except for care services defined as Home-Visit at Night for Long-Term Care) and which are provided to a Person Requiring Long-Term Care at his or her home (herein referred to as "In-Home Person Requiring Long-Term Care") (including a residence room at a moderate-fee home for the elderly as provided in Article 20-6 of the Public Aid for the Aged Act (Act No. 133 of 1963); a Fee-Based Home for the Elderly as prescribed in Article 29-1 of the same Act (referred to as a "Fee-Based Home for the Elderly" in paragraphs (11) and (19)); and other facilities as determined by an Ordinance of the Ministry of Health, Labour, and Welfare; the same shall apply hereinafter).
3 この法律において「訪問入浴介護」とは、居宅要介護者について、その者の居宅を訪問し、浴槽を提供して行われる入浴の介護をいう。
(3) The term "Home-Visit Bathing Long-Term Care" as used in this Act means care service that provides bathing service and a bathtub to a Person Requiring Long-Term Care by visiting his or her home.
4 この法律において「訪問看護」とは、居宅要介護者(主治の医師がその治療の必要の程度につき厚生労働省令で定める基準に適合していると認めたものに限る。)について、その者の居宅において看護師その他厚生労働省令で定める者により行われる療養上の世話又は必要な診療の補助をいう。
(4) The term "Home-Visit Nursing" as used in this Act means medical care or assistance for necessary medical care provided to a Person Requiring Long-Term Care at his or her home (limited to those who are considered by an attending physician to be a person in the degree of need of medical treatment that conforms to standards as determined by an Ordinance of the Ministry of Health, Labour, and Welfare) by a nurse or other person as determined by an Ordinance of the Ministry of Health, Labour, and Welfare.
5 この法律において「訪問リハビリテーション」とは、居宅要介護者(主治の医師がその治療の必要の程度につき厚生労働省令で定める基準に適合していると認めたものに限る。)について、その者の居宅において、その心身の機能の維持回復を図り、日常生活の自立を助けるために行われる理学療法、作業療法その他必要なリハビリテーションをいう。
(5) The term "Home-Visit Rehabilitation" as used in this Act means physical therapy, occupational therapy, and other necessary rehabilitation that is provided to an In-Home Person Requiring Long-Term Care at his or her home (limited to those who are considered by an attending physician to be a person in the degree of need of medical treatment that conforms to standards as determined by an Ordinance of the Ministry of Health, Labour, and Welfare) in order to maintain and recover mental or physical functions and to assist with independently performing daily activities.
6 この法律において「居宅療養管理指導」とは、居宅要介護者について、病院、診療所又は薬局(以下「病院等」という。)の医師、歯科医師、薬剤師その他厚生労働省令で定める者により行われる療養上の管理及び指導であって、厚生労働省令で定めるものをいう。
(6) The term "Guidance for Management of In-Home Medical Long-Term Care" as used in this Act means management and instructions for medical care and as determined by an Ordinance of the Ministry of Health, Labour, and Welfare. Said management and instructions are provided to an In-Home Person Requiring Long-Term Care by a physician, dentist, pharmacist or other personnel as determined by an Ordinance of the Ministry of Health, Labour, and Welfare that are associated with a hospital, clinic, or pharmacy (herein referred to as "Hospital, etc.")
7 この法律において「通所介護」とは、居宅要介護者について、老人福祉法第五条の二第三項の厚生労働省令で定める施設又は同法第二十条の二の二に規定する老人デイサービスセンターに通わせ、当該施設において入浴、排せつ、食事等の介護その他の日常生活上の世話であって厚生労働省令で定めるもの及び機能訓練を行うこと(認知症対応型通所介護に該当するものを除く。)をいう。
(7) The term "Outpatient Day Long-Term Care" as used in this Act means care that is for bathing, bodily waste elimination, meals, etc., and other care provided for daily activities and which is provided as defined by an Ordinance of the Ministry of Health, Labour, and Welfare, and functional training (except for care defined as Outpatient Long-Term Care for a Dementia Patient) by having an In-Home Person Requiring Long-Term Care commute to a facility as determined by an Ordinance of the Ministry of Health, Labour, and Welfare as set forth in Article 5-2, paragraph (3) of the Public Aid for the Aged Act or a Long-term care Day Service Center as provided in Article 20-2-2 of the same Act.
8 この法律において「通所リハビリテーション」とは、居宅要介護者(主治の医師がその治療の必要の程度につき厚生労働省令で定める基準に適合していると認めたものに限る。)について、介護老人保健施設、病院、診療所その他の厚生労働省令で定める施設に通わせ、当該施設において、その心身の機能の維持回復を図り、日常生活の自立を助けるために行われる理学療法、作業療法その他必要なリハビリテーションをいう。
(8) The term "Outpatient Rehabilitation" as used in this Act means physical therapy, occupational therapy, and other necessary rehabilitation that is provided to an In-Home Person Requiring Long-Term Care (limited to those who are considered by an attending physician to be a person in the degree of need of medical treatment that conforms to standards as determined by an Ordinance of the Ministry of Health, Labour, and Welfare) by having said person commute to a Long-Term Care Health Facility, hospital, clinic, or other facility as determined by an Ordinance of the Ministry of Health, Labour, and Welfare and providing Outpatient Rehabilitation to said facility in order to maintain and recover his or her mental or physical functions and to assist independently performing daily activities.
9 この法律において「短期入所生活介護」とは、居宅要介護者について、老人福祉法第五条の二第四項の厚生労働省令で定める施設又は同法第二十条の三に規定する老人短期入所施設に短期間入所させ、当該施設において入浴、排せつ、食事等の介護その他の日常生活上の世話及び機能訓練を行うことをいう。
(9) The term "Short-Term Admission for Daily Life Long-Term Care" as used in this Act means to provide care for bathing, bodily waste elimination, meals, etc., and other care for performing daily activities and to provide functional training for an In-Home Person Requiring Long-Term Care by having said person Short-Term Admission at a facility as determined by an Ordinance of the Ministry of Health, Labour, and Welfare as set forth in Article 5-2, paragraph (4) of the Public Aid for the Aged Act or at a Short-Term Admission Facility for the Elderly as provided in Article 20-3 of the same Act.
10 この法律において「短期入所療養介護」とは、居宅要介護者(その治療の必要の程度につき厚生労働省令で定めるものに限る。)について、介護老人保健施設、介護療養型医療施設その他の厚生労働省令で定める施設に短期間入所させ、当該施設において看護、医学的管理の下における介護及び機能訓練その他必要な医療並びに日常生活上の世話を行うことをいう。
(10) The term "Short-Term Admission for Recuperation" as used in this Act means to provide nursing, long-term care and functional training under control of medical management, or other necessary medical treatment, or to provide care for performing daily activities to an In-Home Person Requiring Long-Term Care (limited to persons with the degree of necessity for medical treatment that conforms with standards as determined by an Ordinance of the Ministry of Health, Labour, and Welfare) by having said person Short-Term Admission at a Long-Term Care Health Facility, Sanatorium Medical Facility for the Elderly Requiring Long-Term Care or other facility as determined by an Ordinance of the Ministry of Health, Labour, and Welfare.
11 この法律において「特定施設」とは、有料老人ホームその他厚生労働省令で定める施設であって、第十九項に規定する地域密着型特定施設でないものをいい、「特定施設入居者生活介護」とは、特定施設に入居している要介護者について、当該特定施設が提供するサービスの内容、これを担当する者その他厚生労働省令で定める事項を定めた計画に基づき行われる入浴、排せつ、食事等の介護その他の日常生活上の世話であって厚生労働省令で定めるもの、機能訓練及び療養上の世話をいう。
(11) The term "Specified Facility" as used in this Act means a Fee-Based Home for the Elderly or other facility as determined by an Ordinance of the Ministry of Health, Labour, and Welfare that is not a Community-Based Specified Facility as provided in this Article, paragraph (19) of this Act. The term "Daily Life Long-Term Care Admitted to a Specified Facility" as used in this Act means care for bathing, bodily waste elimination, meals, etc., and other care for performing daily activities that is as determined by an Ordinance of the Ministry of Health, Labour, and Welfare, functional training, and medical care. Said care is provided to a Person Requiring Long-Term Care who is staying in a Specified Facility and is based on a plan which stipulates the content of services to be provided by said Specified Facility, the personnel in charge of the services, and other items as determined by an Ordinance of the Ministry of Health, Labour, and Welfare.
12 この法律において「福祉用具貸与」とは、居宅要介護者について福祉用具(心身の機能が低下し日常生活を営むのに支障がある要介護者等の日常生活上の便宜を図るための用具及び要介護者等の機能訓練のための用具であって、要介護者等の日常生活の自立を助けるためのものをいう。次項並びに次条第十二項及び第十三項において同じ。)のうち厚生労働大臣が定めるものの政令で定めるところにより行われる貸与をいう。
(12) The term "Rental Service of Equipment for Long-Term Care Covered by Public Aid" as used in this Act means the rental of equipment covered by public aid undertaken pursuant to provisions of a Cabinet Order of those types of equipment as determined by the Minister of Health, Labour, and Welfare among equipment covered by public aid for an In-Home Person Requiring Long-Term Care (equipment for the convenience of performing daily activities by a Person Requiring Long-Term Care, etc., whose physical or mental functions are underactive and that cause problems with performing daily activities, equipment to assist an Insured Person Requiring Long-Term Care, etc., independently performing daily activities and equipment for functional training or an Insured Person Requiring Long-Term Care, etc.,; the same shall apply in the following paragraph (13), and to the following Article, paragraph (12) and paragraph (13) of this Act).
13 この法律において「特定福祉用具販売」とは、居宅要介護者について福祉用具のうち入浴又は排せつの用に供するものその他の厚生労働大臣が定めるもの(以下「特定福祉用具」という。)の政令で定めるところにより行われる販売をいう。
(13) The term "Sale of Specified Equipment Covered by Public Aid" as used in this Act means the sale, undertaken pursuant to provisions of a Cabinet Order, of equipment covered by public aid among equipment provided for use in bathing or bodily waste elimination and other items provided by the Minister of Health, Labour, and Welfare (herein referred to as "Specified Equipment Covered by Public Aid") to an In-Home Person Requiring Long-Term Care.
14 この法律において「地域密着型サービス」とは、夜間対応型訪問介護、認知症対応型通所介護、小規模多機能型居宅介護、認知症対応型共同生活介護、地域密着型特定施設入居者生活介護及び地域密着型介護老人福祉施設入所者生活介護をいい、「地域密着型サービス事業」とは、地域密着型サービスを行う事業をいう。
(14) The term "Community-Based Service" as used in this Act means Home-Visit at Night for Long-Term Care, Outpatient Long-Term Care for a Dementia Patient, Multifunctional Long-Term Care in a Small Group Home, Communal Daily Long-Term Care for a Dementia Patient, Daily Life Long-Term Care for a Person Admitted to a Community-Based Specified Facility, and Admission to a Community-Based Facility for Preventive Daily Long-Term Care of the Elderly Covered by Public Aid. The term "Community-Based Service Business" as used in this Act means a business that provides Community-Based Service.
15 この法律において「夜間対応型訪問介護」とは、居宅要介護者について、夜間において、定期的な巡回訪問により、又は通報を受け、その者の居宅において介護福祉士その他第二項の政令で定める者により行われる入浴、排せつ、食事等の介護その他の日常生活上の世話であって、厚生労働省令で定めるものをいう。
(15) The term "Home-Visit at Night for Long-Term Care" as used in this Act means care provided for bathing, bodily waste elimination, meals, etc., and for other daily activities that are as determined by an Ordinance of the Ministry of Health, Labour, and Welfare. Said care is provided to an In-Home Person Requiring Long-Term Care at his or her home by a long-term care public aid worker or other personnel specified by a Cabinet Order and as set forth in paragraph (2) of this Article, according to periodic night visits or as requested during the night.
16 この法律において「認知症対応型通所介護」とは、居宅要介護者であって、脳血管疾患、アルツハイマー病その他の要因に基づく脳の器質的な変化により日常生活に支障が生じる程度にまで記憶機能及びその他の認知機能が低下した状態(以下「認知症」という。)であるものについて、老人福祉法第五条の二第三項の厚生労働省令で定める施設又は同法第二十条の二の二に規定する老人デイサービスセンターに通わせ、当該施設において入浴、排せつ、食事等の介護その他の日常生活上の世話であって厚生労働省令で定めるもの及び機能訓練を行うことをいう。
(16) The term "Outpatient Long-Term Care for a Dementia Patient" as used in this Act means to provide care for bathing, bodily waste elimination, meals, etc., and for other daily activities as determined by an Ordinance of the Ministry of Health, Labour, and Welfare, and functional training for an In-Home Person Requiring Long-Term Care who is in the condition that memory functions and other cognitive functions have become underactive as far as causing disorder with performing daily activities due to organic changes of the brain that are caused by cerebral vascular disease, Alzheimer's disease, or other factors (herein referred to as "Dementia"). This is accomplished by having said person commute to a facility as determined by an Ordinance of the Ministry of Health, Labour, and Welfare as set forth in Article 5-2, paragraph (3) of the Public Aid for the Aged Act or Long-Term Care Day Service Centers for the elderly as provided in Article 20-2-2 of the same Act.
17 この法律において「小規模多機能型居宅介護」とは、居宅要介護者について、その者の心身の状況、その置かれている環境等に応じて、その者の選択に基づき、その者の居宅において、又は厚生労働省令で定めるサービスの拠点に通わせ、若しくは短期間宿泊させ、当該拠点において、入浴、排せつ、食事等の介護その他の日常生活上の世話であって厚生労働省令で定めるもの及び機能訓練を行うことをいう。
(17) The term "Multifunctional Long-Term Care in a Small Group Home" as used in this Act means to provide care for bathing, bodily waste elimination, meals, etc., and for other daily activities as determined by an Ordinance of the Ministry of Health, Labour, and Welfare, and functional training to an In-Home Person Requiring Long-Term Care at his or her home, or said bases of services as determined by an Ordinance of the Ministry of Health, Labour, and Welfare by having the person commute daily to a location or stay for short-term at said bases, according to the person's mental and physical condition, surroundings, etc., and based on his or her preference.
18 この法律において「認知症対応型共同生活介護」とは、要介護者であって認知症であるもの(その者の認知症の原因となる疾患が急性の状態にある者を除く。)について、その共同生活を営むべき住居において、入浴、排せつ、食事等の介護その他の日常生活上の世話及び機能訓練を行うことをいう。
(18) The term "Communal Daily Long-Term Care for a Dementia Patient" as used in this Act means to provide care for bathing, bodily waste elimination, meals, etc., and for other daily activities, and functional training for a Person Requiring Long-Term Care who is suffering from Dementia (except for a person with the cause of Dementia being an acute disease), at a residence where the person lives communally.
19 この法律において「地域密着型特定施設入居者生活介護」とは、有料老人ホームその他第十一項の厚生労働省令で定める施設であって、その入居者が要介護者、その配偶者その他厚生労働省令で定める者に限られるもの(以下「介護専用型特定施設」という。)のうち、その入居定員が二十九人以下であるもの(以下この項において「地域密着型特定施設」という。)に入居している要介護者について、当該地域密着型特定施設が提供するサービスの内容、これを担当する者その他厚生労働省令で定める事項を定めた計画に基づき行われる入浴、排せつ、食事等の介護その他の日常生活上の世話であって厚生労働省令で定めるもの、機能訓練及び療養上の世話をいう。
(19) The term "Daily Life Long-Term Care for a Person Admitted to a Community-Based Specified Facility" as used in this Act means to provide care for bathing, bodily waste elimination, meals, etc., and for other daily activities as determined by an Ordinance of the Ministry of Health, Labour, and Welfare, functional training and medical care based on a plan that stipulates the content of services to be provided by said Community-Based Specified Facility, the personnel in charge of the services, and other items as determined by an Ordinance of the Ministry of Health, Labour, and Welfare. This service is provided to a Person Requiring Long-Term Care who is staying in a Fee-Based Home for the Elderly and other facilities as determined by an Ordinance of the Ministry of Health, Labour, and Welfare as set forth in paragraph (11) of this Article and for which the capacity of the fixed number of said residents is twenty-nine (29) or less (hereinafter referred to as "Community-Based Specified Facility"), among facilities for which residents are limited to a Person Requiring Long-Term Care, said person's spouse, and other personnel as determined by an Ordinance of the Ministry of Health, Labour, and Welfare (herein referred to as a "Specialized Long-Term Care Specified Facility").
20 この法律において「地域密着型介護老人福祉施設」とは、老人福祉法第二十条の五に規定する特別養護老人ホーム(入所定員が二十九人以下であるものに限る。以下この項において同じ。)であって、当該特別養護老人ホームに入所する要介護者に対し、地域密着型施設サービス計画(地域密着型介護老人福祉施設に入所している要介護者について、当該施設が提供するサービスの内容、これを担当する者その他厚生労働省令で定める事項を定めた計画をいう。以下この項において同じ。)に基づいて、入浴、排せつ、食事等の介護その他の日常生活上の世話、機能訓練、健康管理及び療養上の世話を行うことを目的とする施設をいい、「地域密着型介護老人福祉施設入所者生活介護」とは、地域密着型介護老人福祉施設に入所する要介護者に対し、地域密着型施設サービス計画に基づいて行われる入浴、排せつ、食事等の介護その他の日常生活上の世話、機能訓練、健康管理及び療養上の世話をいう。
(20) 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 (limited to facilities for which the capacity of residents is twenty-nine (29) or less; the same shall apply hereinafter in this paragraph) provided in Article 20-5 of the Public Aid for the Aged Act that aims to provide care 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 Intensive Care Home for the Elderly based on a Community-Based Facility Service Plan (one that provides the content of services 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 by said facility, the personnel in charge of said services, and other items as determined by an Ordinance of the Ministry of Health, Labour, and Welfare; the same shall apply hereinafter in this paragraph). The term "Admission to a Community-Based Facility for Preventive Daily Long-Term Care of the Elderly Covered by Public Aid" as used in this Act means to provide care 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 a Community-Based Facility for the Elderly Covered by Public Aid Requiring Long-Term Care, based on a Community-Based Facility Service Plan.
21 この法律において「居宅介護支援」とは、居宅要介護者が第四十一条第一項に規定する指定居宅サービス又は特例居宅介護サービス費に係る居宅サービス若しくはこれに相当するサービス、第四十二条の二第一項に規定する指定地域密着型サービス又は特例地域密着型介護サービス費に係る地域密着型サービス若しくはこれに相当するサービス及びその他の居宅において日常生活を営むために必要な保健医療サービス又は福祉サービス(以下この項において「指定居宅サービス等」という。)の適切な利用等をすることができるよう、当該居宅要介護者の依頼を受けて、その心身の状況、その置かれている環境、当該居宅要介護者及びその家族の希望等を勘案し、利用する指定居宅サービス等の種類及び内容、これを担当する者その他厚生労働省令で定める事項を定めた計画(以下この項、第百十五条の三十八第一項第五号及び別表において「居宅サービス計画」という。)を作成するとともに、当該居宅サービス計画に基づく指定居宅サービス等の提供が確保されるよう、第四十一条第一項に規定する指定居宅サービス事業者、第四十二条の二第一項に規定する指定地域密着型サービス事業者その他の者との連絡調整その他の便宜の提供を行い、並びに当該居宅要介護者が地域密着型介護老人福祉施設又は介護保険施設への入所を要する場合にあっては、地域密着型介護老人福祉施設又は介護保険施設への紹介その他の便宜の提供を行うことをいい、「居宅介護支援事業」とは、居宅介護支援を行う事業をいう。
(21) The term "In-Home Long-Term Care Support" as used in this Act means to establish a plan (herein referred to as an "In-Home Service Plan" in this paragraph, Article 115-38, paragraph (1), item (v), and the appended table to this Act) that provides the types and contents of Designated In-Home Service, etc. (herein referred to as "Designated In-Home Service, etc." in this paragraph), the personnel in charge of said services to be used by an In-Home Person Requiring Long-Term Care, and other items as determined by an Ordinance of the Ministry of Health, Labour, and Welfare, at the request of said Person Requiring Long-Term Care and in consideration of his or her mental and physical condition, surroundings, and the person's and his or her family's preferences, etc., in order for an In-Home Person Requiring Long-Term Care to be able to use appropriately the Designated In-Home Service as prescribed in Article 41, paragraph (1) of this Act, In-Home Service related to Exceptional Allowance for In-Home Long-Term Care Service or equivalent services, Designated Community-Based Service as prescribed in Article 42-2, paragraph (1) of this Act, Community-Based Service related to Exceptional Allowance for Community-Based Long-Term Care Service or equivalent services, and other necessary health and medical services or public aid services for performing daily activities at home (hereinafter referred to as "Designated In-Home Service, etc." in this paragraph); the term also means to provide communication and coordination among Designated Providers of In-Home Long-Term Care as prescribed in Article 41, paragraph (1) of this Act, Designated Community-Based Service Provider as prescribed in Article 42-2, paragraph (1) of this Act and other person and to provide other conveniences in order to ensure provision of the Designated In-Home Service, etc., based on said In-Home Service Plan, and in a case when 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 or a Facility Providing Insured Long-Term Care, the term means to introduce a Community-Based Facility for the Elderly Covered by Public Aid Requiring Long-Term Care or Facility Providing Insured Long-Term Care and to provide other conveniences. The term "Designated In-Home Long-Term Care Support Business" as used in this Act means a business to provide In-Home Long-Term Care Support.
22 この法律において「介護保険施設」とは、第四十八条第一項第一号に規定する指定介護老人福祉施設、介護老人保健施設及び同項第三号に規定する指定介護療養型医療施設をいう。
(22) The term "Facility Covered by Long-Term Care Insurance" as used in this Act means a Designated Facility Covered by Public Aid Providing Long-Term Care to the Elderly or a Long-Term Care Health Facility as prescribed in Article 48, paragraph (1), item (i) of this Act, and a Designated Medical Long-Term Care Sanatorium as prescribed in item (iii) of the same paragraph.
23 この法律において「施設サービス」とは、介護福祉施設サービス、介護保健施設サービス及び介護療養施設サービスをいい、「施設サービス計画」とは、介護老人福祉施設、介護老人保健施設又は介護療養型医療施設に入所している要介護者について、これらの施設が提供するサービスの内容、これを担当する者その他厚生労働省令で定める事項を定めた計画をいう。
(23) The term "Facility Service" as used in this Act means a Facility Service for Long-Term Care Covered by Public Aid, Long-Term Care Health Facility Service, or Sanatorium Long-Term Care Service. The term "Facility Service Plan" as used in this Act means a plan for a Person Requiring Long-Term Care staying at a Designated Facility Covered by Public Aid Providing Long-Term Care to the Elderly, a Long-Term Care Health Facility, or a Sanatorium Medical Facility for the Elderly Requiring Long-Term Care that stipulates the content of services provided by said facilities, the personnel in charge of said services, and other items as determined by an Ordinance of the Ministry of Health, Labour, and Welfare.
24 この法律において「介護老人福祉施設」とは、老人福祉法第二十条の五に規定する特別養護老人ホーム(入所定員が三十人以上であるものに限る。以下この項において同じ。)であって、当該特別養護老人ホームに入所する要介護者に対し、施設サービス計画に基づいて、入浴、排せつ、食事等の介護その他の日常生活上の世話、機能訓練、健康管理及び療養上の世話を行うことを目的とする施設をいい、「介護福祉施設サービス」とは、介護老人福祉施設に入所する要介護者に対し、施設サービス計画に基づいて行われる入浴、排せつ、食事等の介護その他の日常生活上の世話、機能訓練、健康管理及び療養上の世話をいう。
(24) The term "Facility Covered by Public Aid Providing Long-Term Care to the Elderly" as used in this Act means an Intensive Care Home for the Elderly provided in Article 20-5 of the Public Aid for the Aged Act (limited to a facility with a capacity of thirty (30) residents or more; the same shall apply hereinafter in this paragraph). The purpose of said facility is to provide care 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 Intensive Care Home for the Elderly based on 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 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 Covered by Public Aid Providing Long-Term Care to the Elderly.
25 この法律において「介護老人保健施設」とは、要介護者(その治療の必要の程度につき厚生労働省令で定めるものに限る。以下この項において同じ。)に対し、施設サービス計画に基づいて、看護、医学的管理の下における介護及び機能訓練その他必要な医療並びに日常生活上の世話を行うことを目的とする施設として、第九十四条第一項の都道府県知事の許可を受けたものをいい、「介護保健施設サービス」とは、介護老人保健施設に入所する要介護者に対し、施設サービス計画に基づいて行われる看護、医学的管理の下における介護及び機能訓練その他必要な医療並びに日常生活上の世話をいう。
(25) The term "Long-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 94, paragraph (1) of this Act as a facility with the purpose of providing nursing, care and functional training under control of medical management, and other necessary care for medical treatment and daily activities to a Person Requiring Long-Term Care (limited to persons whose degree of necessity for medical treatment conforms with standards as determined by an Ordinance of the Ministry of Health, Labour, and Welfare; the same shall apply hereinafter in this paragraph) based on a Facility Service Plan. The term "Long-Term Care Health Facility Service" as used in this Act means nursing, care and functional training under control of medical management, and other necessary care for medical treatment and daily activities for a Person Requiring Long-Term Care who is staying in a Long-Term Care Health Facility, based on a Facility Service Plan.
26 この法律において「介護療養型医療施設」とは、療養病床等(医療法(昭和二十三年法律第二百五号)第七条第二項第四号に規定する療養病床のうち要介護者の心身の特性に応じた適切な看護が行われるものとして政令で定めるもの又は療養病床以外の病院の病床のうち認知症である要介護者の心身の特性に応じた適切な看護が行われるものとして政令で定めるものをいう。以下同じ。)を有する病院又は診療所であって、当該療養病床等に入院する要介護者(その治療の必要の程度につき厚生労働省令で定めるものに限る。以下この項において同じ。)に対し、施設サービス計画に基づいて、療養上の管理、看護、医学的管理の下における介護その他の世話及び機能訓練その他必要な医療を行うことを目的とする施設をいい、「介護療養施設サービス」とは、介護療養型医療施設の療養病床等に入院する要介護者に対し、施設サービス計画に基づいて行われる療養上の管理、看護、医学的管理の下における介護その他の世話及び機能訓練その他必要な医療をいう。
(26) The term "Sanatorium Medical Facility for the Elderly Requiring Long-Term Care as used in this Act means a facility such as a hospital or clinic that maintains a sanatorium ward or other beds ("Sanatorium Ward, etc.") that are specified by a Cabinet Order to provide appropriate nursing services according to the mental and physical characteristics of a Person Requiring Long-Term Care among Sanatorium Ward, etc., as prescribed in Article 7, paragraph (2) item (iv) of the Medical Care Act (Act No. 205, 1948), or beds which are specified by a Cabinet Order to provide appropriate nursing services according to the mental and physical characteristics of a Person Requiring Long-Term Care with Dementia among beds other than those for Long-Term Care Beds in the hospital; the same shall apply hereinafter), and with the purpose of providing medical care management, nursing, long-term care and other care under medical management, functional training, and other necessary medical care to a Person Requiring Long-Term Care who is in said bed for long-term care, etc., (limited to a person with the degree of need for medical treatment that conforms with standards as determined by an Ordinance of the Ministry of Health, Labour, and Welfare; the same shall apply hereinafter in this paragraph), based on a Facility Service Plan. The term "Sanatorium Long-Term Care Service" as used in this Act means medical care management, nursing, long-term care under medical management, and other care, functional training, and other necessary medical care provided to a Person Requiring Long-Term Care who is in a Sanatorium Ward, etc., for long-term care of a Sanatorium Medical Facility for the Elderly Requiring Long-Term Care based on a Facility Service Plan.
第八条の二 この法律において「介護予防サービス」とは、介護予防訪問介護、介護予防訪問入浴介護、介護予防訪問看護、介護予防訪問リハビリテーション、介護予防居宅療養管理指導、介護予防通所介護、介護予防通所リハビリテーション、介護予防短期入所生活介護、介護予防短期入所療養介護、介護予防特定施設入居者生活介護、介護予防福祉用具貸与及び特定介護予防福祉用具販売をいい、「介護予防サービス事業」とは、介護予防サービスを行う事業をいう。
Article 8-2 (1) The term "Preventive Long-Term Care Service" as used in this Act means Home-Visit Service for Preventive Long-Term Care, Home-Visit Bathing Service for Preventive Long-Term Care, Home-Visit Nursing Service for Preventive Long-Term Care, Home-Visit Rehabilitation Service for Preventive Long-Term Care, Management and Guidance for In-Home Medical Service for Preventive Long-Term Care, other Outpatient Preventive Long-Term Care, Outpatient Rehabilitation for Preventive Long-Term Care, Short-Term Admission for Daily Preventive Long-Term Care, Short-Term Admission for Recuperation for Preventive Long-Term Care, Daily Preventive Long-Term Care Admitted to a Specified Facility, Rental of Specified Equipment for Preventive Long-Term Care Covered by Public Aid, and the Sale of Specified Equipment for Preventive Long-Term Care Covered by Public Aid. The term "Preventive Long-Term Care Service Business" as used in this Act means a business that provides Preventive Long-Term Care Service.
2 この法律において「介護予防訪問介護」とは、要支援者であって、居宅において支援を受けるもの(以下「居宅要支援者」という。)について、その者の居宅において、その介護予防(身体上又は精神上の障害があるために入浴、排せつ、食事等の日常生活における基本的な動作の全部若しくは一部について常時介護を要し、又は日常生活を営むのに支障がある状態の軽減又は悪化の防止をいう。以下同じ。)を目的として、介護福祉士その他政令で定める者により、厚生労働省令で定める期間にわたり行われる入浴、排せつ、食事等の介護その他の日常生活上の支援であって、厚生労働省令で定めるものをいう。
(2) The term "Home-Visit Service for Preventive Long-Term Care" as used in this Act means support for bathing, bodily waste elimination, meals, etc., and for other daily activities as determined by an Ordinance of the Ministry of Health, Labour, and Welfare. Said support is provided to a Person Requiring Support who receives support (herein referred to as a "Person Requiring In-Home Support"), at his or her home for the purpose of prevention of long-term care (reduction or prevention of deterioration of conditions for which a person requires continuous care for the whole or a part of basic movements during daily activities, such as bathing, bodily waste elimination, meals, etc., or a person that has difficulty performing daily activities due to physical or mental disabilities; the same shall apply herein) by a long-term care public aid worker or other personnel as provided by a Cabinet Order and for the period as determined by an Ordinance of the Ministry of Health, Labour, and Welfare.
3 この法律において「介護予防訪問入浴介護」とは、居宅要支援者について、その介護予防を目的として、厚生労働省令で定める場合に、その者の居宅を訪問し、厚生労働省令で定める期間にわたり浴槽を提供して行われる入浴の介護をいう。
(3) The term "Home-Visit Bathing Service for Preventive Long-Term Care" as used in this Act means bathing care provided to a Person Requiring In-Home Support with the purpose of preventing the long-term care of said person by visiting said person at his or her home and providing a bathing tub for the period as determined by an Ordinance of the Ministry of Health, Labour, and Welfare.
4 この法律において「介護予防訪問看護」とは、居宅要支援者(主治の医師がその治療の必要の程度につき厚生労働省令で定める基準に適合していると認めたものに限る。)について、その者の居宅において、その介護予防を目的として、看護師その他厚生労働省令で定める者により、厚生労働省令で定める期間にわたり行われる療養上の世話又は必要な診療の補助をいう。
(4) The term "Home-Visit Nursing Service for Preventive Long-Term Care" as used in this Act means medical care or assistance of a necessary medical care provided to a Person Requiring In-Home Support (limited to a person that is considered by an attending physician to be a person with the degree of need for medical treatment that conforms to standards as determined by an Ordinance of the Ministry of Health, Labour, and Welfare) at his or her home for the purpose of prevention of long-term care, and by a nurse or other personnel as determined by an Ordinance of the Ministry of Health, Labour, and Welfare and for the period as determined by an Ordinance of the Ministry of Health, Labour, and Welfare.
5 この法律において「介護予防訪問リハビリテーション」とは、居宅要支援者(主治の医師がその治療の必要の程度につき厚生労働省令で定める基準に適合していると認めたものに限る。)について、その者の居宅において、その介護予防を目的として、厚生労働省令で定める期間にわたり行われる理学療法、作業療法その他必要なリハビリテーションをいう。
(5) The term "Home-Visit Rehabilitation Service for Preventive Long-Term Care" as used in this Act means physical therapy, occupational therapy, and other necessary rehabilitation provided to a Person Requiring In-Home Support (limited to a person that is considered by an attending physician to be a person with the degree of need for medical treatment that conforms to standards as determined by an Ordinance of the Ministry of Health, Labour, and Welfare) at his or her home for the purpose of prevention of long-term care and for the period as determined by an Ordinance of the Ministry of Health, Labour, and Welfare.
6 この法律において「介護予防居宅療養管理指導」とは、居宅要支援者について、その介護予防を目的として、病院等の医師、歯科医師、薬剤師その他厚生労働省令で定める者により行われる療養上の管理及び指導であって、厚生労働省令で定めるものをいう。
(6) The term "Management and Guidance for In-Home Medical Service for Preventive Long-Term Care" as used in this Act means management and guidance for medical care that is stipulated by an Ordinance of the Ministry of Health, Labour, and Welfare and said management and guidance for medical care is provided to a Person Requiring In-Home Support for the purpose of prevention of long-term care, and by a physician in a Hospital, etc., dentist, pharmacist, or other personnel as determined by an Ordinance of the Ministry of Health, Labour, and Welfare.
7 この法律において「介護予防通所介護」とは、居宅要支援者について、その介護予防を目的として、老人福祉法第五条の二第三項の厚生労働省令で定める施設又は同法第二十条の二の二に規定する老人デイサービスセンターに通わせ、当該施設において、厚生労働省令で定める期間にわたり、入浴、排せつ、食事等の介護その他の日常生活上の支援であって厚生労働省令で定めるもの及び機能訓練を行うこと(介護予防認知症対応型通所介護に該当するものを除く。)をいう。
(7) The term "Outpatient Preventive Long-Term Care" as used in this Act means care for bathing, bodily waste elimination, meals, etc., and other support for daily activities as determined by an Ordinance of the Ministry of Health, Labour, and Welfare and performing functional training (except that which is defined as Preventive Long-Term Care for a Dementia Outpatient) that is provided to a Person Requiring In-Home Support for the purpose of prevention of long-term care by having said person commute to a facility as determined by an Ordinance of the Ministry of Health, Labour, and Welfare as set forth in Article 5-2, paragraph (3) of the Public Aid for the Aged Act, or a Long-Term Care Day Service Center as provided in Article 20-2-2 of the same Act, at said facility and for the period as determined by an Ordinance of the Ministry of Health, Labour, and Welfare.
8 この法律において「介護予防通所リハビリテーション」とは、居宅要支援者(主治の医師がその治療の必要の程度につき厚生労働省令で定める基準に適合していると認めたものに限る。)について、介護老人保健施設、病院、診療所その他の厚生労働省令で定める施設に通わせ、当該施設において、その介護予防を目的として、厚生労働省令で定める期間にわたり行われる理学療法、作業療法その他必要なリハビリテーションをいう。
(8) The term "Outpatient Rehabilitation for Preventive Long-Term Care" as used in this Act means physical therapy, occupational therapy, and other necessary rehabilitation provided to a Person Requiring In-Home Support (limited to a person that is considered by an attending physician to be a person with the degree of need for medical treatment that conforms to standards as determined by an Ordinance of the Ministry of Health, Labour, and Welfare) by having said person commute to a Long-Term Care Health Facility, hospital, clinic, or other facility as determined by an Ordinance of the Ministry of Health, Labour, and Welfare at said facility for the purpose of prevention of long-term care for the period as determined by an Ordinance of the Ministry of Health, Labour, and Welfare.
9 この法律において「介護予防短期入所生活介護」とは、居宅要支援者について、老人福祉法第五条の二第四項の厚生労働省令で定める施設又は同法第二十条の三に規定する老人短期入所施設に短期間入所させ、その介護予防を目的として、厚生労働省令で定める期間にわたり、当該施設において入浴、排せつ、食事等の介護その他の日常生活上の支援及び機能訓練を行うことをいう。
(9) The term "Short-Term Admission for Daily Preventive Long-Term Care" as used in this Act means to provide care for bathing, bodily waste elimination, meals, etc., support for other daily activities, and functional training to a Person Requiring In-Home Support by having said person stay for a short-term in a facility as determined by an Ordinance of the Ministry of Health, Labour, and Welfare as set forth in Article 5-2, paragraph (4) of the Public Aid for the Aged Act, or in a Short-Term Admission Facility for the Elderly as provided in Article 20-3 of the same Act, for the purpose of prevention of long-term care for the period as determined by an Ordinance of the Ministry of Health, Labour, and Welfare at said facility.
10 この法律において「介護予防短期入所療養介護」とは、居宅要支援者(その治療の必要の程度につき厚生労働省令で定めるものに限る。)について、介護老人保健施設、介護療養型医療施設その他の厚生労働省令で定める施設に短期間入所させ、その介護予防を目的として、厚生労働省令で定める期間にわたり、当該施設において看護、医学的管理の下における介護及び機能訓練その他必要な医療並びに日常生活上の支援を行うことをいう。
(10) The term "Short-Term Admission for Recuperation for Preventive Long-Term Care" as used in this Act means to provide nursing, long-term care, functional training and other necessary care for medical treatment under control of medical management, and support for daily activities to a Person Requiring In-Home Support (limited to a person with the degree of need for medical treatment that conforms with an Ordinance of the Ministry of Health, Labour, and Welfare) by having the person stay for a short-term in a Long-Term Care Health Facility, a Sanatorium Medical Facility for the Elderly Requiring Long-Term Care or other facility as determined by an Ordinance of the Ministry of Health, Labour, and Welfare for the purpose of prevention of long-term care for the period as determined by an Ordinance of the Ministry of Health, Labour, and Welfare at said facility.
11 この法律において「介護予防特定施設入居者生活介護」とは、特定施設(介護専用型特定施設を除く。)に入居している要支援者について、その介護予防を目的として、当該特定施設が提供するサービスの内容、これを担当する者その他厚生労働省令で定める事項を定めた計画に基づき行われる入浴、排せつ、食事等の介護その他の日常生活上の支援であって厚生労働省令で定めるもの、機能訓練及び療養上の世話をいう。
(11) The term "Daily Preventive Long-Term Care Admitted to a Specified Facility" as used in this Act means care for bathing, bodily waste elimination, meals, etc., and support for other daily activities as determined by an Ordinance of the Ministry of Health, Labour, and Welfare, functional training, and medical care that is provided to a Person Requiring Support who is staying in a Specified Facility (except for a Specialized Long-Term Care Specified Facility) for the purpose of prevention of long-term care, and based on a plan for providing services of specified content by said Specified Facility, the personnel in charge of said services, and other items as determined by an Ordinance of the Ministry of Health, Labour, and Welfare.
12 この法律において「介護予防福祉用具貸与」とは、居宅要支援者について福祉用具のうちその介護予防に資するものとして厚生労働大臣が定めるものの政令で定めるところにより行われる貸与をいう。
(12) The term "Equipment Rental for Preventive Long-Term Care Covered by Public Aid" as used in this Act means a rental of equipment undertaken for a Person Requiring In-Home Support pursuant to the provisions of a Cabinet Order for equipment covered by public aid that is specified by the Minister of Health, Labour, and Welfare as equipment contributing to the prevention of long-term care to a Person Requiring In-Home Support among equipment covered by public aid.
13 この法律において「特定介護予防福祉用具販売」とは、居宅要支援者について福祉用具のうちその介護予防に資するものであって入浴又は排せつの用に供するものその他の厚生労働大臣が定めるもの(以下「特定介護予防福祉用具」という。)の政令で定めるところにより行われる販売をいう。
(13) The term "Sale of Specified Equipment for Preventive Long-Term Care Covered by Public Aid" as used in this Act means sales undertaken for a Person Requiring In-Home Support pursuant to the provisions of a Cabinet Order of equipment covered by public aid that contributes to the prevention of long-term care that is provided for use in bathing or bodily waste elimination, as specified by the Ministry of Health, Labour, and Welfare, among equipment covered by public aid (herein referred to as "Specified Equipment for Preventive Long-Term Care Covered by Public Aid").
14 この法律において「地域密着型介護予防サービス」とは、介護予防認知症対応型通所介護、介護予防小規模多機能型居宅介護及び介護予防認知症対応型共同生活介護をいい、「地域密着型介護予防サービス事業」とは、地域密着型介護予防サービスを行う事業をいう。
(14) The term "Community-Based Service for Preventive Long-Term Care" as used in this Act means Preventive Long-Term Care for a Dementia Outpatient, Multifunctional Preventive Long-Term Care in a Small Group Home, and Preventive Long-Term Care for a Dementia Patient in Communal Living. The term "Community-Based Preventive Long-Term Care Business" as used in this Act means a business that provides Community-Based Service for Preventive Long-Term Care.
15 この法律において「介護予防認知症対応型通所介護」とは、居宅要支援者であって、認知症であるものについて、その介護予防を目的として、老人福祉法第五条の二第三項の厚生労働省令で定める施設又は同法第二十条の二の二に規定する老人デイサービスセンターに通わせ、当該施設において、厚生労働省令で定める期間にわたり、入浴、排せつ、食事等の介護その他の日常生活上の支援であって厚生労働省令で定めるもの及び機能訓練を行うことをいう。
(15) The term "Preventive Long-Term Care for a Dementia Outpatient" as used in this Act means to provide care for bathing, bodily waste elimination, meals, etc., and support for other daily activities as determined by an Ordinance of the Ministry of Health, Labour, and Welfare, and functional training to a Person Requiring In-Home Support who is suffering from Dementia, for the purpose of prevention of long-term care by having the person commute to a facility as determined by an Ordinance of the Ministry of Health, Labour, and Welfare as set forth in Article 5-2, paragraph (3) of the Public Aid for the Aged Act or a Long-Term Care Day Service Center as provided in Article 20-2-2 of the same Act, at said facility and for the period as determined by an Ordinance of the Ministry of Health, Labour, and Welfare.
16 この法律において「介護予防小規模多機能型居宅介護」とは、居宅要支援者について、その者の心身の状況、その置かれている環境等に応じて、その者の選択に基づき、その者の居宅において、又は厚生労働省令で定めるサービスの拠点に通わせ、若しくは短期間宿泊させ、当該拠点において、その介護予防を目的として、入浴、排せつ、食事等の介護その他の日常生活上の支援であって厚生労働省令で定めるもの及び機能訓練を行うことをいう。
(16) The term "Multifunctional Preventive Long-Term Care in a Small Group Home" as used in this Act means to provide care for bathing, bodily waste elimination, meals, etc., and support for other daily activities as determined by an Ordinance of the Ministry of Health, Labour, and Welfare, and functional training to a Person Requiring In-Home Support according to the mental and physical conditions of said person and according to the environment, etc., of said person based on the preferences of said person at his or her home or at a base of service as determined by an Ordinance of the Ministry of Health, Labour, and Welfare by having the person commute daily or stay for a short-term for the purpose of prevention of long-term care.
17 この法律において「介護予防認知症対応型共同生活介護」とは、要支援者(厚生労働省令で定める要支援状態区分に該当する状態である者に限る。)であって認知症であるもの(その者の認知症の原因となる疾患が急性の状態にある者を除く。)について、その共同生活を営むべき住居において、その介護予防を目的として、入浴、排せつ、食事等の介護その他の日常生活上の支援及び機能訓練を行うことをいう。
(17) The term "Preventive Long-Term Care for a Dementia Patient in Communal Living" as used in this Act means to provide care for bathing, bodily waste elimination, meals, etc., support for other activities, and functional training to a Person Requiring Support (limited to a person that corresponds to a Category of Needed Support Condition as determined by an Ordinance of the Ministry of Health, Labour, and Welfare) who are suffering from Dementia (except for a person that cause of Dementia is an acute disease) at a residence where the person lives communally and for the purpose of prevention of long-term care.
18 この法律において「介護予防支援」とは、居宅要支援者が第五十三条第一項に規定する指定介護予防サービス又は特例介護予防サービス費に係る介護予防サービス若しくはこれに相当するサービス、第五十四条の二第一項に規定する指定地域密着型介護予防サービス又は特例地域密着型介護予防サービス費に係る地域密着型介護予防サービス若しくはこれに相当するサービス及びその他の介護予防に資する保健医療サービス又は福祉サービス(以下この項において「指定介護予防サービス等」という。)の適切な利用等をすることができるよう、第百十五条の三十九第一項に規定する地域包括支援センターの職員のうち厚生労働省令で定める者が、当該居宅要支援者の依頼を受けて、その心身の状況、その置かれている環境、当該居宅要支援者及びその家族の希望等を勘案し、利用する指定介護予防サービス等の種類及び内容、これを担当する者その他厚生労働省令で定める事項を定めた計画(以下この項及び別表において「介護予防サービス計画」という。)を作成するとともに、当該介護予防サービス計画に基づく指定介護予防サービス等の提供が確保されるよう、第五十三条第一項に規定する指定介護予防サービス事業者、第五十四条の二第一項に規定する指定地域密着型介護予防サービス事業者その他の者との連絡調整その他の便宜の提供を行うことをいい、「介護予防支援事業」とは、介護予防支援を行う事業をいう。
(18) The term "Preventive Long-Term Care Support" as used in this Act means that a person as determined by an Ordinance of the Ministry of Health, Labour, and Welfare among the personnel of a community general support center as prescribed in Article 115-39, paragraph (1) of this Act, with regard to a Person Requiring In-Home Support, considers said a Person's mental and physical condition, the present environment of said Person, the preferences, etc., of said Person Requiring In-Home Support and those of his or her family according to the request of said Person Requiring In-Home Support, and establishes a plan that stipulates the type and content of a Designated Provider of a Preventive Service to Long-Term Care Service, etc., that said Person will use, the personnel in charge of said services, and other items as determined by an Ordinance of the Ministry of Health, Labour, and Welfare (herein referred to as "Preventive Long-Term Care Service Plan" in this paragraph and the appended table) in order for the Person Requiring In-Home Support to be able to use appropriately those services as prescribed in Article 53, paragraph (1) of this Act that are of a Designated Preventive Long-Term Care Service, Preventive Long-Term Care Service pertaining to Exceptional Allowance for Preventive Service of Long-Term Care or services equivalent to said service, those services as prescribed in Article 54-2, paragraph (1) that are Designated Community-Based Preventive Service of Long-Term Care, Community-Based Service for Preventive Long-Term Care pertaining to Exceptional Allowance for Community-Based Preventive Service of Long-Term Care, or equivalent services to said service, or other health and medical services or public aid services contributing to prevention of long-term care (herein referred to as "Designated Preventive Long-Term Care Service, etc.") and that said personnel provide liaison and coordination among those who are a Designated Provider of a Preventive Service to Long-Term Care prescribed in Article 53, paragraph (1) of this Act, those who are a Designated Person Providing Community-Based Preventive Service of Long-Term Care as prescribed in Article 54-2, paragraph (1), and other personnel, and other convenience in order to ensure the provision of the Designated Preventive Long-Term Care Service, etc., based on said Preventive Long-Term Care Service Plan. The term "Preventive Long-Term Care Support Business" as used in this Act means a business that provides a Preventive Long-Term Care Support.
第二章 被保険者
Chapter II Insured Persons
(被保険者)
(Insured Person)
第九条 次の各号のいずれかに該当する者は、市町村又は特別区(以下単に「市町村」という。)が行う介護保険の被保険者とする。
Article 9 A person that corresponds to any of the following items shall be an Insured Person of Long-Term Care for the Aged Insurance provided by a municipality or special city ward (herein referred to simply as "Municipality"):
一 市町村の区域内に住所を有する六十五歳以上の者(以下「第一号被保険者」という。)
(i) a person that is domiciled in the Municipality and is 65 years of age or more (herein referred to as "Primary Insured Person");
二 市町村の区域内に住所を有する四十歳以上六十五歳未満の医療保険加入者(以下「第二号被保険者」という。)
(ii) a person insured by medical insurance that is domiciled in the Municipality and is 40 years of age or more but less than 65 years of age (herein referred to as "Secondary Insured Person").
(資格取得の時期)
(Time of Acquisition of Qualifications)
第十条 前条の規定による当該市町村が行う介護保険の被保険者は、次の各号のいずれかに該当するに至った日から、その資格を取得する。
Article 10 An Insured Person by Long-Term Care Insurance as provided by a Municipality pursuant to the provisions of the preceding Article shall acquire said eligibility on the date when said Person first corresponds to any of the following items:
一 当該市町村の区域内に住所を有する医療保険加入者が四十歳に達したとき。
(i) when a Medical Insurance Subscriber who is domiciled in said Municipality becomes 40 years of age;
二 四十歳以上六十五歳未満の医療保険加入者又は六十五歳以上の者が当該市町村の区域内に住所を有するに至ったとき。
(ii) when a Medical Insurance Subscriber who is 40 years of age or more but less than 65 years of age acquires domicile in said Municipality;
三 当該市町村の区域内に住所を有する四十歳以上六十五歳未満の者が医療保険加入者となったとき。
(iii) when a person that is domiciled in said Municipality and is 40 years of age or more but less than 65 years of age becomes a Medical Insurance Subscriber;
四 当該市町村の区域内に住所を有する者(医療保険加入者を除く。)が六十五歳に達したとき。
(iv) when a person that is domiciled in said Municipality (other than a Medical Insurance Subscriber) becomes 65 years of age.
(資格喪失の時期)
(Time of Loss of Qualification)
第十一条 第九条の規定による当該市町村が行う介護保険の被保険者は、当該市町村の区域内に住所を有しなくなった日の翌日から、その資格を喪失する。ただし、当該市町村の区域内に住所を有しなくなった日に他の市町村の区域内に住所を有するに至ったときは、その日から、その資格を喪失する。
Article 11 (1) An Insured Person by Long-Term Care Insurance provided by said Municipality pursuant to the provisions of Article 9 of this Act shall lose said qualification from the day following the date when said person fails to have domicile in said Municipality, however, provided that said person shall lose this qualification on said date when the person fails to have domicile in said Municipality and obtains domicile in another Municipality on the same day.
2 第二号被保険者は、医療保険加入者でなくなった日から、その資格を喪失する。
(2) A Secondary Insured Person shall lose this qualification on the date when said person becomes a non-Medical Insurance Subscriber.
(届出等)
(Notifications, etc.)
第十二条 第一号被保険者は、厚生労働省令で定めるところにより、被保険者の資格の取得及び喪失に関する事項その他必要な事項を市町村に届け出なければならない。ただし、第十条第四号に該当するに至ったことにより被保険者の資格を取得した場合(厚生労働省令で定める場合を除く。)については、この限りでない。
Article 12 (1) A Primary Insured Person shall notify the Municipality of matters regarding acquisition and loss of qualification of Insured Person status and other necessary matters pursuant to the provisions of an Ordinance of the Ministry of Health, Labour, and Welfare, however, provided that this provision shall not apply to a case when the Primary Insured Person acquired the qualification of an Insured Person due to becoming subject to Article 10, item (iv) of this Act (except for a case pursuant to the provisions of an Ordinance of the Ministry of Health, Labour, and Welfare).
2 第一号被保険者の属する世帯の世帯主は、その世帯に属する第一号被保険者に代わって、当該第一号被保険者に係る前項の規定による届出をすることができる。
(2) The householder of said family in which a Primary Insured Person resides may provide the notification pursuant to the provisions of the preceding paragraph regarding said Primary Insured Person on behalf of a Primary Insured Person that resides in the household.
3 被保険者は、市町村に対し、当該被保険者に係る被保険者証の交付を求めることができる。
(3) An Insured Person may request the Municipality to issue a Certificate of Insured Person pertaining to said Insured Person.
4 被保険者は、その資格を喪失したときは、厚生労働省令で定めるところにより、速やかに、被保険者証を返還しなければならない。
(4) An Insured Person shall return the Certificate of Insured Person pursuant to the provisions of an Ordinance of the Ministry of Health, Labour, and Welfare when said Person no longer meets said qualifications.
5 住民基本台帳法(昭和四十二年法律第八十一号)第二十二条から第二十四条まで又は第二十五条の規定による届出があったとき(当該届出に係る書面に同法第二十八条の二の規定による付記がされたときに限る。)は、その届出と同一の事由に基づく第一項本文の規定による届出があったものとみなす。
(5) When a notification is issued pursuant to the provisions of Articles 22 to 24, or Article 25 of the Basic Resident Registration Act (Act No. 81 of 1967) (limited to a case when a supplementary note is appended to the document pertaining to said notification pursuant to the provisions of Article 28-2 of the same Act), it shall be deemed as a notification pursuant to the main clause of paragraph (1) based on the same reason for said notification.
6 前各項に規定するもののほか、被保険者に関する届出及び被保険者証に関して必要な事項は、厚生労働省令で定める。
(6) In addition to the provisions as prescribed in each of the preceding paragraphs of this Article, necessary matters for notification pertaining to an Insured Person and that pertaining to the Certificate of Insured Person shall be as determined by an Ordinance of the Ministry of Health, Labour, and Welfare.
(住所地特例対象施設に入所又は入居中の被保険者の特例)
(Domicile Exception of an Insured Person that is Admitted to or has been a Resident of a Facility Subject to Domicile Exception)
第十三条 次に掲げる施設(以下「住所地特例対象施設」という。)に入所又は入居(以下この条において「入所等」という。)をすることにより当該住所地特例対象施設の所在する場所に住所を変更したと認められる被保険者(第三号に掲げる施設に入所することにより当該施設の所在する場所に住所を変更したと認められる被保険者にあっては、老人福祉法第十一条第一項第一号の規定による入所措置がとられた者に限る。以下この条において「住所地特例対象被保険者」という。)であって、当該住所地特例対象施設に入所等をした際他の市町村(当該住所地特例対象施設が所在する市町村以外の市町村をいう。)の区域内に住所を有していたと認められるものは、第九条の規定にかかわらず、当該他の市町村が行う介護保険の被保険者とする。ただし、二以上の住所地特例対象施設に継続して入所等をしている住所地特例対象被保険者であって、現に入所等をしている住所地特例対象施設(以下この項及び次項において「現入所施設」という。)に入所等をする直前に入所等をしていた住所地特例対象施設(以下この項において「直前入所施設」という。)及び現入所施設のそれぞれに入所等をすることにより直前入所施設及び現入所施設のそれぞれの所在する場所に順次住所を変更したと認められるもの(次項において「特定継続入所被保険者」という。)については、この限りでない。
Article 13 (1) An Insured Person for whom it is determined that his or her domicile has changed to a location of one of the following facilities (herein referred to as "Facility Subject to Domicile Exception") and is located by admission or residence (herein referred to as "Admission, etc.") in said Facility Subject to Domicile Exception (an Insured Person for whom it is determined that his or her domicile has changed to a location where said Facility is located by moving into said Facility as listed in item (iii) is limited to a person for whom the admission measures are pursuant to the provisions of Article 11, paragraph (1), item (i) of the Public Aid for the Aged Act; hereinafter referred to as "Insured Person Subject to Domicile Exception" in this Article) and for whom it is determined to have had domicile in another Municipality (a Municipality other than the Municipality where said Facility Subject to Domicile Exception is located) at the time of moving in for Admission, etc., at said Facility Subject to Domicile Exception, shall be an Insured Person of Long-Term Care Insurance provided by said other Municipality of prior domicile, notwithstanding the provisions of Article 9; however, provided that this provision shall not apply to an Insured Person Subject to Domicile Exception who moved in for Admission, etc., into two or more of a said Facility Subject to Domicile Exception, and said Person is determined to have moved consecutively from one said Facility Subject to Domicile Exception in which said Insured Person was admitted immediately prior to the said Facility Subject to Domicile Exception where said Insured Person is currently residing for Admission, etc. (herein referred to as the "Facility of First Prior Admission of an Insured Person" in this paragraph) into a Facility Subject to Domicile Exception in which said Insured Person is currently residing (herein referred to as the "Facility of Current Admission of an Insured Person" in this paragraph and the following paragraph) (collectively herein referred to as "Specified Continuous Admission of an Insured Person" in the following paragraph):
一 介護保険施設
(i) Facility Covered by Long-Term Care Insurance;
二 特定施設
(ii) Specified Facility;
三 老人福祉法第二十条の四に規定する養護老人ホーム
(iii) a Care Facility for the Elderly as provided in Article 20-4 of the Public Aid for the Aged Act.
2 特定継続入所被保険者のうち、次の各号に掲げるものは、第九条の規定にかかわらず、当該各号に定める市町村が行う介護保険の被保険者とする。
(2) A person described in any of the following items that corresponds to the conditions of a Specified Continuous Admission of an Insured Person shall be an Insured Person of Long-Term Care Insurance of the Municipality as prescribed respectively in the following items, notwithstanding the provisions of Article 9:
一 継続して入所等をしている二以上の住所地特例対象施設のそれぞれに入所等をすることによりそれぞれの住所地特例対象施設の所在する場所に順次住所を変更したと認められる住所地特例対象被保険者であって、当該二以上の住所地特例対象施設のうち最初の住所地特例対象施設に入所等をした際他の市町村(現入所施設が所在する市町村以外の市町村をいう。)の区域内に住所を有していたと認められるもの 当該他の市町村
(i) an Insured Person Subject to Domicile Exception for whom it is determined to have changed his or her domicile consecutively from one location where a Facility Subject to Domicile Exception is located to another such Facility by moving in for Admission, etc., at two or more of a Facility Subject to Domicile Exception, where in each said Facility the Insured Person moved in for Admission, etc., continuously, and is considered to have had domicile in another Municipality (a Municipality other than the Municipality where the Facility of Current Admission of an Insured Person is located) when said Insured Person moved in for Admission, etc., at said Facility of First Prior Admission of an Insured Person, from among two or more of a said Facility Subject to Domicile Exception, said other Municipality;
二 継続して入所等をしている二以上の住所地特例対象施設のうち一の住所地特例対象施設から継続して他の住所地特例対象施設に入所等をすること(以下この号において「継続入所等」という。)により当該一の住所地特例対象施設の所在する場所以外の場所から当該他の住所地特例対象施設の所在する場所への住所の変更(以下この号において「特定住所変更」という。)を行ったと認められる住所地特例対象被保険者であって、最後に行った特定住所変更に係る継続入所等の際他の市町村(現入所施設が所在する市町村以外の市町村をいう。)の区域内に住所を有していたと認められるもの 当該他の市町村
(ii) an Insured Person Subject to Domicile Exception for whom it is determined to have changed domicile from a location other than where one of a Facility Subject to Domicile Exception is located to a place where another said Facility Subject to Domicile Exception is located (herein referred to as "Change of Specified Domicile" in this item) by moving in for continuous Admission, etc., from one of two or more of a said Facility Subject to Domicile Exception where the Insured Person continues Admission, etc., to another said Facility Subject to Domicile Exception (herein referred to as "Continuous Admission, etc." in this item), and is considered to have had a domicile in another Municipality (a Municipality other than the Municipality where the Facility of Current Admission of an Insured Person is located) when moving in for Continuous Admission, etc., pertaining to a Change of Specified Domicile for the most recent occurrence, said other Municipality.
3 住所地特例対象被保険者が入所等をしている住所地特例対象施設は、当該住所地特例対象施設の所在する市町村及び当該住所地特例対象被保険者に対し介護保険を行う市町村に、必要な協力をしなければならない。
(3) A Facility Subject to Domicile Exception where an Insured Person Subject to Domicile Exception is in Admission, etc., shall provide the necessary cooperation to the Municipality where said Facility Subject to Domicile Exception is located and is the Municipality that provides Long-Term Care Insurance to said Insured Person Subject to Domicile Exception.
第三章 介護認定審査会
Chapter III Certification Committee of Needed Long-Term Care
(介護認定審査会)
(Certification Committee of Needed Long-Term Care)
第十四条 第三十八条第二項に規定する審査判定業務を行わせるため、市町村に介護認定審査会(以下「認定審査会」という。)を置く。
Article 14 A Certification Committee of Needed Long-Term Care (herein referred to as "Certification Committee") shall be established in a Municipality in order to perform the examination and determination as prescribed in Article 38, paragraph (2) of this Act.
(委員)
(Certification Committee Members)
第十五条 認定審査会の委員の定数は、政令で定める基準に従い条例で定める数とする。
Article 15 (1) The fixed number of Certification Committee members shall be the number specified by prefectural ordinance in accordance with standards specified by a Cabinet Order.
2 委員は、要介護者等の保健、医療又は福祉に関する学識経験を有する者のうちから、市町村長(特別区にあっては、区長。以下同じ。)が任命する。
(2) Certification Committee members shall be appointed by the mayor of a Municipality (or the ward mayor, for special city wards; the same shall apply hereinafter) and shall be a person with relevant knowledge and experience pertaining to health care, medical care, or for the administration of public aid of an Insured Person Requiring Long-Term Care, etc.
(共同設置の支援)
(Support for Co-Establishment)
第十六条 都道府県は、認定審査会について地方自治法(昭和二十二年法律第六十七号)第二百五十二条の七第一項の規定による共同設置をしようとする市町村の求めに応じ、市町村相互間における必要な調整を行うことができる。
Article 16 (1) A prefecture may perform the necessary coordination among Municipalities according to a request from a Municipality that intends to co-establish a Certification Committee pursuant to Article 252-7, paragraph (1) of the Local Autonomy Act (Act No. 67 of 1947).
2 都道府県は、認定審査会を共同設置した市町村に対し、その円滑な運営が確保されるように必要な技術的な助言その他の援助をすることができる。
(2) A prefecture may provide to Municipalities that have co-established a Certification Committee the technical advice and other support necessary for ensuring its efficient operation.
(政令への委任規定)
(Provisions Pertaining to Delegation of a Cabinet Order)
第十七条 この法律に定めるもののほか、認定審査会に関し必要な事項は、政令で定める。
Article 17 In addition to the provisions of this Act, necessary matters pertaining to a Certification Committee shall be provided by a Cabinet Order.
第四章 保険給付
Chapter IV Insurance Benefits
第一節 通則
Section 1 General Rules
(保険給付の種類)
(Types of Insurance Benefits)
第十八条 この法律による保険給付は、次に掲げる保険給付とする。
Article 18 Insurance benefits provided by this Act shall be the following insurance benefits:
一 被保険者の要介護状態に関する保険給付(以下「介護給付」という。)
(i) insurance benefits pertaining to the Condition of Need for Long-Term Care of an Insured Person (hereinafter referred to as "Long-Term Care Benefit");
二 被保険者の要支援状態に関する保険給付(以下「予防給付」という。)
(ii) insurance benefits pertaining to the Needed Support Condition of an Insured Person (herein referred to as "Prevention Benefit");
三 前二号に掲げるもののほか、要介護状態又は要支援状態の軽減又は悪化の防止に資する保険給付として条例で定めるもの(第五節において「市町村特別給付」という。)
(iii) in addition to the provisions of the preceding two items, insurance benefits provided by a municipal ordinance as insurance benefits that contribute to the reduction or prevention of deterioration of a Condition of Need for Long-Term Care or a Needed Support Condition (herein referred to as "Municipal Special Benefit" in Section V).
(市町村の認定)
(Certification by a Municipality)
第十九条 介護給付を受けようとする被保険者は、要介護者に該当すること及びその該当する要介護状態区分について、市町村の認定(以下「要介護認定」という。)を受けなければならない。
Article 19 (1) An Insured Person that intends to receive a Long-Term Care Benefit shall obtain certification by a Municipality pertaining to the fact that said Insured Person qualifies as a Person Requiring Long-Term Care and as to the Category of Condition of Need for Long-Term Care for which said Insured Person qualifies (herein referred to as "Certification of Needed Long-Term Care").
2 予防給付を受けようとする被保険者は、要支援者に該当すること及びその該当する要支援状態区分について、市町村の認定(以下「要支援認定」という。)を受けなければならない。
(2) An Insured Person that intends to receive a Prevention Benefit shall obtain certification by a Municipality pertaining to the fact that said Insured Person qualifies as a Person Requiring Support and as to the Category of Needed Support Condition for which said Insured Person qualifies (herein referred to as "Certification of Needed Support").
(他の法令による給付との調整)
(Coordination with Benefits Provided by Other Laws and Regulations)
第二十条 介護給付又は予防給付(以下「介護給付等」という。)は、当該要介護状態又は要支援状態(以下「要介護状態等」という。)につき、労働者災害補償保険法(昭和二十二年法律第五十号)の規定による療養補償給付若しくは療養給付その他の法令に基づく給付であって政令で定めるもののうち介護給付等に相当するものを受けることができるときは政令で定める限度において、又は当該政令で定める給付以外の給付であって国若しくは地方公共団体の負担において介護給付等に相当するものが行われたときはその限度において、行わない。
Article 20 A Long-Term Care Benefit or Prevention Benefit (herein referred to as "Long-Term Care Benefit, etc.") with regard to said Condition of Need for Long-Term Care or Needed Support Condition (herein referred to as "Condition of Need for Long-Term Care, etc.") shall not be provided within the limit provided by a Cabinet Order when a benefit equivalent to a Long-Term Care Benefit, etc., can be received from among benefits that is a medical compensation benefit pursuant to the provisions of the Worker Accident Compensation Insurance Act (Act No. 50 of 1947), a medical benefit, or other benefits based on laws and regulations and provided by a Cabinet Order, or within said limit when benefits other than those provided by said a Cabinet Order and those benefits equivalent to a Long-Term Care Benefit, etc., are granted under the covered expenses of a plan of the national government or a local government.
(損害賠償請求権)
(Right to Claim Compensation for Damages)
第二十一条 市町村は、給付事由が第三者の行為によって生じた場合において、保険給付を行ったときは、その給付の価額の限度において、被保険者が第三者に対して有する損害賠償の請求権を取得する。
Article 21 (1) When the basis for benefit claim is caused by the act of a third party and a Municipality provides insurance benefits, the Municipality shall obtain the right to claim compensation for the damages which an Insured Person holds against the third party within the limit of the amount of said benefit.
2 前項に規定する場合において、保険給付を受けるべき者が第三者から同一の事由について損害賠償を受けたときは、市町村は、その価額の限度において、保険給付を行う責めを免れる。
(2) In a case as prescribed in the preceding paragraph, when a person to be granted an insurance benefit receives compensation for damages for the same reason from a third party, a Municipality shall not be responsible for payment of said insurance benefit within the limit of the compensation amount.
3 市町村は、第一項の規定により取得した請求権に係る損害賠償金の徴収又は収納の事務を国民健康保険法第四十五条第五項に規定する国民健康保険団体連合会(以下「連合会」という。)であって厚生労働省令で定めるものに委託することができる。
(3) A Municipality may entrust affairs of the collection or receipt of compensation for damages pertaining to the claim of right obtained pursuant to the provisions of paragraph (1) of this Article to the Federation of National Health Insurance Associations as prescribed in Article 45, paragraph (5) of the National Health Insurance Act (herein referred to as "Association") as determined by an Ordinance of the Ministry of Health, Labour, and Welfare.
(不正利得の徴収等)
(Collection, etc., of Fraudulent Gain)
第二十二条 偽りその他不正の行為によって保険給付を受けた者があるときは、市町村は、その者からその給付の価額の全部又は一部を徴収することができる。
Article 22 (1) In a case when a person receives an insurance benefit by deception or other wrongful act, a Municipality may collect in whole or a portion of said benefit amount from said person.
2 前項に規定する場合において、訪問看護、訪問リハビリテーション、通所リハビリテーション若しくは短期入所療養介護又は介護予防訪問看護、介護予防訪問リハビリテーション、介護予防通所リハビリテーション若しくは介護予防短期入所療養介護についてその治療の必要の程度につき診断する医師その他居宅サービス若しくはこれに相当するサービス、施設サービス又は介護予防サービス若しくはこれに相当するサービスに従事する医師又は歯科医師が、市町村に提出されるべき診断書に虚偽の記載をしたため、その保険給付が行われたものであるときは、市町村は、当該医師又は歯科医師に対し、保険給付を受けた者に連帯して同項の徴収金を納付すべきことを命ずることができる。
(2) In a case as prescribed in the preceding paragraph, with regard to Home-Visit Nursing, Home-Visit Rehabilitation, Outpatient Rehabilitation, Short-Term Admission for Recuperation, Home-Visit Nursing Service for Preventive Long-Term Care, Home-Visit Rehabilitation Service for Preventive Long-Term Care, Outpatient Rehabilitation for Preventive Long-Term Care, Short-Term Admission for Recuperation for Preventive Long-Term Care, when an insurance benefit for said services is granted because a physician who diagnoses the degree of necessity of said treatment or another physician or dentist who engages in In-Home Long-Term Care or equivalent services, Facility Service, Preventive Long-Term Care Service or equivalent services, has made a false entry on the medical certification which is to be submitted to a Municipality, the Municipality may order said physician or dentist to pay the levy as prescribed by the above paragraph jointly and severally with the person that received the insurance benefit.
3 市町村は、第四十一条第一項に規定する指定居宅サービス事業者、第四十二条の二第一項に規定する指定地域密着型サービス事業者、第四十六条第一項に規定する指定居宅介護支援事業者、介護保険施設、第五十三条第一項に規定する指定介護予防サービス事業者、第五十四条の二第一項に規定する指定地域密着型介護予防サービス事業者又は第五十八条第一項に規定する指定介護予防支援事業者(以下この項において「指定居宅サービス事業者等」という。)が、偽りその他不正の行為により第四十一条第六項、第四十二条の二第六項、第四十六条第四項、第四十八条第四項、第五十一条の二第四項、第五十三条第四項、第五十四条の二第六項、第五十八条第四項又は第六十一条の二第四項の規定による支払を受けたときは、当該指定居宅サービス事業者等に対し、その支払った額につき返還させるほか、その返還させる額に百分の四十を乗じて得た額を支払わせることができる。
(3) When a Designated In-Home Service Provider as prescribed in Article 41, paragraph (1) of this Act; a Designated Community-Based Service Provider as prescribed in Article 42-2, paragraph (1); a Designated In-Home Long-Term Care Support Provider as prescribed in Article 46, paragraph (1); a Facility Covered by Long-Term Care Insurance; a Designated Provider of a Preventive Service to Long-Term Care as prescribed in Article 53, paragraph (1); a Designated Provider of Community-Based Preventive Service of Long-Term Care as prescribed in Article 54-2, paragraph (1); or a Designated Provider of Support for Prevention of Long-Term Care as prescribed in Article 58, paragraph (1) (hereinafter collectively referred to as "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 48, paragraph (4), Article 51-2, paragraph (4), Article 53, paragraph (4), Article 54-2, paragraph (6), Article 58, paragraph (4), or Article 61-2, paragraph (4) by deception or other wrongful act, a Municipality may require said Designated In-Home Service Provider, etc., to return the amount paid, or to pay the amount obtained by multiplying 40 percent of the principal amount to be returned.
(文書の提出等)
(Submission, etc., of Documents)
第二十三条 市町村は、保険給付に関して必要があると認めるときは、当該保険給付を受ける者若しくは当該保険給付に係る居宅サービス等(居宅サービス(これに相当するサービスを含む。)、地域密着型サービス(これに相当するサービスを含む。)、居宅介護支援(これに相当するサービスを含む。)、施設サービス、介護予防サービス(これに相当するサービスを含む。)、地域密着型介護予防サービス(これに相当するサービスを含む。)若しくは介護予防支援(これに相当するサービスを含む。)をいう。以下同じ。)を担当する者若しくは保険給付に係る第四十五条第一項に規定する住宅改修を行う者又はこれらの者であった者(第二十四条の二第一項第一号において「照会等対象者」という。)に対し、文書その他の物件の提出若しくは提示を求め、若しくは依頼し、又は当該職員に質問若しくは照会をさせることができる。
Article 23 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), Facility Service, Preventive Long-Term Care Service (including equivalent services), Community-Based Service for Preventive Long-Term Care (including equivalent services), or a Preventive Long-Term Care Support (including equivalent services); the same shall apply hereinafter) , or a person that provides a house modification for in-home care 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").
(帳簿書類の提示等)
(Presentation, etc., of Record Books and Documents)
第二十四条 厚生労働大臣又は都道府県知事は、介護給付等(居宅介護住宅改修費の支給及び介護予防住宅改修費の支給を除く。次項及び第二百八条において同じ。)に関して必要があると認めるときは、居宅サービス等を行った者又はこれを使用する者に対し、その行った居宅サービス等に関し、報告若しくは当該居宅サービス等の提供の記録、帳簿書類その他の物件の提示を命じ、又は当該職員に質問させることができる。
Article 24 (1) The Minister of Health, Labour, and Welfare or a prefectural governor may, when it is determined that it is necessary as pertaining to a Long-Term Care Benefit, etc. (except for payments of an Allowance for Home Modification for In-Home Long-Term Care and an Allowance for Preventive Long-Term Care Home Modification; the same shall apply in the following paragraph and Article 208), order a person that has provided In-Home Service, etc., or employees of said Services, etc., to report and provide records of said In-Home Service, etc., to present record books and documents, and other items, and direct personnel to ask questions concerning the In-Home Service, etc., provided by said person.
2 厚生労働大臣又は都道府県知事は、必要があると認めるときは、介護給付等を受けた被保険者又は被保険者であった者に対し、当該介護給付等に係る居宅サービス等(以下「介護給付等対象サービス」という。)の内容に関し、報告を命じ、又は当該職員に質問させることができる。
(2) The Minister of Health, Labour, and Welfare or a prefectural governor, when it is determined that it is necessary, may order an Insured Person that received a Long-Term Care Benefit, etc., and a person that was the Insured Person to report and direct its personnel to ask questions concerning the content of the In-Home Service, etc., pertaining to said Long-Term Care Benefit, etc. (herein referred to as "Service Covered by Long-Term Care Benefits, etc.").
3 前二項の規定による質問を行う場合においては、当該職員は、その身分を示す証明書を携帯し、かつ、関係人の請求があるときは、これを提示しなければならない。
(3) In a case of asking questions pursuant to the provisions of the preceding two paragraphs, said personnel shall carry identification and shall present the same if required by the relevant person to be questioned.
4 第一項及び第二項の規定による権限は、犯罪捜査のために認められたものと解釈してはならない。
(4) The authority granted pursuant to the provisions of paragraphs (1) and (2) shall not be construed as an approval of a criminal investigation.
(指定市町村事務受託法人)
(Designated and Entrusted Juridical Person for Municipal Affairs)
第二十四条の二 市町村は、次に掲げる事務の一部を、法人であって厚生労働省令で定める要件に該当し、当該事務を適正に実施することができると認められるものとして都道府県知事が指定するもの(以下この条において「指定市町村事務受託法人」という。)に委託することができる。
Article 24-2 (1) A Municipality may entrust a portion of the following affairs to a juridical person that qualifies as per the requirements as determined by an Ordinance of the Ministry of Health, Labour, and Welfare, and is designated by a prefectural governor as a person that can perform said affairs appropriately (herein referred to as "Designated and Entrusted Juridical Person for Municipal Affairs" in this Article):
一 第二十三条に規定する事務(照会等対象者の選定に係るものを除く。)
(i) affairs as prescribed in Article 23 of this Act (except for affairs pertaining to the selection of a Person Subject to an Inquiry, etc.);
二 第二十七条第二項(第二十八条第四項、第二十九条第二項、第三十条第二項、第三十一条第二項及び第三十二条第二項(第三十三条第四項、第三十三条の二第二項、第三十三条の三第二項及び第三十四条第二項において準用する場合を含む。)において準用する場合を含む。)の規定による調査に関する事務
(ii) 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 (2), 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 (2)));
三 その他厚生労働省令で定める事務
(iii) other affairs as determined by an Ordinance of the Ministry of Health, Labour, and Welfare.
2 指定市町村事務受託法人は、前項第二号の事務を行うときは、介護支援専門員その他厚生労働省令で定める者に当該委託に係る調査を行わせるものとする。
(2) A Designated and Entrusted Juridical Person for Municipal Affairs, when performing affairs as set forth in item (ii) of the preceding paragraph, shall assign a Long-Term Care Support Specialist or other person as determined by an Ordinance of the Ministry of Health, Labour, and Welfare to implement the inspection pertaining to said entrustment.
3 指定市町村事務受託法人の役員若しくは職員(前項の介護支援専門員その他厚生労働省令で定める者を含む。次項において同じ。)又はこれらの職にあった者は、正当な理由なしに、当該委託事務に関して知り得た秘密を漏らしてはならない。
(3) An Officer or personnel of a Designated and Entrusted Juridical Person for Municipal Affairs (including a Long-Term Care Support Specialist or other person as determined by an Ordinance of the Ministry of Health, Labour, and Welfare as set forth in the preceding paragraph; the same shall apply in the following paragraph) or a person that held that position shall not divulge any confidential information learned pertaining to said entrusted affairs without a justifiable reason.
4 指定市町村事務受託法人の役員又は職員で、当該委託事務に従事するものは、刑法(明治四十年法律第四十五号)その他の罰則の適用については、法令により公務に従事する職員とみなす。
(4) An Officer or personnel of a Designated and Entrusted Juridical Person for Municipal Affairs who engage in said entrusted affairs shall be deemed as personnel engaged in public service pursuant to the provisions of laws and regulations with regard to the application of the Penal Code (Act No. 45 of 1907) and other penal provisions.
5 市町村は、第一項の規定により事務を委託したときは、厚生労働省令で定めるところにより、その旨を公示しなければならない。
(5) A Municipality, when entrusting affairs pursuant to the provisions of paragraph (1), shall issue public notice of this effect pursuant to the provisions of an Ordinance of the Ministry of Health, Labour, and Welfare.
6 前各項に定めるもののほか、指定市町村事務受託法人に関し必要な事項は、政令で定める。
(6) In addition to the provisions as prescribed in each of the preceding paragraphs of this Article, other necessary matters pertaining to a Designated and Entrusted Juridical Person for Municipal Affairs shall be as prescribed by a Cabinet Order.
(受給権の保護)
(Protection of Right to Benefit)
第二十五条 保険給付を受ける権利は、譲り渡し、担保に供し、又は差し押さえることができない。
Article 25 The right to receive an insurance benefit may not be transferred, pledged as collateral, or levied.
(租税その他の公課の禁止)
(Prohibition of Taxation and Other Public Dues)
第二十六条 租税その他の公課は、保険給付として支給を受けた金品を標準として、課することができない。
Article 26 Taxation and other public dues may not be imposed by establishing money or goods that are provided as an insurance benefit as a standard.
第二節 認定
Section 2 Certification
(要介護認定)
(Certification of Needed Long-Term Care)
第二十七条 要介護認定を受けようとする被保険者は、厚生労働省令で定めるところにより、申請書に被保険者証を添付して市町村に申請をしなければならない。この場合において、当該被保険者は、厚生労働省令で定めるところにより、第四十六条第一項に規定する指定居宅介護支援事業者、地域密着型介護老人福祉施設若しくは介護保険施設であって厚生労働省令で定めるもの又は第百十五条の三十九第一項に規定する地域包括支援センターに、当該申請に関する手続を代わって行わせることができる。
Article 27 (1) An Insured Person that intends to obtain a Certification of Needed Long-Term Care, pursuant to the provisions of an Ordinance of the Ministry of Health, Labour, and Welfare, shall submit an application with attachment of Certificate of Insured Person to a Municipality. In this case, said Insured Person, pursuant to the provisions of an Ordinance of the Ministry of Health, Labour, and Welfare, may have a Designated In-Home Long-Term Care Support Provider as prescribed in Article 46, paragraph (1), a Community-Based Facility for the Elderly Covered by Public Aid Requiring Long-Term Care, or a Facility Covered by Long-Term Care Insurance, and those which are determined by an Ordinance of the Ministry of Health, Labour, and Welfare, or a community general support center as prescribed in Article 115-39, paragraph (1) implement procedures pertaining to said application on behalf of said Insured Person.
2 市町村は、前項の申請があったときは、当該職員をして、当該申請に係る被保険者に面接させ、その心身の状況、その置かれている環境その他厚生労働省令で定める事項について調査をさせるものとする。この場合において、市町村は、当該被保険者が遠隔の地に居所を有するときは、当該調査を他の市町村に嘱託することができる。
(2) A Municipality shall, when the application as prescribed in the preceding paragraph is submitted, direct its personnel to interview said Insured Person pertaining to said application and investigate the mental and physical condition and surroundings of said Insured Person, and other matters as determined by an Ordinance of the Ministry of Health, Labour, and Welfare. In this case, the Municipality may, when said Insured Person has a residence in a remote place, commission said investigation to another Municipality.
3 市町村は、第一項の申請があったときは、当該申請に係る被保険者の主治の医師に対し、当該被保険者の身体上又は精神上の障害の原因である疾病又は負傷の状況等につき意見を求めるものとする。ただし、当該被保険者に係る主治の医師がないときその他当該意見を求めることが困難なときは、市町村は、当該被保険者に対して、その指定する医師又は当該職員で医師であるものの診断を受けるべきことを命ずることができる。
(3) A Municipality shall, when the application as prescribed in paragraph (1) is submitted, request an attending physician of the Insured Person pertaining to said application for opinions regarding the status of illness or injury that is the cause of the physical or mental problems of said Insured Person, however, provided that the Municipality may, when there is no attending physician of the Insured Person pertaining to said application, or it is difficult to request for said opinion, etc., order said Insured Person to obtain the diagnosis of a designated physician or from the Municipality's personnel who is a physician.
4 市町村は、第二項の調査(第二十四条の二第一項第二号の規定により委託された場合にあっては、当該委託に係る調査を含む。)の結果、前項の主治の医師の意見又は指定する医師若しくは当該職員で医師であるものの診断の結果その他厚生労働省令で定める事項を認定審査会に通知し、第一項の申請に係る被保険者について、次の各号に掲げる被保険者の区分に応じ、当該各号に定める事項に関し審査及び判定を求めるものとする。
(4) A Municipality shall notify the relevant Certification Committee of the result of the investigation as set forth in paragraph (2) (in a case of entrustment pursuant to the provisions of Article 24-2, paragraph (1), item (ii), including an investigation pertaining to said entrustment) of the opinion of the attending physician as prescribed in the preceding paragraph, the result of a diagnosis by the designated physician or its personnel who is a physician, and other matters as specified by an Ordinance of the Ministry of Health, Labour, and Welfare, and request an examination and judgment pertaining to matters as prescribed in each said item according to the Category of the Insured Person as listed in the following items with regard to the Insured Person pertaining to an application as prescribed in paragraph (1):
一 第一号被保険者 要介護状態に該当すること及びその該当する要介護状態区分
(i) Primary Insured Person: those who qualify with a Condition of Need for Long-Term Care and Category of Condition of Need for Long-Term Care that said condition is subject to;
二 第二号被保険者 要介護状態に該当すること、その該当する要介護状態区分及びその要介護状態の原因である身体上又は精神上の障害が特定疾病によって生じたものであること。
(ii) Secondary Insured Person: those who qualify with a Condition of Need for Long-Term Care and Category of Condition of Need for Long-Term Care that said condition is subject to, and the physical or mental problems causing said Condition of Need for Long-Term Care is caused by a Specified Disease.
5 認定審査会は、前項の規定により審査及び判定を求められたときは、厚生労働大臣が定める基準に従い、当該審査及び判定に係る被保険者について、同項各号に規定する事項に関し審査及び判定を行い、その結果を市町村に通知するものとする。この場合において、認定審査会は、必要があると認めるときは、次に掲げる事項について、市町村に意見を述べることができる。
(5) A Certification Committee shall, when being requested to conduct an examination and provide judgment pursuant to the provisions of the preceding paragraph, act in compliance with standards as determined by the Minister of Health, Labour, and Welfare, examine and judge matters as prescribed in each item of the same paragraph of the Insured Person pertaining to said examination and judgment, and notify said result to the Municipality. In this case, a Certification Committee may, when it determines it necessary, state opinions to the Municipality regarding the matters listed as follows:
一 当該被保険者の要介護状態の軽減又は悪化の防止のために必要な療養に関する事項
(i) matters concerning the necessary medical care for the reduction or prevention of deterioration of the Condition of Need for Long-Term Care of said Insured Person;
二 第四十一条第一項に規定する指定居宅サービス、第四十二条の二第一項に規定する指定地域密着型サービス又は第四十八条第一項に規定する指定施設サービス等の適切かつ有効な利用等に関し当該被保険者が留意すべき事項
(ii) matters that said Insured Person shall heed for the appropriate and effective use of a Designated In-Home Service as prescribed in Article 41, paragraph (1) of this Act, a Designated Community-Based Service as prescribed in Article 42-2, paragraph (1), or a Designated Facility Service, etc., as prescribed in Article 48, paragraph (1).
6 認定審査会は、前項前段の審査及び判定をするに当たって必要があると認めるときは、当該審査及び判定に係る被保険者、その家族、第三項の主治の医師その他の関係者の意見を聴くことができる。
(6) A Certification Committee may, when it determines it necessary in an examination or judgment referred to in the first sentence of the preceding paragraph, hear opinions of the Insured Person pertaining to said examination and judgment, said Person's family members, the attending physician as set forth in paragraph (3), and other relevant persons.
7 市町村は、第五項前段の規定により通知された認定審査会の審査及び判定の結果に基づき、要介護認定をしたときは、その結果を当該要介護認定に係る被保険者に通知しなければならない。この場合において、市町村は、次に掲げる事項を当該被保険者の被保険者証に記載し、これを返付するものとする。
(7) 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), shall 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 the Certificate of Insured Person of said Insured Person and return the Certificate of Insured Person to the Insured Person:
一 該当する要介護状態区分
(i) applicable Category of Condition of Need for Long-Term Care;
二 第五項第二号に掲げる事項に係る認定審査会の意見
(ii) opinions of the Certification Committee pertaining to the matters listed in paragraph (5), item (ii).
8 要介護認定は、その申請のあった日にさかのぼってその効力を生ずる。
(8) A Certification of Needed Long-Term Care shall become effective retroactively on the date that said application was submitted.
9 市町村は、第五項前段の規定により通知された認定審査会の審査及び判定の結果に基づき、要介護者に該当しないと認めたときは、理由を付して、その旨を第一項の申請に係る被保険者に通知するとともに、当該被保険者の被保険者証を返付するものとする。
(9) 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), shall notify said Insured Person of that effect, indicating the reason(s), and return the Certificate of Insured Person of said Insured Person.
10 市町村は、第一項の申請に係る被保険者が、正当な理由なしに、第二項の規定による調査(第二十四条の二第一項第二号の規定により委託された場合にあっては、当該委託に係る調査を含む。)に応じないとき、又は第三項ただし書の規定による診断命令に従わないときは、第一項の申請を却下することができる。
(10) A Municipality may dismiss an application submitted pursuant to paragraph (1) when the Insured Person pertaining to the application as set forth in paragraph (1) fails to respond to an investigation pursuant to the provisions of paragraph (2) (in a case of entrustment pursuant to the provisions of Article 24-2, paragraph (1), item (ii), an investigation pertaining to said entrustment shall be included) without a justifiable reason or when said Insured Person fails to comply with an order for a diagnosis pursuant to the provisions of the proviso of paragraph (3).
11 第一項の申請に対する処分は、当該申請のあった日から三十日以内にしなければならない。ただし、当該申請に係る被保険者の心身の状況の調査に日時を要する等特別な理由がある場合には、当該申請のあった日から三十日以内に、当該被保険者に対し、当該申請に対する処分をするためになお要する期間(次項において「処理見込期間」という。)及びその理由を通知し、これを延期することができる。
(11) Action for an application as set forth in paragraph (1) shall be performed within thirty (30) days from the date of submission of said application, however, provided that in a case that there are special reasons that an investigation of the mental or physical conditions of the Insured Person pertaining to said application may require additional hours or days, etc., said action for the matter may be postponed after notifying said Insured Person of the additional period necessary for the action for said application (herein referred to as the "Prospective Processing Period" in the following paragraph) and said reasons within thirty (30) days from the date of submission of said application.
12 第一項の申請をした日から三十日以内に当該申請に対する処分がされないとき、若しくは前項ただし書の通知がないとき、又は処理見込期間が経過した日までに当該申請に対する処分がされないときは、当該申請に係る被保険者は、市町村が当該申請を却下したものとみなすことができる。
(12) In a case when the action for an application as set forth in paragraph (1) has not been executed within thirty (30) days from the date of submission of said application or the notification as set forth in the proviso of the preceding paragraph has not been issued, or when the action for said application has not been executed by the date that the Prospective Processing Period expires, the Insured Person pertaining to said application may deem that the Municipality has dismissed said application.
(要介護認定の更新)
(Renewal of Certification of Needed Long-Term Care)
第二十八条 要介護認定は、要介護状態区分に応じて厚生労働省令で定める期間(以下この条において「有効期間」という。)内に限り、その効力を有する。
Article 28 (1) A Certification of Needed Long-Term Care shall be effective according to the Category of Condition of Need for Long-Term Care during the period as determined by an Ordinance of the Ministry of Health, Labour, and Welfare (herein referred to as the "Effective Period" in this Article).
2 要介護認定を受けた被保険者は、有効期間の満了後においても要介護状態に該当すると見込まれるときは、厚生労働省令で定めるところにより、市町村に対し、当該要介護認定の更新(以下「要介護更新認定」という。)の申請をすることができる。
(2) An Insured Person that is issued a Certification of Needed Long-Term Care, when he or she is expected to be in a Condition of Need for Long-Term Care although after the expiry of the Effective Period, may apply to the Municipality for an application of renewal of said Certification of Needed Long-Term Care (herein referred to as a "Renewal of Certification of Needed Long-Term Care") pursuant to the provisions of an Ordinance of the Ministry of Health, Labour, and Welfare.
3 前項の申請をすることができる被保険者が、災害その他やむを得ない理由により当該申請に係る要介護認定の有効期間の満了前に当該申請をすることができなかったときは、当該被保険者は、その理由のやんだ日から一月以内に限り、要介護更新認定の申請をすることができる。
(3) In a case when an Insured Person that may apply for the renewal application as set forth in the preceding paragraph was not able to apply for said renewal application prior to the expiry of the Effective Period of Certification of Needed Long-Term Care pertaining to said application due to a disaster or other compelling reason, said Insured Person may apply for a Renewal of Certification of Needed Long-Term Care within one month following the date on which said reason for delay is no longer valid.
4 前条(第八項を除く。)の規定は、前二項の申請及び当該申請に係る要介護更新認定について準用する。この場合において、同条の規定に関し必要な技術的読替えは、政令で定める。
(4) The provisions of the preceding Article (except paragraph (8)) shall apply mutatis mutandis to an application as set forth in the preceding two paragraphs and to an application for Renewal of Certification of Needed Long-Term Care pertaining to said application. In this case, the necessary technical replacement of terms used in the provisions of the same Article shall be provided by a Cabinet Order.
5 市町村は、前項において準用する前条第二項の調査を第四十六条第一項に規定する指定居宅介護支援事業者、地域密着型介護老人福祉施設、介護保険施設その他の厚生労働省令で定める事業者若しくは施設(以下この条において「指定居宅介護支援事業者等」という。)又は介護支援専門員であって厚生労働省令で定めるものに委託することができる。
(5) 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 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 an Ordinance 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 an Ordinance of the Ministry of Health, Labour, and Welfare.
6 前項の規定により委託を受けた指定居宅介護支援事業者等は、介護支援専門員その他厚生労働省令で定める者に当該委託に係る調査を行わせるものとする。
(6) A Designated In-Home Long-Term Care Support Provider, etc., entrusted pursuant to the provisions of the preceding paragraph shall direct a Long-Term Care Support Specialist or other person as determined by an Ordinance of the Ministry of Health, Labour, and Welfare to perform an investigation pertaining to said entrustment.
7 第五項の規定により委託を受けた指定居宅介護支援事業者等(その者が法人である場合にあっては、その役員。次項において同じ。)若しくはその職員(前項の介護支援専門員その他厚生労働省令で定める者を含む。次項において同じ。)若しくは介護支援専門員又はこれらの職にあった者は、正当な理由なしに、当該委託業務に関して知り得た個人の秘密を漏らしてはならない。
(7) A Designated In-Home Long-Term Care Support Provider, etc., entrusted pursuant to the provisions of paragraph (5) (in cases when said person is a juridical person, its Officers; the same shall apply in the following paragraph), its personnel (including a Long-Term Care Support Specialist as prescribed in the preceding paragraph or other person as determined by an Ordinance of the Ministry of Health, Labour, and Welfare; the same shall apply in the following paragraph), a Long-Term Care Support Specialist or other person that was in said position shall not divulge any personal confidential information learned from said entrusted operations without a justifiable reason.
8 第五項の規定により委託を受けた指定居宅介護支援事業者等若しくはその職員又は介護支援専門員で、当該委託業務に従事するものは、刑法その他の罰則の適用については、法令により公務に従事する職員とみなす。
(8) A Designated In-Home Long-Term Care Support Provider, etc., entrusted pursuant to the provisions of paragraph (5), its personnel, or a Long-Term Care Support Specialist that engages in said entrusted operations shall be deemed as personnel who engage in public service pursuant to the provisions of laws and regulations with regard to the application of the Penal Code and other penal provisions.
9 第三項の申請に係る要介護更新認定は、当該申請に係る要介護認定の有効期間の満了日の翌日にさかのぼってその効力を生ずる。
(9) A Renewal of Certification of Needed Long-Term Care pertaining to an application as set forth in paragraph (3) shall be effective retroactively on the date following the date of expiry of the Effective Period of Certification of Needed Long-Term Care pertaining to said renewal application.
10 第一項の規定は、要介護更新認定について準用する。この場合において、同項中「厚生労働省令で定める期間」とあるのは、「有効期間の満了日の翌日から厚生労働省令で定める期間」と読み替えるものとする。
(10) The provisions of paragraph (1) shall apply mutatis mutandis to a Renewal of Certification of Needed Long-Term Care. In this case, the phrase "period as determined by an Ordinance of the Ministry of Health, Labour, and Welfare" in the same paragraph shall be deemed to be replaced with "period as determined by an Ordinance of the Ministry of Health, Labour, and Welfare from the date following the expiry of the Effective Period."
(要介護状態区分の変更の認定)
(Certification of Change of Category of Condition of Need for Long-Term Care)
第二十九条 要介護認定を受けた被保険者は、その介護の必要の程度が現に受けている要介護認定に係る要介護状態区分以外の要介護状態区分に該当すると認めるときは、厚生労働省令で定めるところにより、市町村に対し、要介護状態区分の変更の認定の申請をすることができる。
Article 29 (1) An Insured Person that was issued a Certification of Needed Long-Term Care, when it is determined that the degree of necessity of 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 the Certification of Needed Long-Term Care which is currently issued, may apply to a Municipality for a Certification of Change of Category of Condition of Need for Long-Term Care, pursuant to the provisions of an Ordinance of the Ministry of Health, Labour, and Welfare.
2 第二十七条及び前条第五項から第八項までの規定は、前項の申請及び当該申請に係る要介護状態区分の変更の認定について準用する。この場合において、これらの規定に関し必要な技術的読替えは、政令で定める。
(2) The provisions of Article 27 and the preceding Article, paragraphs (5) to (8) shall apply mutatis mutandis to an application as prescribed in the preceding paragraph and to a Certification of Change of Category of Condition of Need for Long-Term Care pertaining to said application. In this case, the necessary technical replacement of the terms of these provisions shall be provided by a Cabinet Order.
第三十条 市町村は、要介護認定を受けた被保険者について、その介護の必要の程度が低下したことにより当該要介護認定に係る要介護状態区分以外の要介護状態区分に該当するに至ったと認めるときは、要介護状態区分の変更の認定をすることができる。この場合において、市町村は、厚生労働省令で定めるところにより、当該変更の認定に係る被保険者に対しその被保険者証の提出を求め、これに当該変更の認定に係る要介護状態区分及び次項において準用する第二十七条第五項後段の規定による認定審査会の意見(同項第二号に掲げる事項に係るものに限る。)を記載し、これを返付するものとする。
Article 30 (1) 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 shall request the Insured Person pertaining to said change of certification to submit said Certificate of Insured Person, shall enter the Category of Condition of Need for Long-Term Care pertaining to said change of certification and the opinion of the Certification Committee pursuant to the provisions of the second sentence of Article 27, paragraph (5) as applied mutatis mutandis pursuant to the following paragraph (limited to those changes pertaining to matters listed in item (ii) of the same paragraph), and then return said Certificate of Insured Person to the Insured Person.
2 第二十七条第二項から第六項まで及び第七項前段並びに第二十八条第五項から第八項までの規定は、前項の要介護状態区分の変更の認定について準用する。この場合において、これらの規定に関し必要な技術的読替えは、政令で定める。
(2) The provisions of Article 27, paragraphs (2) to (6), the first sentence of paragraph (7), and Article 28, paragraphs (5) to (8) shall 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.
(要介護認定の取消し)
(Rescission of Certification of Needed Long-Term Care)
第三十一条 市町村は、要介護認定を受けた被保険者が次の各号のいずれかに該当するときは、当該要介護認定を取り消すことができる。この場合において、市町村は、厚生労働省令で定めるところにより、当該取消しに係る被保険者に対しその被保険者証の提出を求め、第二十七条第七項各号に掲げる事項の記載を消除し、これを返付するものとする。
Article 31 (1) 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, pursuant to the provisions of an Ordinance of the Ministry of Health, Labour, and Welfare, the Municipality shall 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:
一 要介護者に該当しなくなったと認めるとき。
(i) when the Municipality determines that the Insured Person fails to or no longer qualifies as a Person Requiring Long-Term Care;
二 正当な理由なしに、前条第二項若しくは次項において準用する第二十七条第二項の規定による調査(第二十四条の二第一項第二号又は前条第二項若しくは次項において準用する第二十八条第五項の規定により委託された場合にあっては、当該委託に係る調査を含む。)に応じないとき、又は前条第二項若しくは次項において準用する第二十七条第三項ただし書の規定による診断命令に従わないとき。
(ii) 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 paragraph (in a case when said investigation is entrusted pursuant to the provisions of Article 28, paragraph (5) as applied mutatis mutandis pursuant to Article 24-2, paragraph (1), item (ii), the preceding Article, paragraph (2), or the following paragraph, 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), and the following paragraph.
2 第二十七条第二項から第四項まで、第五項前段、第六項及び第七項前段並びに第二十八条第五項から第八項までの規定は、前項第一号の規定による要介護認定の取消しについて準用する。この場合において、これらの規定に関し必要な技術的読替えは、政令で定める。
(2) 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) shall apply mutatis mutandis to a rescission of a Certification of Needed Long-Term Care pursuant to the provisions of the preceding paragraph, item (i). In this case, the necessary technical replacement of the terms of these provisions shall be provided by a Cabinet Order.
(要支援認定)
(Certification of Needed Support)
第三十二条 要支援認定を受けようとする被保険者は、厚生労働省令で定めるところにより、申請書に被保険者証を添付して市町村に申請をしなければならない。この場合において、当該被保険者は、厚生労働省令で定めるところにより、第四十六条第一項に規定する指定居宅介護支援事業者、地域密着型介護老人福祉施設若しくは介護保険施設であって厚生労働省令で定めるもの又は第百十五条の三十九第一項に規定する地域包括支援センターに、当該申請に関する手続を代わって行わせることができる。
Article 32 (1) An Insured Person that intends to receive a Certification of Needed Support shall submit to a Municipality an application with a Certificate of Insured Person pursuant to the provisions of an Ordinance of the Ministry of Health, Labour, and Welfare. In this case, said Insured Person may, pursuant to the provisions of an Ordinance of the Ministry of Health, Labour, and Welfare, have a Designated In-Home Long-Term Care Support Provider, etc., as prescribed in Article 46, paragraph (1), a Community-Based Facility for the Elderly Covered by Public Aid Requiring Long-Term Care or a Facility Covered by Long-Term Care Insurance as determined by an Ordinance of the Ministry of Health, Labour, and Welfare, or a community general support center as prescribed in Article 115-39, paragraph (1), perform the procedures of said application on behalf of the Insured Person.
2 第二十七条第二項及び第三項の規定は、前項の申請に係る調査並びに同項の申請に係る被保険者の主治の医師の意見及び当該被保険者に対する診断命令について準用する。
(2) The provisions of Article 27, paragraphs (2) and (3) shall apply mutatis mutandis to an investigation pertaining to an application as prescribed in the preceding paragraph, opinions of an attending physician of the Insured Person pertaining to an application as set forth in the same paragraph, and an order for diagnosis to said Insured Person.
3 市町村は、前項において準用する第二十七条第二項の調査(第二十四条の二第一項第二号の規定により委託された場合にあっては、当該委託に係る調査を含む。)の結果、前項において準用する第二十七条第三項の主治の医師の意見又は指定する医師若しくは当該職員で医師であるものの診断の結果その他厚生労働省令で定める事項を認定審査会に通知し、第一項の申請に係る被保険者について、次の各号に掲げる被保険者の区分に応じ、当該各号に定める事項に関し審査及び判定を求めるものとする。
(3) A Municipality shall notify the Certification Committee of the result of an investigation as set forth in Article 27, paragraph (2) as applied mutatis mutandis pursuant to the preceding paragraph (in a case when the investigation is entrusted pursuant to the provisions of Article 24-2, paragraph (1), item (ii), including an investigation pertaining to said entrustment), the opinion of an attending physician as set forth in Article 27, paragraph (2) as applied mutatis mutandis pursuant to the preceding paragraph, the result of a diagnosis of a designated physician or its personnel who is a physician, or other matters specified by an Ordinance of the Ministry of Health, Labour, and Welfare, and request an examination and judgment pertaining to matters as prescribed in each said item according to the category of Insured Person listed in the following items with regard to the Insured Person pertaining to an application as set forth in paragraph (1):
一 第一号被保険者 要支援状態に該当すること及びその該当する要支援状態区分
(i) Primary Insured Person: those who qualify for a Needed Support Condition and Category of Needed Support Condition for which said condition qualifies;
二 第二号被保険者 要支援状態に該当すること、その該当する要支援状態区分及びその要支援状態の原因である身体上又は精神上の障害が特定疾病によって生じたものであること。
(ii) Secondary Insured Person: those who qualify for a Needed Support Condition, a Category of Needed Support Condition for which said condition qualifies, and the physical or mental problem(s) that is the cause of said Needed Support Condition as caused by a Specified Disease.
4 認定審査会は、前項の規定により審査及び判定を求められたときは、厚生労働大臣が定める基準に従い、当該審査及び判定に係る被保険者について、同項各号に規定する事項に関し審査及び判定を行い、その結果を市町村に通知するものとする。この場合において、認定審査会は、必要があると認めるときは、次に掲げる事項について、市町村に意見を述べることができる。
(4) A Certification Committee, when being requested to perform an examination and judgment pursuant to the provisions of the preceding paragraph, shall act in compliance with standards as determined by the Minister of Health, Labour, and Welfare, examine and judge matters as prescribed in each item of the same paragraph of an Insured Person pertaining to said examination and judgment, and notify the Municipality of said result. In this case, a Certification Committee, when it determines necessary, may state opinions to the Municipality regarding the following matters:
一 当該被保険者の要支援状態の軽減又は悪化の防止のために必要な療養及び家事に係る援助に関する事項
(i) matters of necessary medical care for or support pertaining to domestic home duties for the reduction or prevention of deterioration of a Needed Support Condition of said Insured Person;
二 第五十三条第一項に規定する指定介護予防サービス又は第五十四条の二第一項に規定する指定地域密着型介護予防サービスの適切かつ有効な利用等に関し当該被保険者が留意すべき事項
(ii) matters that said Insured Person shall heed to appropriately and effectively use Designated Preventive Long-Term Care Service as prescribed in Article 53, paragraph (1) or a Designated Community-Based Preventive Service of Long-Term Care as prescribed in Article 54-2, paragraph (1).
5 第二十七条第六項の規定は、前項前段の審査及び判定について準用する。
(5) The provisions of Article 27, paragraph (6) shall apply mutatis mutandis to an examination and judgment as prescribed in the first sentence of the preceding paragraph.
6 市町村は、第四項前段の規定により通知された認定審査会の審査及び判定の結果に基づき、要支援認定をしたときは、その結果を当該要支援認定に係る被保険者に通知しなければならない。この場合において、市町村は、次に掲げる事項を当該被保険者の被保険者証に記載し、これを返付するものとする。
(6) 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), shall 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 the Certificate of Insured Person of said Insured Person and return the Certificate of Insured Person to the Insured Person:
一 該当する要支援状態区分
(i) said Category of Needed Support Condition;
二 第四項第二号に掲げる事項に係る認定審査会の意見
(ii) opinions of the Certification Committee pertaining to matters listed in paragraph (4), item (ii).
7 要支援認定は、その申請のあった日にさかのぼってその効力を生ずる。
(7) A Certification of Needed Support shall become effective retroactively on the date that said application was submitted.
8 市町村は、第四項前段の規定により通知された認定審査会の審査及び判定の結果に基づき、要支援者に該当しないと認めたときは、理由を付して、その旨を第一項の申請に係る被保険者に通知するとともに、当該被保険者の被保険者証を返付するものとする。
(8) A Municipality, when it is determined that the Insured Person predating the application as set forth in paragraph (1) fails to qualify the 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), shall notify said Insured Person pertaining of the results, indicating the reasons, and return the Certificate of Insured Person to said Insured Person.
9 第二十七条第十項から第十二項までの規定は、第一項の申請及び当該申請に対する処分について準用する。
(9) The provisions of Article 27, paragraph (10) to (12) shall apply mutatis mutandis to an application as set forth in paragraph (1) and the action for said application.
(要支援認定の更新)
(Renewal of Certification of Needed Support)
第三十三条 要支援認定は、要支援状態区分に応じて厚生労働省令で定める期間(以下この条において「有効期間」という。)内に限り、その効力を有する。
Article 33 (1) A Certification of Needed Support shall be effective according to the Category of Needed Support Condition during the period as determined by an Ordinance of the Ministry of Health, Labour, and Welfare (herein referred to as "Effective Period" in this Article).
2 要支援認定を受けた被保険者は、有効期間の満了後においても要支援状態に該当すると見込まれるときは、厚生労働省令で定めるところにより、市町村に対し、当該要支援認定の更新(以下「要支援更新認定」という。)の申請をすることができる。
(2) An Insured Person that has been issued a Certification of Needed Support, when he or she is expected to be in a Needed Support Condition after the expiry of the Effective Period, may apply to the Municipality for application of renewal of said Certification of Needed Support (herein referred to as "Renewal of Certification of Needed Support") pursuant to the provisions of an Ordinance of the Ministry of Health, Labour, and Welfare.
3 前項の申請をすることができる被保険者が、災害その他やむを得ない理由により当該申請に係る要支援認定の有効期間の満了前に当該申請をすることができなかったときは、当該被保険者は、その理由のやんだ日から一月以内に限り、要支援更新認定の申請をすることができる。
(3) In a case when an Insured Person that may apply for the application as set forth in the preceding paragraph was not able to apply for said application prior to expiry of the Effective Period of Certification of Needed Support pertaining to said application due to a disaster or other compelling reason, said Insured Person may apply for a Renewal of Certification of Needed Support within one month from the date on which said reasons are no longer valid.
4 前条(第七項を除く。)及び第二十八条第五項から第八項までの規定は、前二項の申請及び当該申請に係る要支援更新認定について準用する。この場合において、これらの規定に関し必要な技術的読替えは、政令で定める。
(4) The provisions of the preceding Article (except for paragraph (7)) and Article 28, paragraphs (5) to (8) shall apply mutatis mutandis to an application as prescribed in the preceding two paragraphs and a Renewal of Certification of Needed Support pertaining to said application. In this case, the necessary technical replacement of the terms of these provisions shall be provided by a Cabinet Order.
5 第三項の申請に係る要支援更新認定は、当該申請に係る要支援認定の有効期間の満了日の翌日にさかのぼってその効力を生ずる。
(5) A Renewal of Certification of Needed Support pertaining to an application as set forth in paragraph (3) shall be effective retroactively on the date following the date of expiry of the Effective Period of Certification of Needed Support pertaining to said application.
6 第一項の規定は、要支援更新認定について準用する。この場合において、同項中「厚生労働省令で定める期間」とあるのは、「有効期間の満了日の翌日から厚生労働省令で定める期間」と読み替えるものとする。
(6) The provisions of paragraph (1) shall apply mutatis mutandis to a Renewal of Certification of Needed Support. In this case, the phrase "period as determined by an Ordinance of the Ministry of Health, Labour, and Welfare" in the same paragraph shall be deemed to be replaced with "period as determined by an Ordinance of the Ministry of Health, Labour, and Welfare from the date following the expiry of the Effective Period."
(要支援状態区分の変更の認定)
(Certification of Change of Category of Needed Support Condition)
第三十三条の二 要支援認定を受けた被保険者は、その支援の必要の程度が現に受けている要支援認定に係る要支援状態区分以外の要支援状態区分に該当すると認めるときは、厚生労働省令で定めるところにより、市町村に対し、要支援状態区分の変更の認定の申請をすることができる。
Article 33-2 (1) An Insured Person that has been issued a Certification of Needed Support, when it is determined that the degree of Needed Support Condition qualifies for a Category of Needed Support Condition other than the Category of Needed Support Condition pertaining to said Certification of Needed Support that is issued currently, may apply to the Municipality for a certification of change of Category of Needed Support Condition, pursuant to the provisions of an Ordinance of the Ministry of Health, Labour, and Welfare.
2 第二十八条第五項から第八項まで及び第三十二条の規定は、前項の申請及び当該申請に係る要支援状態区分の変更について準用する。この場合において、これらの規定に関し必要な技術的読替えは、政令で定める。
(2) The provisions of Article 28, paragraph (5) to paragraph (8), and Article 33 shall apply mutatis mutandis to an application as prescribed in the preceding paragraph and change of Category of Needed Support Condition pertaining to said application. In this case, the necessary technical replacement of terms for these provisions shall be provided by a Cabinet Order.
第三十三条の三 市町村は、要支援認定を受けた被保険者について、その支援の必要の程度が低下したことにより当該要支援認定に係る要支援状態区分以外の要支援状態区分に該当するに至ったと認めるときは、要支援状態区分の変更の認定をすることができる。この場合において、市町村は、厚生労働省令で定めるところにより、当該変更の認定に係る被保険者に対しその被保険者証の提出を求め、これに当該変更の認定に係る要支援状態区分及び次項において準用する第三十二条第四項後段の規定による認定審査会の意見(同項第二号に掲げる事項に係るものに限る。)を記載し、これを返付するものとする。
Article 33-3 (1) 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 shall request the Insured Person pertaining to said change of certification to submit said Certificate of Insured Person, shall enter the Category of Needed Support Condition pertaining to said change of certification and the opinion of the Certification Committee pursuant to the provisions of the second sentence of Article 32, paragraph (4) as applied mutatis mutandis pursuant to the following paragraph (limited to those pertaining to matters listed in item (ii) of the same paragraph), and then return the Certificate of Insured Person to the Insured Person.
2 第二十八条第五項から第八項まで並びに第三十二条第二項から第五項まで及び第六項前段の規定は、前項の要支援状態区分の変更の認定について準用する。この場合において、これらの規定に関し必要な技術的読替えは、政令で定める。
(2) The provisions of Article 28, paragraph (5) to paragraph (8), Article 32, paragraph (2) to paragraph (5), and the first sentence of paragraph (6), shall apply mutatis mutandis to a certification of Change of Category of Needed Support Condition as prescribed in the preceding paragraph. In this case, the necessary technical replacement of terms of these provisions shall be provided by a Cabinet Order.
(要支援認定の取消し)
(Rescission of Certification of Needed Support)
第三十四条 市町村は、要支援認定を受けた被保険者が次の各号のいずれかに該当するときは、当該要支援認定を取り消すことができる。この場合において、市町村は、厚生労働省令で定めるところにより、当該取消しに係る被保険者に対しその被保険者証の提出を求め、第三十二条第六項各号に掲げる事項の記載を消除し、これを返付するものとする。
Article 34 (1) 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, pursuant to the provisions of an Ordinance of the Ministry of Health, Labour, and Welfare, shall 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:
一 要支援者に該当しなくなったと認めるとき。
(i) when it is determined that the Insured Person fails to qualify as a Person Requiring Support;
二 正当な理由なしに、前条第二項若しくは次項において準用する第三十二条第二項の規定により準用される第二十七条第二項の規定による調査(第二十四条の二第一項第二号又は前条第二項若しくは次項において準用する第二十八条第五項の規定により委託された場合にあっては、当該委託に係る調査を含む。)に応じないとき、又は次項において準用する第三十二条第二項の規定により準用される第二十七条第三項ただし書の規定による診断命令に従わないとき。
(ii) when the Insured Person fails to qualify after 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 following paragraph (in a case when said investigation is entrusted pursuant to the provisions of Article 28, paragraph (5) as applied mutatis mutandis pursuant to the provisions of Article 24-2, paragraph (1), item (ii) or paragraph (2) of the preceding Article or the following paragraph, 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 provisions of Article 33, paragraph (2) as applied mutatis mutandis pursuant to the following paragraph.
2 第二十八条第五項から第八項まで並びに第三十二条第二項、第三項、第四項前段、第五項及び第六項前段の規定は、前項第一号の規定による要支援認定の取消しについて準用する。この場合において、これらの規定に関し必要な技術的読替えは、政令で定める。
(2) 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) shall apply mutatis mutandis to a rescission of Certification of Needed Support pursuant to the provisions of the preceding paragraph, item (i). In this case, the necessary technical replacement of terms for these provisions shall be provided by a Cabinet Order.
(要介護認定等の手続の特例)
(Exception for Procedures of Certification of Needed Long-Term Care, etc.)
第三十五条 認定審査会は、第二十七条第四項(第二十八条第四項において準用する場合を含む。)の規定により審査及び判定を求められた被保険者について、要介護者に該当しないと認める場合であっても、要支援者に該当すると認めるときは、第二十七条第五項(第二十八条第四項において準用する場合を含む。)の規定にかかわらず、その旨を市町村に通知することができる。
Article 35 (1) A Certification Committee, when it is determined that an Insured Person that is the subject of a request for investigation or judgment pursuant to the provisions of Article 27, paragraph (4) (including a case when applied mutatis mutandis pursuant to Article 28, paragraph (4)) qualifies as a Person Requiring Support, although it is determined that said Insured Person fails to qualify as a Person Requiring Long-Term Care, may notify said result to the Municipality, notwithstanding the provisions of Article 27, paragraph (5) (including a case when applied mutatis mutandis pursuant to Article 28, paragraph (4)).
2 市町村は、前項の規定による通知があったときは、当該通知に係る被保険者について、第三十二条第一項の申請がなされ、同条第三項の規定により認定審査会に審査及び判定を求め、同条第四項の規定により認定審査会の通知を受けたものとみなし、要支援認定をすることができる。この場合において、市町村は、当該被保険者に、要支援認定をした旨を通知するとともに、同条第六項各号に掲げる事項を当該被保険者の被保険者証に記載し、これを返付するものとする。
(2) 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 shall notify said Insured Person that a Certification of Needed Support is provided, enter 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.
3 認定審査会は、第三十二条第三項(第三十三条第四項において準用する場合を含む。)の規定により審査及び判定を求められた被保険者について、要介護者に該当すると認めるときは、第三十二条第四項(第三十三条第四項において準用する場合を含む。)の規定にかかわらず、その旨を市町村に通知することができる。
(3) 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 32, paragraph (3) (including the case it is applied mutatis mutandis pursuant to Article 33, paragraph (4)) qualifies as a Person Requiring Long-Term Care, may notify said result to the Municipality, notwithstanding the provision of Article 32, paragraph (4) (including a case applied mutatis mutandis pursuant to Article 33, paragraph (4)).
4 市町村は、前項の規定による通知があったときは、当該通知に係る被保険者について、第二十七条第一項の申請がなされ、同条第四項の規定により認定審査会に審査及び判定を求め、同条第五項の規定により認定審査会の通知を受けたものとみなし、要介護認定をすることができる。この場合において、市町村は、当該被保険者に、要介護認定をした旨を通知するとともに、同条第七項各号に掲げる事項を当該被保険者の被保険者証に記載し、これを返付するものとする。
(4) 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 shall notify said Insured Person that a Certification of Needed Long-Term Care is provided, enter 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.
5 認定審査会は、第三十一条第二項において準用する第二十七条第四項の規定により審査及び判定を求められた被保険者について、要介護者に該当しないと認める場合であっても、要支援者に該当すると認めるときは、第三十一条第二項において準用する第二十七条第五項の規定にかかわらず、その旨を市町村に通知することができる。
(5) 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 certified 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 (2).
6 市町村は、前項の規定による通知があったときは、当該通知に係る被保険者について、第三十二条第一項の申請がなされ、同条第三項の規定により認定審査会に審査及び判定を求め、同条第四項の規定により認定審査会の通知を受けたものとみなし、要支援認定をすることができる。この場合において、市町村は、厚生労働省令で定めるところにより、当該通知に係る被保険者に対しその被保険者証の提出を求め、これに同条第六項各号に掲げる事項を記載し、これを返付するものとする。
(6) 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 shall, pursuant to the provisions of an Ordinance of the Ministry of Health, Labour, and Welfare, request to Insured Person pertaining to said notification to submit such Insured Person's Certificate 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.
(住所移転後の要介護認定及び要支援認定)
(Certification of Needed Long-Term Care and Certification of Needed Support after Relocation of Domicile)
第三十六条 市町村は、他の市町村による要介護認定又は要支援認定を受けている者が当該市町村の行う介護保険の被保険者となった場合において、当該被保険者が、その資格を取得した日から十四日以内に、当該他の市町村から交付された当該要介護認定又は要支援認定に係る事項を証明する書面を添えて、要介護認定又は要支援認定の申請をしたときは、第二十七条第四項及び第七項前段又は第三十二条第三項及び第六項前段の規定にかかわらず、認定審査会の審査及び判定を経ることなく、当該書面に記載されている事項に即して、要介護認定又は要支援認定をすることができる。
Article 36 A Municipality, in a case when a person that is issued a Certification of Needed Long-Term Care or a Certification of Needed Support by another Municipality becomes an Insured Person of Long-Term Care Insurance of said Municipality and when said Insured Person submits an application for a Certification of Needed Long-Term Care or a Certification of Needed Support attached with the documents that are issued by said Municipality and the other Municipality and proves matters pertaining to said Certification of Needed Long-Term Care or Certification of Needed Support within fourteen (14) days from the date on which said qualification was obtained, may provide a Certification of Needed Long-Term Care or a Certification of Needed Support according to the matters entered on said documents, notwithstanding the provisions of Article 27, paragraph (4) and the first sentence of paragraph (7), or Article 32, paragraph (3) and the first sentence of paragraph (6), and without awaiting an examination or judgment of a Certification Committee.
(介護給付等対象サービスの種類の指定)
(Specification of Type of Service Covered by Long-Term Care Benefits, etc.)
第三十七条 市町村は、要介護認定、要介護更新認定、第二十九条第二項において準用する第二十七条第七項若しくは第三十条第一項の規定による要介護状態区分の変更の認定、要支援認定、要支援更新認定又は第三十三条の二第二項において準用する第三十二条第六項若しくは第三十三条の三第一項の規定による要支援状態区分の変更の認定(以下この項において単に「認定」という。)をするに当たっては、第二十七条第五項第一号(第二十八条第四項、第二十九条第二項及び第三十条第二項において準用する場合を含む。)又は第三十二条第四項第一号(第三十三条第四項、第三十三条の二第二項及び第三十三条の三第二項において準用する場合を含む。)に掲げる事項に係る認定審査会の意見に基づき、当該認定に係る被保険者が受けることができる居宅介護サービス費若しくは特例居宅介護サービス費に係る居宅サービス、地域密着型介護サービス費若しくは特例地域密着型介護サービス費に係る地域密着型サービス、施設介護サービス費若しくは特例施設介護サービス費に係る施設サービス、介護予防サービス費若しくは特例介護予防サービス費に係る介護予防サービス又は地域密着型介護予防サービス費若しくは特例地域密着型介護予防サービス費に係る地域密着型介護予防サービスの種類を指定することができる。この場合において、市町村は、当該被保険者の被保険者証に、第二十七条第七項後段(第二十八条第四項及び第二十九条第二項において準用する場合を含む。)、第三十条第一項後段若しくは第三十五条第四項後段又は第三十二条第六項後段(第三十三条第四項及び第三十三条の二第二項において準用する場合を含む。)、第三十三条の三第一項後段若しくは第三十五条第二項後段若しくは第六項後段の規定による記載に併せて、当該指定に係る居宅サービス、地域密着型サービス、施設サービス、介護予防サービス又は地域密着型介護予防サービスの種類を記載するものとする。
Article 37 (1) A Municipality, when providing a Certification of Needed Long-Term Care; a Renewal of Certification of Needed Long-Term Care; a Certification of Change of Category of Condition of Need for Long-Term Care pursuant to the provisions of Article 27, paragraph (7) or Article 30, paragraph (1) as applied mutatis mutandis pursuant to Article 29, paragraph (2); a Certification of Needed Support; a Renewal of Certification of Needed Support; a Certification of Change of Category of Needed Support Condition pursuant to the provisions of Article 32, paragraph (6) or Article 33-3, paragraph (1) as applied mutatis mutandis pursuant to Article 33-2, paragraph (2); (hereinafter simply referred to as "Certification" in this paragraph) may specify the type of services to be performed for an Insured Person pertaining to said Certification, including In-Home Service pertaining to Allowance for In-Home Long-Term Care Service or Exceptional Allowance for In-Home Long-Term Care Service, Community-Based Service pertaining to Allowance for Community-Based Long-Term Care Service or Exceptional Allowance for Community-Based Long-Term Care Service, Facility Service pertaining to Allowance for Long-Term Care Facility Service or Exceptional Allowance for Long-Term Care Facility Service, Preventive Long-Term Care Service pertaining to Allowance for Preventive Long-Term Care Service or Exceptional Allowance for Preventive Service of Long-Term Care, or Community-Based Service for Preventive Long-Term Care pertaining to Allowance for Community-Based Preventive Long-Term Care Service, or Exceptional Allowance for Community-Based Preventive Service of Long-Term Care, based on the opinion of the Certification Committee pertaining to the matter listed in Article 27, paragraph (5), item (i) (including a case it is applied mutatis mutandis pursuant to Article 28, paragraph (4), Article 29, paragraph (2), or Article 30, paragraph (2)) or Article 32, paragraph (4), item (i) (including a case it is applied mutatis mutandis pursuant to Article 33, paragraph (4), or Article 33-2, paragraph (2)). In this case, the Municipality shall enter on the Certificate of Insured Person of said Insured Person the type of services pertaining to said specification including In-Home Service, Community-Based Service, Facility Service, Preventive Long-Term Care Service, or Community-Based Service for Preventive Long-Term Care together with an entry pursuant to the provisions of Article 27, paragraph (7) second sentence (including a case it is applied mutatis mutandis pursuant to Article 28, paragraph (4) or Article 29, paragraph (2)), Article 30, paragraph (1), second sentence, Article 35, paragraph (4), second sentence, or Article 32, paragraph (6) second sentence (including a case it is applied mutatis mutandis pursuant to Article 33, paragraph (4) or Article 33-2, paragraph (2)), Article 33-3, paragraph (1) second sentence, Article 35, paragraph (2), second sentence, or paragraph (6), second sentence.
2 前項前段の規定による指定を受けた被保険者は、当該指定に係る居宅サービス、地域密着型サービス、施設サービス、介護予防サービス又は地域密着型介護予防サービスの種類の変更の申請をすることができる。
(2) An Insured Person specified pursuant to the provisions of the preceding paragraph, first sentence, may apply for a change of type of services pertaining to said specification including In-Home Service, Community-Based Service, Facility Service, Preventive Long-Term Care Service, or Community-Based Service for Preventive Long-Term Care.
3 前項の申請は、厚生労働省令で定めるところにより、被保険者証を添付して行うものとする。
(3) The application as prescribed in the preceding paragraph shall be submitted with the Certificate of Insured Person, pursuant to the provisions of an Ordinance of the Ministry of Health, Labour, and Welfare.
4 市町村は、第二項の申請があった場合において、厚生労働省令で定めるところにより、認定審査会の意見を聴き、必要があると認めるときは、当該指定に係る居宅サービス、地域密着型サービス、施設サービス、介護予防サービス又は地域密着型介護予防サービスの種類の変更をすることができる。
(4) In a case when the application as set forth in paragraph (2) is submitted, a Municipality, pursuant to the provisions of an Ordinance of the Ministry of Health, Labour, and Welfare, when it hears the opinion of the Certification Committee and determines it necessary, may change the type of services pertaining to said specification including In-Home Service, Community-Based Service, Facility Service, Preventive Long-Term Care Service, or Community-Based Service for Preventive Long-Term Care.
5 市町村は、前項の規定により第二項の申請に係る被保険者について第一項前段の規定による指定に係る居宅サービス、地域密着型サービス、施設サービス、介護予防サービス又は地域密着型介護予防サービスの種類を変更したときは、その結果を当該被保険者に通知するとともに、当該被保険者の被保険者証に変更後の居宅サービス、地域密着型サービス、施設サービス、介護予防サービス又は地域密着型介護予防サービスの種類を記載し、これを返付するものとする。
(5) When a Municipality, with regard to an Insured Person pertaining to the application as set forth in paragraph (2), has changed the type of services pertaining to the specification pursuant to the provisions of paragraph (1), first sentence, including In-Home Service, Community-Based Service, Facility Service, Preventive Long-Term Care Service, or Community-Based Service for Preventive Long-Term Care pursuant to the provisions of the preceding paragraph, it shall notify said Insured Person of said result, enter the type of services, including In-Home Service, Community-Based Service, Facility Service, Preventive Long-Term Care Service, or Community-Based Service for Preventive Long-Term Care after amending the Certificate of Insured Person of said Insured Person, and return the Certificate of Insured Person to the Insured Person.
(都道府県の援助等)
(Assistance, etc., of Prefectures)
第三十八条 都道府県は、市町村が行う第二十七条から第三十五条まで及び前条の規定による業務に関し、その設置する福祉事務所(社会福祉法(昭和二十六年法律第四十五号)に定める福祉に関する事務所をいう。)又は保健所による技術的事項についての協力その他市町村に対する必要な援助を行うことができる。
Article 38 (1) A prefecture, with regard to affairs pursuant to the provisions of Article 27 to Article 35 and the preceding Article that a Municipality performs, may cooperate regarding technical matters at public aid office (those offices regarding public aid provided by the Social Welfare Act (Act No. 45 of 1951)) or a health center, and provide other necessary assistance to a Municipality.
2 地方自治法第二百五十二条の十四第一項の規定により市町村の委託を受けて審査判定業務(第二十七条から第三十五条まで及び前条の規定により認定審査会が行う業務をいう。以下この条において同じ。)を行う都道府県に、当該審査判定業務を行わせるため、都道府県介護認定審査会を置く。
(2) Pursuant to the provisions of Article 252-14, paragraph (1) of the Local Autonomy Act, a Prefectural Certification Committee of Needed Long-Term Care shall be established by entrustment from a Municipality, in order for the prefecture to perform examinations and judgments (operations that a Certification Committee performs pursuant to the provisions of Article 27 to Article 35 and the preceding Article; the same shall apply hereinafter in this Article).
3 第十五条及び第十七条の規定は、前項の都道府県介護認定審査会について準用する。この場合において、第十五条中「市町村長(特別区にあっては、区長。以下同じ。)」とあるのは、「都道府県知事」と読み替えるものとする。
(3) The provisions of Article 15 and Article 17 shall apply mutatis mutandis to a Prefectural Certification Committee of Needed Long-Term Care as prescribed in the preceding paragraph. In this case, the phrase "mayor of a Municipality ("ward mayor" for special city wards; the same shall apply hereinafter)" in Article 15 shall be deemed to be replaced with "prefectural governor."
4 審査判定業務を都道府県に委託した市町村について第二十七条(第二十八条第四項、第二十九条第二項、第三十条第二項、第三十一条第二項及び第三十二条第五項において準用する場合を含む。)、第三十条、第三十二条(第三十三条第四項、第三十三条の二第二項、第三十三条の三第二項及び第三十四条第二項において準用する場合を含む。)、第三十三条の三及び第三十五条から前条までの規定を適用する場合においては、これらの規定中「認定審査会」とあるのは、「都道府県介護認定審査会」とする。
(4) With regard to a Municipality that entrusts examinations and judgments to a prefecture, in a case of applying the provisions of Article 27 (including a case applied mutatis mutandis pursuant to Article 28, paragraph (4), Article 29, paragraph (2), Article 30, paragraph (2), Article 31, paragraph (2) or Article 32, paragraph (5)), Article 30, Article 32 (including a case applied mutatis mutandis pursuant to Article 33, paragraph (4), Article 33-2, paragraph (2), Article 33-3, paragraph (2), or Article 34, paragraph (2)), Article 33-3 or Article 35 to the preceding Article, the term "Certification Committee" shall be deemed to be replaced with "Prefectural Certification Committee of Needed Long-Term Care."
(厚生労働省令への委任)
(Delegation to an Ordinance of the Ministry of Health, Labour, and Welfare)
第三十九条 この節に定めるもののほか、要介護認定及び要支援認定の申請その他の手続に関し必要な事項は、厚生労働省令で定める。
Article 39 In addition to those matters provided by this Section, an application for Certification of Needed Long-Term Care and Certification of Needed Support, and other procedures necessary matters shall be as determined by an Ordinance of the Ministry of Health, Labour, and Welfare.
第三節 介護給付
Section 3 Long-Term Care Benefits
(介護給付の種類)
(Types of Long-Term Care Benefits)
第四十条 介護給付は、次に掲げる保険給付とする。
Article 40 A Long-Term Care Benefit shall be any of the insurance benefits listed below:
一 居宅介護サービス費の支給
(i) payment of an Allowance for In-Home Long-Term Care Service;
二 特例居宅介護サービス費の支給
(ii) payment of an Exceptional Allowance for In-Home Long-Term Care Service;
三 地域密着型介護サービス費の支給
(iii) payment of an Allowance for Community-Based Long-Term Care Service;
四 特例地域密着型介護サービス費の支給
(iv) payment of an Exceptional Allowance for Community-Based Long-Term Care Service;
五 居宅介護福祉用具購入費の支給
(v) payment of an Allowance for Purchasing Equipment for In-Home Long-Term Care Covered by Public Aid;
六 居宅介護住宅改修費の支給
(vi) payment of an Allowance for Home Modification for In-Home Long-Term Care;
七 居宅介護サービス計画費の支給
(vii) payment of an Allowance for In-Home Long-Term Care Service Plan;
八 特例居宅介護サービス計画費の支給
(viii) payment of an Exceptional Allowance for an In-Home Long-Term Care Service Plan;
九 施設介護サービス費の支給
(ix) payment of an Allowance for Long-Term Care Facility Service;
十 特例施設介護サービス費の支給
(x) payment of an Exceptional Allowance for Long-Term Care Facility Service;
十一 高額介護サービス費の支給
(xi) payment of an Allowance for High-Cost Long-Term Care Service;
十二 特定入所者介護サービス費の支給
(xii) payment of an Allowance for Long-Term Care Service to a Person Admitted to a Specified Facility;
十三 特例特定入所者介護サービス費の支給
(xiii) payment of an Exceptional Allowance for Long-Term Care Service to a Person Admitted to a Specified Facility.
(居宅介護サービス費の支給)
(Payment of an Allowance for In-Home Long-Term Care Service)
第四十一条 市町村は、要介護認定を受けた被保険者(以下「要介護被保険者」という。)のうち居宅において介護を受けるもの(以下「居宅要介護被保険者」という。)が、都道府県知事が指定する者(以下「指定居宅サービス事業者」という。)から当該指定に係る居宅サービス事業を行う事業所により行われる居宅サービス(以下「指定居宅サービス」という。)を受けたときは、当該居宅要介護被保険者に対し、当該指定居宅サービスに要した費用(特定福祉用具の購入に要した費用を除き、通所介護、通所リハビリテーション、短期入所生活介護、短期入所療養介護及び特定施設入居者生活介護に要した費用については、食事の提供に要する費用、滞在に要する費用その他の日常生活に要する費用として厚生労働省令で定める費用を除く。以下この条において同じ。)について、居宅介護サービス費を支給する。ただし、当該居宅要介護被保険者が、第三十七条第一項の規定による指定を受けている場合において、当該指定に係る種類以外の居宅サービスを受けたときは、この限りでない。
Article 41 (1) A Municipality, when an Insured Person that receives long-term care at his or her home (herein referred to as "Insured In-Home Person Requiring Long-Term Care") among persons who have obtained a Certification of Needed Long-Term Care (herein referred to as "Insured Person Requiring Long-Term Care") receives from a person designated by prefectural governor (hereinafter referred to as "Designated In-Home Service Provider") an In-Home Service provided by an appointed provider that performs In-Home Service Business pertaining to said specification (herein referred to as "Designated In-Home Service"), shall pay an Allowance for In-Home Long-Term Care Service to said Insured In-Home Person Requiring Long-Term Care regarding expenses required for said Designated In-Home Service (except for expenses required for purchase of Specified Equipment Covered by Public Aid, and excluding the expenses necessary to provide meals, residence, and other expenses as determined by an Ordinance of the Ministry of Health, Labour, and Welfare as necessary for daily life with regard to the expenses required for Outpatient Day Long-Term Care, Outpatient Rehabilitation, a Short-Term Admission for Daily Life Long-Term Care, Short-Term Admission for Recuperation, and Daily Life Long-Term Care Admitted to a Specified Facility; the same shall apply hereinafter in this Act), however, provided that this provision shall not apply to a case when said Insured In-Home Person Requiring Long-Term Care is specified pursuant to the provisions of Article 37, paragraph (1) and the Person receives In-Home Service other than the type pertaining to said specification.
2 居宅介護サービス費は、厚生労働省令で定めるところにより、市町村が必要と認める場合に限り、支給するものとする。
(2) An Allowance for In-Home Long-Term Care Service, pursuant to the provisions of an Ordinance of the Ministry of Health, Labour, and Welfare, shall be paid only when a Municipality determines that it is necessary.
3 指定居宅サービスを受けようとする居宅要介護被保険者は、厚生労働省令で定めるところにより、自己の選定する指定居宅サービス事業者について、被保険者証を提示して、当該指定居宅サービスを受けるものとする。
(3) An Insured In-Home Person Requiring Long-Term Care who intends to receive Designated In-Home Service pursuant to the provisions of an Ordinance of the Ministry of Health, Labour, and Welfare shall present a Certificate of Insured Person to the Designated In-Home Service Provider that said Insured Person selects and will receive said Designated In-Home Service.
4 居宅介護サービス費の額は、次の各号に掲げる居宅サービスの区分に応じ、当該各号に定める額とする。
(4) The amount of Allowance for In-Home Long-Term Care Service shall be the amount provided by each of the following items according to the category of In-Home Service listed in the said items:
一 訪問介護、訪問入浴介護、訪問看護、訪問リハビリテーション、居宅療養管理指導、通所介護、通所リハビリテーション及び福祉用具貸与これらの居宅サービスの種類ごとに、当該居宅サービスの種類に係る指定居宅サービスの内容、当該指定居宅サービスの事業を行う事業所の所在する地域等を勘案して算定される当該指定居宅サービスに要する平均的な費用(通所介護及び通所リハビリテーションに要する費用については、食事の提供に要する費用その他の日常生活に要する費用として厚生労働省令で定める費用を除く。)の額を勘案して厚生労働大臣が定める基準により算定した費用の額(その額が現に当該指定居宅サービスに要した費用の額を超えるときは、当該現に指定居宅サービスに要した費用の額とする。)の百分の九十に相当する額
(i) the amount equivalent to 90 percent of the expenses calculated based on the standards provided by the Minister of Health, Labour, and Welfare (but shall be the actual expenses required for Designated In-Home Service in a case when the standard amount exceeds the actual expenses required for said Designated In-Home Service) by considering the average expenses required for said Designated In-Home Service calculated by considering the content of Designated In-Home Service pertaining to the type of said In-Home Service, the area where the provider that performs said Designated In-Home Service business is located, etc. (with regard to the expenses necessary for Outpatient Day Long-Term Care and Outpatient Rehabilitation, excluding the expenses necessary to provide meals, residence, and other necessary expenses for daily life as determined by an Ordinance of the Ministry of Health, Labour, and Welfare), according to by the type of In-Home Service including Home-Visit Long-Term Care, Home-Visit Bathing Long-Term Care, Home-Visit Nursing, Home-Visit Rehabilitation, Guidance for Management of In-Home Medical Long-Term Care, Outpatient Day Long-Term Care, Outpatient Rehabilitation, and Rental Service of Equipment for Long-Term Care Covered by Public Aid;
二 短期入所生活介護、短期入所療養介護及び特定施設入居者生活介護これらの居宅サービスの種類ごとに、要介護状態区分、当該居宅サービスの種類に係る指定居宅サービスの事業を行う事業所の所在する地域等を勘案して算定される当該指定居宅サービスに要する平均的な費用(食事の提供に要する費用、滞在に要する費用その他の日常生活に要する費用として厚生労働省令で定める費用を除く。)の額を勘案して厚生労働大臣が定める基準により算定した費用の額(その額が現に当該指定居宅サービスに要した費用の額を超えるときは、当該現に指定居宅サービスに要した費用の額とする。)の百分の九十に相当する額
(ii) the amount equivalent to 90 percent of the expenses calculated based on the standards provided by the Minister of Health, Labour, and Welfare (but shall be the actual expenses required for Designated In-Home Service in a case when the standard amount exceeds the actual expenses required for said Designated In-Home Service) by considering the average expenses required for said Designated In-Home Service calculated by considering the Category of Needed Support Condition, , the area where the provider that performs said Designated In-Home Service Business pertaining to the type of said In-Home Service is located, etc. (excluding the expenses necessary to provide meals, residence, and other necessary expenses for daily life as determined by an Ordinance of the Ministry of Health, Labour, and Welfare), according to by the type of In-Home Service including a Short-Term Admission for Daily Life Long-Term Care, Short-Term Admission for Recuperation, and Daily Life Long-Term Care Admitted to a Specified Facility.
5 厚生労働大臣は、前項各号の基準を定めようとするときは、あらかじめ社会保障審議会の意見を聴かなければならない。
(5) The Minister of Health, Labour, and Welfare, when it intends to determine the standards as prescribed in the items of the preceding paragraph, shall hear the opinion of the Social Security Council in advance.
6 居宅要介護被保険者が指定居宅サービス事業者から指定居宅サービスを受けたとき(当該居宅要介護被保険者が第四十六条第四項の規定により指定居宅介護支援を受けることにつきあらかじめ市町村に届け出ている場合であって、当該指定居宅サービスが当該指定居宅介護支援の対象となっている場合その他の厚生労働省令で定める場合に限る。)は、市町村は、当該居宅要介護被保険者が当該指定居宅サービス事業者に支払うべき当該指定居宅サービスに要した費用について、居宅介護サービス費として当該居宅要介護被保険者に対し支給すべき額の限度において、当該居宅要介護被保険者に代わり、当該指定居宅サービス事業者に支払うことができる。
(6) When an Insured In-Home Person Requiring Long-Term Care is provided Designated In-Home Service (limited to a case when said Insured In-Home Person Requiring Long-Term Care has notified the Municipality to receive Designated In-Home Long-Term Care Support pursuant to the provisions of Article 46, paragraph (4) in advance, that said Designated In-Home Service is subject to said Designated In-Home Long-Term Care Support and other cases as determined by an Ordinance of the Ministry of Health, Labour, and Welfare) by a Designated In-Home Service Provider, the Municipality may pay expenses required for said Designated In-Home Service that said Insured In-Home Person Requiring Long-Term Care should pay to said Designated In-Home Service Provider on behalf of said Insured In-Home Person Requiring Long-Term Care to said Designated In-Home Service Provider within the specified limit of the amount that shall be paid to said Insured In-Home Person Requiring Long-Term Care as Allowance for In-Home Long-Term Care Service.
7 前項の規定による支払があったときは、居宅要介護被保険者に対し居宅介護サービス費の支給があったものとみなす。
(7) When the payment pursuant to the provisions of the preceding paragraph is paid, it shall be deemed as an Allowance for In-Home Long-Term Care Service that has been paid to an Insured In-Home Person Requiring Long-Term Care.
8 指定居宅サービス事業者は、指定居宅サービスその他のサービスの提供に要した費用につき、その支払を受ける際、当該支払をした居宅要介護被保険者に対し、厚生労働省令で定めるところにより、領収証を交付しなければならない。
(8) A Designated In-Home Service Provider, when accepting payment of the expenses required for providing the Designated In-Home Service and other services, shall deliver a receipt to the Insured In-Home Person Requiring Long-Term Care who made said payment, pursuant to the provisions of an Ordinance of the Ministry of Health, Labour, and Welfare.
9 市町村は、指定居宅サービス事業者から居宅介護サービス費の請求があったときは、第四項各号の厚生労働大臣が定める基準及び第七十四条第二項に規定する指定居宅サービスの事業の設備及び運営に関する基準(指定居宅サービスの取扱いに関する部分に限る。)に照らして審査した上、支払うものとする。
(9) A Municipality, when a Designated In-Home Service Provider requests an Allowance for In-Home Long-Term Care Service, shall pay said allowance after conducting an examination according to standards provided by the Minister of Health, Labour, and Welfare as prescribed in the each item of paragraph (4) and the standards of facilities and management of Designated In-Home Service Business as prescribed in Article 74, paragraph (2) (limited to the part regarding the handling of Designated In-Home Service).
10 市町村は、前項の規定による審査及び支払に関する事務を連合会に委託することができる。
(10) A Municipality may entrust an examination and payment affairs prescribed in the preceding paragraph to an Association.
11 前項の規定による委託を受けた連合会は、当該委託をした市町村の同意を得て、厚生労働省令で定めるところにより、当該委託を受けた事務の一部を、営利を目的としない法人であって厚生労働省令で定める要件に該当するものに委託することができる。
(11) An Association that undertakes entrustment pursuant to the provisions of the preceding paragraph, after obtaining the consent of the Municipality that delegated said entrustment and pursuant to the provisions of an Ordinance of the Ministry of Health, Labour, and Welfare, may entrust a part of the affairs that are under said entrustment to a not-for-profit juridical person that qualifies with requirements as determined by an Ordinance of the Ministry of Health, Labour, and Welfare.
12 前各項に規定するもののほか、居宅介護サービス費の支給及び指定居宅サービス事業者の居宅介護サービス費の請求に関して必要な事項は、厚生労働省令で定める。
(12) In addition to the provisions of the preceding paragraph, necessary matters for payment of an Allowance for In-Home Long-Term Care Service and a request for an Allowance for In-Home Long-Term Care Service by a Designated In-Home Service Provider shall be as prescribed by an Ordinance of the Ministry of Health, Labour, and Welfare.
(特例居宅介護サービス費の支給)
(Payment of an Exceptional Allowance for In-Home Long-Term Care Service)
第四十二条 市町村は、次に掲げる場合には、居宅要介護被保険者に対し、特例居宅介護サービス費を支給する。
Article 42 (1) A Municipality shall pay an Exceptional Allowance for In-Home Long-Term Care Service to an Insured In-Home Person Requiring Long-Term Care in the following cases:
一 居宅要介護被保険者が、当該要介護認定の効力が生じた日前に、緊急その他やむを得ない理由により指定居宅サービスを受けた場合において、必要があると認めるとき。
(i) when a Municipality determines it necessary in a case when an Insured In-Home Person Requiring Long-Term Care receives Designated In-Home Service prior to the date said Certification of Needed Long-Term Care becomes effective due to an emergency or other compelling reason;
二 居宅要介護被保険者が、指定居宅サービス以外の居宅サービス又はこれに相当するサービス(指定居宅サービスの事業に係る第七十四条第一項の厚生労働省令で定める基準及び同項の厚生労働省令で定める員数並びに同条第二項に規定する指定居宅サービスの事業の設備及び運営に関する基準のうち、厚生労働省令で定めるものを満たすと認められる事業を行う事業所により行われるものに限る。次号において「基準該当居宅サービス」という。)を受けた場合において、必要があると認めるとき。
(ii) when a Municipality determines it necessary in a case when an Insured In-Home Person Requiring Long-Term Care receives In-Home Service other than Designated In-Home Service or service equivalent to said services (limited to those services provided by a provider that performs a business that is judged to satisfy standards as determined by an Ordinance of the Ministry of Health, Labour, and Welfare among the standards provided by the Ordinance of the Ministry of Health, Labour, and Welfare as set forth in Article 74, paragraph (1) pertaining to Designated In-Home Service Business, the number of employees as determined by an Ordinance of the Ministry of Health, Labour, and Welfare as prescribed in the same paragraph, and standards for equipment and the management of the Designated In-Home Service Business as prescribed in paragraph (2) of the same Article; herein referred to as "In-Home Service Applicable to Standards" in the following item);
三 指定居宅サービス及び基準該当居宅サービスの確保が著しく困難である離島その他の地域であって厚生労働大臣が定める基準に該当するものに住所を有する居宅要介護被保険者が、指定居宅サービス及び基準該当居宅サービス以外の居宅サービス又はこれに相当するサービスを受けた場合において、必要があると認めるとき。
(iii) when a Municipality determines it necessary in a case when an Insured In-Home Person Requiring Long-Term Care who is domiciled on an isolated island or other area where it is significantly difficult to secure Designated In-Home Service and In-Home Service Applicable to Standards and is in a location that qualifies with the standards as determined by the Minister of Health, Labour, and Welfare, receives In-Home Service other than Designated In-Home Service or In-Home Service Applicable to Standards, or services equivalent to those services;
四 その他政令で定めるとき。
(iv) when provided by a Cabinet Order.
2 特例居宅介護サービス費の額は、当該居宅サービス又はこれに相当するサービスについて前条第四項各号の厚生労働大臣が定める基準により算定した費用の額(その額が現に当該居宅サービス又はこれに相当するサービスに要した費用(特定福祉用具の購入に要した費用を除き、通所介護、通所リハビリテーション、短期入所生活介護、短期入所療養介護及び特定施設入居者生活介護並びにこれらに相当するサービスに要した費用については、食事の提供に要する費用、滞在に要する費用その他の日常生活に要する費用として厚生労働省令で定める費用を除く。)の額を超えるときは、当該現に居宅サービス又はこれに相当するサービスに要した費用の額とする。)の百分の九十に相当する額を基準として、市町村が定める。
(2) The amount of Exceptional Allowance for In-Home Long-Term Care Service shall be specified by a Municipality with regard to said In-Home Service or services equivalent to said service based on an amount equivalent to 90 percent of the expenses calculated by standards determined by the Minister of Health, Labour, and Welfare as prescribed in each item of the preceding Article, paragraph (4) (but shall be the actual expenses required for said In-Home Service or service equivalent to said services when said calculated standard amount exceeds the actual expenses required for said In-Home Service or service equivalent to said services (except for purchases of Specified Equipment Covered by Public Aid; with regard to expenses necessary for Outpatient Day Long-Term Care, Outpatient Rehabilitation, Short-Term Admission for Daily Life Long-Term Care, Short-Term Admission for Recuperation, Daily Life Long-Term Care Admitted to a Specified Facility, excluding expenses necessary to provide meals, residence, other expenses, other expenses necessary for daily life as determined by an Ordinance of the Ministry of Health, Labour, and Welfare)).
3 市町村長は、特例居宅介護サービス費の支給に関して必要があると認めるときは、当該支給に係る居宅サービス若しくはこれに相当するサービスを担当する者若しくは担当した者(以下この項において「居宅サービス等を担当する者等」という。)に対し、報告若しくは帳簿書類の提出若しくは提示を命じ、若しくは出頭を求め、又は当該職員に関係者に対して質問させ、若しくは当該居宅サービス等を担当する者等の当該支給に係る事業所に立ち入り、その設備若しくは帳簿書類その他の物件を検査させることができる。
(3) A Municipality, when it determines the necessity for payment of an Exceptional Allowance for In-Home Long-Term Care Service, may order a person that has been in charge of the In-Home Service pertaining to said payment or equivalent service (herein referred to as "Person, etc., in Charge of In-Home Service, etc." in this paragraph) to report, submit, or present record books and documents, appear before, or direct its personnel to question the relevant person and enter the Business Office of the service provider of said Person, etc., in Charge of In-Home Service, etc., pertaining to said payment in order to inspect said equipment, record books and documents, and other items.
4 第二十四条第三項の規定は前項の規定による質問又は検査について、同条第四項の規定は前項の規定による権限について準用する。
(4) The provisions of Article 24, paragraph (3) shall apply mutatis mutandis to questions and inspections as prescribed in the preceding paragraph and the provisions of paragraph (4) of the same Article shall apply mutatis mutandis to the authority granted as prescribed in the preceding paragraph.
(地域密着型介護サービス費の支給)
(Payment of an Allowance for Community-Based Long-Term Care Service)
第四十二条の二 市町村は、要介護被保険者が、当該市町村の長が指定する者(以下「指定地域密着型サービス事業者」という。)から当該指定に係る地域密着型サービス事業を行う事業所により行われる地域密着型サービス(以下「指定地域密着型サービス」という。)を受けたときは、当該要介護被保険者に対し、当該指定地域密着型サービスに要した費用(認知症対応型通所介護、小規模多機能型居宅介護、認知症対応型共同生活介護、地域密着型特定施設入居者生活介護及び地域密着型介護老人福祉施設入所者生活介護に要した費用については、食事の提供に要する費用、居住に要する費用その他の日常生活に要する費用として厚生労働省令で定める費用を除く。以下この条において同じ。)について、地域密着型介護サービス費を支給する。ただし、当該要介護被保険者が、第三十七条第一項の規定による指定を受けている場合において、当該指定に係る種類以外の地域密着型サービスを受けたときは、この限りでない。
Article 42-2 (1) A Municipality, when an Insured Person Requiring Long-Term Care received from a person designated by the mayor of said Municipality (herein referred to as "Designated Community-Based Service Provider") a Community-Based Service from a provider that performs Community-Based Service Business pertaining to said designation (herein referred to as "Designated Community-Based Service"), shall pay to said Insured Person Requiring Long-Term Care an Allowance for Community-Based Long-Term Care Service with regard to the expenses required for said Designated Community-Based Service (except for expenses necessary to provide meals, residence, and other expenses as determined by an Ordinance of the Ministry of Health, Labour, and Welfare as necessary for daily life with regard to the expenses required for Outpatient Long-Term Care for a Dementia Patient, Multifunctional Long-Term Care in a Small Group Home, Communal Daily Long-Term Care for a Dementia Patient, Daily Life Long-Term Care for a Person Admitted to a Community-Based Specified Facility, and Admission to a Community-Based Facility for Preventive Daily Long-Term Care of the Elderly Covered by Public Aid; hereinafter the same shall apply in this Article), however, provided that this provision shall not apply when said Insured Person Requiring Long-Term Care receives Community-Based Service other than the type pertaining to said designation in a case said Insured Person is issued a designation pursuant to the provision of Article 37, paragraph (1).
2 地域密着型介護サービス費の額は、次の各号に掲げる地域密着型サービスの区分に応じ、当該各号に定める額とする。
(2) The amount of Allowance for Community-Based Long-Term Care Service shall be the amount provided by each item of following, according to the category of Community-Based Service listed in said item:
一 夜間対応型訪問介護及び認知症対応型通所介護 これらの地域密着型サービスの種類ごとに、当該地域密着型サービスの種類に係る指定地域密着型サービスの内容、当該指定地域密着型サービスの事業を行う事業所の所在する地域等を勘案して算定される当該指定地域密着型サービスに要する平均的な費用(認知症対応型通所介護に要する費用については、食事の提供に要する費用その他の日常生活に要する費用として厚生労働省令で定める費用を除く。)の額を勘案して厚生労働大臣が定める基準により算定した費用の額(その額が現に当該指定地域密着型サービスに要した費用の額を超えるときは、当該現に指定地域密着型サービスに要した費用の額とする。)の百分の九十に相当する額
(i) Home-Visit at Night for Long-Term Care and Outpatient Long-Term Care for a Dementia Patient: the amount equivalent to 90 percent of the expenses calculated based on the standards determined by the Minister of Health, Labour, and Welfare (but shall be the actual expenses required for said Designated Community-Based Service in a case such calculated amount exceeds the actual expenses required for said Designated Community-Based Service) by considering the average expenses required for said Designated Community-Based Service calculated by considering the content of the Designated Community-Based Service pertaining to the type of said Community-Based Service, the area where the provider that performs said Designated Community-Based Service Business is located, etc. (except for expenses necessary to provide meals, residence, and other necessary expenses for daily life as determined by an Ordinance of the Ministry of Health, Labour, and Welfare with regard to the expenses necessary for Outpatient Long-Term Care for a Dementia Patient), according to by the type of Community-Based Service;
二 小規模多機能型居宅介護、認知症対応型共同生活介護、地域密着型特定施設入居者生活介護及び地域密着型介護老人福祉施設入所者生活介護 これらの地域密着型サービスの種類ごとに、要介護状態区分、当該地域密着型サービスの種類に係る指定地域密着型サービスの事業を行う事業所の所在する地域等を勘案して算定される当該指定地域密着型サービスに要する平均的な費用(食事の提供に要する費用、居住に要する費用その他の日常生活に要する費用として厚生労働省令で定める費用を除く。)の額を勘案して厚生労働大臣が定める基準により算定した費用の額(その額が現に当該指定地域密着型サービスに要した費用の額を超えるときは、当該現に指定地域密着型サービスに要した費用の額とする。)の百分の九十に相当する額
(ii) Multifunctional Long-Term Care in a Small Group Home, Communal Daily Long-Term Care for a Dementia Patient, Daily Life Long-Term Care for a Person Admitted to a Community-Based Specified Facility, and Admission to a Community-Based Facility for Preventive Daily Long-Term Care of the Elderly Covered by Public Aid: the amount equivalent to 90 percent of the expenses calculated based on standards determined by the Minister of Health, Labour, and Welfare (which shall be the actual expenses required for said Designated Community-Based Service in a case said standard amount exceeds the actual expenses required for said Designated Community-Based Service) by considering the average expenses required for said Designated Community-Based Service calculated by considering the Category of Condition of Need for Long-Term Care and the area where the provider that performs said Designated Community-Based Service Business is located, etc. (excluding the expenses necessary to provide meals, residence, and other necessary expenses for daily life as determined by an Ordinance of the Ministry of Health, Labour, and Welfare), according to the type of Community-Based Service.
3 厚生労働大臣は、前項各号の基準を定めようとするときは、あらかじめ社会保障審議会の意見を聴かなければならない。
(3) The Minister of Health, Labour, and Welfare, when providing standards for each item of the preceding paragraph, shall hear the opinion of the Social Security Committee in advance.
4 市町村は、第二項各号の規定にかかわらず、同項各号に定める地域密着型介護サービス費の額に代えて、その額を超えない額を、当該市町村における地域密着型介護サービス費の額とすることができる。
(4) A Municipality, notwithstanding the provision of each item of paragraph (2), may determine the amount for the Allowance for Community-Based Long-Term Care Service in said Municipality, in lieu of the amount of Allowance for Community-Based Long-Term Care Service prescribed in the same paragraph and same item, the amount of which shall not exceed the amount of said Allowance for Community-Based Long-Term Care Service prescribed in the same paragraph and same item.
5 市町村は、前項の当該市町村における地域密着型介護サービス費の額を定めようとするときは、あらかじめ、当該市町村が行う介護保険の被保険者その他の関係者の意見を反映させ、及び学識経験を有する者の知見の活用を図るために必要な措置を講じなければならない。
(5) A Municipality, when it intends to determine the amount of Allowance for Community-Based Long-Term Care Service in said Municipality as prescribed in the preceding paragraph, shall reflect the opinions of Insured Persons of Long-Term Care Insurance undertaken by said Municipality and take necessary measures in order to promote the use of knowledge of persons with relevant knowledge and experience, in advance.
6 要介護被保険者が指定地域密着型サービス事業者から指定地域密着型サービスを受けたとき(当該要介護被保険者が第四十六条第四項の規定により指定居宅介護支援を受けることにつきあらかじめ市町村に届け出ている場合であって、当該指定地域密着型サービスが当該指定居宅介護支援の対象となっている場合その他の厚生労働省令で定める場合に限る。)は、市町村は、当該要介護被保険者が当該指定地域密着型サービス事業者に支払うべき当該指定地域密着型サービスに要した費用について、地域密着型介護サービス費として当該要介護被保険者に対し支給すべき額の限度において、当該要介護被保険者に代わり、当該指定地域密着型サービス事業者に支払うことができる。
(6) When an Insured Person Requiring Long-Term Care receives Designated Community-Based Service from a Designated Community-Based Service Provider (limited to a case when said Insured Person Requiring Long-Term Care notifies the Municipality regarding the receiving of Designated In-Home Long-Term Care Support pursuant to the provision of Article 46, paragraph (4) in advance, and a case when said Designated Community-Based Service is subject to said Designated In-Home Long-Term Care Support, or other cases as determined by an Ordinance of the Ministry of Health, Labour, and Welfare), the Municipality may pay the expenses required for said Designated Community-Based Service that are to be paid to said Designated Community-Based Service Provider by said Insured Person Requiring Long-Term Care on behalf of said Insured Person Requiring Long-Term Care within the limit of the amount to be paid to said Insured Person Requiring Long-Term Care as an Allowance for Community-Based Long-Term Care Service.
7 前項の規定による支払があったときは、要介護被保険者に対し地域密着型介護サービス費の支給があったものとみなす。
(7) When the payment as prescribed in the preceding paragraph is paid, it shall be deemed that an Allowance for Community-Based Long-Term Care Service is paid to Insured Person Requiring Long-Term Care.
8 市町村は、指定地域密着型サービス事業者から地域密着型介護サービス費の請求があったときは、第二項各号の厚生労働大臣が定める基準又は第四項の規定により市町村が定める額及び第七十八条の四第二項又は第四項に規定する指定地域密着型サービスの事業の設備及び運営に関する基準(指定地域密着型サービスの取扱いに関する部分に限る。)に照らして審査した上、支払うものとする。
(8) A Municipality, when a Designated Community-Based Service Provider requests payment for Allowance for Designated Community-Based Service, shall pay said amount after conducting an examination according to the amount specified by the Municipality pursuant to the provisions of the standards determined by the Ministry of Health, Labour, and Welfare as set forth in each item of paragraph (2) and pursuant to the provision of paragraph (4), and according to the standards pertaining to facilities and management of Designated Community-Based Service Business as prescribed by Article 78-4, paragraph (2) or paragraph (4) (limited to the part regarding the handling of Designated Community-Based Service).
9 第四十一条第二項、第三項、第十項及び第十一項の規定は地域密着型介護サービス費の支給について、同条第八項の規定は指定地域密着型サービス事業者について準用する。この場合において、これらの規定に関し必要な技術的読替えは、政令で定める。
(9) The provisions of Article 41, paragraph (2), paragraph (3), paragraph (10), and paragraph (11) shall apply mutatis mutandis to the payment of an Allowance for Designated Community-Based Service and the provisions of paragraph (8) of the same Article shall apply mutatis mutandis to a Designated Community-Based Service Provider. In this case, the necessary technical replacement of terms in these provisions shall be provided by a Cabinet Order.
10 前各項に規定するもののほか、地域密着型介護サービス費の支給及び指定地域密着型サービス事業者の地域密着型介護サービス費の請求に関して必要な事項は、厚生労働省令で定める。
(10) In addition to the provisions as prescribed in each of the preceding items, necessary matters for payment of an Allowance for Designated Community-Based Service and a request by a Designated Community-Based Service Provider for an Allowance for Designated Community-Based Service shall be as determined by an Ordinance of the Ministry of Health, Labour, and Welfare.
(特例地域密着型介護サービス費の支給)
(Payment of an Exceptional Allowance for Community-Based Long-Term Care Service)
第四十二条の三 市町村は、次に掲げる場合には、要介護被保険者に対し、特例地域密着型介護サービス費を支給する。
Article 42-3 (1) A Municipality shall, in the following cases, pay an Exceptional Allowance for Community-Based Long-Term Care Service to an Insured Person Requiring Long-Term Care:
一 要介護被保険者が、当該要介護認定の効力が生じた日前に、緊急その他やむを得ない理由により指定地域密着型サービスを受けた場合において、必要があると認めるとき。
(i) when the Municipality determines it necessary in a case when an Insured Person Requiring Long-Term Care receives a Designated Community-Based Service prior to the date said Certification of Needed Long-Term Care becomes effective due to an emergency or other compelling reason;
二 指定地域密着型サービス(地域密着型介護老人福祉施設入所者生活介護を除く。以下この号において同じ。)の確保が著しく困難である離島その他の地域であって厚生労働大臣が定める基準に該当するものに住所を有する要介護被保険者が、指定地域密着型サービス以外の地域密着型サービス(地域密着型介護老人福祉施設入所者生活介護を除く。)又はこれに相当するサービスを受けた場合において、必要があると認めるとき。
(ii) when the Municipality determines it necessary in a case when an Insured Person Requiring Long-Term Care has a domicile on an isolated island or other area where it is significantly difficult to secure Designated Community-Based Service (except for Admission to a Community-Based Facility for Preventive Daily Long-Term Care of the Elderly Covered by Public Aid; the same shall apply hereinafter in this item) and in a location that qualifies with standards as determined by the Minister of Health, Labour, and Welfare, and an Insured Person receives Community-Based Service other than Designated Community-Based Service (except for Admission to a Community-Based Facility for Preventive Daily Long-Term Care of the Elderly Covered by Public Aid) or an equivalent service to said services;
三 その他政令で定めるとき。
(iii) when provided by a Cabinet Order.
2 特例地域密着型介護サービス費の額は、当該地域密着型サービス又はこれに相当するサービスについて前条第二項各号の厚生労働大臣が定める基準により算定した費用の額(その額が現に当該地域密着型サービス又はこれに相当するサービスに要した費用(認知症対応型通所介護、小規模多機能型居宅介護、認知症対応型共同生活介護、地域密着型特定施設入居者生活介護及び地域密着型介護老人福祉施設入所者生活介護並びにこれらに相当するサービスに要した費用については、食事の提供に要する費用、居住に要する費用その他の日常生活に要する費用として厚生労働省令で定める費用を除く。)の額を超えるときは、当該現に地域密着型サービス又はこれに相当するサービスに要した費用の額とする。)の百分の九十に相当する額又は同条第四項の規定により市町村が定めた額を基準として、市町村が定める。
(2) The amount of an Exceptional Allowance for Community-Based Long-Term Care Service shall be provided by a Municipality based on the amount equivalent to 90 percent of the expenses calculated by standards determined by the Minister of Health, Labour, and Welfare as prescribed for each item of the preceding Article, paragraph (2) regarding said Community-Based Service or equivalent service (except when said calculated standard amount exceeds the actual expenses required for said Community-Based Service or equivalent service (excluding the expenses necessary to provide meals, residence, and other expenses as determined by an Ordinance of the Ministry of Health, Labour, and Welfare as necessary for daily life with regard to the expenses required for Outpatient Long-Term Care for a Dementia Patient, Multifunctional Long-Term Care in a Small Group Home, Communal Daily Long-Term Care for a Dementia Patient, Daily Life Long-Term Care for a Person Admitted to a Community-Based Specified Facility, Admission to a Community-Based Facility for Preventive Daily Long-Term Care of the Elderly Covered by Public Aid, and equivalent services), said amount shall be the actual expenses required for said Community-Based Service or equivalent service), or the amount specified by the Municipality pursuant to the provision of paragraph (4) of the same Article.
3 市町村長は、特例地域密着型介護サービス費の支給に関して必要があると認めるときは、当該支給に係る地域密着型サービス若しくはこれに相当するサービスを担当する者若しくは担当した者(以下この項において「地域密着型サービス等を担当する者等」という。)に対し、報告若しくは帳簿書類の提出若しくは提示を命じ、若しくは出頭を求め、又は当該職員に関係者に対して質問させ、若しくは当該地域密着型サービス等を担当する者等の当該支給に係る事業所に立ち入り、その設備若しくは帳簿書類その他の物件を検査させることができる。
(3) The mayor of a Municipality, when he or she determines the necessity of payment of an Exceptional Allowance for Community-Based Long-Term Care Service, shall order a person that has been in charge of said Community-Based Service pertaining to said payment or in charge of an equivalent service (herein referred to as "Person, etc., in Charge of Community-Based Service, etc." in this paragraph) to report, submit or present record books and documents, appear, or direct its personnel to question the relevant person or enter the Business Office of the provider of said Person, etc., in Charge of Community-Based Service, etc., pertaining to said payment in order to inspect said equipment, record books and documents, and other items.
4 第二十四条第三項の規定は前項の規定による質問又は検査について、同条第四項の規定は前項の規定による権限について準用する。
(4) The provisions of Article 24, paragraph (3) shall apply mutatis mutandis to questions or inspections as prescribed in the preceding paragraph, and the provisions of paragraph (4) of the same Article shall apply mutatis mutandis to the authority granted as prescribed in the preceding paragraph.
(居宅介護サービス費等に係る支給限度額)
(Maximum Amount of Payment Pertaining to an Allowance for In-Home Long-Term Care Service, etc.)
第四十三条 居宅要介護被保険者が居宅サービス等区分(居宅サービス(これに相当するサービスを含む。以下この条において同じ。)及び地域密着型サービス(これに相当するサービスを含み、地域密着型介護老人福祉施設入所者生活介護を除く。以下この条において同じ。)について、その種類ごとの相互の代替性の有無等を勘案して厚生労働大臣が定める二以上の種類からなる区分をいう。以下同じ。)ごとに月を単位として厚生労働省令で定める期間において受けた一の居宅サービス等区分に係る居宅サービスにつき支給する居宅介護サービス費の額の総額及び特例居宅介護サービス費の額の総額並びに地域密着型サービスにつき支給する地域密着型介護サービス費の額の総額及び特例地域密着型介護サービス費の額の総額の合計額は、居宅介護サービス費等区分支給限度基準額を基礎として、厚生労働省令で定めるところにより算定した額の百分の九十に相当する額を超えることができない。
Article 43 (1) The total sum of allowances that are paid monthly for In-Home Service pertaining to one classification of In-Home Service, etc., that an Insured In-Home Person Requiring Long-Term Care during the period determined by Ordinance of Ministry of Health, Labour, and Welfare for each classification of In-Home Service, etc. (which means with regard to In-Home Service (including equivalent services; hereinafter the same shall apply in this Article) and Community-Based Service (including equivalent services except for Admission to a Community-Based Facility for Preventive Daily Long-Term Care of the Elderly Covered by Public Aid; the same shall apply hereinafter in this Article) by categories of two or more types as determined by the Minister of Health, Labour, and Welfare, considering the inter-substitution by each type of category; the same shall apply hereinafter) shall not exceed the amount equivalent to 90 percent of the amount calculated pursuant to the provisions of an Ordinance of the Ministry of Health, Labour, and Welfare based on the base amount of maximum payment for each category of Allowance for In-Home Long-Term Care Service, etc. The total sum of allowance is the total amount of Allowance for In-Home Long-Term Care Service or Exceptional Allowance for In-Home Long-Term Care Service, or the total amount of Allowance for Community-Based Long-Term Care Service to be paid for Community-Based Service or the total amount of Exceptional Allowance for Community-Based Long-Term Care Service.
2 前項の居宅介護サービス費等区分支給限度基準額は、居宅サービス等区分ごとに、同項に規定する厚生労働省令で定める期間における当該居宅サービス等区分に係る居宅サービス及び地域密着型サービスの要介護状態区分に応じた標準的な利用の態様、当該居宅サービス及び地域密着型サービスに係る第四十一条第四項各号及び第四十二条の二第二項各号の厚生労働大臣が定める基準等を勘案して厚生労働大臣が定める額とする。
(2) The base amount of maximum payment by classification of Allowance for In-Home Long-Term Care Service, etc., as prescribed in the preceding paragraph shall be an amount determined by the Minister of Health, Labour, and Welfare by classification of In-Home Service, etc., and by considering the standard use, according to the categories of Condition of Need for Long-Term Care, of In-Home Service pertaining to the category of said In-Home Service and Community-Based Service, etc., during the period as determined by an Ordinance of the Ministry of Health, Labour, and Welfare as prescribed in the same paragraph, and standards, etc., provided by the Minister of Health, Labour, and Welfare as set forth in each item of Article 41, paragraph (4) and each item of Article 42-2, paragraph (2) pertaining to said In-Home Service and Community-Based Service.
3 市町村は、前項の規定にかかわらず、条例で定めるところにより、第一項の居宅介護サービス費等区分支給限度基準額に代えて、その額を超える額を、当該市町村における居宅介護サービス費等区分支給限度基準額とすることができる。
(3) A Municipality, notwithstanding the provisions of the preceding paragraph and pursuant to the provisions of a municipal ordinance, in lieu of the base amount of maximum payment for the categories of allowances for In-Home Long-Term Care, etc., as prescribed in paragraph (1), may determine an amount exceeding said base amount as the base amount of maximum payment for the categories of allowances for In-Home Long-Term Care, etc., in said Municipality.
4 市町村は、居宅要介護被保険者が居宅サービス及び地域密着型サービスの種類(居宅サービス等区分に含まれるものであって厚生労働大臣が定めるものに限る。次項において同じ。)ごとに月を単位として厚生労働省令で定める期間において受けた一の種類の居宅サービスにつき支給する居宅介護サービス費の額の総額及び特例居宅介護サービス費の額の総額の合計額並びに一の種類の地域密着型サービスにつき支給する地域密着型介護サービス費の額の総額及び特例地域密着型介護サービス費の額の総額の合計額について、居宅介護サービス費等種類支給限度基準額を基礎として、厚生労働省令で定めるところにより算定した額の百分の九十に相当する額を超えることができないこととすることができる。
(4) A Municipality, with regard to the total sum of the total amount of allowances for In-Home Long-Term Care and exceptional allowances for In-Home Long-Term Care that are paid by each type of In-Home Service and the total amount of allowances for Community-Based Service and exceptional allowances for Community-Based Service that are paid by each type of Community-Based Service when said allowances are paid monthly to an Insured In-Home Person Requiring Long-Term Care by the type of In-Home Service and Community-Based Service (limited to those types that are included in categories of In-Home Service, etc., and that are determined by the Minister of Health, Labour, and Welfare) during the period as determined by an Ordinance of the Ministry of Health, Labour, and Welfare, may determine that said total sum shall not exceed 90 percent of the calculated standard amount pursuant to the provisions of an Ordinance of the Ministry of Health, Labour, and Welfare based on base amount of maximum payment for the categories of allowances for In-Home Long-Term Care, etc.
5 前項の居宅介護サービス費等種類支給限度基準額は、居宅サービス及び地域密着型サービスの種類ごとに、同項に規定する厚生労働省令で定める期間における当該居宅サービス及び地域密着型サービスの要介護状態区分に応じた標準的な利用の態様、当該居宅サービス及び地域密着型サービスに係る第四十一条第四項各号及び第四十二条の二第二項各号の厚生労働大臣が定める基準等を勘案し、当該居宅サービス及び地域密着型サービスを含む居宅サービス等区分に係る第一項の居宅介護サービス費等区分支給限度基準額(第三項の規定に基づき条例を定めている市町村にあっては、当該条例による措置が講じられた額とする。)の範囲内において、市町村が条例で定める額とする。
(5) The base amount of maximum payment for the categories of allowances for In-Home Long-Term Care, etc., as set forth in the preceding paragraph shall be the amount specified by a municipal ordinance within the limit of the base amount of maximum payment for the categories of allowances for In-Home Long-Term Care, etc., prescribed in paragraph (1) pertaining to the categories of In-Home Service, etc., including said In-Home Service and Community-Based Service (with regard to the Municipality that provides a municipal ordinance pursuant to the provisions of paragraph (3), the base amount shall be the amount for which measures pursuant to the provisions of said municipal ordinance are undertaken) by considering each type of In-Home Service and Community-Based Service for its standard use according to the categories of Condition of Need for Long-Term Care of said In-Home Service and Community-Based Service during the period as determined by an Ordinance of the Ministry of Health, Labour, and Welfare as prescribed in the preceding paragraph and of standards, etc., provided by the Minister of Health, Labour, and Welfare as set forth in each item of Article 41, paragraph (4) and each item of Article 42-2, paragraph (2) pertaining to said In-Home Service and Community-Based Service.
6 居宅介護サービス費若しくは特例居宅介護サービス費又は地域密着型介護サービス費若しくは特例地域密着型介護サービス費を支給することにより第一項に規定する合計額が同項に規定する百分の九十に相当する額を超える場合又は第四項に規定する合計額が同項に規定する百分の九十に相当する額を超える場合における当該居宅介護サービス費若しくは特例居宅介護サービス費又は地域密着型介護サービス費若しくは特例地域密着型介護サービス費の額は、第四十一条第四項各号若しくは第四十二条第二項又は第四十二条の二第二項各号若しくは第四項若しくは前条第二項の規定にかかわらず、政令で定めるところにより算定した額とする。
(6) In a case when the total sum as prescribed in paragraph (1) exceeds the amount equivalent to 90 percent of the calculated amount as prescribed in the same paragraph for payment of allowances for In-Home Long-Term Care, Exceptional Allowance for In-Home Long-Term Care Service, Allowance for Community-Based Long-Term Care Service, or Exceptional Allowance for Community-Based Long-Term Care Service, or in a case when the total sum as prescribed in paragraph (4) exceeds the amount equivalent to 90 percent of the calculated amount as prescribed in the same paragraph, the amount of allowances of said In-Home Long-Term Care, Exceptional Allowance for In-Home Long-Term Care Service, Allowance for Community-Based Long-Term Care Service, or Exceptional Allowance for Community-Based Long-Term Care Service shall be the amount calculated pursuant to the provisions of a Cabinet Order, notwithstanding the provisions of each item of Article 41, paragraph (4), Article 42, paragraph (2), each item of Article 42-2, paragraph (2) or paragraph (4), or paragraph (2) of the preceding Article.
(居宅介護福祉用具購入費の支給)
(Payment of an Allowance for Purchasing Equipment for In-Home Long-Term Care Covered by Public Aid)
第四十四条 市町村は、居宅要介護被保険者が、特定福祉用具販売に係る指定居宅サービス事業者から当該指定に係る居宅サービス事業を行う事業所において販売される特定福祉用具を購入したときは、当該居宅要介護被保険者に対し、居宅介護福祉用具購入費を支給する。
Article 44 (1) A Municipality, when an Insured In-Home Person Requiring Long-Term Care purchases from a Designated In-Home Service Provider pertaining to the Sale of Specified Equipment Covered by Public Aid an article of the Specified Equipment Covered by Public Aid that is sold by a provider that performs an In-Home Service pertaining to said designation, shall pay to said Insured In-Home Person Requiring Long-Term Care an Allowance for purchasing Equipment for In-Home Long-Term Care Covered by Public Aid.
2 居宅介護福祉用具購入費は、厚生労働省令で定めるところにより、市町村が必要と認める場合に限り、支給するものとする。
(2) An Allowance for purchasing Equipment for In-Home Long-Term Care Covered by Public Aid shall be paid pursuant to the provisions of an Ordinance of the Ministry of Health, Labour, and Welfare and limited to when the Municipality determines it necessary.
3 居宅介護福祉用具購入費の額は、現に当該特定福祉用具の購入に要した費用の額の百分の九十に相当する額とする。
(3) The amount of Allowance for purchasing Equipment for In-Home Long-Term Care Covered by Public Aid shall be the amount equivalent to 90 percent of the actual expenses required for the purchase of said Specified Equipment Covered by Public Aid.
4 居宅要介護被保険者が月を単位として厚生労働省令で定める期間において購入した特定福祉用具につき支給する居宅介護福祉用具購入費の額の総額は、居宅介護福祉用具購入費支給限度基準額を基礎として、厚生労働省令で定めるところにより算定した額の百分の九十に相当する額を超えることができない。
(4) The total Allowance for purchasing Equipment for In-Home Long-Term Care Covered by Public Aid that is paid monthly for Specified Equipment Covered by Public Aid purchased by an Insured In-Home Person Requiring Long-Term Care during the period as determined by an Ordinance of the Ministry of Health, Labour, and Welfare shall not exceed the amount equivalent to 90 percent of the amount calculated pursuant to the provision of an Ordinance of the Ministry of Health, Labour, and Welfare based on the base amount of maximum payment for Allowance for purchasing Equipment for In-Home Long-Term Care Covered by Public Aid.
5 前項の居宅介護福祉用具購入費支給限度基準額は、同項に規定する厚生労働省令で定める期間における特定福祉用具の購入に通常要する費用を勘案して厚生労働大臣が定める額とする。
(5) The base amount of maximum payment for Allowance for purchasing Equipment for In-Home Long-Term Care Covered by Public Aid as prescribed in the preceding paragraph shall be an amount provided by the Minister of Health, Labour, and Welfare as prescribed in the same paragraph after considering the average expenses required for the purchase of said Specified Equipment Covered by Public Aid during the period as determined by an Ordinance of the Ministry of Health, Labour, and Welfare.
6 市町村は、前項の規定にかかわらず、条例で定めるところにより、第四項の居宅介護福祉用具購入費支給限度基準額に代えて、その額を超える額を、当該市町村における居宅介護福祉用具購入費支給限度基準額とすることができる。
(6) A Municipality, notwithstanding the provisions of the preceding paragraph, in lieu of the base amount of maximum payment for Allowance for purchasing Equipment for In-Home Long-Term Care Covered by Public Aid as set forth in paragraph (4), may determine an amount that exceeds said base amount as the base amount of maximum payment for Allowance for purchasing Equipment for In-Home Long-Term Care Covered by Public Aid in said Municipality.
7 居宅介護福祉用具購入費を支給することにより第四項に規定する総額が同項に規定する百分の九十に相当する額を超える場合における当該居宅介護福祉用具購入費の額は、第三項の規定にかかわらず、政令で定めるところにより算定した額とする。
(7) In a case when the total sum as prescribed in paragraph (4) exceeds the amount equivalent to 90 percent of the calculated amount as prescribed in the same paragraph for payment of an Allowance for purchasing Equipment for In-Home Long-Term Care Covered by Public Aid, the amount of said Allowance for purchasing Equipment for In-Home Long-Term Care Covered by Public Aid shall be the amount calculated pursuant to the provisions of a Cabinet Order, notwithstanding the provision of paragraph (3).
(居宅介護住宅改修費の支給)
(Payment of an Allowance for Home Modification for In-Home Long-Term Care)
第四十五条 市町村は、居宅要介護被保険者が、手すりの取付けその他の厚生労働大臣が定める種類の住宅の改修(以下「住宅改修」という。)を行ったときは、当該居宅要介護被保険者に対し、居宅介護住宅改修費を支給する。
Article 45 (1) A Municipality, when an Insured In-Home Person Requiring Long-Term Care implements a type of modification determined by the Minister of Health, Labour, and Welfare, such as installing handrails or other fixtures (herein referred to as "Home Modification"), shall pay an Allowance for Home Modification for In-Home Long-Term Care to said Insured In-Home Person Requiring Long-Term Care.
2 居宅介護住宅改修費は、厚生労働省令で定めるところにより、市町村が必要と認める場合に限り、支給するものとする。
(2) An Allowance for Home Modification for In-Home Long-Term Care shall be paid pursuant to the provisions of an Ordinance of the Ministry of Health, Labour, and Welfare limited to a case when the Municipality determines it necessary.
3 居宅介護住宅改修費の額は、現に当該住宅改修に要した費用の額の百分の九十に相当する額とする。
(3) The amount of Allowance for Home Modification for In-Home Long-Term Care shall be the amount equivalent to 90 percent of the actual expenses required for said Home Modification.
4 居宅要介護被保険者が行った一の種類の住宅改修につき支給する居宅介護住宅改修費の額の総額は、居宅介護住宅改修費支給限度基準額を基礎として、厚生労働省令で定めるところにより算定した額の百分の九十に相当する額を超えることができない。
(4) The total amount of Allowance for Home Modification for In-Home Long-Term Care that is paid for a single type of modifying house for in-home care undertaken by an Insured In-Home Person Requiring Long-Term Care shall not exceed the amount equivalent to 90 percent of the amount calculated pursuant to the provisions of an Ordinance of the Ministry of Health, Labour, and Welfare based on the base amount of maximum payment for Allowance for Home Modification for In-Home Long-Term Care.
5 前項の居宅介護住宅改修費支給限度基準額は、住宅改修の種類ごとに、通常要する費用を勘案して厚生労働大臣が定める額とする。
(5) The base amount of maximum payment for Allowance for Home Modification for In-Home Long-Term Care as prescribed in the preceding paragraph shall be the amount specified by the Minister of Health, Labour, and Welfare by type of Home Modification after considering the average expenses required.
6 市町村は、前項の規定にかかわらず、条例で定めるところにより、第四項の居宅介護住宅改修費支給限度基準額に代えて、その額を超える額を、当該市町村における居宅介護住宅改修費支給限度基準額とすることができる。
(6) A Municipality, notwithstanding the provision of the preceding paragraph, pursuant to the provisions of a municipal ordinance, and in lieu of the base amount of maximum payment for Allowance for Home Modification for In-Home Long-Term Care as set forth in paragraph (4), may determine an amount that exceeds said base amount as the base amount of maximum payment for Allowance for Home Modification for In-Home Long-Term Care in said Municipality.
7 居宅介護住宅改修費を支給することにより第四項に規定する総額が同項に規定する百分の九十に相当する額を超える場合における当該居宅介護住宅改修費の額は、第三項の規定にかかわらず、政令で定めるところにより算定した額とする。
(7) In a case when the total amount as prescribed in paragraph (4) exceeds the amount equivalent to 90 percent of the calculated amount as prescribed in the same paragraph due to payment of said Allowance for Home Modification for In-Home Long-Term Care, the amount of said Allowance for Home Modification for In-Home Long-Term Care shall be the amount calculated pursuant to the provisions of a Cabinet Order, notwithstanding the provision of paragraph (3).
8 市町村長は、居宅介護住宅改修費の支給に関して必要があると認めるときは、当該支給に係る住宅改修を行う者若しくは住宅改修を行った者(以下この項において「住宅改修を行う者等」という。)に対し、報告若しくは帳簿書類の提出若しくは提示を命じ、若しくは出頭を求め、又は当該職員に関係者に対して質問させ、若しくは当該住宅改修を行う者等の当該支給に係る事業所に立ち入り、その帳簿書類その他の物件を検査させることができる。
(8) A Municipality, when it determines the necessity for payment of an Allowance for Home Modification for In-Home Long-Term Care, may order a person that implements or implemented the Home Modification pertaining to said payment (herein referred to as "Person, etc., that Implements the Home Modification" in this paragraph) to report, submit or present record books and documents, appear, or direct its personnel to question said relevant Person or enter the Business Office of the provider of said Person, etc., that Implements the Home Modification in order to inspect said books, documents, and other items.
9 第二十四条第三項の規定は前項の規定による質問又は検査について、同条第四項の規定は前項の規定による権限について準用する。
(9) The provisions of Article 24, paragraph (3) shall apply mutatis mutandis to questions and inspections as prescribed in the preceding paragraph and the provisions of paragraph (4) of the same Article shall apply mutatis mutandis to the authority granted as prescribed in the preceding paragraph.
(居宅介護サービス計画費の支給)
(Payment of an Allowance for In-Home Long-Term Care Service Plan)
第四十六条 市町村は、居宅要介護被保険者が、都道府県知事が指定する者(以下「指定居宅介護支援事業者」という。)から当該指定に係る居宅介護支援事業を行う事業所により行われる居宅介護支援(以下「指定居宅介護支援」という。)を受けたときは、当該居宅要介護被保険者に対し、当該指定居宅介護支援に要した費用について、居宅介護サービス計画費を支給する。
Article 46 (1) A Municipality, when an Insured In-Home Person Requiring Long-Term Care receives Designated In-Home Long-Term Care Support from a person designated by the prefectural governor (herein referred to as "Designated In-Home Long-Term Care Support Provider") provided by the provider that performs a Designated In-Home Long-Term Care Support Business pertaining to said designation (herein referred to as "Designated In-Home Long-Term Care Support"), may pay to said Insured In-Home Person Requiring Long-Term Care the Allowance for In-Home Long-Term Care Service Plan for the expenses required for said Designated In-Home Long-Term Care Support.
2 居宅介護サービス計画費の額は、指定居宅介護支援の事業を行う事業所の所在する地域等を勘案して算定される指定居宅介護支援に要する平均的な費用の額を勘案して厚生労働大臣が定める基準により算定した費用の額(その額が現に当該指定居宅介護支援に要した費用の額を超えるときは、当該現に指定居宅介護支援に要した費用の額とする。)とする。
(2) The amount of Allowance for In-Home Long-Term Care Service Plan shall be the amount of expenses calculated by standards as prescribed by the Minister of Health, Labour, and Welfare after considering the average expenses necessary for the Designated In-Home Long-Term Care Support, calculated after considering the area, etc., where the provider that performs the Designated In-Home Long-Term Care Support Business is located (in a case when said calculated amount exceeds the actual expenses necessary for the Designated In-Home Long-Term Care Support, the amount of Allowance for In-Home Long-Term Care Service Plan shall be the actual expenses necessary for said Designated In-Home Long-Term Care Support.)
3 厚生労働大臣は、前項の基準を定めようとするときは、あらかじめ社会保障審議会の意見を聴かなければならない。
(3) The Minister of Health, Labour, and Welfare, when intending to specify standards as prescribed in the preceding paragraph, shall hear the opinions of the Social Security Council in advance.
4 居宅要介護被保険者が指定居宅介護支援事業者から指定居宅介護支援を受けたとき(当該居宅要介護被保険者が、厚生労働省令で定めるところにより、当該指定居宅介護支援を受けることにつきあらかじめ市町村に届け出ている場合に限る。)は、市町村は、当該居宅要介護被保険者が当該指定居宅介護支援事業者に支払うべき当該指定居宅介護支援に要した費用について、居宅介護サービス計画費として当該居宅要介護被保険者に対し支給すべき額の限度において、当該居宅要介護被保険者に代わり、当該指定居宅介護支援事業者に支払うことができる。
(4) When an Insured In-Home Person Requiring Long-Term Care receives Designated In-Home Long-Term Care Support from a Designated In-Home Long-Term Care Support Provider (limited to a case when said Insured In-Home Person Requiring Long-Term Care has notified the Municipality in advance to receive said Designated In-Home Long-Term Care Support pursuant to the provisions of an Ordinance of the Ministry of Health, Labour, and Welfare), the Municipality may pay to said Designated In-Home Long-Term Care Support Provider on behalf of said Insured In-Home Person Requiring Long-Term Care the expenses required for said Designated In-Home Long-Term Care Support that said Insured In-Home Person Requiring Long-Term Care should pay to said Designated In-Home Long-Term Care Support Provider.
5 前項の規定による支払があったときは、居宅要介護被保険者に対し居宅介護サービス計画費の支給があったものとみなす。
(5) When the payment pursuant to the provisions of the preceding paragraph is paid, it shall be deemed that an Allowance for In-Home Long-Term Care Service Plan is paid to the Insured In-Home Person Requiring Long-Term Care.
6 市町村は、指定居宅介護支援事業者から居宅介護サービス計画費の請求があったときは、第二項の厚生労働大臣が定める基準及び第八十一条第二項に規定する指定居宅介護支援の事業の運営に関する基準(指定居宅介護支援の取扱いに関する部分に限る。)に照らして審査した上、支払うものとする。
(6) A Municipality, when requested to pay an Allowance for In-Home Long-Term Care Service Plan by a Designated In-Home Long-Term Care Support Provider, shall conduct an examination according to standards provided by the Minister of Health, Labour, and Welfare as set forth in the paragraph (2) and the standards of business management of a Designated In-Home Long-Term Care Support Provider as prescribed in Article 81, paragraph (2) (limited to the part regarding the handling of Designated In-Home Long-Term Care Support).
7 第四十一条第二項、第三項、第十項及び第十一項の規定は、居宅介護サービス計画費の支給について、同条第八項の規定は、指定居宅介護支援事業者について準用する。この場合において、これらの規定に関し必要な技術的読替えは、政令で定める。
(7) The provisions of Article 41, paragraph (2), paragraph (3), paragraph (10) and paragraph (11) shall apply mutatis mutandis to the payment of an Allowance for In-Home Long-Term Care Service Plan and the provisions of paragraph (8) of the same Article shall apply mutatis mutandis to the Designated In-Home Long-Term Care Support Provider. In this case, the necessary technical replacement of terms in these provisions shall be provided by a Cabinet Order.
8 前各項に規定するもののほか、居宅介護サービス計画費の支給及び指定居宅介護支援事業者の居宅介護サービス計画費の請求に関して必要な事項は、厚生労働省令で定める。
(8) In addition to the provisions of each preceding paragraph, other necessary matters for the payment of Allowance for In-Home Long-Term Care Service Plan and for requesting an Allowance for In-Home Long-Term Care Service Plan from a Designated In-Home Long-Term Care Support Provider shall be as determined by an Ordinance of the Ministry of Health, Labour, and Welfare.
(特例居宅介護サービス計画費の支給)
(Payment of an Exceptional Allowance for In-Home Long-Term Care Service Plan)
第四十七条 市町村は、次に掲げる場合には、居宅要介護被保険者に対し、特例居宅介護サービス計画費を支給する。
Article 47 (1) A Municipality shall, in the following cases, pay an Allowance for an Exceptional Allowance for In-Home Long-Term Care Service Plan to an Insured In-Home Person Requiring Long-Term Care:
一 居宅要介護被保険者が、指定居宅介護支援以外の居宅介護支援又はこれに相当するサービス(指定居宅介護支援の事業に係る第八十一条第一項の厚生労働省令で定める員数及び同条第二項に規定する指定居宅介護支援の事業の運営に関する基準のうち、厚生労働省令で定めるものを満たすと認められる事業を行う事業所により行われるものに限る。次号において「基準該当居宅介護支援」という。)を受けた場合において、必要があると認めるとき。
(i) when the Municipality determines it necessary in a case when an Insured In-Home Person Requiring Long-Term Care receives In-Home Long-Term Care Support other than Designated In-Home Long-Term Care Support or an equivalent service (limited to those services provided by a provider performing business that is determined to satisfy the standards as determined by an Ordinance of the Ministry of Health, Labour, and Welfare among the number of employees as determined by an Ordinance of the Ministry of Health, Labour, and Welfare as set forth in Article 81, paragraph (1) pertaining to Designated In-Home Long-Term Care Support Business and the standards of management of a Designated In-Home Long-Term Care Support Business as prescribed in paragraph (2) of the same Article; hereinafter referred to as "In-Home Long-Term Care Support Applicable to Standards" in the following item);
二 指定居宅介護支援及び基準該当居宅介護支援の確保が著しく困難である離島その他の地域であって厚生労働大臣が定める基準に該当するものに住所を有する居宅要介護被保険者が、指定居宅介護支援及び基準該当居宅介護支援以外の居宅介護支援又はこれに相当するサービスを受けた場合において、必要があると認めるとき。
(ii) when the Municipality determines it necessary in a case when an Insured In-Home Person Requiring Long-Term Care who is domiciled on an isolated island or other area where it is significantly difficult to secure Designated In-Home Long-Term Care Support or In-Home Long-Term Care Support Applicable to Standards and in a location that qualifies pursuant to standards as determined by the Minister of Health, Labour, and Welfare receives In-Home Long-Term Care other than Designated In-Home Long-Term Care Support and Designated In-Home Long-Term Care Support that qualifies with standards or service equivalent to those services;
三 その他政令で定めるとき。
(iii) when provided by a Cabinet Order.
2 特例居宅介護サービス計画費の額は、当該居宅介護支援又はこれに相当するサービスについて前条第二項の厚生労働大臣が定める基準により算定した費用の額(その額が現に当該居宅介護支援又はこれに相当するサービスに要した費用の額を超えるときは、当該現に居宅介護支援又はこれに相当するサービスに要した費用の額とする。)を基準として、市町村が定める。
(2) The amount of Allowance for an Exceptional Allowance for In-Home Long-Term Care Service Plan shall be specified by the Municipality based on the expenses calculated by standards determined by the Minister of Health, Labour, and Welfare as set forth in paragraph (2) of the preceding Article for said Designated In-Home Long-Term Care Support or equivalent service (in a case said calculated amount exceeds the amount of actual expenses of said Designated In-Home Long-Term Care Support or equivalent service, the base amount shall be the actual expenses required for said Designated In-Home Long-Term Care Support or equivalent service).
3 市町村長は、特例居宅介護サービス計画費の支給に関して必要があると認めるときは、当該支給に係る居宅介護支援若しくはこれに相当するサービスを担当する者若しくは担当した者(以下この項において「居宅介護支援等を担当する者等」という。)に対し、報告若しくは帳簿書類の提出若しくは提示を命じ、若しくは出頭を求め、又は当該職員に関係者に対して質問させ、若しくは当該居宅介護支援等を担当する者等の当該支給に係る事業所に立ち入り、その帳簿書類その他の物件を検査させることができる。
(3) A Municipality, when it determines the necessity for payment of an Exceptional Allowance for In-Home Long-Term Care Service Plan, may order a person that has been in charge of the Designated In-Home Long-Term Care Support pertaining to said payment or equivalent service (herein referred to as "Person, etc., in Charge of Designated In-Home Long-Term Care Support" in this paragraph) to report, submit, or present record books and documents, appear, or direct its personnel to question the relevant person and to enter the Business Office of the provider of said Person, etc., in Charge of Designated In-Home Long-Term Care Support pertaining to said payment in order to inspect said books, documents, and other items.
4 第二十四条第三項の規定は前項の規定による質問又は検査について、同条第四項の規定は前項の規定による権限について準用する。
(4) The provisions of Article 24, paragraph (3) shall apply mutatis mutandis to questions and inspections pursuant to the provisions of the preceding paragraph and the provisions of paragraph (4) of the same Article shall apply mutatis mutandis to the authority granted pursuant to the provisions of the preceding paragraph.
(施設介護サービス費の支給)
(Payment of an Allowance for Long-Term Care Facility Service)
第四十八条 市町村は、要介護被保険者が、次に掲げる施設サービス(以下「指定施設サービス等」という。)を受けたときは、当該要介護被保険者に対し、当該指定施設サービス等に要した費用(食事の提供に要する費用、居住に要する費用その他の日常生活に要する費用として厚生労働省令で定める費用を除く。以下この条において同じ。)について、施設介護サービス費を支給する。ただし、当該要介護被保険者が、第三十七条第一項の規定による指定を受けている場合において、当該指定に係る種類以外の施設サービスを受けたときは、この限りでない。
Article 48 (1) A Municipality, when an Insured Person Requiring Long-Term Care receives the following Facility Service (herein referred to as "Designated Facility Service, etc."), shall pay to said Insured Person Requiring Long-Term Care an Allowance for Long-Term Care Facility Service of the expenses required for said Designated Facility Service, etc. (excluding the expenses necessary to provide meals, residence, and other necessary expenses for daily life as determined by an Ordinance of the Ministry of Health, Labour, and Welfare; the same shall herein apply in this Article), however, provided that this provision shall not apply to a case that said Insured Person Requiring Long-Term Care who is designated pursuant to the provision of Article 37, paragraph (1), received Facility Service other than the type pertaining to said designation:
一 都道府県知事が指定する介護老人福祉施設(以下「指定介護老人福祉施設」という。)により行われる介護福祉施設サービス(以下「指定介護福祉施設サービス」という。)
(i) Facility Service for Long-Term Care Covered by Public Aid (herein referred to as "Designated Facility Service for Long-Term Care Covered by Public Aid") provided by a Facility Covered by Public Aid Providing Long-Term Care to the Elderly that is designated by said prefectural governor (herein referred to as "Designated Facility Covered by Public Aid Providing Long-Term Care to the Elderly");
二 介護保健施設サービス
(ii) Long-Term Care Health Facility Service;
三 都道府県知事が指定する介護療養型医療施設(以下「指定介護療養型医療施設」という。)により行われる介護療養施設サービス(以下「指定介護療養施設サービス」という。)
(iii) Sanatorium Long-Term Care Service (herein referred to as "Designated Sanatorium Service for Long-Term Care") provided by a Sanatorium Medical Facility for the Elderly Requiring Long-Term Care that is designated as such by the prefectural governor (herein referred to as "Designated Medical Long-Term Care Sanatorium").
2 施設介護サービス費の額は、施設サービスの種類ごとに、要介護状態区分、当該施設サービスの種類に係る指定施設サービス等を行う介護保険施設の所在する地域等を勘案して算定される当該指定施設サービス等に要する平均的な費用(食事の提供に要する費用、居住に要する費用その他の日常生活に要する費用として厚生労働省令で定める費用を除く。)の額を勘案して厚生労働大臣が定める基準により算定した費用の額(その額が現に当該指定施設サービス等に要した費用の額を超えるときは、当該現に指定施設サービス等に要した費用の額とする。)の百分の九十に相当する額とする。
(2) The amount of allowance for Long-Term Care Facility Service shall be 90 percent of the amount of expenses calculated by type of Facility Service with standards as prescribed by the Minister of Health, Labour, and Welfare after considering the average expenses (excluding the expenses necessary to provide meals, residence, and other necessary expenses for daily life as determined by an Ordinance of the Ministry of Health, Labour, and Welfare; the same shall apply hereinafter in this Article) necessary for the Designated Facility Service, etc., that are calculated by considering the categories of Condition of Need for Long-Term Care, the area where the Facility Covered by Long-Term Care Insurance that provides the Designated Facility Service, etc., pertaining to the type of said Facility Service is located, etc. (in a case when said calculated amount exceeds the actual expenses necessary for the Designated Facility Service, etc., the amount of Allowance for Long-Term Care Facility Service shall be the actual expenses necessary for said Designated Facility Service, etc.).
3 厚生労働大臣は、前項の基準を定めようとするときは、あらかじめ社会保障審議会の意見を聴かなければならない。
(3) The Minister of Health, Labour, and Welfare, when intending to specify standards as prescribed in the preceding paragraph, shall hear the opinion of the Social Security Council in advance.
4 要介護被保険者が、介護保険施設から指定施設サービス等を受けたときは、市町村は、当該要介護被保険者が当該介護保険施設に支払うべき当該指定施設サービス等に要した費用について、施設介護サービス費として当該要介護被保険者に支給すべき額の限度において、当該要介護被保険者に代わり、当該介護保険施設に支払うことができる。
(4) When an Insured Person Requiring Long-Term Care receives Designated Facility Service, etc., from a Facility Covered by Long-Term Care Insurance, the Municipality may pay to said Facility Covered by Long-Term Care Insurance on behalf of said Insured In-Home Person Requiring Long-Term Care the expenses required for said Designated Facility Service, etc., that said Insured Person Requiring Long-Term Care should pay to said Facility Covered by Long-Term Care Insurance as an Allowance for Long-Term Care Facility Service within the maximum amount to be paid to said Facility Providing Insured Health Benefits of Long-Term Care.
5 前項の規定による支払があったときは、要介護被保険者に対し施設介護サービス費の支給があったものとみなす。
(5) When a payment pursuant to the provisions of the preceding paragraph is paid, it shall be deemed that an Allowance for Long-Term Care Facility Service is paid to said Insured Person Requiring Long-Term Care.
6 市町村は、介護保険施設から施設介護サービス費の請求があったときは、第二項の厚生労働大臣が定める基準及び第八十八条第二項に規定する指定介護老人福祉施設の設備及び運営に関する基準(指定介護福祉施設サービスの取扱いに関する部分に限る。)、第九十七条第三項に規定する介護老人保健施設の設備及び運営に関する基準(介護保健施設サービスの取扱いに関する部分に限る。)又は第百十条第二項に規定する指定介護療養型医療施設の設備及び運営に関する基準(指定介護療養施設サービスの取扱いに関する部分に限る。)に照らして審査した上、支払うものとする。
(6) A Municipality, when a Facility Covered by Long-Term Care Insurance requests an Allowance for Long-Term Care Facility Service, shall pay said allowance after conducting an examination according to the standards determined by the Minister of Health, Labour, and Welfare as set forth in paragraph (2), the standards concerning facilities and management of a Designated Facility Covered by Public Aid Providing Long-Term Care to the Elderly as prescribed in Article 88, paragraph (2) (limited to the part concerning the handling of Designated Facility Service for Long-Term Care Covered by Public Aid), the standards concerning facilities and management of a Long-Term Care Health Facility as prescribed in Article 97, paragraph (3) (limited to the part concerning the handling of a Long-Term Care Health Facility Service), and standards concerning facilities and management of a Designated Medical Long-Term Care Sanatorium as prescribed in Article 110, paragraph (2) (limited to the part concerning the handling of a Designated Sanatorium Service for Long-Term Care).
7 第四十一条第二項、第三項、第十項及び第十一項の規定は、施設介護サービス費の支給について、同条第八項の規定は、介護保険施設について準用する。この場合において、これらの規定に関し必要な技術的読替えは、政令で定める。
(7) The provisions of Article 41, paragraph (2), paragraph (3), paragraph (10), and paragraph (11) shall apply mutatis mutandis to payment of an Allowance for Long-Term Care Facility Service, and the provisions of paragraph (8) of the same Article shall apply mutatis mutandis to a Facility Covered by Long-Term Care Insurance. In this case, the necessary technical replacement of terms in these provisions shall be provided by a Cabinet Order.
8 前各項に規定するもののほか、施設介護サービス費の支給及び介護保険施設の施設介護サービス費の請求に関して必要な事項は、厚生労働省令で定める。
(8) In addition to the provisions as prescribed in the preceding paragraph, other necessary matters for payment of an Allowance for Long-Term Care Facility Service and a request for an Allowance for Long-Term Care Facility Service of a Facility Covered by Long-Term Care Insurance shall be as determined by an Ordinance of the Ministry of Health, Labour, and Welfare.
(特例施設介護サービス費の支給)
(Payment of an Exceptional Allowance for Long-Term Care Facility Service)
第四十九条 市町村は、次に掲げる場合には、要介護被保険者に対し、特例施設介護サービス費を支給する。
Article 49 (1) A Municipality shall, in the following cases, pay to an Insured Person Requiring Long-Term Care an Exceptional Allowance for Long-Term Care Facility Service:
一 要介護被保険者が、当該要介護認定の効力が生じた日前に、緊急その他やむを得ない理由により指定施設サービス等を受けた場合において、必要があると認めるとき。
(i) when the Municipality determines it necessary in a case when an Insured Person Requiring Long-Term Care receives Designated Facility Service, etc., prior to the date said Certification of Needed Long-Term Care becomes effective due to an emergency or other compelling reason;
二 その他政令で定めるとき。
(ii) when provided by a Cabinet Order.
2 特例施設介護サービス費の額は、当該施設サービスについて前条第二項の厚生労働大臣が定める基準により算定した費用の額(その額が現に当該施設サービスに要した費用(食事の提供に要する費用、居住に要する費用その他の日常生活に要する費用として厚生労働省令で定める費用を除く。)の額を超えるときは、当該現に施設サービスに要した費用の額とする。)の百分の九十に相当する額を基準として、市町村が定める。
(2) The amount of Exceptional Allowance for Long-Term Care Facility Service shall be specified by the Municipality based on 90 percent of the amount equivalent to the expenses calculated with regard to said Facility Service according to the standards as prescribed by the Minister of Health, Labour, and Welfare (in a case when said calculated expenses exceed the actual expenses required for said Facility Service (excluding the expenses necessary to provide meals, residence, and other necessary expenses for daily life as determined by an Ordinance of the Ministry of Health, Labour, and Welfare), the base amount shall be the actual expenses required for said Facility Service).
3 市町村長は、特例施設介護サービス費の支給に関して必要があると認めるときは、当該支給に係る施設サービスを担当する者若しくは担当した者(以下この項において「施設サービスを担当する者等」という。)に対し、報告若しくは帳簿書類の提出若しくは提示を命じ、若しくは出頭を求め、又は当該職員に関係者に対して質問させ、若しくは当該施設サービスを担当する者等の当該支給に係る施設に立ち入り、その設備若しくは帳簿書類その他の物件を検査させることができる。
(3) The mayor of a Municipality, when he or she determines the necessity for payment of an Exceptional Allowance for Long-Term Care Facility Service, may order a person that has been in charge of the Facility Service pertaining to said payment or equivalent service (herein referred to as "Person, etc., in Charge of Facility Service" in this paragraph) to report, submit or present record books and documents, appear, or direct its personnel to question the relevant person or enter the Business Office of the provider of said Person, etc., in Charge of Facility Service pertaining to said payment in order to inspect said equipment, books, documents, and other items.
4 第二十四条第三項の規定は前項の規定による質問又は検査について、同条第四項の規定は前項の規定による権限について準用する。
(4) The provisions of Article 24, paragraph (3) shall apply mutatis mutandis to questions and inspections pursuant to the provisions of the preceding paragraph and the provisions of paragraph (4) of the same Article shall apply mutatis mutandis to the authority granted pursuant to the provisions of the preceding paragraph.
(居宅介護サービス費等の額の特例)
(Exceptions to the Amount of Allowance for In-Home Long-Term Care Service, etc.)
第五十条 市町村が、災害その他の厚生労働省令で定める特別の事情があることにより、居宅サービス(これに相当するサービスを含む。)、地域密着型サービス(これに相当するサービスを含む。)若しくは施設サービス又は住宅改修に必要な費用を負担することが困難であると認めた要介護被保険者が受ける次の各号に掲げる介護給付について当該各号に定める規定を適用する場合においては、これらの規定中「百分の九十」とあるのは、「百分の九十を超え百分の百以下の範囲内において市町村が定めた割合」とする。
Article 50 In a case when a Municipality applies the provisions as prescribed in the following items to a Long-Term Care Benefit as listed in said items received by an Insured Person Requiring Long-Term Care for whom it is deemed difficult to pay the necessary expenses for In-Home Service (including equivalent services), Community-Based Service (including equivalent services), Facility Service, or a Home Modification due to disaster or other special reason as determined by an Ordinance of the Ministry of Health, Labour, and Welfare, the term "90 percent" in the referenced provisions shall be deemed to be replaced with "the percentage determined by the Municipality within the range of more than 90 percent to 100 percent or less":
一 居宅介護サービス費の支給 第四十一条第四項第一号及び第二号並びに第四十三条第一項、第四項及び第六項
(i) payment of an Allowance for In-Home Long-Term Care Service: Article 41, paragraph (4) item (i) and item (ii), and Article 43, paragraph (1), paragraph (4) and paragraph (6);
二 特例居宅介護サービス費の支給 第四十二条第二項並びに第四十三条第一項、第四項及び第六項
(ii) payment of an Exceptional Allowance for In-Home Long-Term Care Service: Article 42, paragraph (2), Article 43, paragraph (1), paragraph (4) and paragraph (6);
三 地域密着型介護サービス費の支給 第四十二条の二第二項第一号及び第二号並びに第四十三条第一項、第四項及び第六項
(iii) payment of an Allowance for Community-Based Long-Term Care Service: Article 42-2, paragraph (2), item (i) and item (ii), and Article 43, paragraph (1), paragraph (4) and paragraph (6);
四 特例地域密着型介護サービス費の支給 第四十二条の三第二項並びに第四十三条第一項、第四項及び第六項
(iv) payment of an Exceptional Allowance for Community-Based Long-Term Care Service: Article 42-3, paragraph (2), and Article 43, paragraph (1), paragraph (4), and paragraph (6);
五 施設介護サービス費の支給 第四十八条第二項
(v) payment of an Allowance for Long-Term Care Facility Service: Article 48, paragraph (2);
六 特例施設介護サービス費の支給 前条第二項
(vi) payment of an Exceptional Allowance for Long-Term Care Facility Service: paragraph (2) of the preceding Article;
七 居宅介護福祉用具購入費の支給 第四十四条第三項、第四項及び第七項
(vii) payment of an Allowance for purchasing Equipment for In-Home Long-Term Care Covered by Public Aid: Article 44, paragraph (3), paragraph (4), and paragraph (7);
八 居宅介護住宅改修費の支給 第四十五条第三項、第四項及び第七項
(viii) payment for Allowance for Home Modification for In-Home Long-Term Care: Article 45, paragraph (3), paragraph (4), and paragraph (7).
(高額介護サービス費の支給)
(Payment of an Allowance for High-Cost Long-Term Care Service)
第五十一条 市町村は、要介護被保険者が受けた居宅サービス(これに相当するサービスを含む。)、地域密着型サービス(これに相当するサービスを含む。)又は施設サービスに要した費用の合計額として政令で定めるところにより算定した額から、当該費用につき支給された居宅介護サービス費、特例居宅介護サービス費、地域密着型介護サービス費、特例地域密着型介護サービス費、施設介護サービス費及び特例施設介護サービス費の合計額を控除して得た額が、著しく高額であるときは、当該要介護被保険者に対し、高額介護サービス費を支給する。
Article 51 (1) When the amount that is obtained by deducting the amount calculated pursuant to the provisions of a Cabinet Order as the total amount of expenses required for each of In-Home Service (including equivalent service), Community-Based Service (including equivalent service), or Facility Service that an Insured Person Requiring Long-Term Care receives as the total amount of allowances for In-Home Long-Term Care, Exceptional Allowance for In-Home Long-Term Care Service, Allowance for Community-Based Long-Term Care Service, Exceptional Allowance for Community-Based Long-Term Care Service, Allowance for Long-Term Care Facility Service, and Exceptional Allowance for Long-Term Care Facility Service from the expenses that are actually paid for said calculated expenses is extremely large, a Municipality shall pay an Allowance for High-Cost Long-Term Care Service to said Insured Person Requiring Long-Term Care.
2 前項に規定するもののほか、高額介護サービス費の支給要件、支給額その他高額介護サービス費の支給に関して必要な事項は、居宅サービス、地域密着型サービス又は施設サービスに必要な費用の負担の家計に与える影響を考慮して、政令で定める。
(2) In addition to the provisions as set forth in the preceding paragraph, requirements for payment of an Allowance for High-Cost Long-Term Care Service, the amount of said allowance, and other matters necessary for the payment of an Allowance for High-Cost Long-Term Care Service shall be provided by a Cabinet Order after considering the impact on said household budget due to the burden of the expenses necessary for In-Home Service, Community-Based Service, or Facility Service.
(特定入所者介護サービス費の支給)
(Payment of an Allowance for Long-Term Care Service to a Person Admitted to a Specified Facility)
第五十一条の二 市町村は、要介護被保険者のうち所得の状況その他の事情をしん酌して厚生労働省令で定めるものが、次に掲げる指定施設サービス等、指定地域密着型サービス又は指定居宅サービス(以下この条及び次条第一項において「特定介護サービス」という。)を受けたときは、当該要介護被保険者(以下この条及び次条第一項において「特定入所者」という。)に対し、当該特定介護サービスを行う介護保険施設、指定地域密着型サービス事業者又は指定居宅サービス事業者(以下この条において「特定介護保険施設等」という。)における食事の提供に要した費用及び居住又は滞在(以下「居住等」という。)に要した費用について、特定入所者介護サービス費を支給する。ただし、当該特定入所者が、第三十七条第一項の規定による指定を受けている場合において、当該指定に係る種類以外の特定介護サービスを受けたときは、この限りでない。
Article 51-2 (1) A Municipality, when a person as determined by an Ordinance of the Ministry of Health, Labour, and Welfare due to an extenuating income condition or other circumstances among those who are an Insured Person Requiring Long-Term Care, receives Designated Facility Service, etc., Designated Community-Based Service, or Designated In-Home Service (herein referred to as "Specified Long-Term Care Service" in this Article and the following Article, paragraph (1)) as listed below, shall pay to said Insured Person Requiring Long-Term Care (herein referred to as "Specified Person Admitted to a Facility" in this Article and the following Article, paragraph (1)) an Allowance for Long-Term Care Service to a Person Admitted to a Specified Facility for the expenses required to provide meals and residence or stay (hereinafter referred to as "Residence, etc.") at a Facility Covered by Long-Term Care Insurance, Designated Community-Based Service Provider, or Designated In-Home Service Provider that provides said Specified Long-Term Care Service (herein referred to as "Specified Facility, etc., for Insured Long-Term Care" in this Article), however, provided that this provision shall not apply when said Specified Person Admitted to a Facility that is issued a designation pursuant to the provisions of Article 37, paragraph (1) receives Specified Long-Term Care Service other than the type pertaining to said designation:
一 指定介護福祉施設サービス
(i) Designated Facility Service for Long-Term Care Covered by Public Aid;
二 介護保健施設サービス
(ii) Long-Term Care Health Facility Service;
三 指定介護療養施設サービス
(iii) Designated Sanatorium Service for Long-Term Care;
四 地域密着型介護老人福祉施設入所者生活介護
(iv) Admission to a Community-Based Facility for Preventive Daily Long-Term Care of the Elderly Covered by Public Aid;
五 短期入所生活介護
(v) Short-Term Admission for Daily Life Long-Term Care;
六 短期入所療養介護
(vi) Short-Term Admission for Recuperation.
2 特定入所者介護サービス費の額は、第一号に規定する額及び第二号に規定する額の合計額とする。
(2) The amount of the Allowance for Long-Term Care Service to a Person Admitted to a Specified Facility shall be the total sum of the amount as prescribed in item (i) and the amount as prescribed in item (ii) below:
一 特定介護保険施設等における食事の提供に要する平均的な費用の額を勘案して厚生労働大臣が定める費用の額(その額が現に当該食事の提供に要した費用の額を超えるときは、当該現に食事の提供に要した費用の額とする。以下この条及び次条第二項において「食費の基準費用額」という。)から、平均的な家計における食費の状況及び特定入所者の所得の状況その他の事情を勘案して厚生労働大臣が定める額(以下この条及び次条第二項において「食費の負担限度額」という。)を控除した額
(i) the amount after the amount determined by the Minister of Health, Labour, and Welfare after considering the status of food expenses for an average household budget, the income status of the Specified Person Admitted to a Facility, and other circumstances (hereinafter referred to as "Maximum Allowance for Meal Expense" in this Article and the following Article, paragraph (2)) is deducted from the amount of expenses determined by the Minister of Health, Labour, and Welfare after considering the average expenses required to provide meals at a Specified Facility, etc., for Insured Long-Term Care (in a case when said amount exceeds the actual expenses of providing said meals, the amount shall be the actual expenses of providing said meals; herein referred to as "Base Cost for Meal Expenses" in this Article and in the following Article, paragraph (2));
二 特定介護保険施設等における居住等に要する平均的な費用の額及び施設の状況その他の事情を勘案して厚生労働大臣が定める費用の額(その額が現に当該居住等に要した費用の額を超えるときは、当該現に居住等に要した費用の額とする。以下この条及び次条第二項において「居住費の基準費用額」という。)から、特定入所者の所得の状況その他の事情を勘案して厚生労働大臣が定める額(以下この条及び次条第二項において「居住費の負担限度額」という。)を控除した額
(ii) the amount after the amount provided by the Minister of Health, Labour, and Welfare after considering the income status of the Specified Person Admitted to a Facility and other circumstances (herein referred to as "Maximum Allowance for Residence Expenses") is deducted from the amount provided by the Minister of Health, Labour, and Welfare after considering the average expenses necessary for Residence, etc., at a Specified Facility, etc., for Insured Long-Term Care, the status of such facility, and other circumstances (in a case when such amount exceeds the actual expenses for said Residence, etc., the amount shall be the actual expenses for said Residence, etc.; herein referred to as "Base Costs for Residence" in this Article and the following Article, paragraph (2)).
3 厚生労働大臣は、食費の基準費用額若しくは食費の負担限度額又は居住費の基準費用額若しくは居住費の負担限度額を定めた後に、特定介護保険施設等における食事の提供に要する費用又は居住等に要する費用の状況その他の事情が著しく変動したときは、速やかにそれらの額を改定しなければならない。
(3) When the expenses necessary of providing meals, Residence, etc., at a Specified Facility, etc., for Insured Long-Term Care, and other circumstances have changed significantly from the Base Cost for Meal Expense or Maximum Allowance for Meal Expense, or Base Costs for Residence or Maximum Allowance for Residence Expenses after the Minister of Health, Labour, and Welfare has issued a determination of these expenses, the Minister shall revise those amounts immediately.
4 特定入所者が、特定介護保険施設等から特定介護サービスを受けたときは、市町村は、当該特定入所者が当該特定介護保険施設等に支払うべき食事の提供に要した費用及び居住等に要した費用について、特定入所者介護サービス費として当該特定入所者に対し支給すべき額の限度において、当該特定入所者に代わり、当該特定介護保険施設等に支払うことができる。
(4) When a Specified Person Admitted to a Facility receives Specified Long-Term Care Service from a Specified Facility, etc., for Insured Long-Term Care, a Municipality may pay the expenses required for providing meals and Residence, etc., that said Specified Person Admitted to a Facility should pay to said Specified Facility, etc., for Insured Long-Term Care, within the limit of the amount to be paid to said Specified Person Admitted to a Facility as an Allowance for Long-Term Care Service to a Person Admitted to a Specified Facility on behalf of said Specified Person Admitted to a Facility to said Specified Facility, etc., for Insured Long-Term Care
5 前項の規定による支払があったときは、特定入所者に対し特定入所者介護サービス費の支給があったものとみなす。
(5) When the payment pursuant to the provisions of the preceding paragraph is paid, it shall be deemed that an Allowance for Long-Term Care Service to a Person Admitted to a Specified Facility is paid to the Specified Person Admitted to a Facility.
6 市町村は、第一項の規定にかかわらず、特定入所者が特定介護保険施設等に対し、食事の提供に要する費用又は居住等に要する費用として、食費の基準費用額又は居住費の基準費用額(前項の規定により特定入所者介護サービス費の支給があったものとみなされた特定入所者にあっては、食費の負担限度額又は居住費の負担限度額)を超える金額を支払った場合には、特定入所者介護サービス費を支給しない。
(6) A Municipality, notwithstanding the provisions of paragraph (1) in a case when a Specified Person Admitted to a Facility paid to a Specified Facility, etc., for Insured Long-Term Care, an amount exceeding the Base Cost for Meal Expense or the Base Costs for Residence (with regard to a Specified Person Admitted to a Facility, one who is deemed to be paid an Allowance for Long-Term Care Service to a Person Admitted to a Specified Facility pursuant to the provisions of the preceding paragraph, Maximum Allowance for Meal Expense, or Maximum Allowance for Residence Expenses) as the expenses necessary for providing meals or for Residence, etc., shall not pay an Allowance for Long-Term Care Service to a Person Admitted to a Specified Facility.
7 市町村は、特定介護保険施設等から特定入所者介護サービス費の請求があったときは、第一項、第二項及び前項の定めに照らして審査の上、支払うものとする。
(7) A Municipality, when a Specified Facility, etc., for Insured Long-Term Care, requests an Allowance for Long-Term Care Service to a Person Admitted to a Specified Facility, shall pay said allowance after conducting an examination according to the provisions of paragraph (1), paragraph (2) and the preceding paragraph.
8 第四十一条第三項、第十項及び第十一項の規定は特定入所者介護サービス費の支給について、同条第八項の規定は特定介護保険施設等について準用する。この場合において、これらの規定に関し必要な技術的読替えは、政令で定める。
(8) The provisions of Article 41, paragraph (3), paragraph (10), and paragraph (11) shall apply mutatis mutandis to the payment of an Allowance for Long-Term Care Service to a Person Admitted to a Specified Facility and the provisions of paragraph (8) of the same Article shall apply mutatis mutandis to a Specified Facility, etc., for Insured Long-Term Care in this case, the necessary technical replacement of terms in these provisions shall be provided by a Cabinet Order.
9 前各項に規定するもののほか、特定入所者介護サービス費の支給及び特定介護保険施設等の特定入所者介護サービス費の請求に関して必要な事項は、厚生労働省令で定める。
(9) In addition to the provisions as prescribed in the preceding paragraphs, the other necessary matters the payment of an Allowance for Long-Term Care Service to a Person Admitted to a Specified Facility and a request for an Allowance for Long-Term Care Service to a Person Admitted to a Specified Facility by a Specified Facility, etc., for Insured Long-Term Care, shall be as determined by an Ordinance of the Ministry of Health, Labour, and Welfare.
(特例特定入所者介護サービス費の支給)
(Payment of an Exceptional Allowance for Long-Term Care Service to a Person Admitted to a Specified Facility)
第五十一条の三 市町村は、次に掲げる場合には、特定入所者に対し、特例特定入所者介護サービス費を支給する。
Article 51-3 (1) A Municipality shall, in the following cases, pay an Exceptional Allowance for Long-Term Care Service to a Person Admitted to a Specified Facility to a Specified Person Admitted to a Facility:
一 特定入所者が、当該要介護認定の効力が生じた日前に、緊急その他やむを得ない理由により特定介護サービスを受けた場合において、必要があると認めるとき。
(i) when the Municipality determines it necessary in a case when a Specified Person Admitted to a Facility receives Specified Long-Term Care Service prior to the date said Certification of Needed Long-Term Care becomes effective due to an emergency or other compelling reason;
二 その他政令で定めるとき。
(ii) when provided by a Cabinet Order.
2 特例特定入所者介護サービス費の額は、当該食事の提供に要した費用について食費の基準費用額から食費の負担限度額を控除した額及び当該居住等に要した費用について居住費の基準費用額から居住費の負担限度額を控除した額の合計額を基準として、市町村が定める。
(2) The amount of an Exceptional Allowance for Long-Term Care Service to a Person Admitted to a Specified Facility shall be determined by a Municipality based on the total sum of the amounts remaining after the amount of Base Cost for Meal Expense is deducted from the Maximum Allowance for Meal Expense with regard to the expense required to provide said meal and the amount of Base Costs for Residence is deducted from the amount of Maximum Allowance for Residence Expenses with regard to the expense required for said Residence, etc..
第四節 予防給付
Section 4 Prevention Benefits
(予防給付の種類)
(Type of Prevention Benefits)
第五十二条 予防給付は、次に掲げる保険給付とする。
Article 52 A prevention benefit shall be an insurance benefit listed in the following:
一 介護予防サービス費の支給
(i) payment of a Preventive Long-Term Care Service Allowance;
二 特例介護予防サービス費の支給
(ii) payment of an Exceptional Allowance for Preventive Service of Long-Term Care;
三 地域密着型介護予防サービス費の支給
(iii) payment of an Allowance for Community-Based Preventive Long-Term Care Service;
四 特例地域密着型介護予防サービス費の支給
(iv) payment of an Exceptional Allowance for Community-Based Preventive Service of Long-Term Care;
五 介護予防福祉用具購入費の支給
(v) payment of an Allowance for Purchasing Equipment for Preventive Long-Term Care Covered by Public Aid;
六 介護予防住宅改修費の支給
(vi) payment of an Allowance for Preventive Long-Term Care Home Modification;
七 介護予防サービス計画費の支給
(vii) payment of an Allowance for Preventive Long-Term Care Service Plan;
八 特例介護予防サービス計画費の支給
(viii) payment of an Exceptional Allowance for a Preventive Service Plan of Long-term care;
九 高額介護予防サービス費の支給
(ix) payment of an Allowance for High-Cost Preventive Long-Term Care Service;
十 特定入所者介護予防サービス費の支給
(x) payment of an Allowance for Preventive Long-Term Care Service to a Person Admitted to a Specified Facility;
十一 特例特定入所者介護予防サービス費の支給
(xi) payment of an Exceptional Allowance for Preventive Long-Term Care Service to a Person Admitted to a Specified Facility.
(介護予防サービス費の支給)
(Payment of an Allowance for Preventive Long-Term Care Service)
第五十三条 市町村は、要支援認定を受けた被保険者のうち居宅において支援を受けるもの(以下「居宅要支援被保険者」という。)が、都道府県知事が指定する者(以下「指定介護予防サービス事業者」という。)から当該指定に係る介護予防サービス事業を行う事業所により行われる介護予防サービス(以下「指定介護予防サービス」という。)を受けたとき(当該居宅要支援被保険者が、第五十八条第四項の規定により同条第一項に規定する指定介護予防支援を受けることにつきあらかじめ市町村に届け出ている場合であって、当該指定介護予防サービスが当該指定介護予防支援の対象となっているときその他の厚生労働省令で定めるときに限る。)は、当該居宅要支援被保険者に対し、当該指定介護予防サービスに要した費用(特定介護予防福祉用具の購入に要した費用を除き、介護予防通所介護、介護予防通所リハビリテーション、介護予防短期入所生活介護、介護予防短期入所療養介護及び介護予防特定施設入居者生活介護に要した費用については、食事の提供に要する費用、滞在に要する費用その他の日常生活に要する費用として厚生労働省令で定める費用を除く。以下この条において同じ。)について、介護予防サービス費を支給する。ただし、当該居宅要支援被保険者が、第三十七条第一項の規定による指定を受けている場合において、当該指定に係る種類以外の介護予防サービスを受けたときは、この限りでない。
Article 53 (1) A Municipality, when a person that receives support in his or her home is an Insured Person that has been issued a Certification of Needed Support (herein referred to as "Insured In-Home Person Requiring Support") receives from a person designated by a prefectural governor (herein referred to as "Designated Provider of a Preventive Service to Long-Term Care") a Preventive Service of Long-Term Care provided by a provider that performs Preventive Service of Long-Term Care Business pertaining to said designation (herein referred to as "Designated Preventive Service of Long-Term Care") (limited to a case when said Insured In-Home Person Requiring Support has notified a Municipality in advance pursuant to the provisions of Article 58, paragraph (4) concerning the receipt of a Designated Support for Prevention of Long-Term Care as prescribed in paragraph (1) of the same Article, when said Designated Preventive Service of Long-Term Care is subject to said Designated Support for Prevention of Long-Term Care or when provided by an Ordinance of the Ministry of Health, Labour, and Welfare), shall pay to said Insured In-Home Person Requiring Support an Allowance for Preventive Long-Term Care Service for the expenses required for said Designated Preventive Service of Long-Term Care (except for the expenses required to purchase Specified Equipment for Preventive Long-Term Care Covered by Public Aid, excluding the expenses necessary to provide meals, residence, and other necessary expenses for daily life as determined by an Ordinance of the Ministry of Health, Labour, and Welfare with regard to the expenses required for Outpatient Preventive Long-Term Care, Outpatient Rehabilitation for Preventive Long-Term Care, a Short-Term Admission for Daily Preventive Long-Term Care, and Short-Term Admission for Recuperation for Preventive Long-Term Care, Daily Preventive Long-Term Care Admitted to a Specified Facility), provided however, that this provision shall not apply to a case when said Insured In-Home Person Requiring Support that has been designated pursuant to the provisions of Article 37, paragraph (1) receives Preventive Service of Long-Term Care other than the type pertaining to said designation.
2 介護予防サービス費の額は、次の各号に掲げる介護予防サービスの区分に応じ、当該各号に定める額とする。
(2) The amount of Allowance for Preventive Long-Term Care Service shall be according to the categories of Preventive Service of Long-Term Care listed in each item of the following and the amount as prescribed in said items:
一 介護予防訪問介護、介護予防訪問入浴介護、介護予防訪問看護、介護予防訪問リハビリテーション、介護予防居宅療養管理指導、介護予防通所介護、介護予防通所リハビリテーション及び介護予防福祉用具貸与 これらの介護予防サービスの種類ごとに、当該介護予防サービスの種類に係る指定介護予防サービスの内容、当該指定介護予防サービスの事業を行う事業所の所在する地域等を勘案して算定される当該指定介護予防サービスに要する平均的な費用(介護予防通所介護及び介護予防通所リハビリテーションに要する費用については、食事の提供に要する費用その他の日常生活に要する費用として厚生労働省令で定める費用を除く。)の額を勘案して厚生労働大臣が定める基準により算定した費用の額(その額が現に当該指定介護予防サービスに要した費用の額を超えるときは、当該現に指定介護予防サービスに要した費用の額とする。)の百分の九十に相当する額
(i) Home-Visit Service for Preventive Long-Term Care, Home-Visit Bathing Long-Term Care for Preventive Service of Long-Term Care, Home-Visit Nursing for Preventive Service of Long-Term Care, Home-Visit Rehabilitation Service for Preventive Long-Term Care, Management and Guidance for In-Home Medical Service for Preventive Long-Term Care, Outpatient Preventive Long-Term Care, Outpatient Rehabilitation for Preventive Long-Term Care, and Rental Service of Preventive Long-Term Care Covered by Public Aid Equipment: the amount equivalent to 90 percent of the amount calculated by the type of Preventive Service of Long-Term Care and after considering the average expenses necessary for said Designated Preventive Service of Long-Term Care that is calculated after considering the content of the Designated Preventive Service of Long-Term Care pertaining to the type of said Preventive Service of Long-Term Care, the area where the provider that performs said Designated Preventive Service of Long-Term Care Business is located, etc. (excluding the expenses necessary to provide meals and other expenses as determined by an Ordinance of the Ministry of Health, Labour, and Welfare as necessary for daily life with regard to the expenses necessary for Outpatient Preventive Long-Term Care and Outpatient Rehabilitation for Preventive Long-Term Care), based on the standards provided by the Minister of Health, Labour, and Welfare (when said calculated amount exceeds the actual expenses required for said Designated Preventive Service of Long-Term Care, said amount shall be the actual expenses that are required for said Designated Preventive Service of Long-Term Care);
二 介護予防短期入所生活介護、介護予防短期入所療養介護及び介護予防特定施設入居者生活介護 これらの介護予防サービスの種類ごとに、要支援状態区分、当該介護予防サービスの種類に係る指定介護予防サービスの事業を行う事業所の所在する地域等を勘案して算定される当該指定介護予防サービスに要する平均的な費用(食事の提供に要する費用、滞在に要する費用その他の日常生活に要する費用として厚生労働省令で定める費用を除く。)の額を勘案して厚生労働大臣が定める基準により算定した費用の額(その額が現に当該指定介護予防サービスに要した費用の額を超えるときは、当該現に指定介護予防サービスに要した費用の額とする。)の百分の九十に相当する額
(ii) Short-Term Admission for Daily Preventive Long-Term Care, Short-Term Admission for Recuperation for Preventive Long-Term Care, and Daily Preventive Long-Term Care Admitted to a Specified Facility: the amount equivalent to 90 percent of the amount calculated by the type of Preventive Service of Long-Term Care and after considering the average expenses necessary for said Designated Preventive Service of Long-Term Care that is calculated after considering the categories of Needed Support Condition, the area where the provider that performs said Designated Preventive Service of Long-Term Care Business is located, etc., pertaining the type of said Preventive Service of Long-Term Care (excluding the expenses necessary to provide meals, residence, and other expenses as determined by an Ordinance of the Ministry of Health, Labour, and Welfare as necessary for daily life), based on the standards provided by the Minister of Health, Labour, and Welfare (when said calculated amount exceeds the actual expenses required for said Designated Preventive Service of Long-Term Care, said amount shall be the actual expenses required for said Designated Preventive Service of Long-Term Care).
3 厚生労働大臣は、前項各号の基準を定めようとするときは、あらかじめ社会保障審議会の意見を聴かなければならない。
(3) The Minister of Health, Labour, and Welfare, when it intends to determine the standards as prescribed in the items of the preceding paragraph, shall hear the opinion of the Social Security Council in advance.
4 居宅要支援被保険者が指定介護予防サービス事業者から指定介護予防サービスを受けたときは、市町村は、当該居宅要支援被保険者が当該指定介護予防サービス事業者に支払うべき当該指定介護予防サービスに要した費用について、介護予防サービス費として当該居宅要支援被保険者に対し支給すべき額の限度において、当該居宅要支援被保険者に代わり、当該指定介護予防サービス事業者に支払うことができる。
(4) When an Insured In-Home Person Requiring Support receives Designated Preventive Service of Long-Term Care from a Designated Provider of a Preventive Service to Long-Term Care, a Municipality may pay the expenses required for said Designated Preventive Service of Long-Term Care that said Insured In-Home Person Requiring Support should pay to said Designated Provider of a Preventive Service to Long-Term Care to said Designated Provider of a Preventive Service to Long-Term Care on behalf of said Insured In-Home Person Requiring Support within the limit of the amount to be paid to said Insured In-Home Person Requiring Support as an Allowance for Preventive Long-Term Care Service.
5 前項の規定による支払があったときは、居宅要支援被保険者に対し介護予防サービス費の支給があったものとみなす。
(5) When the payment pursuant to the provisions of the preceding paragraph is paid, it shall be deemed that an Allowance for Preventive Long-Term Care Service is paid to said Insured In-Home Person Requiring Support.
6 市町村は、指定介護予防サービス事業者から介護予防サービス費の請求があったときは、第二項各号の厚生労働大臣が定める基準並びに第百十五条の四第二項に規定する指定介護予防サービスに係る介護予防のための効果的な支援の方法に関する基準及び指定介護予防サービスの事業の設備及び運営に関する基準(指定介護予防サービスの取扱いに関する部分に限る。)に照らして審査した上、支払うものとする。
(6) A Municipality, when a Designated Provider of a Preventive Service to Long-Term Care requests an Allowance for Preventive Long-Term Care Service, shall pay after conducting an examination according to standards provided by the Minister of Health, Labour, and Welfare as set forth in each item of paragraph (2), standards concerning effective support methods for prevention of long-term care pertaining to the Designated Preventive Service of Long-Term Care as prescribed in Article 115-4, paragraph (4), and standards concerning facilities and management of a Designated Preventive Service to Long-Term Care Business (limited to the part concerning the handling of Designated Preventive Service of Long-Term Care).
7 第四十一条第二項、第三項、第十項及び第十一項の規定は、介護予防サービス費の支給について、同条第八項の規定は、指定介護予防サービス事業者について準用する。この場合において、これらの規定に関し必要な技術的読替えは、政令で定める。
(7) The provisions of Article 41, paragraph (2), paragraph (3), paragraph (10), and paragraph (11) shall apply mutatis mutandis to payment of an Allowance for Preventive Long-Term Care Service and the provisions of paragraph (8) of the same Article shall apply mutatis mutandis to a Designated Provider of a Preventive Service to Long-Term Care. In this case, the necessary technical replacement of terms in these provisions shall be provided by a Cabinet Order.
8 前各項に規定するもののほか、介護予防サービス費の支給及び指定介護予防サービス事業者の介護予防サービス費の請求に関して必要な事項は、厚生労働省令で定める。
(8) In addition to those matters as prescribed in each of the preceding paragraphs, other necessary matters for payment of an Allowance for Preventive Long-Term Care Service and for the request of an Allowance for Preventive Long-Term Care Service by a Designated Provider of a Preventive Service to Long-Term Care shall be provided by an Ordinance of the Ministry of Health, Labour, and Welfare.
(特例介護予防サービス費の支給)
(Payment of an Exceptional Allowance for Preventive Service of Long-Term Care)
第五十四条 市町村は、次に掲げる場合には、居宅要支援被保険者に対し、特例介護予防サービス費を支給する。
Article 54 (1) A Municipality, in the following cases, shall pay an Exceptional Allowance for Preventive Service of Long-Term Care to an Insured In-Home Person Requiring Support:
一 居宅要支援被保険者が、当該要支援認定の効力が生じた日前に、緊急その他やむを得ない理由により指定介護予防サービスを受けた場合において、必要があると認めるとき。
(i) when a Municipality determines it necessary in a case when an Insured Person Requiring Support receives Designated Preventive Service of Long-Term Care prior to the date said Certification of Needed Support becomes effective due to an emergency or other compelling reason;
二 居宅要支援被保険者が、指定介護予防サービス以外の介護予防サービス又はこれに相当するサービス(指定介護予防サービスの事業に係る第百十五条の四第一項の厚生労働省令で定める基準及び同項の厚生労働省令で定める員数並びに同条第二項に規定する指定介護予防サービスに係る介護予防のための効果的な支援の方法に関する基準及び指定介護予防サービスの事業の設備及び運営に関する基準のうち、厚生労働省令で定めるものを満たすと認められる事業を行う事業所により行われるものに限る。次号において「基準該当介護予防サービス」という。)を受けた場合において、必要があると認めるとき。
(ii) when a Municipality determines it necessary in a case when an Insured Person Requiring Support receives Preventive Service of Long-Term Care other than Designated Preventive Service of Long-Term Care or equivalent service (limited to those provided by a provider that performs business that has been determined to satisfy the standards for Preventive Service of Long-Term Care among standards provided by an Ordinance of the Ministry of Health, Labour, and Welfare as set forth in Article 115-4, paragraph (1) pertaining to a Designated Provider of a Preventive Service to Long-Term Care and standards concerning the number of employees provided by an Ordinance of the Ministry of Health, Labour, and Welfare as set forth in the same paragraph that concern effective support methods for Prevention of Long-Term Care pertaining to a Designated Preventive Service of Long-Term Care as prescribed in paragraph (2) of the same Article and concerning facilities and management of Designated Preventive Service to Long-Term Care Business; herein referred to as "Preventive Long-Term Care Service Applicable to Standards" in the following item);
三 指定介護予防サービス及び基準該当介護予防サービスの確保が著しく困難である離島その他の地域であって厚生労働大臣が定める基準に該当するものに住所を有する居宅要支援被保険者が、指定介護予防サービス及び基準該当介護予防サービス以外の介護予防サービス又はこれに相当するサービスを受けた場合において、必要があると認めるとき。
(iii) when a Municipality determines it necessary in a case when an Insured In-Home Person Requiring Support who is domiciled on an isolated island or other location where it is significantly difficult to secure Designated Preventive Service of Long-Term Care and Preventive Long-Term Care Service Applicable to Standards and is in a location that is subject to standards as determined by an Ordinance of the Minister of Health, Labour, and Welfare receives Preventive Service of Long-Term Care other than Designated Preventive Service of Long-Term Care and Preventive Long-Term Care Service Applicable to Standards or equivalent services;
四 その他政令で定めるとき。
(iv) when provided by a Cabinet Order.
2 特例介護予防サービス費の額は、当該介護予防サービス又はこれに相当するサービスについて前条第二項各号の厚生労働大臣が定める基準により算定した費用の額(その額が現に当該介護予防サービス又はこれに相当するサービスに要した費用(特定介護予防福祉用具の購入に要した費用を除き、介護予防通所介護、介護予防通所リハビリテーション、介護予防短期入所生活介護、介護予防短期入所療養介護及び介護予防特定施設入居者生活介護並びにこれらに相当するサービスに要した費用については、食事の提供に要する費用、滞在に要する費用その他の日常生活に要する費用として厚生労働省令で定める費用を除く。)の額を超えるときは、当該現に介護予防サービス又はこれに相当するサービスに要した費用の額とする。)の百分の九十に相当する額を基準として、市町村が定める。
(2) The amount of Exceptional Allowance for Preventive Service of Long-Term Care shall be determined by a Municipality based on the amount equivalent to 90 percent of the amount of expenses calculated based on standards provided by the Minister of Health, Labour, and Welfare as set forth in each item of paragraph(2) of the preceding Article pertaining to said Preventive Service of Long-Term Care or equivalent service (when the calculated amount exceeds the actual expenses required for said Preventive Service of Long-Term Care or equivalent service (except for the expenses required to purchase Specified Equipment for Preventive Long-Term Care Covered by Public Aid and excluding the expenses necessary to provide meals, residence, and other expenses as determined by an Ordinance of the Ministry of Health, Labour, and Welfare as necessary for daily life with regard to the expenses required for Outpatient Preventive Long-Term Care, Outpatient Rehabilitation for Preventive Long-Term Care, a Short-Term Admission for Daily Preventive Long-Term Care, Short-Term Admission for Recuperation for Preventive Long-Term Care and Daily Preventive Long-Term Care Admitted to a Specified Facility), said calculated amount shall be the actual expenses required for said Preventive Service of Long-Term Care or equivalent service).
3 市町村長は、特例介護予防サービス費の支給に関して必要があると認めるときは、当該支給に係る介護予防サービス若しくはこれに相当するサービスを担当する者若しくは担当した者(以下この項において「介護予防サービス等を担当する者等」という。)に対し、報告若しくは帳簿書類の提出若しくは提示を命じ、若しくは出頭を求め、又は当該職員に関係者に対して質問させ、若しくは当該介護予防サービス等を担当する者等の当該支給に係る事業所に立ち入り、その設備若しくは帳簿書類その他の物件を検査させることができる。
(3) The mayor of a Municipality, when he or she determines the necessity of payment of an Exceptional Allowance for Preventive Service of Long-Term Care, may order a person that has been in charge of the Preventive Service of Long-Term Care pertaining to said payment or equivalent service (herein referred to as "Person, etc., in Charge of Providing Preventive Long-Term Care Service" in this paragraph) to report, submit, or present record books and documents, appear, or direct personnel to question the relevant Person or enter the Business Office of the provider of said Person, etc., in Charge of said Preventive Service of Long-Term Care pertaining to said payment in order to inspect said equipment, record books and documents, and other items.
4 第二十四条第三項の規定は前項の規定による質問又は検査について、同条第四項の規定は前項の規定による権限について準用する。
(4) The provisions of Article 24, paragraph (3) shall apply mutatis mutandis to questions and inspections pursuant to the provisions of the preceding paragraph, and the provisions of paragraph (4) of the same Article shall apply mutatis mutandis to the authority granted pursuant to the provisions of the preceding paragraph.
(地域密着型介護予防サービス費の支給)
(Payment of an Allowance for Community-Based Preventive Long-Term Care Service)
第五十四条の二 市町村は、居宅要支援被保険者が、当該市町村の長が指定する者(以下「指定地域密着型介護予防サービス事業者」という。)から当該指定に係る地域密着型介護予防サービス事業を行う事業所により行われる地域密着型介護予防サービス(以下「指定地域密着型介護予防サービス」という。)を受けたとき(当該居宅要支援被保険者が、第五十八条第四項の規定により同条第一項に規定する指定介護予防支援を受けることにつきあらかじめ市町村に届け出ている場合であって、当該指定地域密着型介護予防サービスが当該指定介護予防支援の対象となっているときその他の厚生労働省令で定めるときに限る。)は、当該居宅要支援被保険者に対し、当該指定地域密着型介護予防サービスに要した費用(食事の提供に要する費用その他の日常生活に要する費用として厚生労働省令で定める費用を除く。以下この条において同じ。)について、地域密着型介護予防サービス費を支給する。ただし、当該居宅要支援被保険者が、第三十七条第一項の規定による指定を受けている場合において、当該指定に係る種類以外の地域密着型介護予防サービスを受けたときは、この限りでない。
Article 54-2 (1) A Municipality, when an Insured In-Home Person Requiring Support receives from a person designated by the mayor of said Municipality (herein referred to as "Designated Provider of Community-Based Preventive Service of Long-Term Care") the Community-Based Preventive Service of Long-Term Care (herein referred to as "Designated Community-Based Preventive Service of Long-Term Care") provided by a provider that performs Community-Based Preventive Long-Term Care Business pertaining to said designation (limited to a case said Insured In-Home Person Requiring Support has notified the Municipality pursuant to the provisions of Article 58, paragraph (4) to receive a Designated Support for Prevention of Long-Term Care as prescribed in paragraph (1) of the same Article when said Designated Community-Based Preventive Service of Long-Term Care is subject to said Designated Support for Prevention of Long-Term Care and other matters as determined by an Ordinance of the Ministry of Health, Labour, and Welfare), shall pay to said Insured In-Home Person Requiring Support the Allowance for Community-Based Preventive Long-Term Care Service for the expenses required for said Community-Based Service for Preventive Long-Term Care (excluding the expenses necessary to provide meals and other expenses as determined by an Ordinance of the Ministry of Health, Labour, and Welfare as necessary for daily life; the same shall apply hereinafter in this Article), however, provided that this provision shall not apply to a case when said Insured In-Home Person Requiring Support that has been designated pursuant to the provisions of Article 37, paragraph (1), receives a Community-Based Service for Preventive Long-Term Care other than the type pertaining to said designation.
2 地域密着型介護予防サービス費の額は、次の各号に掲げる地域密着型介護予防サービスの区分に応じ、当該各号に定める額とする。
(2) The amount of Allowance for Community-Based Preventive Long-Term Care Service shall be according to the categories of Community-Based Service for Preventive Long-Term Care listed in the following items and the amount as prescribed in said item:
一 介護予防認知症対応型通所介護 介護予防認知症対応型通所介護に係る指定地域密着型介護予防サービスの内容、当該指定地域密着型介護予防サービスの事業を行う事業所の所在する地域等を勘案して算定される当該指定地域密着型介護予防サービスに要する平均的な費用(食事の提供に要する費用その他の日常生活に要する費用として厚生労働省令で定める費用を除く。)の額を勘案して厚生労働大臣が定める基準により算定した費用の額(その額が現に当該指定地域密着型介護予防サービスに要した費用の額を超えるときは、当該現に指定地域密着型介護予防サービスに要した費用の額とする。)の百分の九十に相当する額
(i) Preventive Long-Term Care for a Dementia Outpatient: the amount equivalent to 90 percent of the amount calculated after considering the amount of average expenses (excluding the expenses necessary to provide meals and other expenses as determined by an Ordinance of the Ministry of Health, Labour, and Welfare as necessary for daily life) that is calculated after considering the content of the Designated Community-Based Preventive Service of Long-Term Care pertaining to Preventive Long-Term Care for a Dementia Outpatient, the area where the provider that performs said Designated Community-Based Preventive Service of Long-Term Care is located, etc., necessary for said Designated Community-Based Preventive Service of Long-Term Care based on the standards provided by the Minister of Health, Labour, and Welfare (when said calculated amount exceeds the actual amount required for said Designated Community-Based Preventive Service of Long-Term Care, the amount of allowance shall be the actual expenses required for said Designated Community-Based Preventive Service of Long-Term Care);
二 介護予防小規模多機能型居宅介護及び介護予防認知症対応型共同生活介護 これらの地域密着型介護予防サービスの種類ごとに、要支援状態区分、当該地域密着型介護予防サービスの種類に係る指定地域密着型介護予防サービスの事業を行う事業所の所在する地域等を勘案して算定される当該指定地域密着型介護予防サービスに要する平均的な費用(食事の提供に要する費用その他の日常生活に要する費用として厚生労働省令で定める費用を除く。)の額を勘案して厚生労働大臣が定める基準により算定した費用の額(その額が現に当該指定地域密着型介護予防サービスに要した費用の額を超えるときは、当該現に指定地域密着型介護予防サービスに要した費用の額とする。)の百分の九十に相当する額
(ii) Multifunctional Preventive Long-Term Care in a Small Group Home, and Preventive Long-Term Care for a Dementia Patient in Communal Living: the amount equivalent to 90 percent of the amount calculated according to type of Community-Based Preventive Service of Long-Term Care, after considering the average expenses (excluding the expenses necessary to provide meals and other expenses as determined by an Ordinance of the Ministry of Health, Labour, and Welfare as necessary for daily life) that is calculated after considering the categories of Needed Support Condition, the location of the provider that performs the Designated Community-Based Preventive Service of Long-Term Care Business pertaining to the type of said Community-Based Preventive Service of Long-Term Care, etc., necessary for said Community-Based Preventive Service of Long-Term Care, based on the standards provided by the Minister of Health, Labour, and Welfare (when said calculated amount exceeds the actual expense required for said Designated Community-Based Preventive Service of Long-Term Care, the allowance shall be the actual amount required for said Designated Community-Based Preventive Service of Long-Term Care).
3 厚生労働大臣は、前項各号の基準を定めようとするときは、あらかじめ社会保障審議会の意見を聴かなければならない。
(3) The Minister of Health, Labour, and Welfare shall, when it intends to provide standards as prescribed in each item of the preceding paragraph, hear opinions of Social Security Council in advance.
4 市町村は、第二項各号の規定にかかわらず、同項各号に定める地域密着型介護予防サービス費の額に代えて、その額を超えない額を、当該市町村における地域密着型介護予防サービス費の額とすることができる。
(4) A Municipality, notwithstanding the provisions of each item of paragraph (2), on behalf of the amount of Allowance for Community-Based Preventive Long-Term Care Service as prescribed in the same paragraph and same item, may determine that the amount for the allowance of Community-Based Preventive Service of Long-Term Care in said Municipality is an amount that shall not exceed the calculated amount of Allowance for said Community-Based Preventive Service of Long-Term Care.
5 市町村は、前項の当該市町村における地域密着型介護予防サービス費の額を定めようとするときは、あらかじめ、当該市町村が行う介護保険の被保険者その他の関係者の意見を反映させ、及び学識経験を有する者の知見の活用を図るために必要な措置を講じなければならない。
(5) A Municipality, when it intends to determine the amount of Allowance for Community-Based Preventive Long-Term Care Service in said Municipality as prescribed in the preceding paragraph, shall reflect the opinions of Insured Persons of Long-Term Care Insurance undertaken by said Municipality and other relevant persons, and take necessary measures in order to promote the use of knowledge of persons with relevant knowledge and experience, in advance.
6 居宅要支援被保険者が指定地域密着型介護予防サービス事業者から指定地域密着型介護予防サービスを受けたときは、市町村は、当該居宅要支援被保険者が当該指定地域密着型介護予防サービス事業者に支払うべき当該指定地域密着型介護予防サービスに要した費用について、地域密着型介護予防サービス費として当該居宅要支援被保険者に対し支給すべき額の限度において、当該居宅要支援被保険者に代わり、当該指定地域密着型介護予防サービス事業者に支払うことができる。
(6) When an Insured In-Home Person Requiring Support receives Designated Preventive Service of Long-Term Care from a Designated Provider of Community-Based Preventive Service of Long-Term Care, a Municipality may pay the expense required for said Designated Preventive Service of Long-Term Care that said Insured In-Home Person Requiring Support should pay to said Designated Provider of a Preventive Service to Long-Term Care, to said Designated Provider of a Preventive Service to Long-Term Care on behalf of said Insured In-Home Person Requiring Support within the limit of the amount to be paid to said Insured In-Home Person Requiring Support as an Allowance for Preventive Long-Term Care Service.
7 前項の規定による支払があったときは、居宅要支援被保険者に対し地域密着型介護予防サービス費の支給があったものとみなす。
(7) When the cost is paid pursuant to the provisions of the preceding paragraph, it shall be deemed that an Allowance for Community-Based Preventive Long-Term Care Service is paid to said Insured In-Home Person Requiring Support.
8 市町村は、指定地域密着型介護予防サービス事業者から地域密着型介護予防サービス費の請求があったときは、第二項各号の厚生労働大臣が定める基準又は第四項の規定により市町村が定める額並びに第百十五条の十三第二項又は第四項に規定する指定地域密着型介護予防サービスに係る介護予防のための効果的な支援の方法に関する基準及び指定地域密着型介護予防サービスの事業の設備及び運営に関する基準(指定地域密着型介護予防サービスの取扱いに関する部分に限る。)に照らして審査した上、支払うものとする。
(8) A Municipality shall, when a Designated Provider of Community-Based Service for Preventive Long-Term Care requests an Allowance for Community-Based Preventive Long-Term Care Service, pay said allowance after conducting an examination according to standards provided by the Minister of Health, Labour, and Welfare as set forth in each item of paragraph (2) or the amount determined by the Municipality pursuant to the provisions of paragraph (4), the standards concerning effective support methods for Prevention of Long-Term Care pertaining to a Designated Community-Based Preventive Service of Long-Term Care as prescribed in Article 115-13, paragraph (2) or paragraph (4), and standards concerning facilities and management of a Designated Community-Based Service for Preventive Long-Term Care Business (limited to the part concerning the handling of Designated Community-Based Preventive Service of Long-Term Care).
9 第四十一条第二項、第三項、第十項及び第十一項の規定は地域密着型介護予防サービス費の支給について、同条第八項の規定は指定地域密着型介護予防サービス事業者について準用する。この場合において、これらの規定に関し必要な技術的読替えは、政令で定める。
(9) The provisions of Article 41, paragraph (2), paragraph (3), paragraph (10) and paragraph (11) shall apply mutatis mutandis to the payment of an Allowance for Community-Based Preventive Long-Term Care Service and the provisions of paragraph (8) of the same Article shall apply mutatis mutandis to a Designated Service Provider of Community-Based Preventive Approach in Long-Term Care. In this case, the necessary technical replacement of terms in these provisions shall be provided by a Cabinet Order.
10 前各項に規定するもののほか、地域密着型介護予防サービス費の支給及び指定地域密着型介護予防サービス事業者の地域密着型介護予防サービス費の請求に関して必要な事項は、厚生労働省令で定める。
(10) In addition to the provisions as prescribed in the items of the preceding paragraph, other necessary matters payment of an Allowance for Community-Based Preventive Long-Term Care Service and for requests of Allowance for Community-Based Preventive Long-Term Care Service by a Designated Provider of Community-Based Service for Preventive Long-Term Care shall be provided by an Ordinance of the Ministry of Health, Labour, and Welfare.
(特例地域密着型介護予防サービス費の支給)
(Payment of an Exceptional Allowance for Community-Based Preventive Service of Long-Term Care)
第五十四条の三 市町村は、次に掲げる場合には、居宅要支援被保険者に対し、特例地域密着型介護予防サービス費を支給する。
Article 54-3 (1) A Municipality shall, in the following cases, pay an Exceptional Allowance for Community-Based Preventive Service of Long-Term Care to an Insured In-Home Person Requiring Support:
一 居宅要支援被保険者が、当該要支援認定の効力が生じた日前に、緊急その他やむを得ない理由により指定地域密着型介護予防サービスを受けた場合において、必要があると認めるとき。
(i) when a Municipality determines it necessary in a case when an Insured Person Requiring Support receives Designated Community-Based Preventive Service of Long-Term Care prior to the date said Certification of Needed Support becomes effective due to an emergency or other compelling reason;
二 指定地域密着型介護予防サービスの確保が著しく困難である離島その他の地域であって厚生労働大臣が定める基準に該当するものに住所を有する居宅要支援被保険者が、指定地域密着型介護予防サービス以外の地域密着型介護予防サービス又はこれに相当するサービスを受けた場合において、必要があると認めるとき。
(ii) when a Municipality determines it necessary in a case when an Insured In-Home Person Requiring Support that is domiciled on an isolated island or other location where it is significantly difficult to secure Designated Community-Based Preventive Service of Long-Term Care and where it is defined by standards provided by an the Minister of Health, Labour, and Welfare, receives Community-Based Preventive Service of Long-Term Care other than Designated Community-Based Preventive Service of Long-Term Care or equivalent services;
三 その他政令で定めるとき。
(iii) when provided by a Cabinet Order.
2 特例地域密着型介護予防サービス費の額は、当該地域密着型介護予防サービス又はこれに相当するサービスについて前条第二項各号の厚生労働大臣が定める基準により算定した費用の額(その額が現に当該地域密着型介護予防サービス又はこれに相当するサービスに要した費用(食事の提供に要する費用その他の日常生活に要する費用として厚生労働省令で定める費用を除く。)の額を超えるときは、当該現に地域密着型介護予防サービス又はこれに相当するサービスに要した費用の額とする。)の百分の九十に相当する額又は同条第四項の規定により市町村が定めた額を基準として、市町村が定める。
(2) The amount of an Exceptional Allowance for Community-Based Preventive Service of Long-Term Care shall be provided by a Municipality based on the amount equivalent to 90 percent of the amount of expenses calculated, with regard to said Community-Based Preventive Service of Long-Term Care or equivalent service, based on standards provided by the Minister of Health, Labour, and Welfare as set forth in each item of paragraph (2) of the preceding Article (when said calculated amount exceeds the amount of actual expenses required for said Community-Based Preventive Service of Long-Term Care or equivalent service (excluding the expenses necessary to provide meals and other necessary expenses as determined by an Ordinance of the Ministry of Health, Labour, and Welfare as necessary for daily life), the allowance shall be the actual amount of expenses required for said Community-Based Preventive Service of Long-Term Care or equivalent service), or based on the amount provided by a Municipality pursuant to the provisions of paragraph (4) of the same Article.
3 市町村長は、特例地域密着型介護予防サービス費の支給に関して必要があると認めるときは、当該支給に係る地域密着型介護予防サービス若しくはこれに相当するサービスを担当する者若しくは担当した者(以下この項において「地域密着型介護予防サービス等を担当する者等」という。)に対し、報告若しくは帳簿書類の提出若しくは提示を命じ、若しくは出頭を求め、又は当該職員に関係者に対して質問させ、若しくは当該地域密着型介護予防サービス等を担当する者等の当該支給に係る事業所に立ち入り、その設備若しくは帳簿書類その他の物件を検査させることができる。
(3) The mayor of a Municipality, when he or she determines the necessary for payment of an Exceptional Allowance for Community-Based Preventive Service of Long-Term Care, may order a person that has been in charge of the Community-Based Preventive Service of Long-Term Care pertaining to said payment or equivalent service (hereinafter referred to as "Person, etc., in Charge of Community-Based Preventive Long-Term Care, etc." in this paragraph) to report, submit or present record books and documents, appear, or direct its personnel to question the relevant person or enter the Business Office of the provider of said Person, etc., in Charge of said Community-Based Preventive Service of Long-Term Care pertaining to said payment in order to inspect said equipment, record books and documents, and other items.
4 第二十四条第三項の規定は前項の規定による質問又は検査について、同条第四項の規定は前項の規定による権限について準用する。
(4) The provisions of Article 24, paragraph (3) shall apply mutatis mutandis to questions and inspections pursuant to the provisions of the preceding paragraph, and the provisions of paragraph (4) of the same Article shall apply mutatis mutandis to the authority granted pursuant to the provisions of the preceding paragraph.
(介護予防サービス費等に係る支給限度額)
(Maximum Payment pertaining to an Allowance for Preventive Long-Term Care Service, etc.)
第五十五条 居宅要支援被保険者が介護予防サービス等区分(介護予防サービス(これに相当するサービスを含む。以下この条において同じ。)及び地域密着型介護予防サービス(これに相当するサービスを含む。以下この条において同じ。)について、その種類ごとの相互の代替性の有無等を勘案して厚生労働大臣が定める二以上の種類からなる区分をいう。以下この条において同じ。)ごとに月を単位として厚生労働省令で定める期間において受けた一の介護予防サービス等区分に係る介護予防サービスにつき支給する介護予防サービス費の額の総額及び特例介護予防サービス費の額の総額並びに地域密着型介護予防サービスにつき支給する地域密着型介護予防サービス費の額の総額及び特例地域密着型介護予防サービス費の額の総額の合計額は、介護予防サービス費等区分支給限度基準額を基礎として、厚生労働省令で定めるところにより算定した額の百分の九十に相当する額を超えることができない。
Article 55 (1) Total sum of the total amounts of the Allowance for Preventive Long-Term Care Service and Exceptional Allowance for Preventive Service of Long-Term Care that are paid for Preventive Service of Long-Term Care, and the Allowance for Community-Based Preventive Long-Term Care Service and Exceptional Allowance for Community-Based Preventive Service of Long-Term Care that are paid for Designated Provider of Community-Based Service for Preventive Long-Term Care, as pertaining to a single category of Preventive Service of Long-Term Care, etc., that an In-Home Person Requiring Support receives monthly by category of Preventive Service of Long-Term Care, etc. (which means categories of two or more types as determined by the Minister of Health, Labour, and Welfare, with regard to Preventive Service of Long-Term Care (including equivalent services; the same shall apply hereinafter in this Article) and Community-Based Preventive Service of Long-Term Care (including equivalent services; the same shall apply hereinafter in this Article), after considering the inter-substitution by type; the same shall apply hereinafter in this Article) during the period provided by an Ordinance of the Ministry of Health, Labour, and Welfare, shall not exceed the amount equivalent to 90 percent of the amount calculated pursuant to the provisions of an Ordinance of the Ministry of Health, Labour, and Welfare based on the base amount of maximum benefit for the payment categories of Preventive Service of Long-Term Care, etc.
2 前項の介護予防サービス費等区分支給限度基準額は、介護予防サービス等区分ごとに、同項に規定する厚生労働省令で定める期間における当該介護予防サービス等区分に係る介護予防サービス及び地域密着型介護予防サービスの要支援状態区分に応じた標準的な利用の態様、当該介護予防サービス及び地域密着型介護予防サービスに係る第五十三条第二項各号及び第五十四条の二第二項各号の厚生労働大臣が定める基準等を勘案して厚生労働大臣が定める額とする。
(2) The base amount of maximum benefit for the payment categories of Allowance for Preventive Long-Term Care Service, etc., as set forth in the preceding paragraph shall be the amount determined by the Minister of Health, Labour, and Welfare by category of Preventive Service of Long-Term Care, etc., after considering the types of standard use that are according to the categories of Needed Support Condition, of Preventive Service of Long-Term Care, and of Community-Based Preventive Service of Long-Term Care pertaining to the categories of said Preventive Service of Long-Term Care, etc., during the period as determined by an Ordinance of the Ministry of Health, Labour, and Welfare as prescribed in the same paragraph, standards provided by the Minister of Health, Labour, and Welfare as set forth in each item of Article 53, paragraph (2) and each item of Article 54-2, paragraph (2) pertaining to said Preventive Service of Long-Term Care and Community-Based Preventive Service of Long-Term Care.
3 市町村は、前項の規定にかかわらず、条例で定めるところにより、第一項の介護予防サービス費等区分支給限度基準額に代えて、その額を超える額を、当該市町村における介護予防サービス費等区分支給限度基準額とすることができる。
(3) A Municipality, notwithstanding the provisions of the preceding paragraph and pursuant to the provisions of a municipal ordinance, in lieu of the base amount of the maximum benefit by payment category of Preventive Service of Long-Term Care, etc., as set forth in paragraph (1), may determine that an amount exceeding said base amount as the base amount of maximum benefit by payment category of Preventive Service of Long-Term Care in said Municipality.
4 市町村は、居宅要支援被保険者が介護予防サービス及び地域密着型介護予防サービスの種類(介護予防サービス等区分に含まれるものであって厚生労働大臣が定めるものに限る。次項において同じ。)ごとに月を単位として厚生労働省令で定める期間において受けた一の種類の介護予防サービスにつき支給する介護予防サービス費の額の総額及び特例介護予防サービス費の額の総額の合計額並びに一の種類の地域密着型介護予防サービスにつき支給する地域密着型介護予防サービス費の額の総額及び特例地域密着型介護予防サービス費の額の総額の合計額について、介護予防サービス費等種類支給限度基準額を基礎として、厚生労働省令で定めるところにより算定した額の百分の九十に相当する額を超えることができないこととすることができる。
(4) A Municipality may stipulate that the total sum of the total amounts of Allowance for Preventive Long-Term Care Service and Exceptional Allowance for Preventive Service of Long-Term Care that are paid for single type of Preventive Service of Long-Term Care and the total amount of Allowance for Community-Based Preventive Long-Term Care Service and Exceptional Allowance for Community-Based Preventive Service of Long-Term Care that are paid for single type of Community-Based Preventive Service of Long-Term Care as allowances that were paid monthly to an In-Home Person Requiring Support by type of Preventive Service of Long-Term Care and Community-Based Preventive Service of Long-Term Care (limited to those types included in categories of Preventive Service of Long-Term Care, etc., and provided by the Minister of Health, Labour, and Welfare; the same shall apply in the following paragraph) during the period as determined by an Ordinance of the Ministry of Health, Labour, and Welfare shall not exceed the amount equivalent to 90 percent of the amount calculated pursuant to the provisions of an Ordinance of the Ministry of Health, Labour, and Welfare based on the base amount of maximum benefit by payment type of Preventive Service of Long-Term Care, etc.
5 前項の介護予防サービス費等種類支給限度基準額は、介護予防サービス及び地域密着型介護予防サービスの種類ごとに、同項に規定する厚生労働省令で定める期間における当該介護予防サービス及び地域密着型介護予防サービスの要支援状態区分に応じた標準的な利用の態様、当該介護予防サービス及び地域密着型介護予防サービスに係る第五十三条第二項各号及び第五十四条の二第二項各号の厚生労働大臣が定める基準等を勘案し、当該介護予防サービス及び地域密着型介護予防サービスを含む介護予防サービス等区分に係る第一項の介護予防サービス費等区分支給限度基準額(第三項の規定に基づき条例を定めている市町村にあっては、当該条例による措置が講じられた額とする。)の範囲内において、市町村が条例で定める額とする。
(5) The base amount of maximum benefit by payment type of Preventive Service of Long-Term Care, etc., as set forth in the preceding paragraph shall be the amount that a Municipality stipulates by ordinance, by type of Preventive Service of Long-Term Care and Community-Based Preventive Service of Long-Term Care, after considering the type of standard use that is according to each Category of Needed Support Condition, of said Preventive Service of Long-Term Care and Community-Based Preventive Service of Long-Term Care during the period as determined by an Ordinance of the Ministry of Health, Labour, and Welfare as prescribed in the same paragraph, standards determined by the Minister of Health, Labour, and Welfare as set forth in each item of Article 53, paragraph (2) and each item of Article 54-2, paragraph (2) pertaining to said Preventive Service of Long-Term Care and Community-Based Preventive Service of Long-Term Care, etc., within the base amount of maximum benefit by payment category of Preventive Service of Long-Term Care, etc., as set forth in paragraph (1) pertaining to the categories of Preventive Service of Long-Term Care, etc., that include said Preventive Service of Long-Term Care and Community-Based Preventive Service of Long-Term Care (said base amount, with regard to the Municipality that provides an ordinance pursuant to the provisions of paragraph (3), shall be the amount by which measures pursuant to the provisions of said municipal ordinance are undertaken).
6 介護予防サービス費若しくは特例介護予防サービス費又は地域密着型介護予防サービス費若しくは特例地域密着型介護予防サービス費を支給することにより第一項に規定する合計額が同項に規定する百分の九十に相当する額を超える場合又は第四項に規定する合計額が同項に規定する百分の九十に相当する額を超える場合における当該介護予防サービス費若しくは特例介護予防サービス費又は地域密着型介護予防サービス費若しくは特例地域密着型介護予防サービス費の額は、第五十三条第二項各号若しくは第五十四条第二項又は第五十四条の二第二項各号若しくは第四項若しくは前条第二項の規定にかかわらず、政令で定めるところにより算定した額とする。
(6) In a case when the total amount as prescribed in paragraph (1) exceeds the amount equivalent to 90 percent of the amount as prescribed in the same paragraph or when the total amount as prescribed in paragraph (4) exceeds the amount equivalent to 90 percent of the amount as prescribed in the same paragraph by payment of an Allowance for Preventive Long-Term Care Service or Exceptional Allowance for Preventive Service of Long-Term Care, or an Allowance for Community-Based Preventive Long-Term Care Service or an Exceptional Allowance for Community-Based Preventive Service of Long-Term Care, the amount of said Allowance for Preventive Long-Term Care Service or Exceptional Allowance for Preventive Service of Long-Term Care, or Allowance for Community-Based Preventive Long-Term Care Service or Exceptional Allowance for Community-Based Preventive Service of Long-Term Care shall be the amount calculated pursuant to the provisions of a Cabinet Order, notwithstanding the provisions of each item of Article 53, paragraph (2), Article 54, paragraph (2), each item of Article 54-2, paragraph (2) or paragraph (4), or paragraph (2) of the preceding Article.
(介護予防福祉用具購入費の支給)
(Payment of an Allowance for Purchasing Equipment for Preventive Long-Term Care Covered by Public Aid)
第五十六条 市町村は、居宅要支援被保険者が、特定介護予防福祉用具販売に係る指定介護予防サービス事業者から当該指定に係る介護予防サービス事業を行う事業所において販売される特定介護予防福祉用具を購入したときは、当該居宅要支援被保険者に対し、介護予防福祉用具購入費を支給する。
Article 56 (1) A Municipality, when an Insured In-Home Person Requiring Support purchases from a Designated Provider of a Preventive Service to Long-Term Care pertaining to the Sale of Specified Equipment for Preventive Long-Term Care Covered by Public Aid, Specified Equipment for Preventive Long-Term Care Covered by Public Aid that is sold by a Provider that performs Preventive Service of Long-Term Care Business pertaining to said designation, shall pay an Allowance for Purchasing Equipment for Preventive Long-Term Care Covered by Public Aid to said Insured In-Home Person Requiring Support.
2 介護予防福祉用具購入費は、厚生労働省令で定めるところにより、市町村が必要と認める場合に限り、支給するものとする。
(2) An Allowance for Purchasing Equipment for Preventive Long-Term Care Covered by Public Aid shall be paid pursuant to the provisions of an Ordinance of the Ministry of Health, Labour, and Welfare only when a Municipality determines it necessary.
3 介護予防福祉用具購入費の額は、現に当該特定介護予防福祉用具の購入に要した費用の額の百分の九十に相当する額とする。
(3) The amount of Allowance for Purchasing Equipment for Preventive Long-Term Care Covered by Public Aid shall be the amount equivalent to 90 percent of the actual expenses required to purchase said Specified Equipment for Preventive Long-Term Care Covered by Public Aid.
4 居宅要支援被保険者が月を単位として厚生労働省令で定める期間において購入した特定介護予防福祉用具につき支給する介護予防福祉用具購入費の額の総額は、介護予防福祉用具購入費支給限度基準額を基礎として、厚生労働省令で定めるところにより算定した額の百分の九十に相当する額を超えることができない。
(4) The total amount of Allowance for Purchasing Equipment for Preventive Long-Term Care Covered by Public Aid that is paid monthly for Specified Equipment for Preventive Long-Term Care Covered by Public Aid that an Insured In-Home Person Requiring Support purchases during the period as determined by an Ordinance of the Ministry of Health, Labour, and Welfare shall not exceed the amount equivalent to 90 percent of the amount calculated pursuant to the provisions of an Ordinance of the Ministry of Health, Labour, and Welfare based on the base amount of maximum payment of the Allowance for Purchasing Equipment for Preventive Long-Term Care Covered by Public Aid .
5 前項の介護予防福祉用具購入費支給限度基準額は、同項に規定する厚生労働省令で定める期間における特定介護予防福祉用具の購入に通常要する費用を勘案して厚生労働大臣が定める額とする。
(5) The base amount of maximum payment of the Allowance for Purchasing Equipment for Preventive Long-Term Care Covered by Public Aid as set forth in the preceding paragraph shall be the amount determined by the Minister of Health, Labour, and Welfare after considering the expenses normally required to purchase Specified Equipment for Preventive Long-Term Care Covered by Public Aid during the period as determined by an Ordinance of the Ministry of Health, Labour, and Welfare as set forth in the same paragraph.
6 市町村は、前項の規定にかかわらず、条例で定めるところにより、第四項の介護予防福祉用具購入費支給限度基準額に代えて、その額を超える額を、当該市町村における介護予防福祉用具購入費支給限度基準額とすることができる。
(6) A Municipality, notwithstanding the provisions of the preceding paragraph and pursuant to the provisions of a municipal ordinance, in lieu of the base amount of maximum payment of the Allowance for Purchasing Equipment for Preventive Long-Term Care Covered by Public Aid as set forth in paragraph (4), may stipulate an amount that exceeds said base amount as the base amount of maximum payment for the Allowance for Purchasing Equipment for Preventive Long-Term Care Covered by Public Aid in said Municipality.
7 介護予防福祉用具購入費を支給することにより第四項に規定する総額が同項に規定する百分の九十に相当する額を超える場合における当該介護予防福祉用具購入費の額は、第三項の規定にかかわらず、政令で定めるところにより算定した額とする。
(7) In a case when the total amount as prescribed in paragraph (4) exceeds the amount equivalent to 90 percent of the amount as prescribed in the same paragraph due to payment of an Allowance for Purchasing Equipment for Preventive Long-Term Care Covered by Public Aid , the amount of said Allowance for Purchasing Equipment for Preventive Long-Term Care Covered by Public Aid shall be the amount calculated pursuant to the provisions of a Cabinet Order, notwithstanding the provisions of paragraph (3).
(介護予防住宅改修費の支給)
(Payment of Allowance for Preventive Long-Term Care Home Modification)
第五十七条 市町村は、居宅要支援被保険者が、住宅改修を行ったときは、当該居宅要支援被保険者に対し、介護予防住宅改修費を支給する。
Article 57 (1) A Municipality shall, when an Insured In-Home Person Requiring Support modifies his or her home, pay Allowance for Preventive Long-Term Care Home Modification to said Insured In-Home Person Requiring Support.
2 介護予防住宅改修費は、厚生労働省令で定めるところにより、市町村が必要と認める場合に限り、支給するものとする。
(2) Allowance for Preventive Long-Term Care Home Modification shall, pursuant to the provisions of an Ordinance of the Ministry of Health, Labour, and Welfare, be paid only when a Municipality determines it necessary.
3 介護予防住宅改修費の額は、現に当該住宅改修に要した費用の額の百分の九十に相当する額とする。
(3) The amount of Allowance for Preventive Long-Term Care Home Modification shall be the amount equivalent to 90 percent of the actual expenses required for said Home Modification.
4 居宅要支援被保険者が行った一の種類の住宅改修につき支給する介護予防住宅改修費の額の総額は、介護予防住宅改修費支給限度基準額を基礎として、厚生労働省令で定めるところにより算定した額の百分の九十に相当する額を超えることができない。
(4) The total amount of Allowance for Preventive Long-Term Care Home Modification that should be paid for one type of Home Modification that an Insured In-Home Person Requiring Support undertakes shall not exceed the amount equivalent to 90 percent of the amount calculated pursuant to the provisions of an Ordinance of the Ministry of Health, Labour, and Welfare based on the base amount of maximum payment as an Allowance for Preventive Long-Term Care Home Modification.
5 前項の介護予防住宅改修費支給限度基準額は、住宅改修の種類ごとに、通常要する費用を勘案して厚生労働大臣が定める額とする。
(5) The based amount of maximum payment as an Allowance for Preventive Long-Term Care Home Modification as set forth in the preceding paragraph shall be the amount determined by the Minister of Health, Labour, and Welfare by type of Home Modification care after considering the expenses normally required.
6 市町村は、前項の規定にかかわらず、条例で定めるところにより、第四項の介護予防住宅改修費支給限度基準額に代えて、その額を超える額を、当該市町村における介護予防住宅改修費支給限度基準額とすることができる。
(6) A Municipality, notwithstanding the provisions of the preceding paragraph and pursuant to the provisions of a municipal ordinance, in lieu of the base amount of maximum payment as an Allowance for Preventive Long-Term Care Home Modification as set forth in paragraph (4), may stipulate an amount that exceeds said base amount as the base amount of maximum payment as an Allowance for Preventive Long-Term Care Home Modification in said Municipality.
7 介護予防住宅改修費を支給することにより第四項に規定する総額が同項に規定する百分の九十に相当する額を超える場合における当該介護予防住宅改修費の額は、第三項の規定にかかわらず、政令で定めるところにより算定した額とする。
(7) In a case when the total amount as prescribed by paragraph (4) exceeds the amount equivalent to 90 percent of the amount as prescribed in the same paragraph due to payment of an Allowance for Preventive Long-Term Care Home Modification, the amount of said Allowance for Preventive Long-Term Care Home Modification shall be the amount calculated pursuant to the provisions of a Cabinet Order, notwithstanding the provisions of paragraph (3).
8 市町村長は、介護予防住宅改修費の支給に関して必要があると認めるときは、当該支給に係る住宅改修を行う者若しくは住宅改修を行った者(以下この項において「住宅改修を行う者等」という。)に対し、報告若しくは帳簿書類の提出若しくは提示を命じ、若しくは出頭を求め、又は当該職員に関係者に対して質問させ、若しくは当該住宅改修を行う者等の当該支給に係る事業所に立ち入り、その帳簿書類その他の物件を検査させることができる。
(8) The mayor of a Municipality, when he or she determines the necessity of the payment of an Allowance for Preventive Long-Term Care Home Modification, may order a person that modifies the home or equivalent service pertaining to said payment (herein referred to as "Person, etc., that Modifies a Home" in this paragraph") to report, submit or present record books and documents, appear, or direct its personnel to question the relevant Person or enter the Business Office of the provider of said Person, etc., that Modifies a Home pertaining to said payment in order to inspect such facilities, record books and documents, and other items.
9 第二十四条第三項の規定は前項の規定による質問又は検査について、同条第四項の規定は前項の規定による権限について準用する。
(9) The provisions of Article 24, paragraph (3) shall apply mutatis mutandis to questions and inspections as prescribed in the provisions of the preceding paragraph and the provisions of paragraph (4) of the same Article shall apply mutatis mutandis to the authority granted as prescribed in the provisions of the preceding paragraph.
(介護予防サービス計画費の支給)
(Payment of an Allowance for Preventive Long-Term Care Service Plan)
第五十八条 市町村は、居宅要支援被保険者が、当該市町村の長が指定する者(以下「指定介護予防支援事業者」という。)から当該指定に係る介護予防支援事業を行う事業所により行われる介護予防支援(以下「指定介護予防支援」という。)を受けたときは、当該居宅要支援被保険者に対し、当該指定介護予防支援に要した費用について、介護予防サービス計画費を支給する。
Article 58 (1) A Municipality, when an Insured In-Home Person Requiring Support receives from a person designated by the mayor of said Municipality (herein referred to as "Designated Provider of Preventive Support of Long-Term Care"), the Preventive Long-Term Care Support provided by a provider that performs the Preventive Long-Term Care Support Business pertaining to said designation (herein referred to as "Designated Support for Prevention of Long-Term Care"), shall pay to said Insured In-Home Person Requiring Support an Allowance for Preventive Long-Term Care Service Plan for the expenses required for said Designated Support for Prevention of Long-Term Care.
2 介護予防サービス計画費の額は、指定介護予防支援の事業を行う事業所の所在する地域等を勘案して算定される当該指定介護予防支援に要する平均的な費用の額を勘案して厚生労働大臣が定める基準により算定した費用の額(その額が現に当該指定介護予防支援に要した費用の額を超えるときは、当該現に指定介護予防支援に要した費用の額とする。)とする。
(2) The amount of the Allowance for Preventive Long-Term Care Service Plan shall be the amount of expenses calculated by standards as prescribed by the Minister of Health, Labour, and Welfare after considering the average expenses necessary for Designated Support for Prevention of Long-Term Care that is calculated after considering the area, etc., where a provider that performs the Designated Support for Prevention of Long-Term Care Business is located (in a case when said calculated amount exceeds the actual expenses necessary for said Designated Support for Prevention of Long-Term Care, the allowance shall be the actual expenses necessary for said Designated Support for Prevention of Long-Term Care).
3 厚生労働大臣は、前項の基準を定めようとするときは、あらかじめ社会保障審議会の意見を聴かなければならない。
(3) The Minister of Health, Labour, and Welfare, when it intends to provide standards as prescribed in the items of the preceding paragraph, shall hear opinions of the Social Security Council in advance.
4 居宅要支援被保険者が指定介護予防支援事業者から指定介護予防支援を受けたとき(当該居宅要支援被保険者が、厚生労働省令で定めるところにより、当該指定介護予防支援を受けることにつきあらかじめ市町村に届け出ている場合に限る。)は、市町村は、当該居宅要支援被保険者が当該指定介護予防支援事業者に支払うべき当該指定介護予防支援に要した費用について、介護予防サービス計画費として当該居宅要支援被保険者に対し支給すべき額の限度において、当該居宅要支援被保険者に代わり、当該指定介護予防支援事業者に支払うことができる。
(4) When an Insured In-Home Person Requiring Support receives Designated Support for Prevention of Long-Term Care from a Designated Provider of Preventive Support of Long-Term Care (limited to a case when said Insured In-Home Person Requiring Support has notified in advance the Municipality pursuant to the provisions of an Ordinance of the Ministry of Health, Labour, and Welfare of receipt of said Designated Support for Prevention of Long-Term Care), a Municipality may pay the expenses required for said Designated Support for Prevention of Long-Term Care that said Insured In-Home Person Requiring Support should pay to said Designated Provider of Support for Prevention of Long-Term Care, to said Designated Provider of Preventive Support of Long-Term Care on behalf of said Insured In-Home Person Requiring Support within the limit of the amount to be paid to said Insured In-Home Person Requiring Support as an Allowance for Preventive Long-Term Care Service Plan.
5 前項の規定による支払があったときは、居宅要支援被保険者に対し介護予防サービス計画費の支給があったものとみなす。
(5) When the expenses are paid pursuant to the provisions of the preceding paragraph, it shall be deemed that an Allowance for Preventive Long-Term Care Service Plan is paid to said Insured In-Home Person Requiring Support.
6 市町村は、指定介護予防支援事業者から介護予防サービス計画費の請求があったときは、第二項の厚生労働大臣が定める基準並びに第百十五条の二十二第二項に規定する指定介護予防支援に係る介護予防のための効果的な支援の方法に関する基準及び指定介護予防支援の事業の運営に関する基準(指定介護予防支援の取扱いに関する部分に限る。)に照らして審査した上、支払うものとする。
(6) A Municipality, when a Designated Provider of Preventive Support of Long-Term Care requests an Allowance for Preventive Long-Term Care Service Plan, shall pay said allowance after conducting an examination according to standards determined by the Minister of Health, Labour, and Welfare as set forth in each item of paragraph (2), standards concerning effective support methods for Prevention of Long-Term Care pertaining to Designated Support for Prevention of Long-Term Care as prescribed in Article 115-22, paragraph (2), and standards concerning management of the Designated Support for Prevention of Long-Term Care Business (limited to the part concerning the handling of Designated Support for Prevention of Long-Term Care).
7 第四十一条第二項、第三項、第十項及び第十一項の規定は介護予防サービス計画費の支給について、同条第八項の規定は指定介護予防支援事業者について準用する。この場合において、これらの規定に関し必要な技術的読替えは、政令で定める。
(7) The provisions of Article 41, paragraph (2), paragraph (3), paragraph (10), and paragraph (11) shall apply mutatis mutandis to the payment of an Allowance for Preventive Long-Term Care Service Plan and the provisions of paragraph (8) of the same Article shall apply mutatis mutandis to a Designated Provider of Preventive Support of Long-Term Care. In this case, the necessary technical replacement of terms in these provisions shall be provided by a Cabinet Order.
8 前各項に規定するもののほか、介護予防サービス計画費の支給及び指定介護予防支援事業者の介護予防サービス計画費の請求に関して必要な事項は、厚生労働省令で定める。
(8) In addition to those provisions as prescribed in each of the preceding paragraphs, other necessary matters payment of an Allowance for Preventive Long-Term Care Service Plan and the request of an Allowance for Preventive Long-Term Care Service Plan by a Designated Provider of Preventive Support of Long-Term Care shall be as determined by an Ordinance of the Ministry of Health, Labour, and Welfare.
(特例介護予防サービス計画費の支給)
(Payment of an Exceptional Allowance for Preventive Long-Term Care Service Plan)
第五十九条 市町村は、次に掲げる場合には、居宅要支援被保険者に対し、特例介護予防サービス計画費を支給する。
Article 59 (1) A Municipality shall, in the following cases, pay an Exceptional Allowance for Preventive Long-Term Care Service Plan to an Insured In-Home Person Requiring Support:
一 居宅要支援被保険者が、指定介護予防支援以外の介護予防支援又はこれに相当するサービス(指定介護予防支援の事業に係る第百十五条の二十二第一項の厚生労働省令で定める基準及び同項の厚生労働省令で定める員数並びに同条第二項に規定する指定介護予防支援に係る介護予防のための効果的な支援の方法に関する基準及び指定介護予防支援の事業の運営に関する基準のうち、厚生労働省令で定めるものを満たすと認められる事業を行う事業者により行われるものに限る。次号において「基準該当介護予防支援」という。)を受けた場合において、必要があると認めるとき。
(i) when a Municipality determines it necessary in a case when an Insured Person Requiring Support receives a Preventive Long-Term Care Support other than a Designated Support for Prevention of Long-Term Care or equivalent service (limited to services provided by a provider that performs said business in a location that has been determined to satisfy the standards provided by an Ordinance of the Ministry of Health, Labour, and Welfare, among the standards as determined by an Ordinance of the Ministry of Health, Labour, and Welfare as set forth in Article 115-22, paragraph (1) pertaining to a Designated Support for Prevention of Long-Term Care and the number of employees as determined by an Ordinance of the Ministry of Health, Labour, and Welfare as set forth in the same paragraph, and standards concerning effective support methods for Prevention of Long-Term Care pertaining to Designated Support for Prevention of Long-Term Care as prescribed in paragraph (2) of the same Article and standards concerning the management of a business of Designated Support for Prevention of Long-Term Care (herein referred to as "Preventive Long-Term Care Support Applicable to Standards" in the items following);
二 指定介護予防支援及び基準該当介護予防支援の確保が著しく困難である離島その他の地域であって厚生労働大臣が定める基準に該当するものに住所を有する居宅要支援被保険者が、指定介護予防支援及び基準該当介護予防支援以外の介護予防支援又はこれに相当するサービスを受けた場合において、必要があると認めるとき。
(ii) when a Municipality determines it necessary in a case when an Insured In-Home Person Requiring Support that is domiciled on an isolated island or other location where it is significantly difficult to secure Designated Support for Prevention of Long-Term Care, and Preventive Long-Term Care Support Applicable to Standards, and where it is defined by standards as determined by an Ordinance of the Minister of Health, Labour, and Welfare, receives Preventive Long-Term Care Support or equivalent service other than Designated Support for Prevention of Long-Term Care or Preventive Long-Term Care Support Applicable to Standards;
三 その他政令で定めるとき。
(iii) when provided by a Cabinet Order.
2 特例介護予防サービス計画費の額は、当該介護予防支援又はこれに相当するサービスについて前条第二項の厚生労働大臣が定める基準により算定した費用の額(その額が現に当該介護予防支援又はこれに相当するサービスに要した費用の額を超えるときは、当該現に介護予防支援又はこれに相当するサービスに要した費用の額とする。)を基準として、市町村が定める。
(2) The amount of Exceptional Allowance for Preventive Long-Term Care Service Plan shall be specified by a Municipality based on the expenses calculated by standards determined by the Minister of Health, Labour, and Welfare as set forth in paragraph (2) of the preceding Article for said Preventive Long-Term Care Support or equivalent service (in a case said calculated amount exceeds the amount of actual expenses of said Preventive Long-Term Care Support or equivalent service, the base amount shall be the actual expenses required for said Preventive Long-Term Care Support or equivalent service).
3 市町村長は、特例介護予防サービス計画費の支給に関して必要があると認めるときは、当該支給に係る介護予防支援若しくはこれに相当するサービスを担当する者若しくは担当した者(以下この項において「介護予防支援等を担当する者等」という。)に対し、報告若しくは帳簿書類の提出若しくは提示を命じ、若しくは出頭を求め、又は当該職員に関係者に対して質問させ、若しくは当該介護予防支援等を担当する者等の当該支給に係る事業所に立ち入り、その帳簿書類その他の物件を検査させることができる。
(3) The mayor of a Municipality, when he or she determines the necessity for the payment of an Exceptional Allowance for Preventive Long-Term Care Service Plan, may order a person that is or was in charge of the Preventive Long-Term Care Support pertaining to said payment or equivalent service (herein referred to as "Person, etc., in Charge of Preventive Long-Term Care Support, etc." in this paragraph") to report, submit or present record books and documents, appear, or direct its personnel to question the relevant Person or enter the Business Office of the provider of said Person, etc., in Charge of Preventive Long-Term Care Support, etc., pertaining to said payment in order to inspect said record books and documents, and other items.
4 第二十四条第三項の規定は前項の規定による質問又は検査について、同条第四項の規定は前項の規定による権限について準用する。
(4) The provisions of Article 24, paragraph (3) shall apply mutatis mutandis to questions and inspections as prescribed in the preceding paragraph and the provisions of paragraph (4) of the same Article shall apply mutatis mutandis to the authority granted as prescribed in the preceding paragraph.
(介護予防サービス費等の額の特例)
(Exceptions to the Amount of Allowance for Preventive Long-Term Care Service, etc.)
第六十条 市町村が、災害その他の厚生労働省令で定める特別の事情があることにより、介護予防サービス(これに相当するサービスを含む。)、地域密着型介護予防サービス(これに相当するサービスを含む。)又は住宅改修に必要な費用を負担することが困難であると認めた居宅要支援被保険者が受ける次の各号に掲げる予防給付について当該各号に定める規定を適用する場合においては、これらの規定中「百分の九十」とあるのは、「百分の九十を超え百分の百以下の範囲内において市町村が定めた割合」とする。
Article 60 In a case when a Municipality applies provisions as prescribed in the following items to a prevention benefit listed in the said items that an Insured Person Requiring Support receives, for whom it is deemed to be difficult to pay necessary expenses for Preventive Long-Term Care Service (including equivalent services), Community-Based Service for Preventive Long-Term Care (including equivalent services), or Home Modification due to a disaster or other special reasons as determined by an Ordinance of the Ministry of Health, Labour, and Welfare, the term "90 percent" in these provisions shall be deemed to be replaced with "the percentage provided by a Municipality within the range of more than 90 percent to 100 percent or less":
一 介護予防サービス費の支給 第五十三条第二項第一号及び第二号並びに第五十五条第一項、第四項及び第六項
(i) payment of an Allowance for Preventive Service of Long-Term Care of the Age: Article 53, paragraph (2), item (i), and item (ii), and Article 55, paragraph (1), paragraph (4), and paragraph (6);
二 特例介護予防サービス費の支給 第五十四条第二項並びに第五十五条第一項、第四項及び第六項
(ii) payment of an Exceptional Allowance for Preventive Service of Long-Term Care: Article 54, paragraph (2) and Article 55, paragraph (1), paragraph (4), and paragraph (6);
三 地域密着型介護予防サービス費の支給 第五十四条の二第二項第一号及び第二号並びに第五十五条第一項、第四項及び第六項
(iii) payment of an Allowance for Community-Based Preventive Service of Long-Term Care: Article 54-2, paragraph (2), item (i) and item (ii), and Article 55, paragraph (1), paragraph (4), and paragraph (6);
四 特例地域密着型介護予防サービス費の支給 第五十四条の三第二項並びに第五十五条第一項、第四項及び第六項
(iv) payment of an Exceptional Allowance for Community-Based Preventive Service of Long-Term Care: Article 54-3, paragraph (2), and Article 55, paragraph (1), paragraph (4), and paragraph (6);
五 介護予防福祉用具購入費の支給 第五十六条第三項、第四項及び第七項
(v) payment of an Allowance for Purchasing Equipment for Preventive Long-Term Care Covered by Public Aid: Article 56, paragraph (3), paragraph (4) and paragraph (7);
六 介護予防住宅改修費の支給 第五十七条第三項、第四項及び第七項
(vi) payment of an Allowance for Preventive Long-Term Care Home Modification: Article 57, paragraph (3), paragraph (4), and paragraph (7).
(高額介護予防サービス費の支給)
(Payment of an Allowance for High-Cost Preventive Long-Term Care Service)
第六十一条 市町村は、居宅要支援被保険者が受けた介護予防サービス(これに相当するサービスを含む。)又は地域密着型介護予防サービス(これに相当するサービスを含む。)に要した費用の合計額として政令で定めるところにより算定した額から、当該費用につき支給された介護予防サービス費、特例介護予防サービス費、地域密着型介護予防サービス費及び特例地域密着型介護予防サービス費の合計額を控除して得た額が、著しく高額であるときは、当該居宅要支援被保険者に対し、高額介護予防サービス費を支給する。
Article 61 (1) When the amount that is obtained by deducting from the amount calculated pursuant to the provisions of a Cabinet Order as the total amount of each expense required for Preventive Long-Term Care Service (including equivalent service), or Community-Based Service for Preventive Long-Term Care (including equivalent service) that an Insured In-Home Person Requiring Support receives, the total amount of Allowance for Preventive Long-Term Care Service, Exceptional Allowance for Preventive Service of Long-Term Care, Community-Based Preventive Service of Long-Term Care, and Exceptional Allowance for Community-Based Preventive Service of Long-Term Care that are actually paid for the said expenses is significantly large, a Municipality shall pay an Allowance for High-Cost Preventive Long-Term Care Service to said Insured In-Home Person Requiring Support.
2 前項に規定するもののほか、高額介護予防サービス費の支給要件、支給額その他高額介護予防サービス費の支給に関して必要な事項は、介護予防サービス又は地域密着型介護予防サービスに必要な費用の負担の家計に与える影響を考慮して、政令で定める。
(2) In addition to the provisions as set forth in the preceding paragraph, requirements for payment of an Allowance for High-Cost Preventive Long-Term Care Service, the amount of said allowance, and other matters necessary for payment of an Allowance for High-Cost Preventive Long-Term Care Service shall be provided by a Cabinet Order after considering the impact on the household budget from the burden of the expenses necessary for Preventive Long-Term Care Service or Community-Based Service for Preventive Long-Term Care.
(特定入所者介護予防サービス費の支給)
(Payment of an Allowance for Preventive Long-Term Care Service to a Person Admitted to a Specified Facility)
第六十一条の二 市町村は、居宅要支援被保険者のうち所得の状況その他の事情をしん酌して厚生労働省令で定めるものが、次に掲げる指定介護予防サービス(以下この条及び次条第一項において「特定介護予防サービス」という。)を受けたときは、当該居宅要支援被保険者(以下この条及び次条第一項において「特定入所者」という。)に対し、当該特定介護予防サービスを行う指定介護予防サービス事業者(以下この条において「特定介護予防サービス事業者」という。)における食事の提供に要した費用及び滞在に要した費用について、特定入所者介護予防サービス費を支給する。ただし、当該特定入所者が、第三十七条第一項の規定による指定を受けている場合において、当該指定に係る種類以外の特定介護予防サービスを受けたときは、この限りでない。
Article 61-2 (1) A Municipality, when a person as determined by an Ordinance of the Ministry of Health, Labour, and Welfare due to the extenuating income status and other circumstances among those who are an Insured In-Home Person Requiring Support receives Designated Preventive Long-Term Care Service (herein referred to as "Specified Preventive Service of Long-Term Care" in this Article and the following Article paragraph (1)) as listed below, shall pay to said Insured In-Home Person Requiring Support (herein referred to as "Specified Person Admitted to a Facility" in this Article and the following Article paragraph (1)) the Allowance for Preventive Long-Term Care Service to a Person Admitted to a Specified Facility for the expenses required to provide meals and residence by a Designated Provider of Preventive Long-Term Care Service that provides said Specified Preventive Service of Long-Term Care (herein referred to as "Long-Term Care Preventive Service Specified Provider" in this Article), however, provided that this provision shall not apply to when said Specified Person Admitted to a Facility who is assigned a designation pursuant to the provisions of Article 37, paragraph (1) receives Specified Preventive Service of Long-Term Care other than the type pertaining to said designation:
一 介護予防短期入所生活介護
(i) Short-Term Admission for Daily Preventive Long-Term Care;
二 介護予防短期入所療養介護
(ii) Short-Term Admission for Recuperation for Preventive Long-Term Care.
2 特定入所者介護予防サービス費の額は、第一号に規定する額及び第二号に規定する額の合計額とする。
(2) The amount of Allowance for Long-Term Care Preventive Service of a Person Admitted to a Specified Facility shall be the total of the amount as prescribed in item (i) and the amount as prescribed in item (ii):
一 特定介護予防サービス事業者における食事の提供に要する平均的な費用の額を勘案して厚生労働大臣が定める費用の額(その額が現に当該食事の提供に要した費用の額を超えるときは、当該現に食事の提供に要した費用の額とする。以下この条及び次条第二項において「食費の基準費用額」という。)から、平均的な家計における食費の状況及び特定入所者の所得の状況その他の事情を勘案して厚生労働大臣が定める額(以下この条及び次条第二項において「食費の負担限度額」という。)を控除した額
(i) the amount remaining after the amount determined by the Minister of Health, Labour, and Welfare after considering the status of food expenses for an average household budget, the income status of the Specified Person Admitted to a Facility, and other circumstances (herein referred to as "Maximum Allowance for Meal Expense" in this Article and paragraph (2) of the following Article) is deducted from the amount of expenses determined by the Minister of Health, Labour, and Welfare after considering the average expenses required to provide meals at a Long-Term Care Preventive Service Specified Provider (in a case when said amount exceeds the actual expenses of providing said meals, this amount shall be the amount of the actual expenses of providing said meals, herein referred to as "Base Cost for Meal Expense" in this Article and paragraph (2) of the following Article);
二 特定介護予防サービス事業者における滞在に要する平均的な費用の額及び事業所の状況その他の事情を勘案して厚生労働大臣が定める費用の額(その額が現に当該滞在に要した費用の額を超えるときは、当該現に滞在に要した費用の額とする。以下この条及び次条第二項において「滞在費の基準費用額」という。)から、特定入所者の所得の状況その他の事情を勘案して厚生労働大臣が定める額(以下この条及び次条第二項において「滞在費の負担限度額」という。)を控除した額
(ii) the amount remaining after the amount determined by the Minister of Health, Labour, and Welfare after considering the income status of the Special Insured Person Admitted to the Facility and other circumstances (herein referred to as "Maximum Allowance for Room and Board Expense" is deducted from the amount determined by the Ministry of Health, Labour, and Welfare after considering the average expenses necessary for a stay in the Long-Term Care Preventive Service Specified Provider, the status of said facility, and other circumstances (in a case when said amount exceeds the actual expenses for said stay, this amount shall be the amount of the actual expenses for said stay; herein referred to as "Base Costs for Room and Board" in this Article and paragraph (2) of the following Article).
3 厚生労働大臣は、食費の基準費用額若しくは食費の負担限度額又は滞在費の基準費用額若しくは滞在費の負担限度額を定めた後に、特定介護予防サービス事業者における食事の提供に要する費用又は滞在に要する費用の状況その他の事情が著しく変動したときは、速やかにそれらの額を改定しなければならない。
(3) The Ministry of Health, Labour, and Welfare, when the expenses necessary of providing meals and for a stay incurred by a Long-Term Care Preventive Service Specified Provider and other circumstances have changed significantly after the Base Cost for Meal Expense or the Maximum Allowance for Meal Expense, or the Base Costs for Room and Board or the Maximum Allowance for Stay Expense were determined, shall revise those amount immediately.
4 特定入所者が、特定介護予防サービス事業者から特定介護予防サービスを受けたときは、市町村は、当該特定入所者が当該特定介護予防サービス事業者に支払うべき食事の提供に要した費用及び滞在に要した費用について、特定入所者介護予防サービス費として当該特定入所者に対し支給すべき額の限度において、当該特定入所者に代わり、当該特定介護予防サービス事業者に支払うことができる。
(4) When a Specified Person Admitted to a Facility receives Specified Preventive Service of Long-Term Care from a Long-Term Care Preventive Service Specified Provider, a Municipality may pay the expenses required to provide meals and residence that said Specified Person Admitted to a Facility should pay to said Long-Term Care Preventive Service Specified Provider, within the limit of amount to be paid to said Specified Person Admitted to a Facility as an Allowance for Long-Term Care Preventive Service of a Person Admitted to a Specified Facility to said Long-Term Care Preventive Service Specified Provider on behalf of said Specified Person Admitted to a Facility.
5 前項の規定による支払があったときは、特定入所者に対し特定入所者介護予防サービス費の支給があったものとみなす。
(5) When the allowance is paid pursuant to the provisions of the preceding paragraph, it shall be deemed that an Allowance for Long-Term Care Preventive Service of a Person Admitted to a Specified Facility is paid to the Specified Person Admitted to a Facility.
6 市町村は、第一項の規定にかかわらず、特定入所者が特定介護予防サービス事業者に対し、食事の提供に要する費用又は滞在に要する費用として、食費の基準費用額又は滞在費の基準費用額(前項の規定により特定入所者介護予防サービス費の支給があったものとみなされた特定入所者にあっては、食費の負担限度額又は滞在費の負担限度額)を超える金額を支払った場合には、特定入所者介護予防サービス費を支給しない。
(6) A Municipality, notwithstanding the provisions of paragraph (1) in a case when Specified Person Admitted to a Facility pays to a Long-Term Care Preventive Service Specified Provider the amount exceeding the Base Cost for Meal Expense or the Base Costs for Room and Board (with regard to a Specified Person Admitted to a Facility that was deemed to be paid an Allowance for Long-Term Care Preventive Service of a Person Admitted to a Specified Facility pursuant to the provisions of the preceding paragraph, the Maximum Allowance for Meal Expense or the Maximum Allowance for Stay Expense) as the expenses necessary of providing meals or for stay, shall not pay the Allowance for Long-Term Care Preventive Service of a Person Admitted to a Specified Facility.
7 市町村は、特定介護予防サービス事業者から特定入所者介護予防サービス費の請求があったときは、第一項、第二項及び前項の定めに照らして審査の上、支払うものとする。
(7) A Municipality, when a Long-Term Care Preventive Service Specified Provider requests an Allowance for Long-Term Care Preventive Service of a Person Admitted to a Specified Facility provided to a Specified Person Admitted to a Facility, shall pay said allowance after conducting an examination according to provisions of paragraph (1), paragraph (2) and the preceding paragraph.
8 第四十一条第三項、第十項及び第十一項の規定は特定入所者介護予防サービス費の支給について、同条第八項の規定は特定介護予防サービス事業者について準用する。この場合において、これらの規定に関し必要な技術的読替えは、政令で定める。
(8) The provisions of Article 41, paragraph (3), paragraph (10), and paragraph (11) shall apply mutatis mutandis to payment of an Allowance for Long-Term Care Preventive Service of a Person Admitted to a Specified Facility and the provisions of paragraph (8) of the same Article shall apply mutatis mutandis to a Long-Term Care Preventive Service Specified Provider. In this case, the necessary technical replacement of terms in these provisions shall be provided by a Cabinet Order.
9 前各項に規定するもののほか、特定入所者介護予防サービス費の支給及び特定介護予防サービス事業者の特定入所者介護予防サービス費の請求に関して必要な事項は、厚生労働省令で定める。
(9) In addition to those matters as prescribed in each preceding paragraph, other necessary matters payment of an Allowance for Long-Term Care Preventive Service of a Person Admitted to a Specified Facility and for the request of an Allowance for Long-Term Care Preventive Service of a Person Admitted to a Specified Facility by a Long-Term Care Preventive Service Specified Provider shall be as determined by an Ordinance of the Ministry of Health, Labour, and Welfare.
(特例特定入所者介護予防サービス費の支給)
(Payment of an Exceptional Allowance for Long-Term Care Preventive Service of a Person Admitted to a Specified Facility)
第六十一条の三 市町村は、次に掲げる場合には、特定入所者に対し、特例特定入所者介護予防サービス費を支給する。
Article 61-3 (1) A Municipality shall, in the following cases, pay an Exceptional Allowance for Long-Term Care Preventive Service of a Person Admitted to a Specified Facility to a Specified Person Admitted to a Facility:
一 特定入所者が、当該要支援認定の効力が生じた日前に、緊急その他やむを得ない理由により特定介護予防サービスを受けた場合において、必要があると認めるとき。
(i) when a Municipality determines it necessary in a case when Specified Person Admitted to a Facility receives Specified Preventive Service of Long-Term Care prior to the date said Certification of Needed Support becomes effective due to an emergency or other compelling reason;
二 その他政令で定めるとき。
(ii) when provided by a Cabinet Order.
2 特例特定入所者介護予防サービス費の額は、当該食事の提供に要した費用について食費の基準費用額から食費の負担限度額を控除した額及び当該滞在に要した費用について滞在費の基準費用額から滞在費の負担限度額を控除した額の合計額を基準として、市町村が定める。
(2) The amount of Exceptional Allowance for Long-Term Care Preventive Service of a Person Admitted to a Specified Facility to a Specified Person Admitted to a Facility shall be provided by a Municipality based on the total sum of the amount with regard to the expenses required of providing said meals that is the result of deducting the Base Allowance for Food Expense from the Maximum Cost for Food Expense, and the amount with regard to the expenses required for said stay that is the result of deduction of the Base Allowance for Stay from the Maximum Cost for Stay.
第五節 市町村特別給付
Section 5 Municipal Special Benefits
第六十二条 市町村は、要介護被保険者又は居宅要支援被保険者(以下「要介護被保険者等」という。)に対し、前二節の保険給付のほか、条例で定めるところにより、市町村特別給付を行うことができる。
Article 62 A Municipality may pay a Municipal Special Benefit pursuant to the provisions of a municipal ordinance to an Insured Person Requiring Long-Term Care or an Insured In-Home Person Requiring Support (herein referred to as "Insured Person Requiring Long-Term Care, etc.") in addition to the insurance benefits as set forth in the preceding two sections.
第六節 保険給付の制限等
Section 6 Limitation of Insurance Benefits, etc.
(保険給付の制限)
(Limitation of Insurance Benefits)
第六十三条 刑事施設、労役場その他これらに準ずる施設に拘禁された者については、その期間に係る介護給付等は、行わない。
Article 63 With regard to a person that is confined to penal institution, work facility, or other facility mutatis mutandis as these, a Long-Term Care Benefit, etc., pertaining to said period of confinement shall not be paid.
第六十四条 市町村は、自己の故意の犯罪行為若しくは重大な過失により、又は正当な理由なしに介護給付等対象サービスの利用若しくは居宅介護住宅改修費若しくは介護予防住宅改修費に係る住宅改修の実施に関する指示に従わないことにより、要介護状態等若しくはその原因となった事故を生じさせ、又は要介護状態等の程度を増進させた被保険者の当該要介護状態等については、これを支給事由とする介護給付等は、その全部又は一部を行わないことができる。
Article 64 With regard to the Condition of Need for Long-Term Care, etc., of an Insured Person that caused the accident that caused a Condition of Need for Long-Term Care, etc., or the cause of said condition, or who increased the degree of Condition of Need for Long-Term Care, etc., by not obeying instructions for the use of Service Covered by Long-Term Care Benefits, etc., or for a Home Modification pertaining to an Allowance for Home Modification for In-Home Long-Term Care or Allowance for Preventive Long-Term Care Home Modification due to an intentional criminal act or gross negligence or without justifiable reasons, a Municipality may not pay the whole or a part of a Long-Term Care Benefit, etc., for which the reason for payment is said Condition of Need for Long-Term Care, etc.
第六十五条 市町村は、介護給付等を受ける者が、正当な理由なしに、第二十三条の規定による求め(第二十四条の二第一項第一号の規定により委託された場合にあっては、当該委託に係る求めを含む。)に応ぜず、又は答弁を拒んだときは、介護給付等の全部又は一部を行わないことができる。
Article 65 A Municipality, when a person that receives a Long-Term Care Benefit, etc., fails to respond to a request pursuant to the provisions of Article 23 (in a case when it is entrusted pursuant to the provisions of Article 24-2, paragraph (1), item (i), including a request pertaining to said entrustment) or refuses to answer without a justifiable reason, may not pay the whole or a part of a Long-Term Care Benefit, etc.
(保険料滞納者に係る支払方法の変更)
(Change of Payment Method Pertaining to Person Delinquent in Payment of an Insurance Premium)
第六十六条 市町村は、保険料を滞納している第一号被保険者である要介護被保険者等(原子爆弾被爆者に対する援護に関する法律(平成六年法律第百十七号)による一般疾病医療費の支給その他厚生労働省令で定める医療に関する給付を受けることができるものを除く。)が、当該保険料の納期限から厚生労働省令で定める期間が経過するまでの間に当該保険料を納付しない場合においては、当該保険料の滞納につき災害その他の政令で定める特別の事情があると認める場合を除き、厚生労働省令で定めるところにより、当該要介護被保険者等に対し被保険者証の提出を求め、当該被保険者証に、第四十一条第六項、第四十二条の二第六項、第四十六条第四項、第四十八条第四項、第五十一条の二第四項、第五十三条第四項、第五十四条の二第六項、第五十八条第四項及び第六十一条の二第四項の規定を適用しない旨の記載(以下この条及び次条第三項において「支払方法変更の記載」という。)をするものとする。
Article 66 (1) A Municipality, in a case when an Insured Person Requiring Long-Term Care, etc., that is a Primary Insured Person that is a person delinquent in payment of an insurance premium (except for those who can receive a medical allowance for general disease pursuant to the Act for Medical Measures for the Victims of the Atomic Bomb (Act No. 117 of 1994) and other benefits for medical care as determined by an Ordinance of the Ministry of Health, Labour, and Welfare) fails to pay said insurance premium from the payment due date of said insurance premium until the expiry of the period as determined by an Ordinance of the Ministry of Health, Labour, and Welfare, except for a case when it is determined that there is a special circumstance for said delinquency of insurance premium payment such as a disaster or other special circumstances provided by a Cabinet Order, shall request said Insured Person Requiring Long-Term Care, etc., to submit the Certificate of Insured Person, pursuant to the provisions of an Ordinance of the Ministry of Health, Labour, and Welfare, and enter on said Certificate of Insured Person that the provisions of Article 41, paragraph (6), Article 42-2, paragraph (6), Article 46, paragraph (4), Article 48, paragraph (4), Article 51-2, paragraph (4), Article 53, paragraph (4), Article 54-2, paragraph (6), Article 58, paragraph (4) and Article 61-2, paragraph (4) shall not apply (herein referred to as "Entry of Change of Payment Method" in this Article and paragraph (3) of the following Article).
2 市町村は、前項に規定する厚生労働省令で定める期間が経過しない場合においても、同項に規定する政令で定める特別の事情があると認める場合を除き、同項に規定する要介護被保険者等に対し被保険者証の提出を求め、当該被保険者証に支払方法変更の記載をすることができる。
(2) A Municipality, although in a case when the period as determined by an Ordinance of the Ministry of Health, Labour, and Welfare as prescribed in the preceding paragraph has not yet expired, except for a case it is determined that said person delinquent in payment is due to special circumstances provided by a Cabinet Order as prescribed in the same paragraph, may request the Insured Person Requiring Long-Term Care, etc., as prescribed in the same paragraph to submit the Certificate of Insured Person, and include the Entry of Change of Payment Method on said Certificate of Insured Person.
3 市町村は、前二項の規定により支払方法変更の記載を受けた要介護被保険者等が滞納している保険料を完納したとき、又は当該要介護被保険者等に係る滞納額の著しい減少、災害その他の政令で定める特別の事情があると認めるときは、当該支払方法変更の記載を消除するものとする。
(3) A Municipality, when an Insured Person Requiring Long-Term Care, etc., that has received an Entry of Change of Payment Method pursuant to the provisions of the preceding two paragraphs and has completed payment of said delinquent insurance premium or when it is determined that the delinquent payment amount pertaining to said Insured Person Requiring Long-Term Care, etc., has decreased significantly or due to a disaster or other special circumstances provided by a Cabinet Order, shall delete said Entry of Change of Payment Method.
4 第一項又は第二項の規定により支払方法変更の記載を受けた要介護被保険者等が、当該支払方法の変更の記載がなされている間に受けた指定居宅サービス、指定地域密着型サービス、指定居宅介護支援、指定施設サービス等、指定介護予防サービス、指定地域密着型介護予防サービス及び指定介護予防支援に係る居宅介護サービス費の支給、地域密着型介護サービス費の支給、居宅介護サービス計画費の支給、施設介護サービス費の支給、特定入所者介護サービス費の支給、介護予防サービス費の支給、地域密着型介護予防サービス費の支給、介護予防サービス計画費の支給及び特定入所者介護予防サービス費の支給については、第四十一条第六項、第四十二条の二第六項、第四十六条第四項、第四十八条第四項、第五十一条の二第四項、第五十三条第四項、第五十四条の二第六項、第五十八条第四項及び第六十一条の二第四項の規定は適用しない。
(4) With regard to the payment of an Allowance for In-Home Long-Term Care Service, Allowance for Community-Based Long-Term Care Service, Allowance for In-Home Long-Term Care Service Plan, Allowance for Long-Term Care Facility Service, Allowance for Long-Term Care Service to a Person Admitted to a Specified Facility, Allowance for Preventive Long-Term Care Service, Allowance for Community-Based Preventive Long-Term Care Service, Allowance for Preventive Long-Term Care Service Plan, and Allowance for Preventive Long-Term Care Service to a Person Admitted to a Specified Facility, pertaining to a Designated In-Home Service, Designated Community-Based Service, Designated In-Home Long-Term Care Support, Designated Facility Service, etc., Designated Preventive Long-Term Care Service, Designated Community-Based Preventive Service of Long-Term Care, and Designated Support for Prevention of Long-Term Care that an Insured Person Requiring Long-Term Care, etc., who received an Entry of Change of Payment Method pursuant to the provisions of paragraph (1) or paragraph (2), receives during the period said Entry of Change of Payment Method remains on the Certificate of Insured Person, the provisions of Article 41, paragraph (6), Article 42-2, paragraph (6), Article 46, paragraph (4), Article 48, paragraph (4), Article 51-2, paragraph (4), Article 53, paragraph (4), Article 54-2, paragraph (6), Article 58, paragraph (4), and Article 61-2, paragraph (4) shall not apply.
(保険給付の支払の一時差止)
(Temporary Suspension of Payment of Insurance Benefit)
第六十七条 市町村は、保険給付を受けることができる第一号被保険者である要介護被保険者等が保険料を滞納しており、かつ、当該保険料の納期限から厚生労働省令で定める期間が経過するまでの間に当該保険料を納付しない場合においては、当該保険料の滞納につき災害その他の政令で定める特別の事情があると認める場合を除き、厚生労働省令で定めるところにより、保険給付の全部又は一部の支払を一時差し止めるものとする。
Article 67 (1) A Municipality, when an Insured Person Requiring Long-Term Care, etc., that is a Primary Insured Person that can receive an insurance benefit becomes a person delinquent in the payment of an insurance premium and fails to pay said insurance premium from the due date of payment of said insurance premium until the period as determined by an Ordinance of the Ministry of Health, Labour, and Welfare expires, shall temporarily suspend the payment of the whole or a part of an insurance benefit, pursuant to the provisions of an Ordinance of the Ministry of Health, Labour, and Welfare, except for a case when it is determined that said delinquency of payment of an insurance premium is due to a disaster or other special circumstance as determined by a Cabinet Order.
2 市町村は、前項に規定する厚生労働省令で定める期間が経過しない場合においても、保険給付を受けることができる第一号被保険者である要介護被保険者等が保険料を滞納している場合においては、当該保険料の滞納につき災害その他の政令で定める特別の事情があると認める場合を除き、厚生労働省令で定めるところにより、保険給付の全部又は一部の支払を一時差し止めることができる。
(2) A Municipality, in a case when an Insured Person Requiring Long-Term Care, etc., who is a Primary Insured Person that can receive an insurance benefit becomes a person delinquent in the payment of an insurance premium although the period as determined by an Ordinance of the Ministry of Health, Labour, and Welfare as prescribed in the preceding paragraph has not yet expired, except for a case when it is determined that said delinquency of an insurance premium is due to a disaster or other special circumstance as determined by a Cabinet Order as prescribed, may temporarily suspend the whole or a part of an insurance benefit pursuant to the provisions of an Ordinance of the Ministry of Health, Labour, and Welfare.
3 市町村は、前条第一項又は第二項の規定により支払方法変更の記載を受けている要介護被保険者等であって、前二項の規定による保険給付の全部又は一部の支払の一時差止がなされているものが、なお滞納している保険料を納付しない場合においては、厚生労働省令で定めるところにより、あらかじめ、当該要介護被保険者等に通知して、当該一時差止に係る保険給付の額から当該要介護被保険者等が滞納している保険料額を控除することができる。
(3) A Municipality, in a case when an Insured Person Requiring Long-Term Care, etc., that has received an Entry of Change of Payment Method pursuant to the provisions of paragraph (1) or paragraph (2) of the preceding Article and whose insurance benefit has been temporarily suspended in whole or in part pursuant to the provisions of the preceding two paragraphs and who has not yet paid the delinquent insurance premium, may notify in advance said Insured Person Requiring Long-Term Care, etc., pursuant to the provisions of an Ordinance of the Ministry of Health, Labour, and Welfare, and deduct the amount of delinquent insurance premium of said Insured Person Requiring Long-Term Care, etc., from the amount of insurance benefit pertaining to said temporary suspension.
(医療保険各法の規定による保険料等に未納がある者に対する保険給付の一時差止)
(Temporary Suspensions of Insurance Benefits to a Person that has not paid an insurance premium, etc., as prescribed in the Medical Insurance Acts)
第六十八条 市町村は、保険給付を受けることができる第二号被保険者である要介護被保険者等について、医療保険各法の定めるところにより当該要介護被保険者等が納付義務又は払込義務を負う保険料(地方税法(昭和二十五年法律第二百二十六号)の規定による国民健康保険税を含む。)又は掛金であってその納期限又は払込期限までに納付しなかったもの(以下この項及び次項において「未納医療保険料等」という。)がある場合においては、未納医療保険料等があることにつき災害その他の政令で定める特別の事情があると認める場合を除き、厚生労働省令で定めるところにより、当該要介護被保険者等に対し被保険者証の提出を求め、当該被保険者証に、第四十一条第六項、第四十二条の二第六項、第四十六条第四項、第四十八条第四項、第五十一条の二第四項、第五十三条第四項、第五十四条の二第六項、第五十八条第四項及び第六十一条の二第四項の規定を適用しない旨並びに保険給付の全部又は一部の支払を差し止める旨の記載(以下この条において「保険給付差止の記載」という。)をすることができる。
Article 68 (1) With regard to an Insured Person Requiring Long-Term Care, etc., that is a Secondary Insured Person that can receive an insurance benefit, in a case when said Insured Person Requiring Long-Term Care, etc., has an obligatory insurance premium pursuant to the provisions of the Medical Insurance Acts (including national health insurance tax pursuant to the provisions of the Local Tax Act (Act No. 226 of 1950)) or when there is a remaining premium installments that was not paid by the deadline for payment (herein referred to as "Unpaid Medical Insurance Premium, etc." in this paragraph and the following paragraph), except for a case said Unpaid Medical Insurance Premium, etc., is due to a disaster or other special circumstance as determined by a Cabinet Order, a Municipality, pursuant to the provisions of an Ordinance of the Ministry of Health, Labour, and Welfare, may request said Insured Person Requiring Long-Term Care, etc., to submit the Certificate of Insured Person and to enter on said Certificate of Insured Person that the provisions of Article 41, paragraph (6), Article 42-2, paragraph (6), Article 46, paragraph (4), Article 48, paragraph (4), Article 51-2, paragraph (4), Article 53, paragraph (4), Article 54-2, paragraph (6), Article 58, paragraph (4), and Article 61-2, paragraph (4) shall not apply and that the whole or a part of the payment of an insurance benefit shall be suspended (herein referred to as "Entry of Suspension of Insurance Benefit" in this Article).
2 市町村は、前項の規定により保険給付差止の記載を受けた要介護被保険者等が、未納医療保険料等を完納したとき、又は当該要介護被保険者等に係る未納医療保険料等の著しい減少、災害その他の政令で定める特別の事情があると認めるときは、当該保険給付差止の記載を消除するものとする。
(2) When an Insured Person Requiring Long-Term Care, etc., that has received an Entry of Suspension of Insurance Benefit pursuant to the provisions of the preceding paragraph completes payment of an Unpaid Medical Insurance Premium, etc., or when it is determined that there is a significant decrease of an Unpaid Medical Insurance Premium, etc., pertaining to said Insured Person Requiring Long-Term Care, etc., or due to disaster or other special circumstance as provided by a Cabinet Order, said Entry of Suspension of Insurance Benefit shall be deleted.
3 第六十六条第四項の規定は、第一項の規定により保険給付差止の記載を受けた要介護被保険者等について準用する。
(3) The provisions of Article 66, paragraph (4) shall apply mutatis mutandis to an Insured Person Requiring Long-Term Care, etc., that has received an Entry of Suspension of Insurance Benefit pursuant to the provisions of paragraph (1).
4 市町村は、第一項の規定により保険給付差止の記載を受けた要介護被保険者等について、保険給付の全部又は一部の支払を一時差し止めるものとする。
(4) With regard to an Insured Person Requiring Long-Term Care, etc., that has received an Entry of Suspension of Insurance Benefit pursuant to the provisions of paragraph (1), a Municipality shall temporarily suspend the whole or a part of an insurance benefit.
5 市町村は、要介護被保険者等についての保険給付差止の記載に関し必要があると認めるときは、当該要介護被保険者等の加入する医療保険者に対し、当該要介護被保険者等に係る医療保険各法の規定により徴収される保険料(地方税法の規定により徴収される国民健康保険税を含む。)又は掛金の納付状況その他厚生労働省令で定める事項について、厚生労働省令で定めるところにより、当該要介護被保険者等の加入する医療保険者に対し、情報の提供を求めることができる。
(5) A Municipality, when the necessity is determined for an Entry of Suspension of Insurance Benefit of an Insured Person Requiring Long-Term Care, etc., may request the submission of information pursuant to the provisions of an Ordinance of the Ministry of Health, Labour, and Welfare to a Medical Insurer of said Insured Person Requiring Long-Term Care, etc., regarding insurance premium collected pursuant to the provisions of the Medical Insurance Acts pertaining to said Insured Person Requiring Long-Term Care, etc., the status of an insurance premium (including national health insurance tax collected pursuant to the provisions of the Local Tax Act) or installments premium payments, and other matters as determined by an Ordinance of the Ministry of Health, Labour, and Welfare.
(保険料を徴収する権利が消滅した場合の保険給付の特例)
(Exception of Insurance Benefit in a Case of Extinction of Right to Collect an Insurance Premium)
第六十九条 市町村は、要介護認定、要介護更新認定、第二十九条第二項において準用する第二十七条第七項若しくは第三十条第一項の規定による要介護状態区分の変更の認定、要支援認定、要支援更新認定、第三十三条の二第二項において準用する第三十二条第六項若しくは第三十三条の三第一項の規定による要支援状態区分の変更の認定(以下この項において単に「認定」という。)をした場合において、当該認定に係る第一号被保険者である要介護被保険者等について保険料徴収権消滅期間(当該期間に係る保険料を徴収する権利が時効によって消滅している期間につき政令で定めるところにより算定された期間をいう。以下この項において同じ。)があるときは、厚生労働省令で定めるところにより、当該要介護被保険者等の被保険者証に、当該認定に係る第二十七条第七項後段(第二十八条第四項及び第二十九条第二項において準用する場合を含む。)、第三十条第一項後段若しくは第三十五条第四項後段又は第三十二条第六項後段(第三十三条第四項及び第三十三条の二第二項において準用する場合を含む。)、第三十三条の三第一項後段若しくは第三十五条第二項後段若しくは第六項後段の規定による記載に併せて、介護給付等(居宅介護サービス計画費の支給、特例居宅介護サービス計画費の支給、介護予防サービス計画費の支給及び特例介護予防サービス計画費の支給、高額介護サービス費の支給及び高額介護予防サービス費の支給並びに特定入所者介護サービス費の支給、特例特定入所者介護サービス費の支給、特定入所者介護予防サービス費の支給及び特例特定入所者介護予防サービス費の支給を除く。)の額の減額を行う旨並びに高額介護サービス費及び高額介護予防サービス費並びに特定入所者介護サービス費、特例特定入所者介護サービス費、特定入所者介護予防サービス費及び特例特定入所者介護予防サービス費の支給を行わない旨並びにこれらの措置がとられる期間(市町村が、政令で定めるところにより、保険料徴収権消滅期間に応じて定める期間をいう。以下この条において「給付額減額期間」という。)の記載(以下この条において「給付額減額等の記載」という。)をするものとする。ただし、当該要介護被保険者等について、災害その他の政令で定める特別の事情があると認めるときは、この限りでない。
Article 69 (1) In a case when a Municipality issues a Certification of Needed Long-Term Care, a Renewal of Certification of Care Need, or Certification of Change of Condition of Need for Long-Term Care pursuant to the provisions of Article 27, paragraph (7) or Article 30, paragraph (1) as applied mutatis mutandis pursuant to Article 29, paragraph (2), a Certification of Needed Support, a Renewal of Certification of Needed Support, or a Certification of Change of Category of Needed Support Condition pursuant to the provisions of Article 32, paragraph (6) or Article 33-3, paragraph (1) as applied mutatis mutandis pursuant to Article 33-2, paragraph (2) (hereinafter referred to simply as "Certification" in this paragraph) and there is a period when the right to collect an insurance premium has extinguished (which means a period calculated pursuant to the provisions of a Cabinet Order regarding the period when the right to collect an insurance premium pertaining to said period has been extinguished due to a legal proscription) with regard to an Insured Person Requiring Long-Term Care, etc., that is the Primary Insured Person pertaining to said Certification, a Municipality pursuant to the provisions of an Ordinance of the Ministry of Health, Labour, and Welfare shall enter on the Certificate of Insured Person of said Insured Person Requiring Long-Term Care, etc., in addition to the entry pursuant to the provisions of Article 27, paragraph (7), second sentence (including a case applied mutatis mutandis pursuant to Article 28, paragraph (4) and Article 29, paragraph (2)), Article 30, paragraph (1), second sentence, Article 35, paragraph (4), second sentence, Article 32, paragraph (6), second sentence (including a case applied mutatis mutandis pursuant to Article 33, paragraph (4) or Article 33-2, paragraph (2)), Article 33-3, paragraph (1), second sentence, Article 35, paragraph (2), second sentence, or paragraph (6) second sentence as pertaining to said Certification, that the amount of Long-Term Care Benefit, etc., (except for payment of an Allowance for In-Home Long-Term Care Service, Exceptional Allowance for an In-Home Long-Term Care Service Plan, Allowance for Preventive Long-Term Care Service Plan, Exceptional Allowance for a Preventive Service Plan of Long-term care, Allowance for High-Cost Long-Term Care Service, Allowance for High-Cost Preventive Long-Term Care Service, Allowance for Long-Term Care Service to a Person Admitted to a Specified Facility, Exceptional Allowance for Long-Term Care Service to a Person Admitted to a Specified Facility, Allowance for Preventive Long-Term Care Service to a Person Admitted to a Specified Facility, and Exceptional Allowance for Long-Term Care Preventive Service of a Person Admitted to a Specified Facility) shall be reduced and that the Allowance for High-Cost Long-Term Care Service, Allowance for High-Cost Preventive Long-Term Care Service, Allowance for Long-Term Care Service to a Person Admitted to a Specified Facility, Exceptional Allowance for Long-Term Care Service to a Person Admitted to a Specified Facility, Allowance for Preventive Long-Term Care Service to a Person Admitted to a Specified Facility, and Exceptional Allowance for Long-Term Care Preventive Service of a Person Admitted to a Specified Facility shall not be paid, and the period that these measures are applicable (which means a period that a Municipality determines pursuant to the provisions of a Cabinet Order according to the period during which the right to collect an insurance premium is extinguished; herein referred to as "Benefit Reduction Period" in this Article) (hereinafter said entry is referred to as "Entry of Benefit Reduction Amount, etc." in this Article), however, provided that this provision shall not apply to a case when it is determined that said Insured Person Requiring Long-Term Care, etc., suffers due to a disaster or other special circumstance provided by a Cabinet Order.
2 市町村は、前項の規定により給付額減額等の記載を受けた要介護被保険者等について、同項ただし書の政令で定める特別の事情があると認めるとき、又は給付額減額期間が経過したときは、当該給付額減額等の記載を消除するものとする。
(2) A Municipality, when it is determined that an Insured Person Requiring Long-Term Care, etc., that has received an Entry of Benefit Reduction Amount, etc., pursuant to the provisions of the preceding paragraph is subject to a special circumstance as provided by a Cabinet Order as set forth in the proviso of the same paragraph, and when the Benefit Reduction Period expires, shall delete said Entry of Benefit Reduction Amount, etc.
3 第一項の規定により給付額減額等の記載を受けた要介護被保険者等が、当該記載を受けた日の属する月の翌月の初日から当該給付額減額期間が経過するまでの間に利用した居宅サービス(これに相当するサービスを含む。次項において同じ。)、地域密着型サービス(これに相当するサービスを含む。次項において同じ。)、施設サービス、介護予防サービス(これに相当するサービスを含む。次項において同じ。)及び地域密着型介護予防サービス(これに相当するサービスを含む。次項において同じ。)並びに行った住宅改修に係る次の各号に掲げる介護給付等について当該各号に定める規定を適用する場合においては、これらの規定中「百分の九十」とあるのは、「百分の七十」とする。
(3) With regard to In-Home Service (including equivalent service; the same shall apply in the following paragraph), Community-Based Service (including equivalent service; the same shall apply in the following paragraph), Facility Service, Preventive Long-Term Care Service (including equivalent service; the same shall apply in the following paragraph), Community-Based Service for Preventive Long-Term Care (including equivalent service; the same shall apply in the following paragraph), and a Long-Term Care Benefit, etc., as listed in the following items pertaining to a Home Modification that is used or implemented by an Insured Person Requiring Long-Term Care, etc., that has received an Entry of Benefit Reduction Amount, etc., pursuant to the provisions of paragraph (1), from the first day of the month following the month in which said Entry was entered until said Benefit Reduction Period expires, when the provisions as prescribed in each said item shall apply to these services and benefits, etc., the term "90 percent" in the listed provisions shall be "70 percent":
一 居宅介護サービス費の支給 第四十一条第四項第一号及び第二号並びに第四十三条第一項、第四項及び第六項
(i) payment of an Allowance for In-Home Long-Term Care Service: Article 41, paragraph (4), item (i) and item (ii), and Article 43, paragraph (1), paragraph (4) and paragraph (6);
二 特例居宅介護サービス費の支給 第四十二条第二項並びに第四十三条第一項、第四項及び第六項
(ii) payment of an Exceptional Allowance for In-Home Long-Term Care Service: Article 42, paragraph (2) and Article 43, paragraph (1), paragraph (4), and paragraph (6);
三 地域密着型介護サービス費の支給 第四十二条の二第二項第一号及び第二号並びに第四十三条第一項、第四項及び第六項
(iii) payment of an Allowance for Community-Based Long-Term Care Service: Article 42-2, paragraph (2), item (i) and item (ii), and Article 43, paragraph (1), paragraph (4) and paragraph (6);
四 特例地域密着型介護サービス費の支給 第四十二条の三第二項並びに第四十三条第一項、第四項及び第六項
(iv) payment of an Exceptional Allowance for Community-Based Long-Term Care Service: Article 42-3, paragraph (2) and Article 43, paragraph (1), paragraph (4), and paragraph (6);
五 施設介護サービス費の支給 第四十八条第二項
(v) payment of an Allowance for Long-Term Care Facility Service: Article 48, paragraph (2);
六 特例施設介護サービス費の支給 第四十九条第二項
(vi) payment of an Exceptional Allowance for Long-Term Care Facility Service: Article 49, paragraph (2);
七 介護予防サービス費の支給 第五十三条第二項第一号及び第二号並びに第五十五条第一項、第四項及び第六項
(vii) payment of an Allowance for Preventive Long-Term Care Service: Article 53, paragraph (2), item (i) and item (ii), and Article 55, paragraph (1), paragraph (4), and paragraph (6);
八 特例介護予防サービス費の支給 第五十四条第二項並びに第五十五条第一項、第四項及び第六項
(viii) payment of an Exceptional Allowance for Preventive Service of Long-Term Care: Article 54, paragraph (2) and Article 55, paragraph (1), paragraph (4), and paragraph (6);
九 地域密着型介護予防サービス費の支給 第五十四条の二第二項第一号及び第二号並びに第五十五条第一項、第四項及び第六項
(ix) payment of an Exceptional Allowance for Community-Based Preventive Service of Long-Term Care: Article 54-2, paragraph (2), item (i) and item (ii), and Article 55, paragraph (1), paragraph (4), and paragraph (6);
十 特例地域密着型介護予防サービス費の支給 第五十四条の三第二項並びに第五十五条第一項、第四項及び第六項
(x) payment of an Exceptional Allowance for Community-Based Preventive Service of Long-Term Care: Article 54-3, paragraph (2) and Article 55, paragraph (1), paragraph (4), and paragraph (6);
十一 居宅介護福祉用具購入費の支給 第四十四条第三項、第四項及び第七項
(xi) payment of an Allowance for Purchasing Equipment for In-Home Long-Term Care Covered by Public Aid: Article 44, paragraph (3), paragraph (4), and paragraph (7);
十二 介護予防福祉用具購入費の支給 第五十六条第三項、第四項及び第七項
(xii) payment of an Allowance for Purchasing Equipment for Preventive Long-Term Care Covered by Public Aid: Article 56, paragraph (3), paragraph (4), and paragraph (7);
十三 居宅介護住宅改修費の支給 第四十五条第三項、第四項及び第七項
(xiii) payment of an Allowance for Home Modification for In-Home Long-Term Care: Article 45, paragraph (3), paragraph (4) and paragraph (7);
十四 介護予防住宅改修費の支給 第五十七条第三項、第四項及び第七項
(xiv) payment of an Allowance for Preventive Long-Term Care Home Modification: Article 57, paragraph (3), paragraph (4) and paragraph (7).
4 第一項の規定により給付額減額等の記載を受けた要介護被保険者等が、当該記載を受けた日の属する月の翌月の初日から当該給付額減額期間が経過するまでの間に受けた居宅サービス、地域密着型サービス、施設サービス、介護予防サービス及び地域密着型介護予防サービスに要する費用については、第五十一条第一項、第五十一条の二第一項、第五十一条の三第一項、第六十一条第一項、第六十一条の二第一項及び第六十一条の三第一項の規定は、適用しない。
(4) The provisions of Article 51, paragraph (1), Article 51-2, paragraph (1), Article 51-3, paragraph (1), Article 61, paragraph (1), Article 61-2, paragraph (1) and Article 61-3, paragraph (1) shall not apply to the allowance for expenses provided to an Insured Person Requiring Long-Term Care, etc., that has received an Entry of Benefit Reduction Amount, etc., pursuant to the provisions of paragraph (1) from the first day of the month following the month when said Entry is entered to when said Benefit Reduction Period expires regarding the expenses that are necessary for In-Home Service, Community-Based Service, Facility Service, Preventive Long-Term Care Service and Community-Based Service for Preventive Long-Term Care.
第五章 介護支援専門員並びに事業者及び施設
Chapter V Long-Term Care Support Specialists, Providers, and Facilities
第一節 介護支援専門員
Section 1 Long-Term Care Support Specialists
第一款 登録等
Subsection 1 Registration, etc.
(介護支援専門員の登録)
(Registration of Long-Term Care Support Specialists)
第六十九条の二 厚生労働省令で定める実務の経験を有する者であって、都道府県知事が厚生労働省令で定めるところにより行う試験(以下「介護支援専門員実務研修受講試験」という。)に合格し、かつ、都道府県知事が厚生労働省令で定めるところにより行う研修(以下「介護支援専門員実務研修」という。)の課程を修了したものは、厚生労働省令で定めるところにより、当該都道府県知事の登録を受けることができる。ただし、次の各号のいずれかに該当する者については、この限りでない。
Article 69-2 (1) A person that possesses practical experience as determined by an Ordinance of the Ministry of Health, Labour, and Welfare, has passed an examination undertaken pursuant to the provisions of an Ordinance of the Ministry of Health, Labour, and Welfare as administered by a prefectural governor (herein referred to as "Long-Term Care Support Specialist Examination"), and has completed a training program provided pursuant to the provisions of an Ordinance of the Ministry of Health, Labour, and Welfare as administered by a prefectural governor (herein referred to as "Long-Term Care Support Specialist Internship") shall be issued a registration by said prefectural governor pursuant to the provisions of an Ordinance of the Ministry of Health, Labour, and Welfare, however, provided that this provision shall not apply to a person that corresponds to any of following items:
一 成年被後見人又は被保佐人
(i) an adult ward or a person under guardianship;
二 禁錮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
(ii) a person punished by imprisonment without compulsory labor or to a more severe penalty and the execution of said penalty has not yet been completed or has not yet expired;
三 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
(iii) a person punished by a fine pursuant to provisions of a Cabinet Order as set forth in this Act or any another Act concerning national insurance, medical service, or welfare, and has not yet completed the execution of said punishment or remains subject to said punishment;
四 登録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
(iv) a person that has committed a wrongful act or a significantly unjustifiable act concerning In-Home Service, etc. within five years prior to submitting an application for registration;
五 第六十九条の三十八第三項の規定による禁止の処分を受け、その禁止の期間中に第六十九条の六第一号の規定によりその登録が消除され、まだその期間が経過しない者
(v) a person that was subject to a prohibition pursuant to the provisions of Article 69-38, paragraph (3) whose registration was rescinded pursuant to the provisions of Article 69-6, paragraph (1) during said prohibition period, and said prohibition period has not yet expired;
六 第六十九条の三十九の規定による登録の消除の処分を受け、その処分の日から起算して五年を経過しない者
(vi) a person that was subject to a rescinding of registration pursuant to the provisions of Article 69-39 within five years from the date of said disposition of the matter;
七 第六十九条の三十九の規定による登録の消除の処分に係る行政手続法(平成五年法律第八十八号)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登録の消除の申請をした者(登録の消除の申請について相当の理由がある者を除く。)であって、当該登録が消除された日から起算して五年を経過しないもの
(vii) a person that applied for deletion of registration from the date of said notification pursuant to the provisions of Article 15 of the Administrative Procedures Act (Act No. 88 of 1993) pertaining to a deletion of registration pursuant to the provisions of Article 69-39, and five years as not passed yet from the date of said disposition of the matter.
2 前項の登録は、都道府県知事が、介護支援専門員資格登録簿に氏名、生年月日、住所その他厚生労働省令で定める事項並びに登録番号及び登録年月日を登載してするものとする。
(2) A registration as set forth in the preceding paragraph shall be implemented by a prefectural governor by listing the name, date of birth, domicile, and other matters as determined by an Ordinance of the Ministry of Health, Labour, and Welfare, and the registration number and date on a registration list of Long-Term Care Support Specialists.
(登録の移転)
(Transfer of Registration)
第六十九条の三 前条第一項の登録を受けている者は、当該登録をしている都道府県知事の管轄する都道府県以外の都道府県に所在する指定居宅介護支援事業者その他厚生労働省令で定める事業者若しくは施設の業務に従事し、又は従事しようとするときは、当該事業者の事業所又は当該施設の所在地を管轄する都道府県知事に対し、当該登録をしている都道府県知事を経由して、登録の移転の申請をすることができる。ただし、その者が第六十九条の三十八第三項の規定による禁止の処分を受け、その禁止の期間が満了していないときは、この限りでない。
Article 69-3 When a person that is registered as set forth in paragraph (1) of the preceding Article engages in or intends to engage in Designated In-Home Long-Term Care Support Provider, other provider, or a facility as determined by an Ordinance of the Ministry of Health, Labour, and Welfare that located in a prefecture other than the prefecture governed by a prefectural governor where said person is registered, said person may apply for a transfer of registration to the prefectural governor governing the location of the business of said provider or the location of said facility via the prefectural governor who governs said registration, however, provided that this provision shall not apply when said person is punished by a prohibition pursuant to the provisions of Article 69-38, paragraph (3) and said prohibition period has not completely expired.
(登録事項の変更の届出)
(Notification of Change of Registration Matter)
第六十九条の四 第六十九条の二第一項の登録を受けている者は、当該登録に係る氏名その他厚生労働省令で定める事項に変更があったときは、遅滞なく、その旨を都道府県知事に届け出なければならない。
Article 69-4 A person that is registered as set forth in Article 69-2, paragraph (1), when his or her name or other matter as determined by an Ordinance of the Ministry of Health, Labour, and Welfare pertaining to said registration has changed, shall notify the prefectural governor without delay of said fact.
(死亡等の届出)
(Notification of Death, etc.)
第六十九条の五 第六十九条の二第一項の登録を受けている者が次の各号のいずれかに該当することとなった場合には、当該各号に定める者は、その日(第一号の場合にあっては、その事実を知った日)から三十日以内に、その旨を当該登録をしている都道府県知事又は当該各号に定める者の住所地を管轄する都道府県知事に届け出なければならない。
Article 69-5 When a person that is registered as set forth in Article 69-2, paragraph (1) becomes as defined by any of the following items, the person as provided by said item shall provide notification of said fact to the prefectural governor where said person is registered or the prefectural governor governing the domicile of said person as provided in said item within thirty days from the date (in a case of being defined by item (i), on the day) that said fact is known:
一 死亡した場合 その相続人
(i) when the registered person dies: the successor or executor of the estate of said person;
二 第六十九条の二第一項第一号に該当するに至った場合 その後見人又は保佐人
(ii) when the registered person corresponds to Article 69-2, paragraph (1), item (i): the guardian or curator of said person;
三 第六十九条の二第一項第二号又は第三号に該当するに至った場合 本人
(iii) when the registered person corresponds to Article 69-2, paragraph (1), item (ii) or item (iii): said registered person.
(申請等に基づく登録の消除)
(Deletion of Registration Based on an Application, etc.)
第六十九条の六 都道府県知事は、次の各号のいずれかに該当する場合には、第六十九条の二第一項の登録を消除しなければならない。
Article 69-6 A prefectural governor shall, in a case defined by any of the following items, delete the registration as set forth in Article 69-2, paragraph (1):
一 本人から登録の消除の申請があった場合
(i) when the registered person applies for the deletion of registration;
二 前条の規定による届出があった場合
(ii) when notified as set forth in the preceding Article;
三 前条の規定による届出がなくて同条各号のいずれかに該当する事実が判明した場合
(iii) when not notified as set forth in the preceding Article but a fact that corresponds to any of the items of the same Article is known;
四 第六十九条の三十一の規定により合格の決定を取り消された場合
(iv) when a judgment of passing an examination is rescinded pursuant to the provisions of Article 69-31.
(介護支援専門員証の交付等)
(Delivery, etc., of Long-Term Care Support Specialist Certification)
第六十九条の七 第六十九条の二第一項の登録を受けている者は、都道府県知事に対し、介護支援専門員証の交付を申請することができる。
Article 69-7 (1) A person that is registered as set forth in Article 69-2, paragraph (1) may apply for delivery of a Long-Term Care Support Specialist Certification to the prefectural governor.
2 介護支援専門員証の交付を受けようとする者は、都道府県知事が厚生労働省令で定めるところにより行う研修を受けなければならない。ただし、第六十九条の二第一項の登録を受けた日から厚生労働省令で定める期間以内に介護支援専門員証の交付を受けようとする者については、この限りでない。
(2) A person that intends to receive a Long-Term Care Support Specialist Certification, shall undertake training provided by the prefectural governor pursuant to the provisions of an Ordinance of the Ministry of Health, Labour, and Welfare, provided however, that this provision shall not apply to a person that intends to receive a Long-Term Care Support Specialist Certification within the period as determined by an Ordinance of the Ministry of Health, Labour, and Welfare from the date of registration as set forth in Article 69-2, paragraph (1).
3 介護支援専門員証(第五項の規定により交付された介護支援専門員証を除く。)の有効期間は、五年とする。
(3) The effective period of a Long-Term Care Support Specialist Certification (except for Long-Term Care Support Specialist Certification delivered pursuant to the provisions of paragraph (5)) shall be five years.
4 介護支援専門員証が交付された後第六十九条の三の規定により登録の移転があったときは、当該介護支援専門員証は、その効力を失う。
(4) When registration is transferred pursuant to the provisions of Article 69-3 after delivery of a Long-Term Care Support Specialist Certification, said prior Long-Term Care Support Specialist Certification shall cease to be effective.
5 前項に規定する場合において、登録の移転の申請とともに介護支援専門員証の交付の申請があったときは、当該申請を受けた都道府県知事は、同項の介護支援専門員証の有効期間が経過するまでの期間を有効期間とする介護支援専門員証を交付しなければならない。
(5) In a case as prescribed in the preceding paragraph, when the delivery of a Long-Term Care Support Specialist Certification is submitted for together with change of registration, the prefectural governor who receives said application shall deliver a Long-Term Care Support Specialist Certification that is effective until the effective period expires of the Long-Term Care Support Specialist Certification as set forth in the same paragraph.
6 介護支援専門員は、第六十九条の二第一項の登録が消除されたとき、又は介護支援専門員証が効力を失ったときは、速やかに、介護支援専門員証をその交付を受けた都道府県知事に返納しなければならない。
(6) A Long-Term Care Support Specialist, when the registration as set forth in Article 69-2, paragraph (1) is rescinded or the Long-Term Care Support Specialist Certification ceases to be effective, shall return said Long-Term Care Support Specialist Certification immediately to the prefectural governor that delivered said Long-Term Care Support Specialist Certification.
7 介護支援専門員は、第六十九条の三十八第三項の規定による禁止の処分を受けたときは、速やかに、介護支援専門員証をその交付を受けた都道府県知事に提出しなければならない。
(7) A Long-Term Care Support Specialist, when punished by a prohibition pursuant to the provisions of Article 69-38, paragraph (3), shall immediately submit the Long-Term Care Support Specialist Certification to the prefectural governor that issued said certification.
8 前項の規定により介護支援専門員証の提出を受けた都道府県知事は、同項の禁止の期間が満了した場合においてその提出者から返還の請求があったときは、直ちに、当該介護支援専門員証を返還しなければならない。
(8) A prefectural governor who receives a Long-Term Care Support Specialist Certification pursuant to the provisions of the preceding paragraph, when said person that submitted the certification requests the return of said certification in a case when the prohibition period as set forth in the same paragraph expires, shall immediately return said Long-Term Care Support Specialist Certification.
(介護支援専門員証の有効期間の更新)
(Renewal of Effective Period of Long-Term Care Support Specialist Certification)
第六十九条の八 介護支援専門員証の有効期間は、申請により更新する。
Article 69-8 (1) The effective period of a Long-Term Care Support Specialist Certification shall be renewable by the submission of an application.
2 介護支援専門員証の有効期間の更新を受けようとする者は、都道府県知事が厚生労働省令で定めるところにより行う研修(以下「更新研修」という。)を受けなければならない。ただし、現に介護支援専門員の業務に従事しており、かつ、更新研修の課程に相当するものとして都道府県知事が厚生労働省令で定めるところにより指定する研修の課程を修了した者については、この限りでない。
(2) A person that intends to renew the effective period of a Long-Term Care Support Specialist Certification shall undertake the training provided by a prefectural governor pursuant to the provisions of an Ordinance of the Ministry of Health, Labour, and Welfare (herein referred to as "Training for Renewal"), provided however, that this provision shall not apply to a person that currently engages in the business of a Long-Term Care Support Specialist and has completed the training program designated by the prefectural governor pursuant to the provisions of an Ordinance of the Ministry of Health, Labour, and Welfare as an equivalent to a program of Training for Renewal.
3 前条第三項の規定は、更新後の介護支援専門員証の有効期間について準用する。
(3) The provisions of paragraph (3) of the preceding Article shall apply mutatis mutandis to the effective period of a renewed Long-Term Care Support Specialist Certification.
(介護支援専門員証の提示)
(Presentation of Long-Term Care Support Specialist Certification)
第六十九条の九 介護支援専門員は、その業務を行うに当たり、関係者から請求があったときは、介護支援専門員証を提示しなければならない。
Article 69-9 A Long-Term Care Support Specialist, when requested by a relevant person, shall present his or her Long-Term Care Support Specialist Certification prior to conducting said business.
(厚生労働省令への委任)
(Delegation to an Ordinance of the Ministry of Health, Labour, and Welfare)
第六十九条の十 この款に定めるもののほか、第六十九条の二第一項の登録、その移転及び介護支援専門員証に関し必要な事項は、厚生労働省令で定める。
Article 69-10 In addition to the provisions in this Subsection, matters necessary concerning a registration as set forth in Article 69-2, paragraph (1), said transfer or a Long-Term Care Support Specialist Certification, shall be as determined by an Ordinance of the Ministry of Health, Labour, and Welfare.
第二款 登録試験問題作成機関の登録、指定試験実施機関及び指定研修実施機関の指定等
Subsection 2 Registration of Organization that Prepares Registration Examination Questions, and Appointment, etc., of Designated Testing Agencies and Designated Training Agencies
(登録試験問題作成機関の登録)
(Registration of Organization that Prepares Registration Examination Questions)
第六十九条の十一 都道府県知事は、厚生労働大臣の登録を受けた法人(以下「登録試験問題作成機関」という。)に、介護支援専門員実務研修受講試験の実施に関する事務のうち試験の問題の作成及び合格の基準の設定に関するもの(以下「試験問題作成事務」という。)を行わせることができる。
Article 69-11 (1) A prefectural governor may require a juridical person registered with the Minister of Health, Labour, and Welfare (herein referred to as "Organization that Prepares Registration Examination Questions") to undertake affairs concerning the preparation of examination questions and the establishment of criteria for passing (herein referred to as "Examination Question Preparation Affairs") among the affairs concerning the implementation of an Examination for Long-Term Care Support Specialist.
2 前項の登録は、試験問題作成事務を行おうとする者の申請により行う。
(2) A registration as set forth in the preceding paragraph shall be submitted by a person that intends to implement Examination Question Preparation Affairs.
3 都道府県知事は、第一項の規定により登録試験問題作成機関に試験問題作成事務を行わせるときは、試験問題作成事務を行わないものとする。
(3) A prefectural governor, when entrusting an Organization that Prepares Registration Examination Questions with the Examination Question Preparation Affairs pursuant to the provisions of paragraph (1), shall not otherwise implement Examination Question Preparation Affairs.
(欠格条項)
(Reasons of Disqualification)
第六十九条の十二 次の各号のいずれかに該当する法人は、前条第一項の登録を受けることができない。
Article 69-12 A juridical person that corresponds to any of the following items shall not be granted registration as set forth in paragraph (1) of the preceding paragraph:
一 この法律の規定により刑に処せられ、その執行を終わり、又は執行を受けることがなくなった日から起算して二年を経過しない者であること。
(i) a person punished pursuant to a provision of this Act and two years have not elapsed from the date said execution of punishment is completed or expired;
二 第六十九条の二十四第一項又は第二項の規定により登録を取り消され、その取消しの日から起算して二年を経過しない者であること。
(ii) a person that registration is rescinded pursuant to the provisions of Article 69-2, paragraph (1) or paragraph (2) and two years have not elapsed from the date of rescission;
三 その役員のうちに、第一号に該当する者があること。
(iii) a juridical person that has an Officer a person defined by item (i).
(登録の基準)
(Standard of Registration)
第六十九条の十三 厚生労働大臣は、第六十九条の十一第二項の規定により登録を申請した者が次に掲げる要件のすべてに適合しているときは、同条第一項の登録をしなければならない。この場合において、登録に関して必要な手続は、厚生労働省令で定める。
Article 69-13 The Minister of Health, Labour, and Welfare, when a person that applies for registration pursuant to the provisions of Article 69-11, paragraph (2) conforms to all requirements listed in the following items, shall issue the registration as set forth in paragraph (1) of the same Article; in said case, necessary procedures for registration shall be as determined by an Ordinance of the Ministry of Health, Labour, and Welfare:
一 別表の上欄に掲げる科目について同表の下欄に掲げる試験委員が試験の問題の作成及び合格の基準の設定を行うものであること。
(i) with regard to the subjects listed in the upper column of the appended table, the examination board listed in the lower column of the same table shall prepare the examination questions and establish criteria for passing the examination;
二 試験の信頼性の確保のための次に掲げる措置がとられていること。
(ii) measures listed in the following sub-items shall be undertaken in order to ensure the reliability of the examination:
イ 試験問題作成事務について専任の管理者を置くこと。
(a) a full-time supervisor for Examination Question Preparation Affairs shall be assigned;
ロ 試験問題作成事務の管理(試験に関する秘密の保持及び試験の合格の基準に関することを含む。)に関する文書の作成その他の厚生労働省令で定める試験問題作成事務の信頼性を確保するための措置が講じられていること。
(b) measures shall be undertaken in order to ensure the reliability of the preparation of documents concerning management of Examination Question Preparation Affairs (including maintaining the confidentiality of the examination and matters concerning the criteria for passing said examination) and other Examination Question Preparation Affairs as determined by an Ordinance of the Ministry of Health, Labour, and Welfare;
ハ ロの文書に記載されたところに従い試験問題作成事務の管理を行う専任の部門を置くこと。
(c) a department dedicated to the management of Examination Question Preparation Affairs shall be established according to the provisions for documents as set forth in sub-item (b);
三 債務超過の状態にないこと。
(iii) said person shall not be in a financial condition with liabilities in excess of assets.
(登録の公示等)
(Public Notice of Registration, etc.)
第六十九条の十四 厚生労働大臣は、第六十九条の十一第一項の登録をしたときは、当該登録を受けた者の名称及び主たる事務所の所在地並びに当該登録をした日を公示しなければならない。
Article 69-14 (1) The Minister of Health, Labour, and Welfare, when registering a person as set forth in Article 69-11, paragraph (1), issue public notice of the name and location of the main Business Office of said person that is registered and the date of said registration.
2 登録試験問題作成機関は、その名称又は主たる事務所の所在地を変更しようとするときは、変更しようとする日の二週間前までに、その旨を厚生労働大臣及び第六十九条の十一第一項の規定により登録試験問題作成機関にその試験問題作成事務を行わせることとした都道府県知事(以下「委任都道府県知事」という。)に届け出なければならない。
(2) An Organization that Prepares Registration Examination Questions, when it intends to change its name or the location of its main Business Office, shall provide notification two (2) weeks prior to the day of said change of said fact to the Minister of Health, Labour, and Welfare and to the prefectural governor who entrusted said Organization that Prepares Registration Examination Questions to conduct Examination Question Preparation Affairs pursuant to the provisions of Article 69-11, paragraph (1) (herein referred to as "Entrusting Prefectural Governor").
3 厚生労働大臣は、前項の届出があったときは、その旨を公示しなければならない。
(3) The Minister of Health, Labour, and Welfare, when a notification of said change is received as set forth in the preceding paragraph, shall issue public notice of said fact.
(役員の選任及び解任)
(Appointment and Dismissal of Officers)
第六十九条の十五 登録試験問題作成機関は、役員を選任し、又は解任したときは、遅滞なく、その旨を厚生労働大臣に届け出なければならない。
Article 69-15 An Organization that Prepares Registration Examination Questions, when it appoints or dismisses an Officer, shall notify without delay the Minister of Health, Labour, and Welfare of said fact.
(試験委員の選任及び解任)
(Appointment and Dismissal of Examination Board)
第六十九条の十六 登録試験問題作成機関は、第六十九条の十三第一号の試験委員を選任し、又は解任したときは、遅滞なく、その旨を厚生労働大臣に届け出なければならない。
Article 69-16 An Organization that Prepares Registration Examination Questions, when it appoints or dismisses an examination board as set forth in Article 69-13, paragraph (1), shall notify without delay the Minister of Health, Labour, and Welfare of said fact.
(秘密保持義務等)
(Confidentiality Obligations, etc.)
第六十九条の十七 登録試験問題作成機関の役員若しくは職員(第六十九条の十三第一号の試験委員を含む。次項において同じ。)又はこれらの職にあった者は、試験問題作成事務に関して知り得た秘密を漏らしてはならない。
Article 69-17 (1) An Officer or other personnel of an Organization that Prepares Registration Examination Questions (including an examination board as set forth in Article 69-13, paragraph (1); the same shall apply in the following paragraph) or a person that held this occupation shall not divulge any confidential information that said person learns concerning any Examination Question Preparation Affairs.
2 試験問題作成事務に従事する登録試験問題作成機関の役員又は職員は、刑法その他の罰則の適用については、法令により公務に従事する職員とみなす。
(2) An Officer or other personnel of an Organization that Prepares Registration Examination Questions who engages in Examination Question Preparation Affairs shall be deemed as personnel that engage in public service pursuant to the provisions of laws and regulations with regard to application of the Penal Code and other penal provisions.
(試験問題作成事務規程)
(Rules for Examination Question Preparation Affairs)
第六十九条の十八 登録試験問題作成機関は、試験問題作成事務の開始前に、厚生労働省令で定める試験問題作成事務の実施に関する事項について試験問題作成事務規程を定め、厚生労働大臣の認可を受けなければならない。これを変更しようとするときも、同様とする。
Article 69-18 (1) An Organization that Prepares Registration Examination Questions, prior to commencing Examination Question Preparation Affairs, shall stipulate Rules of Examination Question Preparation Affairs with regard to matters pertaining to the conduct of Examination Question Preparation Affairs as determined by an Ordinance of the Ministry of Health, Labour, and Welfare, and obtain the approval of the Minister of Health, Labour, and Welfare; the same shall apply when said rules are changed.
2 厚生労働大臣は、前項の規定により認可をした試験問題作成事務規程が試験問題作成事務の適正かつ確実な実施上不適当となったと認めるときは、登録試験問題作成機関に対し、これを変更すべきことを命ずることができる。
(2) The Minister of Health, Labour, and Welfare, when it is determined that the Rules of Examination Question Preparation Affairs that are approved pursuant to the provisions of the preceding paragraph have become inappropriate for the proper and assured conduct of Examination Question Preparation Affairs, shall order an Organization that Prepares Registration Examination Questions to change said rules.
(財務諸表等の備付け及び閲覧等)
(Maintenance and Inspection of Financial Statements, etc.)
第六十九条の十九 登録試験問題作成機関は、毎事業年度経過後三月以内に、その事業年度の財産目録、貸借対照表及び損益計算書又は収支計算書並びに事業報告書(その作成に代えて電磁的記録(電子的方式、磁気的方式その他の人の知覚によっては認識することができない方式で作られる記録であって、電子計算機による情報処理の用に供されるものをいう。以下この条において同じ。)の作成がされている場合における当該電磁的記録を含む。次項及び第二百十一条の二において「財務諸表等」という。)を作成し、五年間登録試験問題作成機関の事務所に備えて置かなければならない。
Article 69-19 (1) An Organization that Prepares Registration Examination Questions, within three months from the end of every fiscal year, shall prepare a schedule of inventories, a Statement of Financial Position, Statement of Operations, Cash Flow Statement, and business report of such fiscal year (including an electromagnetic record (a record in an electronic format, a magnetic format, or any other format not recognizable to human perception that is used for information processing by a computer; the same shall apply herein this Article) when said electromagnetic record is prepared in lieu of said financial statements, etc.; herein referred to as "Financial Statements, etc." in the following paragraph, and Article 211-2) and maintain said Financial Statements, etc., in the Business Office of the Organization that Prepares Registration Examination Questions for five years.
2 介護支援専門員実務研修受講試験を受けようとする者その他の利害関係人は、登録試験問題作成機関の業務時間内は、いつでも、次に掲げる請求をすることができる。ただし、第二号又は第四号の請求をするには、登録試験問題作成機関の定めた費用を支払わなければならない。
(2) A person that intends to undertake the Examination for Long-Term Care Support Specialist or other interested person may request any time within the business hours of an Organization that Prepares Registration Examination Questions the items listed below, however, provided that said person shall pay the expenses specified by and pay to the Organization that Prepares Registration Examination Questions as requested, as set forth in item (ii) and item (iv):
一 財務諸表等が書面をもって作成されているときは、当該書面の閲覧又は謄写の請求
(i) when the Financial Statements, etc., are prepared on paper, a request of inspection or copy of said documents;
二 前号の書面の謄本又は抄本の請求
(ii) a request of transcripts or extracts of the documents as set forth in the preceding paragraph;
三 財務諸表等が電磁的記録をもって作成されているときは、当該電磁的記録に記録された事項を厚生労働省令で定める方法により表示したものの閲覧又は謄写の請求
(iii) when the Financial Statements, etc., are prepared as an electromagnetic record, request inspection or copy of matters recorded in said electromagnetic record and a display shown of the same by a method as determined by an Ordinance of the Ministry of Health, Labour, and Welfare;
四 前号の電磁的記録に記録された事項を電磁的方法であって厚生労働省令で定めるものにより提供することの請求又は当該事項を記載した書面の交付の請求
(iv) a request to provide matters in an electromagnetic record as set forth in the preceding paragraph by a method as determined by an Ordinance of the Ministry of Health, Labour, and Welfare, or to deliver the documents stated by said matters.
(帳簿の備付け等)
(Maintenance of Records, etc.)
第六十九条の二十 登録試験問題作成機関は、厚生労働省令で定めるところにより、試験問題作成事務に関する事項で厚生労働省令で定めるものを記載した帳簿を備え、保存しなければならない。
Article 69-20 An Organization that Prepares Registration Examination Questions, pursuant to the provisions of an Ordinance of the Ministry of Health, Labour, and Welfare, shall keep and maintain records of all matters concerning Examination Question Preparation Affairs as determined by an Ordinance of the Ministry of Health, Labour, and Welfare, and ensure said matters are recorded.
(適合命令)
(Order for Conformity)
第六十九条の二十一 厚生労働大臣は、登録試験問題作成機関が第六十九条の十三各号のいずれかに適合しなくなったと認めるときは、その登録試験問題作成機関に対し、これらの規定に適合するため必要な措置をとるべきことを命ずることができる。
Article 69-21 The Minister of Health, Labour, and Welfare, when it is determined that an Organization that Prepares Registration Examination Questions is not conforming with any of the items of Article 69-13, may order said Organization that Prepares Registration Examination Questions to take the necessary measures to conform with these provisions.
(報告及び検査)
(Reports and Inspections)
第六十九条の二十二 厚生労働大臣は、試験問題作成事務の適正な実施を確保するため必要があると認めるときは、登録試験問題作成機関に対し、試験問題作成事務の状況に関し必要な報告を求め、又は当該職員に関係者に対して質問させ、若しくは登録試験問題作成機関の事務所に立ち入り、その帳簿書類その他の物件を検査させることができる。
Article 69-22 (1) The Minister of Health, Labour, and Welfare, when it is determined to be necessary to ensure the proper conduct of Examination Question Preparation Affairs, may request an Organization that Prepares Registration Examination Questions to provide necessary reports concerning the status of Examination Question Preparation Affairs, direct said personnel to answer the questions of a relevant person, enter the Business Office of an Organization that Prepares Registration Examination Questions in order to inspect record books and documents, and other items.
2 委任都道府県知事は、その行わせることとした試験問題作成事務の適正な実施を確保するため必要があると認めるときは、登録試験問題作成機関に対し、試験問題作成事務の状況に関し必要な報告を求め、又は当該職員に関係者に対して質問させ、若しくは登録試験問題作成機関の事務所に立ち入り、その帳簿書類その他の物件を検査させることができる。
(2) An Entrusting Prefectural Governor, when it is determined to be necessary to ensure the proper conduct of Examination Question Preparation Affairs that said prefectural governor entrusted, may request an Organization that Prepares Registration Examination Questions to provide necessary reports concerning the status of Examination Question Preparation Affairs, direct its personnel to ask questions to the relevant Persons, enter the Business Office of an Organization that Prepares Registration Examination Questions in order to inspect record books and documents, and other items.
3 第二十四条第三項の規定は前二項の規定による質問又は検査について、同条第四項の規定は前二項の規定による権限について準用する。
(3) The provisions of Article 24, paragraph (3) shall apply mutatis mutandis to questions and inspections pursuant to the provisions of the preceding two paragraphs and the provisions of paragraph (4) of the same Article shall apply mutatis mutandis to the authority granted pursuant to the provisions of the preceding two paragraphs.
(試験問題作成事務の休廃止)
(Discontinuance and Abolishment of Examination Question Preparation Affairs)
第六十九条の二十三 登録試験問題作成機関は、厚生労働大臣の許可を受けなければ、試験問題作成事務の全部又は一部を休止し、又は廃止してはならない。
Article 69-23 (1) An Organization that Prepares Registration Examination Questions shall not discontinue or abolish the whole or a part of the Examination Question Preparation Affairs without the approval of the Minister of Health, Labour, and Welfare.
2 厚生労働大臣は、前項の規定による許可をしようとするときは、関係委任都道府県知事の意見を聴かなければならない。
(2) The Minister of Health, Labour, and Welfare, when granting an approval pursuant to the provisions of the preceding paragraph, shall hear the opinions of relevant Entrusting Prefectural Governor.
3 厚生労働大臣は、第一項の規定による許可をしたときは、その旨を、関係委任都道府県知事に通知するとともに、公示しなければならない。
(3) The Minister of Health, Labour, and Welfare, when granting an approval pursuant to the provisions of paragraph (1), shall issue public notice of and provide notification of said fact to the relevant Entrusting Prefectural Governor.
(登録の取消し等)
(Rescission of Registration, etc.)
第六十九条の二十四 厚生労働大臣は、登録試験問題作成機関が第六十九条の十二第一号又は第三号に該当するに至ったときは、当該登録試験問題作成機関の登録を取り消さなければならない。
Article 69-24 (1) The Minister of Health, Labour, and Welfare, when an Organization that Prepares Registration Examination Questions becomes as defined by Article 69-12, item (i) or item (iii), shall rescind the registration of said Organization that Prepares Registration Examination Questions.
2 厚生労働大臣は、登録試験問題作成機関が次の各号のいずれかに該当するときは、当該登録試験問題作成機関に対し、その登録を取り消し、又は期間を定めて試験問題作成事務の全部若しくは一部の停止を命ずることができる。
(2) The Minister of Health, Labour, and Welfare, when an Organization that Prepares Registration Examination Questions corresponds to any of the following items, may rescind the registration of said Organization that Prepares Registration Examination Questions, or specify a period of suspension for the whole or a part of any Examination Question Preparation Affairs:
一 不正な手段により第六十九条の十一第一項の登録を受けたとき。
(i) when the registration as set forth in Article 69-11, paragraph (1) is performed by wrongful means;
二 第六十九条の十四第二項、第六十九条の十五、第六十九条の十六、第六十九条の十九第一項、第六十九条の二十又は前条第一項の規定に違反したとき。
(ii) when said Organization violates a provision of Article 69-14, paragraph (2), Article 69-15, Article 69-16, Article 69-19, paragraph (1), Article 69-20 or paragraph (1) of the preceding Article;
三 正当な理由がないのに第六十九条の十九第二項各号の規定による請求を拒んだとき。
(iii) when said Organization refuses a request pursuant to the provisions of Article 69-19, paragraph (2) without a justifiable reason;
四 第六十九条の十八第一項の認可を受けた試験問題作成事務規程によらないで試験問題作成事務を行ったとき。
(iv) when said Organization conducts Examination Question Preparation Affairs without conforming to the Rules of Examination Question Preparation Affairs that are approved pursuant to the provisions of Article 69-18, paragraph (1);
五 第六十九条の十八第二項又は第六十九条の二十一の命令に違反したとき。
(v) when said Organization violates an order as set forth in Article 69-18, paragraph (2) or Article 69-21.
3 厚生労働大臣は、前二項の規定により登録を取り消し、又は前項の規定により試験問題作成事務の全部若しくは一部の停止を命じたときは、その旨を、関係委任都道府県知事に通知するとともに、公示しなければならない。
(3) The Minister of Health, Labour, and Welfare, when rescinding a registration pursuant to the provisions of the preceding two paragraphs and ordering a suspension of the whole or a part of Examination Question Preparation Affairs pursuant to the provisions of the preceding paragraph, shall issue public notice of the relevant Entrusting Prefectural Governor and publicly give notice of said fact.
(委任都道府県知事による試験問題作成事務の実施)
(Implementation of Examination Question Preparation Affairs by an Entrusting Prefectural Governor)
第六十九条の二十五 委任都道府県知事は、登録試験問題作成機関が第六十九条の二十三第一項の規定により試験問題作成事務の全部若しくは一部を休止したとき、厚生労働大臣が前条第二項の規定により登録試験問題作成機関に対し試験問題作成事務の全部若しくは一部の停止を命じたとき、又は登録試験問題作成機関が天災その他の事由により試験問題作成事務の全部若しくは一部を実施することが困難となった場合において厚生労働大臣が必要があると認めるときは、第六十九条の十一第三項の規定にかかわらず、当該試験問題作成事務の全部又は一部を行うものとする。
Article 69-25 (1) When an Organization that Prepares Registration Examination Questions discontinues the whole or a part of Examination Question Preparation Affairs pursuant to the provisions of Article 69-23, paragraph (1), or when the Minister of Health, Labour, and Welfare orders an Organization that Prepares Registration Examination Questions pursuant to the provisions of paragraph (2) of the preceding Article to suspend the whole or a part of Examination Question Preparation Affairs, or when it has become difficult for an Organization that Prepares Registration Examination Questions to conduct the whole or a part of Examination Question Preparation Affairs due to a disaster or other reasons, the Entrusting Prefectural Governor, when the Minister of Health, Labour, and Welfare determines it necessary, shall conduct the whole or a part of said Examination Question Preparation Affairs notwithstanding the provisions of Article 69-11, paragraph (3).
2 厚生労働大臣は、委任都道府県知事が前項の規定により試験問題作成事務を行うこととなるとき、又は委任都道府県知事が同項の規定により試験問題作成事務を行うこととなる事由がなくなったときは、速やかにその旨を当該委任都道府県知事に通知しなければならない。
(2) The Minister of Health, Labour, and Welfare, when an Entrusting Prefectural Governor is conducting the Examination Question Preparation Affairs pursuant to the provisions of the preceding paragraph and when the reason is no longer valid for an Entrusting Prefectural Governor to conduct the Examination Question Preparation Affairs pursuant to the provisions of the same paragraph, shall provide notice of said fact immediately to said Entrusting Prefectural Governor.
(試験問題作成事務に係る手数料)
(Fee Pertaining to Examination Question Preparation Affairs)
第六十九条の二十六 委任都道府県知事は、地方自治法第二百二十七条の規定に基づき試験問題作成事務に係る手数料を徴収する場合においては、第六十九条の十一第一項の規定により登録試験問題作成機関が行う試験問題作成事務に係る介護支援専門員実務研修受講試験を受けようとする者に、条例で定めるところにより、当該手数料を当該登録試験問題作成機関に納めさせ、その収入とすることができる。
Article 69-26 An Entrusting Prefectural Governor, in a case when collecting a fee pertaining to Examination Question Preparation Affairs based on the provisions of Article 227 of the Local Autonomy Act, may direct a person that intends to undertake an Examination for Long-Term Care Support Specialist pertaining to Examination Question Preparation Affairs provided by an Organization that Prepares Registration Examination Questions pursuant to the provisions of Article 69-11, paragraph (1) and pursuant to the provisions of a prefectural ordinance, to pay said fee to said Organization that Prepares Registration Examination Questions as income.
(指定試験実施機関の指定)
(Appointment of Designated Testing Agency)
第六十九条の二十七 都道府県知事は、その指定する者(以下「指定試験実施機関」という。)に、介護支援専門員実務研修受講試験の実施に関する事務(試験問題作成事務を除く。以下「試験事務」という。)を行わせることができる。
Article 69-27 (1) A prefectural governor may designate a person (herein referred to as "Designated Testing Agency") to operate affairs concerning implementation of an Examination for Long-Term Care Support Specialist (except for Examination Question Preparation Affairs; herein referred to as "Examination Affairs").
2 前条の規定は、指定試験実施機関が行う試験事務に係る手数料について準用する。
(2) The provisions of the preceding Article shall apply mutatis mutandis to a fee pertaining to Examination Affairs provided by a Designated Testing Agency.
(秘密保持義務等)
(Confidentiality Obligations, etc.)
第六十九条の二十八 指定試験実施機関(その者が法人である場合にあっては、その役員。次項において同じ。)若しくはその職員又はこれらの職にあった者は、試験事務に関して知り得た秘密を漏らしてはならない。
Article 69-28 (1) A Designated Testing Agency (in a case when said person is a juridical person, an Officer of said person; the same shall apply in the following paragraph) or its personnel, or a person that held this occupation shall not divulge any confidential information that was learned pertaining to Examination Affairs.
2 試験事務に従事する指定試験実施機関又はその職員は、刑法その他の罰則の適用については、法令により公務に従事する職員とみなす。
(2) A Designated Testing Agency which engages in Examination Affairs or its personnel shall be deemed as personnel that engage in public service pursuant to the provisions of laws and regulations, with regard to application of the Penal Code or other penal provisions.
(監督命令等)
(Supervisory Orders, etc.)
第六十九条の二十九 都道府県知事は、試験事務の適正な実施を確保するため必要があると認めるときは、指定試験実施機関に対し、試験事務に関し監督上必要な命令をすることができる。
Article 69-29 A prefectural governor, when it is determined that it is necessary for ensuring the proper conduct of Examination Affairs, may give necessary orders for supervision concerning Examination Affairs to a Designated Testing Agency.
(報告及び検査)
(Reports and Inspections)
第六十九条の三十 都道府県知事は、試験事務の適正な実施を確保するため必要があると認めるときは、指定試験実施機関に対し、試験事務の状況に関し必要な報告を求め、又は当該職員に関係者に対して質問させ、若しくは指定試験実施機関の事務所に立ち入り、その設備若しくは帳簿書類その他の物件を検査させることができる。
Article 69-30 (1) A prefectural governor, when it is determined that it is necessary for ensuring proper conduct of Examination Affairs, may request a Designated Testing Agency to submit the necessary reports concerning the status of Examination Affairs, direct its personnel to ask questions of the relevant person, enter the Business Office of a Designated Testing Agency in order to inspect said facility, record books and documents, and other items.
2 第二十四条第三項の規定は前項の規定による質問又は検査について、同条第四項の規定は前項の規定による権限について準用する。
(2) The provisions of Article 24, paragraph (3) shall apply mutatis mutandis to questions and inspections, and the provisions of paragraph (4) of the same Article shall apply mutatis mutandis to the authority granted pursuant to the provisions of the preceding paragraph.
(合格の取消し等)
(Rescission of Passing an Examination, etc.)
第六十九条の三十一 都道府県知事は、不正の手段によって介護支援専門員実務研修受講試験を受け、又は受けようとした者に対しては、合格の決定を取り消し、又はその介護支援専門員実務研修受講試験を受けることを禁止することができる。
Article 69-31 (1) A prefectural governor may rescind an application to take an examination or a judgment of passing an examination for a person that completed or intends to complete an Examination for Long-Term Care Support Specialist by wrongful means, or is prohibited from taking said Examination for Long-Term Care Support Specialist.
2 指定試験実施機関は、その指定をした都道府県知事の前項に規定する職権を行うことができる。
(2) A Designated Testing Agency may exercise the authority as prescribed in the preceding paragraph of the prefectural governor who issued said designation to said Designated Testing Agency.
(政令への委任)
(Delegation to a Cabinet Order)
第六十九条の三十二 第六十九条の二十七から前条までに定めるもののほか、指定試験実施機関に関し必要な事項は、政令で定める。
Article 69-32 In addition to the provisions specified in Article 69-27 through the preceding Article, other necessary matters concerning a Designated Testing Agency shall be provided by a Cabinet Order.
(指定研修実施機関の指定等)
(Appointment of Designated Training Agencies)
第六十九条の三十三 都道府県知事は、その指定する者(以下「指定研修実施機関」という。)に、介護支援専門員実務研修及び更新研修の実施に関する事務(以下「研修事務」という。)を行わせることができる。
Article 69-33 (1) A prefectural governor may designate a person (herein referred to as "Designated Training Agency") to conduct affairs concerning the implementation of a Long-Term Care Support Specialist Internship and Training for Renewal (herein referred to as "Training Affairs").
2 第六十九条の二十七第二項、第六十九条の二十九及び第六十九条の三十の規定は、指定研修実施機関について準用する。この場合において、これらの規定中「指定試験実施機関」とあるのは「指定研修実施機関」と、「試験事務」とあるのは「研修事務」と読み替えるものとする。
(2) The provisions of Article 69-27, paragraph (2), Article 69-29, and Article 69-30 shall apply mutatis mutandis to a Designated Training Agency. In this case, the terms "Designated Testing Agency" and "Examination Affairs" in these provisions shall be deemed to be replaced with "Designated Training Agency" and "Training Affairs," respectively.
3 前二項に定めるもののほか、指定研修実施機関に関し必要な事項は、政令で定める。
(3) In addition to the provisions of the preceding two paragraphs, other necessary matters concerning a Designated Training Agency shall be provided by a Cabinet Order.
第三款 義務等
Subsection 3 Obligations, etc.
(介護支援専門員の義務)
(Obligations of a Long-Term Care Support Specialist)
第六十九条の三十四 介護支援専門員は、その担当する要介護者等の人格を尊重し、常に当該要介護者等の立場に立って、当該要介護者等に提供される居宅サービス、地域密着型サービス、施設サービス、介護予防サービス又は地域密着型介護予防サービスが特定の種類又は特定の事業者若しくは施設に不当に偏ることのないよう、公正かつ誠実にその業務を行わなければならない。
Article 69-34 (1) A Long-Term Care Support Specialist shall operate said business correctly and faithfully with respect to the personality of an Insured Person Requiring Long-Term Care, etc., that is under the responsibility of said Specialist, always from the viewpoint of said Insured Person Requiring Long-Term Care, etc., in order to prevent placing inappropriate or false emphasis on a specific type, or a specific provider or facility that provides In-Home Service, Community-Based Service, Facility Service, Preventive Long-Term Care Service, or Community-Based Service for Preventive Long-Term Care that is provided to said Insured Person Requiring Long-Term Care, etc.
2 介護支援専門員は、厚生労働省令で定める基準に従って、介護支援専門員の業務を行わなければならない。
(2) A Long-Term Care Support Specialist shall perform the business of Long-Term Care Support Specialist according to standards as determined by an Ordinance of the Ministry of Health, Labour, and Welfare.
(名義貸しの禁止等)
(Prohibition on Use of Name, etc.)
第六十九条の三十五 介護支援専門員は、介護支援専門員証を不正に使用し、又はその名義を他人に介護支援専門員の業務のため使用させてはならない。
Article 69-35 A Long-Term Care Support Specialist shall not permit others to wrongfully use the Long-Term Care Support Specialist Certification or the business name of said Long-Term Care Support Specialist.
(信用失墜行為の禁止)
(Prohibition of Acts to Damage Impartiality)
第六十九条の三十六 介護支援専門員は、介護支援専門員の信用を傷つけるような行為をしてはならない。
Article 69-36 A Long-Term Care Support Specialist shall not commit any act that may impair the impartiality of or confidence placed in said Long-Term Care Support Specialist.
(秘密保持義務)
(Confidentiality Obligations, etc.)
第六十九条の三十七 介護支援専門員は、正当な理由なしに、その業務に関して知り得た人の秘密を漏らしてはならない。介護支援専門員でなくなった後においても、同様とする。
Article 69-37 A Long-Term Care Support Specialist shall not divulge any confidential information of an individual person that is learned pertaining to said business without a justifiable basis. The same provision shall apply after said person ceases to be a Long-Term Care Support Specialist.
(報告等)
(Reporting, etc.)
第六十九条の三十八 都道府県知事は、介護支援専門員の業務の適正な遂行を確保するため必要があると認めるときは、その登録を受けている介護支援専門員及び当該都道府県の区域内でその業務を行う介護支援専門員に対し、その業務について必要な報告を求めることができる。
Article 69-38 (1) A prefectural governor, when it is determined that it is necessary for ensuring proper execution of the business of a Long-Term Care Support Specialist, may request necessary reports of said business from a registered Long-Term Care Support Specialist and a Long-Term Care Support Specialist that operates within the area governed by said prefectural governor.
2 都道府県知事は、その登録を受けている介護支援専門員又は当該都道府県の区域内でその業務を行う介護支援専門員が第六十九条の三十四の規定に違反していると認めるときは、当該介護支援専門員に対し、必要な指示をし、又は当該都道府県知事の指定する研修を受けるよう命ずることができる。
(2) A prefectural governor, when it is determined that a registered Long-Term Care Support Specialist or a Long-Term Care Support Specialist that operates within the area governed by said prefectural governor violates the provisions of Article 69-34, may provide necessary instructions to said Long-Term Care Support Specialist and order said Specialist to undertake the training designated by said prefectural governor.
3 都道府県知事は、その登録を受けている介護支援専門員又は当該都道府県の区域内でその業務を行う介護支援専門員が前項の規定による指示又は命令に従わない場合には、当該介護支援専門員に対し、一年以内の期間を定めて、介護支援専門員として業務を行うことを禁止することができる。
(3) A prefectural governor, in a case that a registered Long-Term Care Support Specialist or a Long-Term Care Support Specialist that operates within the area governed by said prefectural governor disobeys instructions or orders pursuant to the provisions of the preceding paragraph, may prohibit said Long-Term Care Support Specialist from operating as a Long-Term Care Support Specialist by specifying a period that is less than one (1) year.
4 都道府県知事は、他の都道府県知事の登録を受けている介護支援専門員に対して前二項の規定による処分をしたときは、遅滞なく、その旨を、当該介護支援専門員の登録をしている都道府県知事に通知しなければならない。
(4) A prefectural governor, when he or she executes an action pursuant to the provisions of the preceding two paragraphs to a Long-Term Care Support Specialist who is registered in an area governed by a different prefectural governor, shall notify without delay the prefectural governor that is governing the area where said Long-Term Care Support Specialist is registered of said fact.
(登録の消除)
(Deletion and Rescission of Registration)
第六十九条の三十九 都道府県知事は、その登録を受けている介護支援専門員が次の各号のいずれかに該当する場合には、当該登録を消除しなければならない。
Article 69-39 (1) A prefectural governor, when a Long-Term Care Support Specialist that is registered in an area governed by said prefectural governor corresponds to any of the following items, shall delete and rescind said registration:
一 第六十九条の二第一項第一号から第三号までのいずれかに該当するに至った場合
(i) when a Specialist corresponds to any provision of Article 69-2, paragraph (1), item (i) to item (iii);
二 不正の手段により第六十九条の二第一項の登録を受けた場合
(ii) when a Specialist is registered as set forth in Article 69-2, paragraph (1) by a wrongful means;
三 不正の手段により介護支援専門員証の交付を受けた場合
(iii) when the Long-Term Care Support Specialist Certification is issued by a wrongful means;
四 前条第三項の規定による業務の禁止の処分に違反した場合
(iv) when a Specialist violates a prohibition of business ordered pursuant to the provisions of paragraph (3) of the preceding Article.
2 都道府県知事は、その登録を受けている介護支援専門員が次の各号のいずれかに該当する場合には、当該登録を消除することができる。
(2) A prefectural governor, in a case when a registered Long-Term Care Support Specialist corresponds to any of the following items, may delete and rescind said registration:
一 第六十九条の三十四から第六十九条の三十七までの規定に違反した場合
(i) when a Specialist violates a provision listed from Article 69-34 to Article 69-37;
二 前条第一項の規定により報告を求められて、報告をせず、又は虚偽の報告をした場合
(ii) when a Specialist is requested to report pursuant to the provisions of paragraph (1) of the preceding Article, but does not report or submits a false report;
三 前条第二項の規定による指示又は命令に違反し、情状が重い場合
(iii) when a Specialist violates an instruction or order pursuant to the provisions of paragraph (2) of the preceding Article and said circumstances are considered serious.
3 第六十九条の二第一項の登録を受けている者で介護支援専門員証の交付を受けていないものが次の各号のいずれかに該当する場合には、当該登録をしている都道府県知事は、当該登録を消除しなければならない。
(3) When a person is registered as set forth in Article 69-2, paragraph (1) that has not been issued a Long-Term Care Support Specialist Certification as defined by any of the following items, the prefectural governor that provides said registration shall delete said registration:
一 第六十九条の二第一項第一号から第三号までのいずれかに該当するに至った場合
(i) when said person corresponds to any provision of Article 69-2, paragraph (1), item (i) to item (iii);
二 不正の手段により第六十九条の二第一項の登録を受けた場合
(ii) when said person is registered as set forth in Article 69-2, paragraph (1) by wrongful means;
三 介護支援専門員として業務を行った場合
(iii) when said person operates a business as a Long-Term Care Support Specialist.
第二節 指定居宅サービス事業者
Section 2 Designated In-Home Service Providers
(指定居宅サービス事業者の指定)
(Appointment as service provider of a Designated In-Home Service Provider)
第七十条 第四十一条第一項本文の指定は、厚生労働省令で定めるところにより、居宅サービス事業を行う者の申請により、居宅サービスの種類及び当該居宅サービスの種類に係る居宅サービス事業を行う事業所(以下この節において単に「事業所」という。)ごとに行う。
Article 70 (1) An appointment as service provider as set forth in the main clause of Article 41, paragraph (1) shall be provided pursuant to the provisions of an Ordinance of the Ministry of Health, Labour, and Welfare, by the submission of an application of a person that operates an In-Home Service Business, and by type of In-Home Service and provider that operates said In-Home Service Business pertaining to the type of said In-Home Service (hereinafter referred to simply as "Business Office" in this Section).
2 都道府県知事は、前項の申請があった場合において、第一号から第三号まで、第五号から第七号まで、第九号又は第十号(病院等により行われる居宅療養管理指導又は病院若しくは診療所により行われる訪問看護、訪問リハビリテーション、通所リハビリテーション若しくは短期入所療養介護に係る指定の申請にあっては、第二号から第十一号まで)のいずれかに該当するときは、第四十一条第一項本文の指定をしてはならない。
(2) A prefectural governor, in a case of an application to provide service as set forth in the preceding paragraph when defined by any provision of item (i) to item (iii), item (v) to item (vii), or item (ix) to item (x) (with regard to an application of appointment as service provider pertaining to Guidance for Management of In-Home Medical Long-Term Care provided by a Hospital, etc., Home-Visit Nursing provided by a hospital or a clinic, Home-Visit Rehabilitation, Outpatient Rehabilitation, or Short-Term Admission for Recuperation, item (ii) to item (xi)), shall not provide the appointment as service provider as set forth in the main clause of Article 41, paragraph (1):
一 申請者が法人でないとき。
(i) when the applicant is not a juridical person;
二 当該申請に係る事業所の従業者の知識及び技能並びに人員が、第七十四条第一項の厚生労働省令で定める基準及び同項の厚生労働省令で定める員数を満たしていないとき。
(ii) when the knowledge, skill, and number of personnel of the Business Office pertaining to said application do not meet standards as determined by an Ordinance of the Ministry of Health, Labour, and Welfare as set forth in Article 74, paragraph (1) and for the number of employees as determined by an Ordinance of the Ministry of Health, Labour, and Welfare as provided in the same paragraph;
三 申請者が、第七十四条第二項に規定する指定居宅サービスの事業の設備及び運営に関する基準に従って適正な居宅サービス事業の運営をすることができないと認められるとき。
(iii) when it is determined that the applicant cannot perform a proper In-Home Service Business in accordance with standards pertaining to facilities and management of a Designated In-Home Service Business as prescribed in Article 74, paragraph (2);
四 申請者が、禁錮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。
(iv) a person punished by imprisonment without compulsory labor and the execution of said penalty has not yet been completed or has not yet expired;
五 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。
(v) when the applicant is punished by a fine pursuant to the provisions of this Act or any other Act pertaining to medical service or the welfare of citizens as provided by a Cabinet Order and the execution of said penalty has not yet been completed or has not yet expired;
六 申請者が、第七十七条第一項又は第百十五条の二十九第六項の規定により指定を取り消され、その取消しの日から起算して五年を経過しない者(当該指定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(業務を執行する社員、取締役、執行役又はこれらに準ずる者をいい、相談役、顧問その他いかなる名称を有する者であるかを問わず、法人に対し業務を執行する社員、取締役、執行役又はこれらに準ずる者と同等以上の支配力を有するものと認められる者を含む。第五節において同じ。)又はその事業所を管理する者その他の政令で定める使用人(以下「役員等」という。)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、当該指定を取り消された者が法人でない病院等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病院等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。
(vi) when the applicant has been rescinded for an appointment as service provider pursuant to the provisions of Article 77, paragraph (1) or Article 115-29, paragraph (6) and five years have not elapsed from the date of said rescission (in a case when a person that has been rescinded for said appointment as service provider is a juridical person, including a person that is or was an Officer of said juridical person (which means an employee, director, or executive Officer that executes the business, or a person in an equivalent position and includes an employee, director, or executive Officer that executes business for a juridical person, or a person that shall be deemed to have the equivalent or higher ascendency of position to these persons; the same shall apply in Section 5), a person that manages said Business Office, or other personnel as provided by a Cabinet Order (herein referred to as "Officers, etc.") within sixty days prior to the date of notification pursuant to the provisions of Article 15 of the Administrative Procedures Act pertaining to said rescission and five years have not elapsed from the date of said rescission, and in a case when a person that has been rescinded for said appointment as service provider, is a Hospital, etc., that is not a juridical person, including a person that is or was a manager of said Hospital, etc., within sixty days prior to the date of said rescission and five years have not elapsed from the date of said rescission;
七 申請者が、第七十七条第一項又は第百十五条の二十九第六項の規定による指定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七十五条の規定による事業の廃止の届出をした者(当該事業の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。
(vii) when the applicant who provided notification of abolishment of business pursuant to the provisions of Article 75 from the date of notification pursuant to the provisions of Article 15 of the Administrative Procedures Act pertaining to rescission of appointment as service provider pursuant to the provisions of Article 77, paragraph (1) or Article 115-29, paragraph (6) until the date when the appointment as service provider is rescinded or when it is determined not to rescind the appointment as service provider (except for a person that has a reasonable basis for said abolishment of business) and five years have not elapsed from the date of said notification;
八 前号に規定する期間内に第七十五条の規定による事業の廃止の届出があった場合において、申請者が、同号の通知の日前六十日以内に当該届出に係る法人(当該事業の廃止について相当の理由がある法人を除く。)の役員等又は当該届出に係る法人でない病院等(当該事業の廃止について相当の理由があるものを除く。)の管理者であった者で、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。
(viii) in a case when abolishment of business pursuant to the provisions of Article 75 was duly provided by notification during the period pursuant to the provisions of the preceding item, when the applicant who was an Officer, etc., of a juridical person (except for a juridical person that has a reasonable basis for said abolishment of business) pertaining to said notification or a manager of a Hospital, etc., that is not a juridical person pertaining to said notification (except for a juridical person that has a reasonable basis for said abolishment of business) within sixty days before the notification as set forth in the same item, and five years have not elapsed from the date of said notification;
九 申請者が、指定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。
(ix) when the applicant 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;
十 申請者が、法人で、その役員等のうちに第四号から前号までのいずれかに該当する者のあるものであるとき。
(x) when the applicant is a juridical person and any said Officer, etc., corresponds to any of the provisions of item (iv) to the preceding item;
十一 申請者が、法人でない病院等で、その管理者が第四号から第九号までのいずれかに該当する者であるとき。
(xi) when the applicant is a Hospital, etc., which is not a juridical person and a manager of said Provider corresponds to any provision of item (iv) to item (ix).
3 都道府県知事は、介護専用型特定施設入居者生活介護(介護専用型特定施設に入居している要介護者について行われる特定施設入居者生活介護をいう。以下同じ。)につき第一項の申請があった場合において、当該申請に係る事業所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。)における介護専用型特定施設入居者生活介護の利用定員の総数及び地域密着型特定施設入居者生活介護の利用定員の総数の合計数が、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専用型特定施設入居者生活介護の必要利用定員総数及び地域密着型特定施設入居者生活介護の必要利用定員総数の合計数に既に達しているか、又は当該申請に係る事業者の指定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、第四十一条第一項本文の指定をしないことができる。
(3) In a case of an application as set forth in paragraph (1) for Daily Life Care of a Patient Admitted to a Specialized Long-Term Care Specified Facility (which means Daily Life Long-Term Care Admitted to a Specified Facility provided to a Person Requiring Long-Term Care who is admitted to a Specialized Long-Term Care Specified Facility; the same shall apply hereinafter), a prefectural governor, when the total sum of the capacity of users of Daily Life Care of a Patient Admitted to a Specialized Long-Term Care Specified Facility and the total capacity of users of Daily Life Long-Term Care for a Person Admitted to a Community-Based Specified Facility in the area including the location of the Business Office pertaining to said application has reached or is it determined to exceed due to the appointment as service provider of said business pertaining to said application the total sum of the total capacity of users of Daily Life Care of a Patient Admitted to a Specialized Long-Term Care Specified Facility and the total capacity of users of Daily Life Long-Term Care for a Person Admitted to a Community-Based Specified Facility in the area as prescribed by a Prefectural Insured Long-Term Care Support Project Plan provided by said prefecture pursuant to the provisions of paragraph (1) of the same Article, or when it is determined that said application may interfere with the accomplishment of said Prefectural Insured Long-Term Care Support Project Plan, may determine not to execute the appointment as service provider as set forth in the main clause of Article 41, paragraph (1).
4 都道府県知事は、混合型特定施設入居者生活介護(介護専用型特定施設以外の特定施設に入居している要介護者について行われる特定施設入居者生活介護をいう。以下同じ。)につき第一項の申請があった場合において、当該申請に係る事業所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。)における混合型特定施設入居者生活介護の推定利用定員(厚生労働省令で定めるところにより算定した定員をいう。)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混合型特定施設入居者生活介護の必要利用定員総数に既に達しているか、又は当該申請に係る事業者の指定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、第四十一条第一項本文の指定をしないことができる。
(4) In a case of an application as set forth in paragraph (1) for Daily Life Activities of a Long-Term Care Patient Admitted to a Combined Specified Facility (which means Daily Life Long-Term Care Admitted to a Specified Facility provided for a Person Requiring Long-Term Care who is a resident in a Specified Facility other than a Specialized Long-Term Care Specified Facility; the same shall apply herein), a prefectural governor, when the total of assumed capacity of users of Daily Life Activities of a Long-Term Care Patient Admitted to a Combined Specified Facility (which means a capacity calculated pursuant to the provisions of an Ordinance of the Ministry of Health, Labour, and Welfare) in the area including the location of the Business Office pertaining to said application (which means an area provided by said prefecture pursuant to the provisions of Article 118, paragraph (2), item (i)) has been reached or is it determined that said capacity will be exceeded by the appointment as service provider pertaining to said application the total of prospective capacity of necessary users of Daily Life Activities of a Long-Term Care Patient Admitted to a Combined Specified Facility (which means a capacity calculated pursuant to the provisions of an Ordinance of the Ministry of Health, Labour, and Welfare) in said area provided by a Prefectural Insured Long-Term Care Support Project Plan provided by said prefecture pursuant to the provisions of paragraph (1) of the same Article, or when it is determined that said application may interfere with the accomplishment of said Prefectural Insured Long-Term Care Support Project Plan, may determine not to execute an appointment as service provider as set forth in the main clause of Article 41, paragraph (1).
5 都道府県知事は、第四十一条第一項本文の指定(特定施設入居者生活介護その他の厚生労働省令で定める居宅サービスに係るものに限る。)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。
(5) A prefectural governor, when he or she intends to determine an appointment as service provider as set forth in the main clause of Article 41, paragraph (1) (limited to Daily Life Long-Term Care Admitted to a Specified Facility or other In-Home Service as determined by an Ordinance of the Ministry of Health, Labour, and Welfare), shall provide notice of matters as determined by an Ordinance 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.
(指定の更新)
(Renewal of Appointment as service provider)
第七十条の二 第四十一条第一項本文の指定は、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。
Article 70-2 (1) An appointment as service provider as set forth in the main clause of Article 41, paragraph (1), if it is not renewed within a period of six years, shall cease to be effective when said period expires.
2 前項の更新の申請があった場合において、同項の期間(以下この条において「指定の有効期間」という。)の満了の日までにその申請に対する処分がされないときは、従前の指定は、指定の有効期間の満了後もその処分がされるまでの間は、なおその効力を有する。
(2) In a case of an application of renewal as set forth in the preceding paragraph, when the disposition of said application does not occur prior to the expiry of the period as set forth in the same paragraph (herein referred to as "Effective Period of Designation as Service Provider" in this Article), the prior appointment as service provider shall remain effective after expiry of the Effective Period of Designation as Service Provider until a determination is reached regarding said application.
3 前項の場合において、指定の更新がされたときは、その指定の有効期間は、従前の指定の有効期間の満了の日の翌日から起算するものとする。
(3) In a case as set forth in the preceding paragraph, when the appointment as service provider is renewed, said Effective Period of Designation as Service Provider shall be from the date following the date of expiry of the prior Effective Period of Designation as Service Provider.
4 前条の規定は、第一項の指定の更新について準用する。
(4) The provisions of the preceding Article shall apply mutatis mutandis to a renewal of appointment as service provider as set forth in paragraph (1).
(指定居宅サービス事業者の特例)
(Exception of a Designated In-Home Service Provider)
第七十一条 病院等について、健康保険法第六十三条第三項第一号の規定による保険医療機関又は保険薬局の指定があったとき(同法第六十九条の規定により同号の指定があったものとみなされたときを含む。)は、その指定の時に、当該病院等の開設者について、当該病院等により行われる居宅サービス(病院又は診療所にあっては居宅療養管理指導その他厚生労働省令で定める種類の居宅サービスに限り、薬局にあっては居宅療養管理指導に限る。)に係る第四十一条第一項本文の指定があったものとみなす。ただし、当該病院等の開設者が、厚生労働省令で定めるところにより別段の申出をしたとき、又はその指定の時前に第七十七条第一項若しくは第百十五条の二十九第六項の規定により第四十一条第一項本文の指定を取り消されているときは、この限りでない。
Article 71 (1) With regard to a Hospital, etc., when a medical facility that provides insured services or pharmacy that provides insured services is appointed pursuant to the provisions of Article 63, paragraph (3), item (i) of the Health Insurance Act (including when it is determined that appointment as service provider as set forth in the same item was provided pursuant to the provisions of Article 69 of the same Act), it shall be deemed that the organizer of said Hospital, etc., was provided an appointment as service provider as set forth in the main clause of Article 41, paragraph (1) pertaining to In-Home Service provided by said Hospital, etc., (with regard to a hospital or a clinic, limited to Guidance for Management of In-Home Medical Long-Term Care and other types of In-Home Service as determined by an Ordinance of the Ministry of Health, Labour, and Welfare, and with regard to a pharmacy, limited to Guidance for Management of In-Home Medical Long-Term Care) at the time of said appointment as service provider, provided however, that this provision shall not apply when the organizer of the Hospital, etc., offers a different notification pursuant to the provisions of an Ordinance of the Ministry of Health, Labour, and Welfare or when the appointment as service provider as set forth in the main clause of Article 41, paragraph (1) is rescinded pursuant to the provisions of Article 77, paragraph(1) or Article 115-29, paragraph (6) prior to said appointment as service provider.
2 前項の規定により指定居宅サービス事業者とみなされた者に係る第四十一条第一項本文の指定は、当該指定に係る病院等について、健康保険法第八十条の規定による保険医療機関又は保険薬局の指定の取消しがあったときは、その効力を失う。
(2) An appointment as service provider as set forth in the main clause of Article 41, paragraph (1) pertaining to a person that was deemed as a Designated In-Home Service Provider pursuant to the provisions of the preceding paragraph, when appointment as service provider of a medical facility that provides insured services or pharmacy that provides insured services is rescinded pursuant to the provisions of Article 80 of the Health Insurance Act with regard to said Hospital, etc., pertaining to said appointment as service provider, shall cease to be effective.
第七十二条 介護老人保健施設又は介護療養型医療施設について、第九十四条第一項の許可又は第四十八条第一項第三号の指定があったときは、その許可又は指定の時に、当該介護老人保健施設又は介護療養型医療施設の開設者について、当該介護老人保健施設又は介護療養型医療施設により行われる居宅サービス(短期入所療養介護その他厚生労働省令で定める居宅サービスの種類に限る。)に係る第四十一条第一項本文の指定があったものとみなす。ただし、当該介護老人保健施設又は介護療養型医療施設の開設者が、厚生労働省令で定めるところにより、別段の申出をしたときは、この限りでない。
Article 72 (1) With regard to a Long-Term Care Health Facility or Sanatorium Medical Facility for the Elderly Requiring Long-Term Care when it is approved as set forth in Article 94, paragraph (1) or appointed as set forth in Article 48, paragraph (1), item (iii), it shall be deemed that the organizer of said Long-Term Care Health Facility or Sanatorium Medical Facility for the Elderly Requiring Long-Term Care shall be appointed as set forth in the main clause of Article 41, paragraph (1) pertaining to In-Home Service (limited to Short-Term Admission for Recuperation or a type of In-Home Service as determined by an Ordinance of the Ministry of Health, Labour, and Welfare) provided by said Long-Term Care Health Facility or Sanatorium Medical Facility for the Elderly Requiring Long-Term Care at the time of said approval or appointment as service provider, however, provided that this provision shall not apply when the organizer of said Long-Term Care Health Facility or Sanatorium Medical Facility for the Elderly Requiring Long-Term Care offers a different notification pursuant to the provisions of an Ordinance of the Ministry of Health, Labour, and Welfare.
2 前項の規定により指定居宅サービス事業者とみなされた者に係る第四十一条第一項本文の指定は、当該指定に係る介護老人保健施設又は介護療養型医療施設について、第九十四条の二第一項の規定により許可の効力が失われたとき若しくは第百四条第一項若しくは第百十五条の二十九第六項の規定により許可の取消しがあったとき、又は第百七条の二第一項の規定により指定の効力が失われたとき若しくは第百十四条第一項若しくは第百十五条の二十九第六項の規定により指定の取消しがあったときは、その効力を失う。
(2) The appointment as service provider as set forth in the main clause of Article 41, paragraph (1) pertaining to a person that is deemed as a Designated In-Home Service Provider pursuant to the provisions of the preceding paragraph, shall cease to be effective when, with regard to a Long-Term Care Health Facility or a Sanatorium Medical Facility for the Elderly Requiring Long-Term Care pertaining to said appointment as service provider, when the approval ceases to be effective pursuant to the provisions of Article 94-2, paragraph (1), when the approval is rescinded pursuant to the provisions of Article 104, paragraph (1) or Article 115-29, paragraph (6), when the appointment as service provider ceased to be effective pursuant to the provisions of Article 170-2, paragraph (1), or when the appointment as service provider is rescinded pursuant to the provisions of Article 114, paragraph (1) or Article 115-29, paragraph(6).
(指定居宅サービスの事業の基準)
(Standards of Designated In-Home Service Business)
第七十三条 指定居宅サービス事業者は、次条第二項に規定する指定居宅サービスの事業の設備及び運営に関する基準に従い、要介護者の心身の状況等に応じて適切な指定居宅サービスを提供するとともに、自らその提供する指定居宅サービスの質の評価を行うことその他の措置を講ずることにより常に指定居宅サービスを受ける者の立場に立ってこれを提供するように努めなければならない。
Article 73 (1) A Designated In-Home Service Provider shall act in compliance with the standards concerning facilities and management of a Designated In-Home Service Business as prescribed in paragraph (2) of the following Article, offer appropriate Designated In-Home Service 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 In-Home Service by implementing a self-evaluation of the quality of the Provider's own Designated In-Home Service and other measures.
2 指定居宅サービス事業者は、指定居宅サービスを受けようとする被保険者から提示された被保険者証に、第二十七条第七項第二号(第二十八条第四項及び第二十九条第二項において準用する場合を含む。)若しくは第三十二条第六項第二号(第三十三条第四項及び第三十三条の二第二項において準用する場合を含む。)に掲げる意見又は第三十条第一項後段若しくは第三十三条の三第一項後段に規定する意見(以下「認定審査会意見」という。)が記載されているときは、当該認定審査会意見に配慮して、当該被保険者に当該指定居宅サービスを提供するように努めなければならない。
(2) A Designated In-Home Service Provider, when an opinion as listed in Article 27, paragraph (7), item (ii) (including a case applied mutatis mutandis pursuant to Article 28, paragraph (4) or Article 29, paragraph (2)) or Article 32, paragraph (6), item (ii) (including a case applied mutatis mutandis pursuant to Article 33, paragraph (4) or Article 33-2, paragraph (2)), or an opinion as prescribed in the second sentence of Article 30, paragraph (1) or in the second sentence of Article 33-3, paragraph (1) (herein referred to as "Opinion of the Certification Committee") is entered on the Certificate of Insured Person that is presented by an Insured Person that intends to receive Designated In-Home Service, shall engage in offering said Designated In-Home Service of said Insured Person in consideration of said Opinion of the Certification Committee.
第七十四条 指定居宅サービス事業者は、当該指定に係る事業所ごとに、厚生労働省令で定める基準に従い厚生労働省令で定める員数の当該指定居宅サービスに従事する従業者を有しなければならない。
Article 74 (1) A Designated In-Home Service Provider shall employ the number of employees engaging in said Designated In-Home Service as determined by an Ordinance of the Ministry of Health, Labour, and Welfare in accordance with standards as determined by an Ordinance of the Ministry of Health, Labour, and Welfare, by each Business Office pertaining to said appointment as service provider.
2 前項に規定するもののほか、指定居宅サービスの事業の設備及び運営に関する基準は、厚生労働大臣が定める。
(2) In addition to the provisions as prescribed in the preceding paragraph, standards concerning facilities and management of a Designated In-Home Service Business shall be determined by the Minister of Health, Labour, and Welfare.
3 厚生労働大臣は、前項に規定する指定居宅サービスの事業の設備及び運営に関する基準(指定居宅サービスの取扱いに関する部分に限る。)を定めようとするときは、あらかじめ社会保障審議会の意見を聴かなければならない。
(3) The Minister of Health, Labour, and Welfare, when providing standards concerning facilities and management of a Designated In-Home Service Business as prescribed in the preceding paragraph (limited to the part concerning the handling of Designated In-Home Service), shall hear the opinion of the Social Security Council in advance.
4 指定居宅サービス事業者は、要介護者の人格を尊重するとともに、この法律又はこの法律に基づく命令を遵守し、要介護者のため忠実にその職務を遂行しなければならない。
(4) A Designated In-Home Service Provider shall 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 executes said duty on behalf of the Person Requiring Long-Term Care.
(変更の届出等)
(Notification of Change, etc.)
第七十五条 指定居宅サービス事業者は、当該指定に係る事業所の名称及び所在地その他厚生労働省令で定める事項に変更があったとき、又は当該指定居宅サービスの事業を廃止し、休止し、若しくは再開したときは、厚生労働省令で定めるところにより、十日以内に、その旨を都道府県知事に届け出なければならない。
Article 75 A Designated In-Home Service Provider, when the name or location of the Business Office pertaining to said appointment as service provider or other matters as determined by an Ordinance of the Ministry of Health, Labour, and Welfare change, or when said Designated In-Home Service Business is abolished, suspended, or recommenced, shall provide notification of said fact to the prefectural governor within ten days pursuant to the provisions of an Ordinance of the Ministry of Health, Labour, and Welfare.
(報告等)
(Reporting, etc.)
第七十六条 都道府県知事又は市町村長は、居宅介護サービス費の支給に関して必要があると認めるときは、指定居宅サービス事業者若しくは指定居宅サービス事業者であった者若しくは当該指定に係る事業所の従業者であった者(以下この項において「指定居宅サービス事業者であった者等」という。)に対し、報告若しくは帳簿書類の提出若しくは提示を命じ、指定居宅サービス事業者若しくは当該指定に係る事業所の従業者若しくは指定居宅サービス事業者であった者等に対し出頭を求め、又は当該職員に関係者に対して質問させ、若しくは当該指定居宅サービス事業者の当該指定に係る事業所に立ち入り、その設備若しくは帳簿書類その他の物件を検査させることができる。
Article 76 (1) A prefectural governor or mayor of a Municipality, when it is determined to be necessary concerning the payment of an allowance for In-Home Long-Term Care, shall order a Designated In-Home Service Provider, a person that is or was a Designated In-Home Service Provider, or a person that is or was an employee or Officer pertaining to said appointment as service provider (herein referred to as a "Person, etc., that was a Designated In-Home Service Provider" in this paragraph) to report, submit or present record books and documents, request a Designated In-Home Service Provider, an employee of the Business Office pertaining to said appointment as service provider, or a Person that is or was a Designated In-Home Service Provider, etc., to appear, to direct its personnel to ask questions to a relevant person, or enter the Business Office pertaining to said appointment as service provider of said Designated In-Home Service Provider in order to inspect said facilities, record books and documents, or other items.
2 第二十四条第三項の規定は、前項の規定による質問又は検査について、同条第四項の規定は、前項の規定による権限について準用する。
(2) The provisions of Article 24, paragraph (3) shall apply mutatis mutandis to questions and inspections pursuant to the provisions of the preceding paragraph, and the provisions of paragraph (4) of the same Article shall apply mutatis mutandis to the authority granted pursuant to the provisions of the preceding paragraph.
(勧告、命令等)
(Recommendations, Orders, etc.)
第七十六条の二 都道府県知事は、指定居宅サービス事業者が、当該指定に係る事業所の従業者の知識若しくは技能若しくは人員について第七十四条第一項の厚生労働省令で定める基準若しくは同項の厚生労働省令で定める員数を満たしておらず、又は同条第二項に規定する指定居宅サービスの事業の設備及び運営に関する基準に従って適正な指定居宅サービスの事業の運営をしていないと認めるときは、当該指定居宅サービス事業者に対し、期限を定めて、同条第一項の厚生労働省令で定める基準を遵守し、若しくは同項の厚生労働省令で定める員数の従業者を有し、又は同条第二項に規定する指定居宅サービスの事業の設備及び運営に関する基準を遵守すべきことを勧告することができる。
Article 76-2 (1) A prefectural governor, when a Designated In-Home Service Provider fails to meet the standards as determined by an Ordinance of the Ministry of Health, Labour, and Welfare as set forth in the Article 74, paragraph (1) or the fixed minimum number of employees as determined by an Ordinance of the Ministry of Health, Labour, and Welfare as set forth in the same paragraph with regard to knowledge, skill, or number of employees of the Business Office pertaining to said appointment as service provider, or when it is determined that said Designated In-Home Service Provider does not operate an appropriate Designated In-Home Service in accordance with the standards concerning Facilities and Management of a Designated In-Home Service Business provided by paragraph (2) of the same Article, may specify a due date and recommend to said Designated In-Home Service Provider to act in compliance with the standards as determined by an Ordinance of the Ministry of Health, Labour, and Welfare as set forth in paragraph (1) of the same Article, to employ the number of employees as determined by an Ordinance of the Ministry of Health, Labour, and Welfare as set forth in the same paragraph, and to act in compliance with the standards concerning Facilities and Management of a Designated In-Home Service Business as prescribed by paragraph (2) of the same Article.
2 都道府県知事は、前項の規定による勧告をした場合において、その勧告を受けた指定居宅サービス事業者が同項の期限内にこれに従わなかったときは、その旨を公表することができる。
(2) A prefectural governor, in a case of providing a recommendation pursuant to the provisions of the preceding paragraph, may provide public notice of the fact that said Designated In-Home Service Provider that was issued said recommendation did not act in compliance with said recommendation within the due date as set forth in the same paragraph.
3 都道府県知事は、第一項の規定による勧告を受けた指定居宅サービス事業者が、正当な理由がなくてその勧告に係る措置をとらなかったときは、当該指定居宅サービス事業者に対し、期限を定めて、その勧告に係る措置をとるべきことを命ずることができる。
(3) When said Designated In-Home Service Provider that was issued a recommendation pursuant to the provisions of paragraph (1) does not implement any measures pertaining to said recommendation without a justifiable cause, a prefectural governor may specify a due date and order said Designated In-Home Service Provider to implement measures pertaining to said recommendation.
4 都道府県知事は、前項の規定による命令をした場合においては、その旨を公示しなければならない。
(4) A prefectural governor, when issuing an order pursuant to the provisions of the preceding paragraph, shall issue public notice of said fact.
5 市町村は、保険給付に係る指定居宅サービスを行った指定居宅サービス事業者について、第七十四条第二項に規定する指定居宅サービスの事業の設備及び運営に関する基準に従って適正な指定居宅サービスの事業の運営をしていないと認めるときは、その旨を当該指定に係る事業所の所在地の都道府県知事に通知しなければならない。
(5) With regard to a Designated In-Home Service Provider who provided Designated In-Home Service pertaining to an insurance benefit, a Municipality, when it is determined that said Designated In-Home Service Provider does not operate an appropriate Designated In-Home Service Business in accordance with standards concerning Facilities and Management of a Designated In-Home Service Business as prescribed in Article 74, paragraph (2), shall provide notification of said fact to the prefectural governor that governs the location of the Business Office pertaining to said appointment as service provider.
(指定の取消し等)
(Rescission of Appointment as service provider, etc.)
第七十七条 都道府県知事は、次の各号のいずれかに該当する場合においては、当該指定居宅サービス事業者に係る第四十一条第一項本文の指定を取り消し、又は期間を定めてその指定の全部若しくは一部の効力を停止することができる。
Article 77 (1) A prefectural governor, in a case that corresponds to any of the following items, may rescind the appointment as service provider as set forth in the main clause of Article 41, paragraph (1) pertaining to said Designated In-Home Service Provider or suspend the whole or a part of the effect of said appointment as service provider by specifying a due date:
一 指定居宅サービス事業者が、第七十条第二項第四号、第五号、第十号又は第十一号のいずれかに該当するに至ったとき。
(i) when a Designated In-Home Service Provider corresponds to any provision of Article 70, paragraph (2), item (iv), item (v), item (x), or item (xi);
二 指定居宅サービス事業者が、当該指定に係る事業所の従業者の知識若しくは技能又は人員について、第七十四条第一項の厚生労働省令で定める基準又は同項の厚生労働省令で定める員数を満たすことができなくなったとき。
(ii) when a Designated In-Home Service Provider becomes unable to meet the standards as determined by an Ordinance of the Ministry of Health, Labour, and Welfare as set forth in Article 74, paragraph (1) or the fixed minimum number of employees as determined by an Ordinance of the Ministry of Health, Labour, and Welfare as set forth in the same paragraph with regard to knowledge, skill, or number of employees of the Business Office pertaining to said appointment as service provider;
三 指定居宅サービス事業者が、第七十四条第二項に規定する指定居宅サービスの事業の設備及び運営に関する基準に従って適正な指定居宅サービスの事業の運営をすることができなくなったとき。
(iii) when a Designated In-Home Service Provider becomes unable to operate an appropriate Designated In-Home Service Business in accordance with standards concerning Facilities and Management of a Designated In-Home Service Business as prescribed in Article 74, paragraph (2);
四 指定居宅サービス事業者が、第七十四条第四項に規定する義務に違反したと認められるとき。
(iv) when it is determined that a Designated In-Home Service Provider violates an obligation as prescribed in Article 74, paragraph (4);
五 居宅介護サービス費の請求に関し不正があったとき。
(v) when an Allowance for In-Home Long-Term Care Service is wrongly requested;
六 指定居宅サービス事業者が、第七十六条第一項の規定により報告又は帳簿書類の提出若しくは提示を命ぜられてこれに従わず、又は虚偽の報告をしたとき。
(vi) when a Designated In-Home Service Provider is ordered to report, submit or present record books and documents pursuant to the provisions of Article 76, paragraph (1), but disobeys said order or submits a false report;
七 指定居宅サービス事業者又は当該指定に係る事業所の従業者が、第七十六条第一項の規定により出頭を求められてこれに応ぜず、同項の規定による質問に対して答弁せず、若しくは虚偽の答弁をし、又は同項の規定による検査を拒み、妨げ、若しくは忌避したとき。ただし、当該指定に係る事業所の従業者がその行為をした場合において、その行為を防止するため、当該指定居宅サービス事業者が相当の注意及び監督を尽くしたときを除く。
(vii) when a Designated In-Home Service Provider or an employee of the Business Office pertaining to said appointment as service provider is requested to appear pursuant to the provisions of Article 76, paragraph (1), fails to respond or fails to reply to questions pursuant to the provisions of the same paragraph or submits a false reply, or refuses, interrupts, or interferes with an inspection pursuant to the provisions of the same paragraph, however, provided that this provision shall not apply when an employee of the Business Office pertaining to said appointment as service provider performs said act but said Designated In-Home Service Provider is faithfully providing reasonable care and supervision in order to prevent said act of said employee;
八 指定居宅サービス事業者が、不正の手段により第四十一条第一項本文の指定を受けたとき。
(viii) when a Designated In-Home Service Provider is appointed to provide service as set forth in the main clause of Article 41, paragraph (1) by wrongful means;
九 前各号に掲げる場合のほか、指定居宅サービス事業者が、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又はこれらの法律に基づく命令若しくは処分に違反したとき。
(ix) in addition to the cases listed in the preceding items, when a Designated In-Home Service Provider violates this Act, another Act concerning citizens' health and medical care or public aid that are provided by a Cabinet Order, or an order or disposition of a matter based on these Acts;
十 前各号に掲げる場合のほか、指定居宅サービス事業者が、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とき。
(x) in addition to the cases listed in the preceding items, when a Designated In-Home Service Provider performs a wrongful or significantly unjustifiable act concerning In-Home Service, etc.;
十一 指定居宅サービス事業者が法人である場合において、その役員等のうちに指定の取消し又は指定の全部若しくは一部の効力の停止をしようとするとき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があるとき。
(xi) in a case when a Designated In-Home Service Provider is a juridical person, when any said Officer, etc., performs a wrongful or significantly unjustifiable act concerning In-Home Service, etc., within five years and the appointment as service provider is rescinded or the whole or a part of the effect of the appointment as service provider is suspended due to said act;
十二 指定居宅サービス事業者が法人でない病院等である場合において、その管理者が指定の取消し又は指定の全部若しくは一部の効力の停止をしようとするとき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。
(xii) in a case when a Designated In-Home Service Provider is a Hospital, etc., that is not a juridical person, when a manager of said Provider performs a wrongful or significantly unjustifiable act concerning In-Home Service, etc., within five years and the appointment as service provider is rescinded or the whole or a part of the effect of the appointment as service provider is suspended due to said act.
2 市町村は、保険給付に係る指定居宅サービスを行った指定居宅サービス事業者について、前項各号のいずれかに該当すると認めるときは、その旨を当該指定に係る事業所の所在地の都道府県知事に通知しなければならない。
(2) A Municipality, when it is determined that a Designated In-Home Service Provider that provides Designated In-Home Service pertaining to an insurance benefit corresponds to any provision of the items in the preceding paragraph, shall provide notification of said fact to the prefectural governor that governs the location of the Business Office pertaining to said appointment as service provider.
(公示)
(Public Notice)
第七十八条 都道府県知事は、次に掲げる場合には、その旨を公示しなければならない。
Article 78 A prefectural governor shall, in the following cases, provide public notice of the said fact:
一 第四十一条第一項本文の指定をしたとき。
(i) when an appointment as service provider as set forth in the main clause of Article 41, paragraph (1) is determined;
二 第七十五条の規定による届出(同条の厚生労働省令で定める事項の変更並びに同条に規定する事業の休止及び再開に係るものを除く。)があったとき。
(ii) when there is a notification pursuant to the provisions of Article 75 (except for change of matters as determined by an Ordinance of the Ministry of Health, Labour, and Welfare as set forth in the same Article and matters pertaining to abolishment or recommencement of business provided by the same Article);
三 前条第一項又は第百十五条の二十九第六項の規定により第四十一条第一項本文の指定を取り消し、又は指定の全部若しくは一部の効力を停止したとき。
(iii) when an appointment as service provider as set forth in the main clause of Article 41, paragraph (1) is rescinded, or the effect of the whole or a part of an appointment as service provider is suspended pursuant to the provisions of paragraph (1) of the preceding Article or Article 115-29, paragraph (6).
第三節 指定地域密着型サービス事業者
Section 3 Designated Community-Based Service Providers
(指定地域密着型サービス事業者の指定)
(Appointment as service provider of Designated Community-Based Service Providers)
第七十八条の二 第四十二条の二第一項本文の指定は、厚生労働省令で定めるところにより、地域密着型サービス事業を行う者(地域密着型介護老人福祉施設入所者生活介護を行う事業にあっては、老人福祉法第二十条の五に規定する特別養護老人ホームであって、その入所定員が二十九人以下であるものの開設者)の申請により、地域密着型サービスの種類及び当該地域密着型サービスの種類に係る地域密着型サービス事業を行う事業所(以下この節において「事業所」という。)ごとに行い、当該指定をする市町村長がその長である市町村の行う介護保険の被保険者に対する地域密着型介護サービス費及び特例地域密着型介護サービス費の支給について、その効力を有する。
Article 78-2 (1) An appointment as service provider as set forth in the main clause of Article 42-2, paragraph (1) shall be provided, pursuant to the provisions of an Ordinance of the Ministry of Health, Labour, and Welfare, based on the application of a person that provides community-based service (with regard to a business to provide Admission to a Community-Based Facility for Preventive Daily Long-Term Care of the Elderly Covered by Public Aid, an organizer of an Intensive Care Home for the Elderly as prescribed in Article 20-5 of the Public Aid for the Aged Act for which capacity of users are twenty-nine (29) or less), by type of Community-Based Service and Business Office of Community-Based Service Business pertaining to the type of said Community-Based Service (herein referred to as "Business Office" in this Section), and shall have an effect on the payment of an Allowance for Community-Based Long-Term Care Service or an Exceptional Allowance for Community-Based Long-Term Care Service to an Insured Person by Long-Term Care Insurance provided by a Municipality of which a mayor provided said appointment as service provider.
2 市町村長は、第四十二条の二第一項本文の指定をしようとするときは、厚生労働省令で定めるところにより、あらかじめその旨を都道府県知事に届け出なければならない。
(2) The mayor of a Municipality shall, when providing an appointment as service provider as set forth in the main clause of Article 42-2, paragraph (1), provide notification of said fact to the prefectural governor in advance pursuant to the provisions of an Ordinance of the Ministry of Health, Labour, and Welfare.
3 都道府県知事は、地域密着型特定施設入居者生活介護につき市町村長から前項の届出があった場合において、当該申請に係る事業所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。)における介護専用型特定施設入居者生活介護の利用定員の総数及び地域密着型特定施設入居者生活介護の利用定員の総数の合計数が、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専用型特定施設入居者生活介護の必要利用定員総数及び地域密着型特定施設入居者生活介護の必要利用定員総数の合計数に既に達しているか、又は当該申請に係る事業者の指定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、当該市町村長に対し、必要な助言又は勧告をすることができる。
(3) A prefectural governor, in a case when a mayor of a Municipality provides notification as set forth in the preceding paragraph regarding Daily Life Long-Term Care for a Person Admitted to a Community-Based Specified Facility, and when it is determined that the total sum of the total number of maximum users of Daily Life Care of a Patient Admitted to a Specialized Long-Term Care Specified Facility and the total number of maximum users of Daily Life Long-Term Care for a Person Admitted to a Community-Based Specified Facility in the area (which shall be an area provided by said prefecture pursuant to the provisions of Article 118, paragraph (2) item (i)) including the location of the Business Office pertaining to said application has been reached or is it determined that said total number of maximum users will be exceeded by the appointment as service provider pertaining to said application to provide service of Daily Life Care of a Patient Admitted to a Specialized Long-Term Care Specified Facility and the total number of the necessary number of users of Daily Life Long-Term Care for a Person Admitted to a Community-Based Specified Facility in said area provided by Prefectural Insured Long-Term Care Support Project Plan that is provided by said prefecture pursuant to the provisions of paragraph (1) of the same Article, or when it is determined that it will be likely to cause a problem with accomplishment of a Prefectural Insured Long-Term Care Support Project Plan, may provide necessary advice or recommendations to said mayor of the Municipality.
4 市町村長は、第一項の申請があった場合において、次の各号のいずれかに該当するときは、第四十二条の二第一項本文の指定をしてはならない。
(4) The mayor of a Municipality, in a case of an application to provide service as set forth in paragraph (1) and when it corresponds to any of the following items, shall not provide an appointment as service provider as set forth in the main clause of Article 42-2, paragraph (1):
一 申請者が法人でないとき。
(i) when said applicant is not a juridical person;
二 当該申請に係る事業所の従業者の知識及び技能並びに人員が、第七十八条の四第一項の厚生労働省令で定める基準若しくは同項の厚生労働省令で定める員数又は同条第四項に規定する指定地域密着型サービスに従事する従業者に関する基準を満たしていないとき。
(ii) when the knowledge, skill, or number personnel of the Business Office pertaining to said application do not meet the standards as determined by an Ordinance of the Ministry of Health, Labour, and Welfare as set forth in Article 78-4, paragraph (1) and number of employees as determined by an Ordinance of the Ministry of Health, Labour, and Welfare of the same paragraph, or standards concerning employees engaged in Designated Community-Based Service as prescribed in paragraph (4) of the same Article;
三 申請者が、第七十八条の四第二項又は第四項に規定する指定地域密着型サービスの事業の設備及び運営に関する基準に従って適正な地域密着型サービス事業の運営をすることができないと認められるとき。
(iii) when it is determined that said applicant cannot perform proper Community-Based Service Business in accordance with standards pertaining to Facilities and Management of a Designated Community-Based Service as prescribed in Article 78-4, paragraph (2) or paragraph (4);
四 当該申請に係る事業所が当該市町村の区域の外にある場合であって、その所在地の市町村長の同意を得ていないとき。
(iv) 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 have not yet been obtained;
五 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。
(v) when said applicant is punished by a fine pursuant to the provisions of this Act, or as provided by a Cabinet Order, concerning citizens' health and medical care or public aid and the execution of said penalty has not yet been completed or has not yet expired;
六 申請者が、第七十八条の九(第二号から第五号までを除く。)の規定により指定を取り消され、その取消しの日から起算して五年を経過しない者であるとき。
(vi) when said applicant has been rescinded for an appointment as service provider pursuant to the provisions of Article 78-9 (except for item (ii) to item (v)) and five years have not elapsed from the date of said rescission;
七 申請者が、第七十八条の九(第二号から第五号までを除く。)の規定による指定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七十八条の五の規定による事業の廃止の届出をした者(当該事業の廃止について相当の理由がある者を除く。)又は第七十八条の七の規定による指定の辞退をした者(当該指定の辞退について相当の理由がある者を除く。)で、当該届出又は指定の辞退の日から起算して五年を経過しないものであるとき。
(vii) when said applicant provides notification of an abolishment of business pursuant to the provisions of Article 78-5 (except for a person that has a reasonable basis for abolishment of said business), or declined an appointment as service provider pursuant to the provisions of Article 78-7 (except for a person that has a reasonable basis to decline said appointment as service provider) from the date of notification pursuant to the provisions of Article 15 of the Administrative Procedures Act pertaining to rescission of appointment as service provider pursuant to the provisions of Article 78-9 (except for item (i) to (v), and five years have not elapsed from the date of said notification;
八 申請者が、指定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。
(viii) when said applicant performs a wrongful or significantly unjustifiable act concerning In-Home Service within five years prior to the application of appointment as service provider;
九 申請者の役員等のうちに次のいずれかに該当する者があるとき。
(ix) when any Officer, etc., of said applicant corresponds to any of the following:
イ 禁錮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
(a) a person punished by imprisonment without compulsory labor and the execution of said penalty has not yet been completed or has not yet expired;
ロ 第五号又は前号に該当する者
(b) a person that corresponds to item (v) or the preceding item;
ハ 第七十八条の九(第二号から第五号までを除く。)の規定により指定を取り消された法人において、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その役員等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
(c) a person that is or was an Officer, etc., of a juridical person which appointment as service provider is rescinded pursuant to the provisions of Article 78-9 (except for item (ii) to item (v)) within sixty days prior to the date of notification pursuant to the provisions of Article 15 of the Administrative Procedures Act pertaining to said rescission and five years have not elapsed from the date of said rescission;
ニ 第七号に規定する期間内に第七十八条の五の規定による事業の廃止の届出をした法人(当該事業の廃止について相当の理由がある法人を除く。)又は第七十八条の七の規定による指定の辞退をした法人(当該指定の辞退について相当の理由がある法人を除く。)において、同号の通知の日前六十日以内にその役員等であった者で当該届出又は指定の辞退の日から起算して五年を経過しないもの
(d) a person that is or was an Officer, etc., of a juridical person that provided notification of an abolishment of business pursuant to the provisions of Article 78-5 (except for a juridical person that has a reasonable basis for said abolishment of business), or a juridical person that declined an appointment as service provider pursuant to the provisions of Article 78-7 (except for a juridical person that has a reasonable basis for said decline of appointment as service provider) within the period provided by item (vii) and within sixty days prior to the date of notification as set forth in the same item and five years have not elapsed from the date of said notification or decline of appointment as service provider.
5 市町村長は、第一項の申請があった場合において、次の各号のいずれかに該当するときは、第四十二条の二第一項本文の指定をしないことができる。
(5) The mayor of a Municipality, in a case when an application as set forth in paragraph (1) is filed and when it corresponds to any of the following items, may not provide an appointment as service provider as set forth in the main clause of Article 42-2, paragraph (1):
一 申請者が、第七十八条の九第二号から第五号までの規定により指定を取り消され、その取消しの日から起算して五年を経過しない者であるとき。
(i) when an applicant has rescinded an appointment as service provider pursuant to the provisions of Article 78-9, item (ii) to item (v) and five years have not elapsed from the date of said rescission;
二 申請者が、第七十八条の九第二号から第五号までの規定による指定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七十八条の五の規定による事業の廃止の届出をした者(当該事業の廃止について相当の理由がある者を除く。)又は第七十八条の七の規定による指定の辞退をした者(当該指定の辞退について相当の理由がある者を除く。)で、当該届出又は指定の辞退の日から起算して五年を経過しないものであるとき。
(ii) when an applicant provides notification of abolishment of business pursuant to the provisions of Article 78-5 (except for a person that has a reasonable basis for said abolishment of business) or declined an appointment as service provider pursuant to the provisions of Article 78-7 (except for a person that has a reasonable basis for said decline of appointment as service provider) from the date of notification pursuant to the provisions of Article 15 of the Administrative Procedures Act pertaining to rescission of appointment as service provider pursuant to the provisions of Article 78-9, item (ii) to item (v) and five years have not elapsed from the date of said notification or decline of appointment as service provider;
三 申請者の役員等のうちに次のいずれかに該当する者があるとき。
(iii) when any Officer, etc., of an applicant corresponds to any of the following:
イ 第七十八条の九第二号から第五号までの規定により指定を取り消された法人において、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その役員等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
(a) a person that is or was an Officer, etc., of a juridical person that appointment as service provider is rescinded pursuant to the provisions of Article 78-9, item (ii) to item (v) within sixty days prior to the date of rescission pursuant to the provisions of Article 15 of the Administrative Procedures Act pertaining to said rescission and five years have not elapsed from the date of said rescission;
ロ 前号に規定する期間内に第七十八条の五の規定による事業の廃止の届出をした法人(当該事業の廃止について相当の理由がある法人を除く。)又は第七十八条の七の規定による指定の辞退をした法人(当該指定の辞退について相当の理由がある法人を除く。)において、同号の通知の日前六十日以内にその役員等であった者で当該届出又は指定の辞退の日から起算して五年を経過しないもの
(b) a person that is or was an Officer, etc., of a juridical person that provides notification of abolishment of business pursuant to the provisions of Article 78-5 (except for a juridical person that has a reasonable basis for said abolishment of business) within the period provided by the preceding item, or a juridical person that declined an appointment as service provider pursuant to the provisions of Article 78-7 (except for a juridical person that has a reasonable basis for said decline of appointment as service provider) within the period provided by the preceding item, within sixty days prior to the date of notification as set forth in the same item, and five years have not elapsed from the date of said notification or said decline of appointment as service provider;
四 認知症対応型共同生活介護、地域密着型特定施設入居者生活介護又は地域密着型介護老人福祉施設入所者生活介護につき第一項の申請があった場合において、当該市町村又は当該申請に係る事業所の所在地を含む区域(第百十七条第二項第一号の規定により当該市町村が定める区域とする。以下この号において「日常生活圏域」という。)における当該地域密着型サービスの利用定員の総数が、同条第一項の規定により当該市町村が定める市町村介護保険事業計画において定める当該市町村又は当該日常生活圏域の当該地域密着型サービスの必要利用定員総数に既に達しているか、又は当該申請に係る事業者の指定によってこれを超えることになると認めるとき、その他の当該市町村介護保険事業計画の達成に支障を生ずるおそれがあると認めるとき。
(iv) in a case when an appointment as service provider as set forth in paragraph (1) was filed for Communal Daily Long-Term Care for a Dementia Patient, Daily Life Long-Term Care for a Person Admitted to a Community-Based Specified Facility, or Admission to a Community-Based Facility for Preventive Daily Long-Term Care of the Elderly Covered by Public Aid, when it is determined that the total capacity of users of said Community-Based Service in said Municipality or in the area including the location of the Business Office pertaining to said application (which means an area provided by said Municipality pursuant to the provisions of Article 117, paragraph (2), item (i); herein referred to as "Daily Activities Area" in this item) has been reached or is it determined that said total number will be exceeded by the appointment as service provider pertaining to said application for the total capacity of necessary users for said Community-Based Service in said Municipality or said Daily Activities Area provided by Municipal Insured Long-Term Care Service Plan provided by said Municipality pursuant to the provisions of paragraph (1) of the same Article, or when it is determined that it is likely to cause problems with the accomplishment of said Municipal Insured Long-Term Care Service Plan.
6 市町村長は、第四十二条の二第一項本文の指定を行おうとするとき又は前項第四号の規定により同条第一項本文の指定をしないこととするときは、あらかじめ、当該市町村が行う介護保険の被保険者その他の関係者の意見を反映させるために必要な措置を講じなければならない。
(6) The mayor of a Municipality, when he or she intends to provide an appointment as service provider as set forth in the main clause of Article 42-2, paragraph (1), or, he or she determines not to provide an appointment as service provider as set forth in the main clause of paragraph (1) of the same Article pursuant to the provisions of item (iv) of the preceding paragraph, shall take necessary measures in advance in order to reflect the opinions of Insured Persons of Long-Term Care Insurance provided by said Municipality or other relevant persons.
7 市町村長は、第四十二条の二第一項本文の指定を行うに当たって、当該事業の適正な運営を確保するために必要と認める条件を付することができる。
(7) The mayor of a Municipality, when providing an appointment as service provider as set forth in the main clause of Article 42-2, paragraph (1), may add a provision that is determined to be necessary for ensuring the appropriate conduct of said business.
(指定地域密着型サービスの事業の基準)
(Standards of Designated Community-Based Service Business)
第七十八条の三 指定地域密着型サービス事業者は、次条第二項又は第四項に規定する指定地域密着型サービスの事業の設備及び運営に関する基準に従い、要介護者の心身の状況等に応じて適切な指定地域密着型サービスを提供するとともに、自らその提供する指定地域密着型サービスの質の評価を行うことその他の措置を講ずることにより常に指定地域密着型サービスを受ける者の立場に立ってこれを提供するように努めなければならない。
Article 78-3 (1) A Designated Community-Based Service Provider shall act in compliance with the standards concerning Facilities and Management of a Designated Community-Based Service Business as prescribed in paragraph (2) or paragraph (4) of the following Article, offer appropriate Designated Community-Based Service 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 Community-Based Service by implementing a self-evaluation of the quality of the Provider's own Designated Community-Based Service and other measures.
2 指定地域密着型サービス事業者は、指定地域密着型サービスを受けようとする被保険者から提示された被保険者証に、認定審査会意見が記載されているときは、当該認定審査会意見に配慮して、当該被保険者に当該指定地域密着型サービスを提供するように努めなければならない。
(2) A Designated Community-Based Service Provider, 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 Designated Community-Based Service, shall engage in offering said Designated Community-Based Service of said Insured Person in consideration of said Opinion of the Certification Committee.
第七十八条の四 指定地域密着型サービス事業者は、当該指定に係る事業所ごとに、厚生労働省令で定める基準に従い厚生労働省令で定める員数の当該指定地域密着型サービスに従事する従業者を有しなければならない。
Article 78-4 (1) A Designated Community-Based Service Provider shall employ the number of employees that engage in said Designated Community-Based Service as determined by an Ordinance of the Ministry of Health, Labour, and Welfare in accordance with the standards as determined by an Ordinance of the Ministry of Health, Labour, and Welfare in each Business Office pertaining to said appointment as service provider.
2 前項に規定するもののほか、指定地域密着型サービスの事業の設備及び運営に関する基準は、厚生労働大臣が定める。
(2) In addition to the provisions in the preceding paragraph, standards concerning Facilities and Management of a Designated Community-Based Service Business shall be determined by the Minister of Health, Labour, and Welfare.
3 厚生労働大臣は、前項に規定する指定地域密着型サービスの事業の設備及び運営に関する基準(指定地域密着型サービスの取扱いに関する部分に限る。)を定めようとするときは、あらかじめ社会保障審議会の意見を聴かなければならない。
(3) The Minister of Health, Labour, and Welfare, when intending to provide standards concerning Facilities and Management of a Designated Community-Based Service Business pursuant to the provisions of the preceding paragraph (limited to the part concerning the handling of Designated Community-Based Service), shall hear the opinion of the Social Security Council in advance.
4 市町村は、第一項及び第二項の規定にかかわらず、厚生労働省令で定める範囲内で、これらの規定に定める基準に代えて、当該市町村における指定地域密着型サービスに従事する従業者に関する基準及び指定地域密着型サービスの事業の設備及び運営に関する基準を定めることができる。
(4) A Municipality, notwithstanding the provisions of paragraph (1) and paragraph (2) and within the scope as determined by an Ordinance of the Ministry of Health, Labour, and Welfare, in lieu of standards provided by these provisions, may provide standards concerning employees that engage in Designated Community-Based Service in said Municipality and standards concerning Facilities and Management of a Designated Community-Based Service Business.
5 市町村は、前項の当該市町村における指定地域密着型サービスに従事する従業者に関する基準及び指定地域密着型サービスの事業の設備及び運営に関する基準を定めようとするときは、あらかじめ、当該市町村が行う介護保険の被保険者その他の関係者の意見を反映させ、及び学識経験を有する者の知見の活用を図るために必要な措置を講じなければならない。
(5) A Municipality, when it intends to provide standards concerning employees that engage in Designated Community-Based Service in said Municipality as set forth in the preceding paragraph and standards concerning Facilities and Management of a Designated Community-Based Service Business, shall reflect the opinions of Insured Persons of Long-Term Care Insurance provided by said Municipality and take necessary measures in order to promote the use of knowledge of persons with relevant knowledge and experience.
6 指定地域密着型サービス事業者は、要介護者の人格を尊重するとともに、この法律又はこの法律に基づく命令を遵守し、要介護者のため忠実にその職務を遂行しなければならない。
(6) A Designated Community-Based Service Provider shall respect the personality of a Person Requiring Long-Term Care, act in compliance with this Act or an Order based on this Act, and faithfully perform said duty for a Person Requiring Long-Term Care.
(変更の届出等)
(Notification of Change, etc.)
第七十八条の五 指定地域密着型サービス事業者は、当該指定に係る事業所の名称及び所在地その他厚生労働省令で定める事項に変更があったとき、又は当該指定地域密着型サービス(地域密着型介護老人福祉施設入所者生活介護を除く。)の事業を廃止し、休止し、若しくは再開したときは、厚生労働省令で定めるところにより、十日以内に、その旨を市町村長に届け出なければならない。
Article 78-5 A Designated Community-Based Service Provider, when the name or location of an Business Office pertaining to an appointment as service provider or other matters as determined by an Ordinance of the Ministry of Health, Labour, and Welfare are changed, or when said Designated Community-Based Service Business (except for Admission to a Community-Based Facility for Preventive Daily Long-Term Care of the Elderly Covered by Public Aid) is abolished, suspended, or recommenced, shall provide notification of said fact to the mayor of the Municipality within ten days pursuant to the provisions of an Ordinance of the Ministry of Health, Labour, and Welfare.
(報告等)
(Reporting, etc.)
第七十八条の六 市町村長は、地域密着型介護サービス費の支給に関して必要があると認めるときは、指定地域密着型サービス事業者若しくは指定地域密着型サービス事業者であった者若しくは当該指定に係る事業所の従業者であった者(以下この項において「指定地域密着型サービス事業者であった者等」という。)に対し、報告若しくは帳簿書類の提出若しくは提示を命じ、指定地域密着型サービス事業者若しくは当該指定に係る事業所の従業者若しくは指定地域密着型サービス事業者であった者等に対し出頭を求め、又は当該職員に関係者に対して質問させ、若しくは当該指定地域密着型サービス事業者の当該指定に係る事業所に立ち入り、その設備若しくは帳簿書類その他の物件を検査させることができる。
Article 78-6 (1) The mayor of a Municipality, when it is determined to be necessary concerning payment of an Allowance for Community-Based Long-Term Care Service, shall order a Designated Community-Based Service Provider, a person that is or was a Designated Community-Based Service Provider, or a person that is or was an employee or an Officer pertaining to said appointment as service provider (herein referred to as a "Person that was a Designated Community-Based Service Provider, etc." in this paragraph) to report, submit or present record books and documents, request a Designated Community-Based Service Provider, an employee of the Business Office pertaining to said appointment as service provider or a Person that was a Designated Community-Based Service Provider, etc., to appear, direct its personnel to ask questions to the relevant Person, or enter the Business Office pertaining to said appointment as service provider of said Designated Community-Based Service Provider in order to inspect said facilities, record books and documents, or other items.
2 第二十四条第三項の規定は前項の規定による質問又は検査について、同条第四項の規定は前項の規定による権限について準用する。
(2) The provisions of Article 24, paragraph (3) shall apply mutatis mutandis to questions and inspections pursuant to the provisions of the preceding paragraph, and the provisions of paragraph (4) of the same Article shall apply mutatis mutandis to the authority granted pursuant to the provisions of the preceding paragraph.
(指定の辞退)
(Decline of an Appointment as service provider)
第七十八条の七 第四十二条の二第一項本文の指定を受けて地域密着型介護老人福祉施設入所者生活介護の事業を行う者は、一月以上の予告期間を設けて、その指定を辞退することができる。
Article 78-7 A person that performs the business of Admission to a Community-Based Facility for Preventive Daily Long-Term Care of the Elderly Covered by Public Aid under appointment as set forth in Article 42-2, paragraph (1), main clause may decline said appointment as service provider by providing a period of one month or longer of said prior notice.
(勧告、命令等)
(Recommendations, Orders, etc.)
第七十八条の八 市町村長は、指定地域密着型サービス事業者が、第七十八条の二第七項の規定により当該指定を行うに当たって付された条件に従わず、当該指定に係る事業所の従業者の知識若しくは技能若しくは人員について第七十八条の四第一項の厚生労働省令で定める基準若しくは同項の厚生労働省令で定める員数若しくは同条第四項に規定する指定地域密着型サービスに従事する従業者に関する基準を満たしておらず、又は同条第二項若しくは第四項に規定する指定地域密着型サービスの事業の設備及び運営に関する基準に従って適正な指定地域密着型サービスの事業の運営をしていないと認めるときは、当該指定地域密着型サービス事業者に対し、期限を定めて、第七十八条の二第七項の規定により当該指定を行うに当たって付された条件に従い、第七十八条の四第一項の厚生労働省令で定める基準を遵守し、若しくは同項の厚生労働省令で定める員数の従業者を有し、若しくは同条第四項に規定する指定地域密着型サービスに従事する従業者に関する基準を遵守し、又は同条第二項若しくは第四項に規定する指定地域密着型サービスの事業の設備及び運営に関する基準を遵守すべきことを勧告することができる。
Article 78-8 (1) The mayor of a Municipality, when it is determined that a Designated Community-Based Service Provider does not act in compliance with the provision provided when providing said appointment as service provider pursuant to the provisions of Article 78-2, paragraph (7), that does not meet the standards as determined by an Ordinance of the Ministry of Health, Labour, and Welfare as set forth in the Article 78-4, paragraph (1) or fixed number as determined by an Ordinance of the Ministry of Health, Labour, and Welfare as set forth in the same paragraph, or standards concerning employees that engage in Designated Community-Based Service provided by paragraph (4) of the same Article, with regard to knowledge, skill, or number of employee of the Business Office pertaining to said appointment as service provider, or when it is determined that said Designated Community-Based Service Provider does not operate an appropriate Designated Community-Based Service in accordance with the standards concerning Facilities and Management of a Designated Community-Based Service Business provided by paragraph (2) or paragraph (4) of the same Article, may specify a due date and recommend to said Designated Community-Based Service Provider to act in compliance with the provisions provided when determining said appointment as service provider pursuant to the provisions of Article 78-2, paragraph (7), to comply with the standards as determined by an Ordinance of the Ministry of Health, Labour, and Welfare as set forth in Article 78-4, paragraph (1), to employ the number of employees as determined by an Ordinance of the Ministry of Health, Labour, and Welfare as set forth in the same paragraph, to comply with standards concerning employees that engage in Designated Community-Based Service as prescribed in paragraph (4) of the same Article, and to comply with standards concerning Facilities and Management of a Designated Community-Based Service Business as prescribed by paragraph (2) or paragraph (4) of the same Article.
2 市町村長は、前項の規定による勧告をした場合において、その勧告を受けた指定地域密着型サービス事業者が同項の期限内にこれに従わなかったときは、その旨を公表することができる。
(2) The mayor of a Municipality, in a case of providing a recommendation pursuant to the provisions of the preceding paragraph, may provide public notice of the fact that said Designated Community-Based Service Provider that was issued said recommendation did not act in compliance with said recommendation within the due date as set forth in the same paragraph.
3 市町村長は、第一項の規定による勧告を受けた指定地域密着型サービス事業者が、正当な理由がなくてその勧告に係る措置をとらなかったときは、当該指定地域密着型サービス事業者に対し、期限を定めて、その勧告に係る措置をとるべきことを命ずることができる。
(3) The mayor of a Municipality, when a Designated Community-Based Service Provider that was issued a recommendation pursuant to the provisions of paragraph (1) does not implement the measures pertaining to said recommendation without justifiable reasons may specify a due date and order said Designated Community-Based Service Provider to implement measures pertaining to said recommendation.
4 市町村長は、前項の規定による命令をした場合においては、その旨を公示しなければならない。
(4) The mayor of a Municipality, when issuing an order pursuant to the provisions of the preceding paragraph, shall issue public notice of the said fact.
(指定の取消し等)
(Rescission of Appointment as service provider, etc.)
第七十八条の九 市町村長は、次の各号のいずれかに該当する場合においては、当該指定地域密着型サービス事業者に係る第四十二条の二第一項本文の指定を取り消し、又は期間を定めてその指定の全部若しくは一部の効力を停止することができる。
Article 78-9 A mayor of a Municipality, in a case that corresponds to any of the following items, may rescind an appointment as service provider as set forth in the main clause of Article 42, paragraph (1) pertaining to said Designated Community-Based Service Provider or suspend the whole or a part of the effect of said appointment as service provider by specifying a due date for compliance:
一 指定地域密着型サービス事業者が、第七十八条の二第四項第五号又は第九号のいずれかに該当するに至ったとき。
(i) when a Designated Community-Based Service Provider corresponds to any provision of Article 78-2, paragraph (4), item (iv), item (v), or item (ix);
二 指定地域密着型サービス事業者が、第七十八条の二第五項第三号に該当するに至ったとき。
(ii) when a Designated Community-Based Service Provider corresponds to any provision of Article 78-2, paragraph (5), item (iii);
三 指定地域密着型サービス事業者が、第七十八条の二第七項の規定により当該指定を行うに当たって付された条件に違反したと認められるとき。
(iii) when it is determined that a Designated Community-Based Service Provider is in violation of a provision determined when granting said appointment as service provider pursuant to the provisions of the provisions of Article 78-2, paragraph (7);
四 指定地域密着型サービス事業者が、当該指定に係る事業所の従業者の知識若しくは技能又は人員について、第七十八条の四第一項の厚生労働省令で定める基準若しくは同項の厚生労働省令で定める員数又は同条第四項に規定する指定地域密着型サービスに従事する従業者に関する基準を満たすことができなくなったとき。
(iv) when a Designated Community-Based Service Provider becomes unable to meet the standards as determined by an Ordinance of the Ministry of Health, Labour, and Welfare as set forth in Article 78-4, paragraph (1), employ the fixed minimum number of employees as determined by an Ordinance of the Ministry of Health, Labour, and Welfare as set forth in the same paragraph, or standards concerning employees that engage in Designated Community-Based Service as prescribed in paragraph (4) of the same Article, with regard to knowledge, skill, or number of employees of the Business Office pertaining to said appointment as service provider;
五 指定地域密着型サービス事業者が、第七十八条の四第二項又は第四項に規定する指定地域密着型サービスの事業の設備及び運営に関する基準に従って適正な指定地域密着型サービスの事業の運営をすることができなくなったとき。
(v) when a Designated Community-Based Service Provider becomes unable to operate an appropriate Designated Community-Based Service Business in accordance with standards concerning Facilities and Management of a Designated Community-Based Service Business as prescribed in Article 78-4, paragraph (2) or paragraph (4);
六 指定地域密着型サービス事業者が、第七十八条の四第六項に規定する義務に違反したと認められるとき。
(vi) when it is determined that a Designated Community-Based Service Provider violates an obligation as prescribed in Article 78-4, paragraph (6);
七 指定地域密着型サービス事業者(地域密着型介護老人福祉施設入所者生活介護を行うものに限る。)が、第二十八条第五項(第二十九条第二項、第三十条第二項、第三十一条第二項、第三十三条第四項、第三十三条の二第二項、第三十三条の三第二項及び第三十四条第二項において準用する場合を含む。第八十四条、第九十二条、第百四条及び第百十四条において同じ。)の規定により調査の委託を受けた場合において、当該調査の結果について虚偽の報告をしたとき。
(vii) when a Designated Community-Based Service Provider (limited to a Provider that provides Admission to a Community-Based Facility for Preventive Daily Long-Term Care of the Elderly Covered by Public Aid) is entrusted with an investigation pursuant to the provisions of Article 28, paragraph (5) (including a case applied mutatis mutandis pursuant to Article 29, paragraph (2), Article 30, paragraph (2), Article 31, paragraph (2), Article 33, paragraph (4), Article 33-2, paragraph (2), Article 33-3, paragraph (2), and Article 34, paragraph (2); the same shall apply to Article 84, Article 92, Article 104 and Article 114), and submits a false report regarding the result of said investigation;
八 地域密着型介護サービス費の請求に関し不正があったとき。
(viii) when an Allowance for Community-Based Long-Term Care Service is wrongly requested;
九 指定地域密着型サービス事業者が、第七十八条の六第一項の規定により報告又は帳簿書類の提出若しくは提示を命ぜられてこれに従わず、又は虚偽の報告をしたとき。
(ix) when a Designated Community-Based Service Provider is ordered to report, submit, or present record books and documents pursuant to the provisions of Article 78-6, paragraph (1), but disobeys said order or submits a false report;
十 指定地域密着型サービス事業者又は当該指定に係る事業所の従業者が、第七十八条の六第一項の規定により出頭を求められてこれに応ぜず、同項の規定による質問に対して答弁せず、若しくは虚偽の答弁をし、又は同項の規定による検査を拒み、妨げ、若しくは忌避したとき。ただし、当該指定に係る事業所の従業者がその行為をした場合において、その行為を防止するため、当該指定地域密着型サービス事業者が相当の注意及び監督を尽くしたときを除く。
(x) when a Designated Community-Based Service Provider or an employee of the Business Office pertaining to said appointment as service provider is requested to appear pursuant to the provisions of Article 78-6, paragraph (1), but does not respond or does not reply to questions pursuant to the provisions of the same paragraph or submits a false reply, or refuses, interrupts, or interferes with an inspection pursuant to the provisions of the same paragraph, however, provided that this provision shall not apply when an employee of the Business Office pertaining to said appointment as service provider performed said act and said Designated Community-Based Service Provider was faithfully providing reasonable care and supervision in order to prevent said act of said employee;
十一 指定地域密着型サービス事業者が、不正の手段により第四十二条の二第一項本文の指定を受けたとき。
(xi) when a Designated Community-Based Service Provider is appointed to provide service as set forth in the main clause of Article 42-2, paragraph (1) by wrongful means;
十二 前各号に掲げる場合のほか、指定地域密着型サービス事業者が、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又はこれらの法律に基づく命令若しくは処分に違反したとき。
(xii) in addition to the cases listed in the preceding items, when a Designated Community-Based Service Provider violates this Act, another Act concerning citizens' health and medical care or public aid as determined by a Cabinet Order, or other Order or the disposition of a matter based on these Acts;
十三 前各号に掲げる場合のほか、指定地域密着型サービス事業者が、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とき。
(xiii) in addition to the cases listed in the preceding items, when a Designated Community-Based Service Provider performs a wrongful or significantly unjustifiable act concerning In-Home Service, etc.;
十四 指定地域密着型サービス事業者の役員等のうちに、指定の取消し又は指定の全部若しくは一部の効力の停止をしようとするとき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があるとき。
(xiv) when any Officer, etc., of a Designated Community-Based Service Provider performs a wrongful or significantly unjustifiable act concerning In-Home Service, etc., within five years and the appointment as service provider is rescinded or the whole or a part of the effect of the appointment as service provider is suspended due to said act.
(公示)
(Public Notice)
第七十八条の十 市町村長は、次に掲げる場合には、遅滞なく、その旨を都道府県知事に届け出るとともに、これを公示しなければならない。
Article 78-10 A mayor of a Municipality, in the following cases, shall provide notification of said fact to the prefectural governor and issue public notice of the said fact without delay:
一 第四十二条の二第一項本文の指定をしたとき。
(i) when an appointment as service provider as set forth in the main clause of Article 42-2, paragraph (1) is determined;
二 第七十八条の五の規定による届出(同条の厚生労働省令で定める事項の変更並びに同条に規定する事業の休止及び再開に係るものを除く。)があったとき。
(ii) when there is a notification pursuant to the provisions of Article 78-5 (except for change of matters as determined by an Ordinance of the Ministry of Health, Labour, and Welfare as set forth in the same Article and matters pertaining to abolishment or recommencement of business provided by the same Article);
三 第七十八条の七の規定による第四十二条の二第一項本文の指定の辞退があったとき。
(iii) when the appointment as service provider as set forth in the main clause of Article 42-2, paragraph (1) is declined pursuant to the provisions of Article 78-7;
四 前条の規定により第四十二条の二第一項本文の指定を取り消し、又は指定の全部若しくは一部の効力を停止したとき。
(iv) when an appointment as service provider as set forth in the main clause of Article 42-2, paragraph (1) is rescinded, or the effect of the whole or a part of an appointment as service provider is suspended.
(準用)
(Mutatis Mutandis Application)
第七十八条の十一 第七十条の二の規定は、第四十二条の二第一項本文の指定について準用する。この場合において、必要な技術的読替えは、政令で定める。
Article 78-11 The provisions of Article 70-2 shall apply mutatis mutandis to the main clause of Article 42-2, paragraph (1). In this case, the necessary technical replacement of terms shall be provided by a Cabinet Order.
第四節 指定居宅介護支援事業者
Section 4 Designated In-Home Long-Term Care Support Providers
(指定居宅介護支援事業者の指定)
(Appointment as service provider of Designated In-Home Long-Term Care Support Providers)
第七十九条 第四十六条第一項の指定は、厚生労働省令で定めるところにより、居宅介護支援事業を行う者の申請により、居宅介護支援事業を行う事業所(以下この節において単に「事業所」という。)ごとに行う。
Article 79 (1) An appointment as service provider as set forth in Article 46, paragraph (1) shall be determined pursuant to the provisions of an Ordinance of the Ministry of Health, Labour, and Welfare, by the application of a Person that operates an In-Home Long-Term Care Support Business, and by type of In-Home Service and provider that operates In-Home Long-Term Care Support Business pertaining to the type of said In-Home Service (hereinafter referred to simply as "Business Office" in this Section).
2 都道府県知事は、前項の申請があった場合において、次の各号のいずれかに該当するときは、第四十六条第一項の指定をしてはならない。
(2) A prefectural governor, in a case of an application as set forth in the preceding paragraph, when it corresponds to any of the following items, shall not provide appointment as service provider as set forth in Article 46, paragraph (1):
一 申請者が法人でないとき。
(i) when the applicant is not a juridical person;
二 当該申請に係る事業所の介護支援専門員の人員が、第八十一条第一項の厚生労働省令で定める員数を満たしていないとき。
(ii) when the number of Long-Term Care Support Specialist s pertaining to said application does not meet the fixed minimum number of employees as determined by an Ordinance of the Ministry of Health, Labour, and Welfare as set forth in Article 81, paragraph (1);
三 申請者が、第八十一条第二項に規定する指定居宅介護支援の事業の運営に関する基準に従って適正な居宅介護支援事業の運営をすることができないと認められるとき。
(iii) when it is determined that the applicant cannot perform proper In-Home Long-Term Care Support Business in accordance with standards pertaining to Management of a Designated In-Home Long-Term Care Support Business as prescribed in Article 81, paragraph (2);
四 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。
(iv) when the applicant is punished by a fine pursuant to the provisions of this Act or another Act pertaining to citizens' health and medical care and public aid as determined by a Cabinet Order and the execution of said penalty has not yet been completed or has not yet expired;
五 申請者が、第八十四条第一項又は第百十五条の二十九第六項の規定により指定を取り消され、その取消しの日から起算して五年を経過しない者であるとき。
(v) when the applicant has rescinded appointment as service provider pursuant to the provisions of Article 84, paragraph (1) or Article 115-29, paragraph (6) and five years have not elapsed from the date of said rescission;
六 申請者が、第八十四条第一項又は第百十五条の二十九第六項の規定による指定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八十二条の規定による事業の廃止の届出をした者(当該事業の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。
(vi) when the applicant provides notification of abolishment of business pursuant to the provisions of Article 82 from the date of notification pursuant to the provisions of Article 15 of the Administrative Procedures Act pertaining to rescission of appointment as service provider pursuant to the provisions of Article 84, paragraph (1) or Article 115-29, paragraph (6) to the date when the appointment as service provider is rescinded or when it is determined not to rescind the appointment as service provider (except for a person that has a reasonable basis for said abolishment of business) and five years have not elapsed yet from the date of said notification;
七 申請者が、指定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。
(vii) when the applicant performs a wrongful or significantly unjustifiable act pertaining to In-Home Service, etc., within five years prior to said application of appointment as service provider;
八 申請者の役員等のうちに次のいずれかに該当する者があるとき。
(viii) when any Officer, etc., of the applicant corresponds to any of the following items:
イ 禁錮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
(a) a person punished by imprisonment without compulsory labor and the execution of said penalty has not yet been completed or has not yet expired;
ロ 第四号又は前号に該当する者
(b) a person that corresponds to item (iv) or the preceding item;
ハ 第八十四条第一項又は第百十五条の二十九第六項の規定により指定を取り消された法人において、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その役員等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
(c) a person that is or was an Officer, etc., of a juridical person that appointment as service provider is rescinded pursuant to the provisions of Article 84, paragraph (1) or Article 115-29, paragraph (6) within sixty days prior to the date of notification pursuant to the provisions of Article 15 of the Administrative Procedures Act pertaining to said rescission and five years have not elapsed from the date of said rescission;
ニ 第六号に規定する期間内に第八十二条の規定による事業の廃止の届出をした法人(当該事業の廃止について相当の理由がある法人を除く。)において、同号の通知の日前六十日以内にその役員等であった者で当該届出の日から起算して五年を経過しないもの
(d) a person that is or was an Officer, etc., of a juridical person that provided notification of an abolishment of business pursuant to the provisions of Article 82 (except for a juridical person that has a reasonable basis for said abolishment of business), within the period provided by item (vi), within sixty days prior to the date of notification as set forth in the same item and five years have not elapsed from the date of said notification or decline of appointment as service provider.
(指定の更新)
(Renewal of Appointment as service provider)
第七十九条の二 第四十六条第一項の指定は、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。
Article 79-2 (1) An appointment as service provider as set forth in Article 46, paragraph (1), if it is not renewed within a period of six years, shall cease to be effective when said period expires.
2 前項の更新の申請があった場合において、同項の期間(以下この条において「指定の有効期間」という。)の満了の日までにその申請に対する処分がされないときは、従前の指定は、指定の有効期間の満了後もその処分がされるまでの間は、なおその効力を有する。
(2) 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 (herein referred to as "Effective Period of Designation as Service Provider" in this Article), the prior appointment as service provider shall remain effective after expiry of the Effective Period of Designation as Service Provider until a determination is reached regarding said application.
3 前項の場合において、指定の更新がされたときは、その指定の有効期間は、従前の指定の有効期間の満了の日の翌日から起算するものとする。
(3) In a case as set forth in the preceding paragraph, when the appointment as service provider is renewed, said Effective Period of Designation as Service Provider shall be from the date following the date of expiry of the prior Effective Period of Designation as Service Provider.
4 前条の規定は、第一項の指定の更新について準用する。
(4) The provisions of the preceding Article shall apply mutatis mutandis to a renewal of appointment as service provider as set forth in paragraph (1).
(指定居宅介護支援の事業の基準)
(Standards of Designated In-Home Long-Term Care Support Business)
第八十条 指定居宅介護支援事業者は、次条第二項に規定する指定居宅介護支援の事業の運営に関する基準に従い、要介護者の心身の状況等に応じて適切な指定居宅介護支援を提供するとともに、自らその提供する指定居宅介護支援の質の評価を行うことその他の措置を講ずることにより常に指定居宅介護支援を受ける者の立場に立ってこれを提供するように努めなければならない。
Article 80 (1) A Designated In-Home Long-Term Care Support Provider shall act in compliance with the standards concerning Management of a Designated In-Home Long-Term Care Support Business as prescribed in paragraph (2) of the following Article, offer appropriate Designated In-Home Long-Term Care Support 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 Community-Based Service by implementing self-evaluation of the quality of the Provider's own Designated Community-Based Service and other measures.
2 指定居宅介護支援事業者は、指定居宅介護支援を受けようとする被保険者から提示された被保険者証に、認定審査会意見が記載されているときは、当該認定審査会意見に配慮して、当該被保険者に当該指定居宅介護支援を提供するように努めなければならない。
(2) A Designated In-Home Long-Term Care Support Provider, 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 Designated In-Home Long-Term Care Support, shall engage in offering said Designated Community-Based Service of said Insured Person in consideration of said Opinion of the Certification Committee.
第八十一条 指定居宅介護支援事業者は、当該指定に係る事業所ごとに、厚生労働省令で定める員数の介護支援専門員を有しなければならない。
Article 81 (1) A Designated In-Home Long-Term Care Support Provider shall employ the number of Long-Term Care Support Specialist s as determined by an Ordinance of the Ministry of Health, Labour, and Welfare by each Business Office pertaining to said appointment as service provider.
2 前項に規定するもののほか、指定居宅介護支援の事業の運営に関する基準は、厚生労働大臣が定める。
(2) In addition to the provisions in the preceding paragraph, standards concerning Facilities and Management of a Designated In-Home Long-Term Care Support Business shall be determined by the Minister of Health, Labour, and Welfare.
3 厚生労働大臣は、前項に規定する指定居宅介護支援の事業の運営に関する基準(指定居宅介護支援の取扱いに関する部分に限る。)を定めようとするときは、あらかじめ社会保障審議会の意見を聴かなければならない。
(3) The Minister of Health, Labour, and Welfare, when intending to provide standards concerning Management of a Designated In-Home Long-Term Care Support Business pursuant to the provisions of the preceding paragraph (limited to the part concerning the handling of Designated In-Home Long-Term Care Support), shall hear the opinion of the Social Security Council in advance.
4 指定居宅介護支援事業者は、要介護者の人格を尊重するとともに、この法律又はこの法律に基づく命令を遵守し、要介護者のため忠実にその職務を遂行しなければならない。
(4) A Designated In-Home Long-Term Care Support Provider shall respect the personality of a Person Requiring Long-Term Care, act in compliance with this Act or an Order based on this Act, and faithfully perform said duty for a Person Requiring Long-Term Care.
(変更の届出等)
(Notification of Change, etc.)
第八十二条 指定居宅介護支援事業者は、当該指定に係る事業所の名称及び所在地その他厚生労働省令で定める事項に変更があったとき、又は当該指定居宅介護支援の事業を廃止し、休止し、若しくは再開したときは、厚生労働省令で定めるところにより、十日以内に、その旨を都道府県知事に届け出なければならない。
Article 82 A Designated In-Home Long-Term Care Support Provider, when the name or location of an Business Office pertaining to said appointment as service provider or other matters as determined by an Ordinance of the Ministry of Health, Labour, and Welfare are changed, or when said Designated In-Home Long-Term Care Support Business is abolished, suspended, or recommenced, shall provide notification of said fact to the mayor of the Municipality within ten days pursuant to the provisions of an Ordinance of the Ministry of Health, Labour, and Welfare.
(報告等)
(Reporting, etc.)
第八十三条 都道府県知事又は市町村長は、必要があると認めるときは、指定居宅介護支援事業者若しくは指定居宅介護支援事業者であった者若しくは当該指定に係る事業所の従業者であった者(以下この項において「指定居宅介護支援事業者であった者等」という。)に対し、報告若しくは帳簿書類の提出若しくは提示を命じ、指定居宅介護支援事業者若しくは当該指定に係る事業所の従業者若しくは指定居宅介護支援事業者であった者等に対し出頭を求め、又は当該職員に関係者に対して質問させ、若しくは当該指定居宅介護支援事業者の当該指定に係る事業所に立ち入り、その帳簿書類その他の物件を検査させることができる。
Article 83 (1) A prefectural governor or mayor of a Municipality, when it is determined to be necessary, shall order a Designated In-Home Long-Term Care Support Provider, a Person that is or was a Designated In-Home Long-Term Care Support Provider, etc., or a person that is or was an employee or an Officer, etc., pertaining to said appointment as service provider (herein referred to as a "Person that is or was a Designated In-Home Long-Term Care Support Provider, etc., etc." in this paragraph) to report, submit, or present record books and documents, request a Designated In-Home Long-Term Care Support Provider, an employee of the Business Office pertaining to said appointment as service provider or a Person that is or was a Designated In-Home Long-Term Care Support Provider, etc., etc., to appear, direct its personnel to ask questions to the relevant Person, or enter the Business Office pertaining to said appointment as service provider of said Designated Community-Based Service Provider in order to inspect said record books and documents, or other items.
2 第二十四条第三項の規定は、前項の規定による質問又は検査について、同条第四項の規定は、前項の規定による権限について準用する。
(2) The provisions of Article 24, paragraph (3) shall apply mutatis mutandis to questions and inspections pursuant to the provisions of the preceding paragraph, and the provisions of paragraph (4) of the same Article shall apply mutatis mutandis to the authority granted pursuant to the provisions of the preceding paragraph.
(勧告、命令等)
(Recommendations, Orders, etc.)
第八十三条の二 都道府県知事は、指定居宅介護支援事業者が、当該指定に係る事業所の介護支援専門員の人員について第八十一条第一項の厚生労働省令で定める員数を満たしておらず、又は同条第二項に規定する指定居宅介護支援の事業の運営に関する基準に従って適正な指定居宅介護支援の事業の運営をしていないと認めるときは、当該指定居宅介護支援事業者に対し、期限を定めて、同条第一項の厚生労働省令で定める員数の介護支援専門員を有し、又は同条第二項に規定する指定居宅介護支援の事業の運営に関する基準を遵守すべきことを勧告することができる。
Article 83-2 (1) A prefectural governor, when it is determined that a Designated In-Home Long-Term Care Support Provider does not meet the fixed minimum number of employees as determined by an Ordinance of the Ministry of Health, Labour, and Welfare as set forth in Article 81, paragraph (1) with regard to the number of Long-Term Care Support Specialist s of an Business Office pertaining to said appointment as service provider, or does not operate an appropriate Designated In-Home Long-Term Care Support Business in accordance with standards concerning Management of a Designated In-Home Long-Term Care Support Business as prescribed in paragraph (2) of the same Article, may specify a due date and recommend to said Designated In-Home Long-Term Care Support Provider to employ the fixed minimum number of employees of Long-Term Care Support Specialist s as determined by an Ordinance of the Ministry of Health, Labour, and Welfare as set forth in paragraph (1) of the same Article and to comply with the standards concerning management of a Designated In-Home Long-Term Care Support Business provided by paragraph (2) of the same Article.
2 都道府県知事は、前項の規定による勧告をした場合において、その勧告を受けた指定居宅介護支援事業者が同項の期限内にこれに従わなかったときは、その旨を公表することができる。
(2) A prefectural governor, in a case of providing a recommendation pursuant to the provisions of the preceding paragraph, may provide public notice of the fact that said Designated In-Home Long-Term Care Support Provider that is issued said recommendation did not act in compliance with said recommendation within the due date as set forth in the same paragraph.
3 都道府県知事は、第一項の規定による勧告を受けた指定居宅介護支援事業者が、正当な理由がなくてその勧告に係る措置をとらなかったときは、当該指定居宅介護支援事業者に対し、期限を定めて、その勧告に係る措置をとるべきことを命ずることができる。
(3) A prefectural governor, when a Designated In-Home Long-Term Care Support Provider that is issued a recommendation pursuant to the provisions of paragraph (1) does not implement the measures pertaining to said recommendation without a justifiable reason, may specify a due date and order said Designated In-Home Long-Term Care Support Provider to implement measures pertaining to said recommendation.
4 都道府県知事は、前項の規定による命令をした場合においては、その旨を公示しなければならない。
(4) A prefectural governor, when issuing an order pursuant to the provisions of the preceding paragraph, shall issue public notice of the said fact.
5 市町村は、保険給付に係る指定居宅介護支援を行った指定居宅介護支援事業者について、第八十一条第二項に規定する指定居宅介護支援の事業の運営に関する基準に従って適正な指定居宅介護支援の事業の運営をしていないと認めるときは、その旨を当該指定に係る事業所の所在地の都道府県知事に通知しなければならない。
(5) With regard to a Designated In-Home Long-Term Care Support Provider that performs Designated In-Home Long-Term Care Support pertaining to an insurance benefit, a Municipality, when it is determined that said Designated In-Home Long-Term Care Support Provider does not operate an appropriate Designated In-Home Long-Term Care Support Business in accordance with standards concerning Management of a Designated In-Home Long-Term Care Support Business as prescribed in Article 81, paragraph (2), shall provide notification of said fact to the prefectural governor that governs the location of the Business Office pertaining to said appointment as service provider.
(指定の取消し等)
(Rescission of Appointment as service provider, etc.)
第八十四条 都道府県知事は、次の各号のいずれかに該当する場合においては、当該指定居宅介護支援事業者に係る第四十六条第一項の指定を取り消し、又は期間を定めてその指定の全部若しくは一部の効力を停止することができる。
Article 84 (1) A prefectural governor, in a case that corresponds to any of the following items, may rescind the appointment as service provider as set forth in Article 46, paragraph (1) pertaining to said Designated In-Home Long-Term Care Support Provider or suspend the whole or a part of the effect of said appointment as service provider by specifying the due date for compliance:
一 指定居宅介護支援事業者が、第七十九条第二項第四号又は第八号のいずれかに該当するに至ったとき。
(i) when a Designated In-Home Long-Term Care Support Provider corresponds to any provision of Article 79, paragraph (2), item (iv), or item (viii);
二 指定居宅介護支援事業者が、当該指定に係る事業所の介護支援専門員の人員について、第八十一条第一項の厚生労働省令で定める員数を満たすことができなくなったとき。
(ii) when a Designated In-Home Long-Term Care Support Provider becomes unable to meet the fixed minimum number of employees of Long-Term Care Support Specialist s as determined by an Ordinance of the Ministry of Health, Labour, and Welfare as set forth in Article 81, paragraph (1) with regard to the number of Long-Term Care Support Specialist s of the Business Office pertaining to said appointment as service provider;
三 指定居宅介護支援事業者が、第八十一条第二項に規定する指定居宅介護支援の事業の運営に関する基準に従って適正な指定居宅介護支援の事業の運営をすることができなくなったとき。
(iii) when a Designated In-Home Long-Term Care Support Provider becomes unable to operate an appropriate Designated In-Home Long-Term Care Support Business in accordance with standards concerning Management of a Designated In-Home Long-Term Care Support Business as prescribed in Article 81, paragraph (2);
四 指定居宅介護支援事業者が、第八十一条第四項に規定する義務に違反したと認められるとき。
(iv) when it is determined that a Designated In-Home Long-Term Care Support Provider violates an obligation as prescribed in Article 81, paragraph (4);
五 第二十八条第五項の規定により調査の委託を受けた場合において、当該調査の結果について虚偽の報告をしたとき。
(v) when a Designated In-Home Long-Term Care Support Provider is entrusted with an investigation pursuant to the provisions of Article 28, paragraph (5), and submits a false report regarding the result of said investigation;
六 居宅介護サービス計画費の請求に関し不正があったとき。
(vi) when an Allowance for In-Home Long-Term Care Service Plan is wrongly requested;
七 指定居宅介護支援事業者が、第八十三条第一項の規定により報告又は帳簿書類の提出若しくは提示を命ぜられてこれに従わず、又は虚偽の報告をしたとき。
(vii) when a Designated In-Home Long-Term Care Support Provider is ordered to report, submit or present record books and documents pursuant to the provisions of Article 83, paragraph (1), but disobeys said order or submits a false report;
八 指定居宅介護支援事業者又は当該指定に係る事業所の従業者が、第八十三条第一項の規定により出頭を求められてこれに応ぜず、同項の規定による質問に対して答弁せず、若しくは虚偽の答弁をし、又は同項の規定による検査を拒み、妨げ、若しくは忌避したとき。ただし、当該指定に係る事業所の従業者がその行為をした場合において、その行為を防止するため、当該指定居宅介護支援事業者が相当の注意及び監督を尽くしたときを除く。
(viii) when a Designated In-Home Long-Term Care Support Provider or an employee of the Business Office pertaining to said appointment as service provider is requested to appear pursuant to the provisions of Article 83, paragraph (1), but does not respond or does not reply to questions pursuant to the provisions of the same paragraph or submits a false reply, or refuses, interrupts, or interferes with an inspection pursuant to the provisions of the same paragraph, however, provided that this provision shall not apply when an employee of the Business Office pertaining to said appointment as service provider performed said act and said Designated In-Home Long-Term Care Support Provider was faithfully providing reasonable care and supervision in order to prevent said act of said employee;
九 指定居宅介護支援事業者が、不正の手段により第四十六条第一項の指定を受けたとき。
(ix) when a Designated In-Home Long-Term Care Support Provider is appointed to provide service as set forth in the main clause of Article 46, paragraph (1) by wrongful means;
十 前各号に掲げる場合のほか、指定居宅介護支援事業者が、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又はこれらの法律に基づく命令若しくは処分に違反したとき。
(x) in addition to the cases listed in the preceding items, when a Designated In-Home Long-Term Care Support Provider violates this Act, another Act concerning citizens' health and medical care or public aid as determined by a Cabinet Order, or an Order or disposition of a matter based on these Acts;
十一 前各号に掲げる場合のほか、指定居宅介護支援事業者が、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とき。
(xi) in addition to the cases listed in the preceding items, when a Designated In-Home Long-Term Care Support Provider performs a wrongful or significantly unjustifiable act concerning In-Home Service, etc.;
十二 指定居宅介護支援事業者の役員等のうちに、指定の取消し又は指定の全部若しくは一部の効力の停止をしようとするとき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があるとき。
(xii) when any Officer, etc., of a Designated In-Home Long-Term Care Support Provider performs a wrongful or significantly unjustifiable act concerning In-Home Service, etc., within five years and the appointment as service provider is rescinded or the whole or a part of the effect of the appointment as service provider is suspended due to said act.
2 市町村は、保険給付に係る指定居宅介護支援又は第二十八条第五項の規定により委託した調査を行った指定居宅介護支援事業者について、前項各号のいずれかに該当すると認めるときは、その旨を当該指定に係る事業所の所在地の都道府県知事に通知しなければならない。
(2) With regard to a Designated In-Home Long-Term Care Support Provider of Designated In-Home Long-Term Care Support pertaining to an insurance benefit or the implementation of an entrusted investigation pursuant to the provisions of Article 28, paragraph (5), a Municipality, when it is determined said Provider corresponds to any provision of the items in the preceding paragraph, shall provide notification of said fact to the prefectural governor that governs the location of the Business Office pertaining to said appointment as service provider.
(公示)
(Public Notice)
第八十五条 都道府県知事は、次に掲げる場合には、その旨を公示しなければならない。
Article 85 A prefectural governor, in the following cases, shall provide public notice of the fact as prescribed in each of the following items:
一 第四十六条第一項の指定をしたとき。
(i) when an appointment as service provider as set forth in the main clause of Article 46, paragraph (1) is determined;
二 第八十二条の規定による届出(同条の厚生労働省令で定める事項の変更並びに同条に規定する事業の休止及び再開に係るものを除く。)があったとき。
(ii) when there is a notification pursuant to the provisions of Article 82 (except for change of matters as determined by an Ordinance of the Ministry of Health, Labour, and Welfare as set forth in the same Article and matters pertaining to abolishment or recommencement of business provided by the same Article);
三 前条第一項又は第百十五条の二十九第六項の規定により第四十六条第一項の指定を取り消し、又は指定の全部若しくは一部の効力を停止したとき。
(iii) when an appointment as service provider as set forth in Article 46, paragraph (1) is rescinded pursuant to the provisions of paragraph (1) of the preceding Article or Article 115-29, paragraph (6), or the effect of the whole or a part of an appointment as service provider is suspended.
第五節 介護保険施設
Section 5 Facilities Covered by Long-Term Care Insurance
第一款 指定介護老人福祉施設
Subsection 1 Designated Facilities Covered by Public Aid Providing Long-Term Care to the Elderly
(指定介護老人福祉施設の指定)
(Appointment as Service Provider of a Designated Facility Covered by Public Aid Providing Long-Term Care to the Elderly)
第八十六条 第四十八条第一項第一号の指定は、厚生労働省令で定めるところにより、老人福祉法第二十条の五に規定する特別養護老人ホームであって、その入所定員が三十人以上であるものの開設者の申請があったものについて行う。
Article 86 (1) The appointment as a service provider as set forth in Article 48, paragraph (1), item (i) shall be provided, pursuant to the provisions of an Ordinance of the Ministry of Health, Labour, and Welfare, to an application filed by an organizer of an Intensive Care Home for the Elderly as prescribed in Article 20-5 of the Public Aid for the Aged Act with an admission capacity of said facility that is thirty (30) or more.
2 都道府県知事は、前項の申請があった場合において、当該特別養護老人ホームが次の各号のいずれかに該当するときは、第四十八条第一項第一号の指定をしてはならない。
(2) A prefectural governor, in a case of an application as set forth in the preceding paragraph, when said Intensive Care Home for the Elderly corresponds to any of the following items, shall not provide appointment as service provider as set forth in the main clause of Article 48, paragraph (1), item (i):
一 第八十八条第一項に規定する人員を有しないとき。
(i) when it does not employ personnel as provided by Article 88, paragraph (1);
二 第八十八条第二項に規定する指定介護老人福祉施設の設備及び運営に関する基準に従って適正な介護老人福祉施設の運営をすることができないと認められるとき。
(ii) when it is determined that said Intensive Care Home for the Elderly cannot properly manage a Facility Covered by Public Aid Providing Long-Term Care to the Elderly in accordance with standards pertaining to facilities and management of a Designated Facility Covered by Public Aid Providing Long-Term Care to the Elderly as prescribed in Article 88, paragraph (2);
三 当該特別養護老人ホームの開設者が、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。
(iii) when the organizer of said Intensive Care Home for the Elderly was punished by a fine pursuant to the provisions of this Act, provided by a Cabinet Order, concerning citizens' health and medical care or public aid and execution of said penalty has not yet been completed or has not yet expired;
四 当該特別養護老人ホームの開設者が、第九十二条第一項又は第百十五条の二十九第六項の規定により指定を取り消され、その取消しの日から起算して五年を経過しない者であるとき。
(iv) when an organizer of said Intensive Care Home for the Elderly is rescinded as the appointed service provider pursuant to the provisions of Article 92, paragraph (1) or Article 115-29, paragraph (6) and five years have not elapsed from the date of said rescission;
五 当該特別養護老人ホームの開設者が、第九十二条第一項又は第百十五条の二十九第六項の規定による指定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九十一条の規定による指定の辞退をした者(当該指定の辞退について相当の理由がある者を除く。)で、当該指定の辞退の日から起算して五年を経過しないものであるとき。
(v) when an organizer of said Intensive Care Home for the Elderly declined an appointment as service provider of business pursuant to the provisions of article 91 (except for a person that has a reasonable basis for abolishment of said business) from the date of notification pursuant to the provisions of Article 15 of the Administrative Procedures Act pertaining to rescission of appointment as service provider pursuant to the provisions of Article 92, paragraph (1) or Article 115-29, paragraph (6) to the date of said rescission or the date it is determined that said termination of appointment will not be accepted, and five years have not elapsed from the date of said notification or decline of appointment as service provider;
六 当該特別養護老人ホームの開設者が、指定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。
(vi) when an organizer of said Intensive Care Home for the Elderly performs a wrongful or significantly unjustifiable act concerning In-Home Service, etc., within five years prior to an application of appointment as service provider;
七 当該特別養護老人ホームの開設者の役員又はその長のうちに次のいずれかに該当する者があるとき。
(vii) when any Officer, etc., or the chairperson of an organizer of said Intensive Care Home for the Elderly corresponds to any of the following:
イ 禁錮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
(a) a person punished by imprisonment without compulsory labor and execution of said penalty has not yet been completed or has not yet expired;
ロ 第三号又は前号に該当する者
(b) a person that corresponds to item (iii) or the preceding item;
ハ 第九十二条第一項又は第百十五条の二十九第六項の規定により指定を取り消された特別養護老人ホームにおいて、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その開設者の役員又はその長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
(c) a person that is or was an Officer, etc., of an organizer or the chairperson of the board of an Intensive Care Home for the Elderly for which appointment as service provider is rescinded pursuant to the provisions of Article 92, paragraph (1) or Article 115-29, paragraph (6) within sixty days prior to the date of notification pursuant to the provisions of Article 15 of the Administrative Procedures Act pertaining to said rescission and five years have not elapsed from the date of said rescission;
ニ 第五号に規定する期間内に第九十一条の規定による指定の辞退をした特別養護老人ホーム(当該指定の辞退について相当の理由がある特別養護老人ホームを除く。)において、同号の通知の日前六十日以内にその開設者の役員又はその長であった者で当該指定の辞退の日から起算して五年を経過しないもの
(d) a person that is or was an Officer, etc., of an organizer or the chairperson of the board of an Intensive Care Home for the Elderly that declined an appointment as service provider pursuant to the provisions of Article 91 within the period provided by item (v) (except for an Intensive Care Home for the Elderly which has a reasonable basis for said decline of appointment as service provider) within sixty days prior to the date of notification as set forth in the same item and five years have not elapsed from the date of said decline of appointment as service provider.
3 都道府県知事は、第四十八条第一項第一号の指定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。
(3) A prefectural governor, when he or she intends to provide appointment as service provider as set forth in Article 48, paragraph (1), item (i), shall provide notice of matters as determined by an Ordinance 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.
(指定の更新)
(Renewal of Appointment as Service Provider)
第八十六条の二 第四十八条第一項第一号の指定は、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。
Article 86-2 (1) Appointment as service provider as set forth in Article 48, paragraph (1), item (i), if it is not renewed within a period of six years, shall cease to be effective when said period expires.
2 前項の更新の申請があった場合において、同項の期間(以下この条において「指定の有効期間」という。)の満了の日までにその申請に対する処分がされないときは、従前の指定は、指定の有効期間の満了後もその処分がされるまでの間は、なおその効力を有する。
(2) In a case of application of renewal as set forth in the preceding paragraph, when a final determination of the application does not occur prior to the expiry of the period as set forth in the same paragraph (herein referred to as "Effective Period of Designation as Service Provider" in this Act), the prior appointment as service provider shall remain effective after expiry of the Effective Period of Designation as Service Provider until a determination is reached regarding said application.
3 前項の場合において、指定の更新がされたときは、その指定の有効期間は、従前の指定の有効期間の満了の日の翌日から起算するものとする。
(3) In a case as set forth in the preceding paragraph, when the appointment as service provider is renewed, said Effective Period of Designation as Service Provider shall be from the date following the date of expiry of the prior Effective Period of Designation as Service Provider.
4 前条の規定は、第一項の指定の更新について準用する。
(4) The provisions of the preceding Article shall apply mutatis mutandis to renewal of appointment as service provider as set forth in paragraph (1).
(指定介護老人福祉施設の基準)
(Standards of a Designated Facility Covered by Public Aid Providing Long-Term Care to the Elderly)
第八十七条 指定介護老人福祉施設の開設者は、次条第二項に規定する指定介護老人福祉施設の設備及び運営に関する基準に従い、要介護者の心身の状況等に応じて適切な指定介護福祉施設サービスを提供するとともに、自らその提供する指定介護福祉施設サービスの質の評価を行うことその他の措置を講ずることにより常に指定介護福祉施設サービスを受ける者の立場に立ってこれを提供するように努めなければならない。
Article 87 (1) An organizer of a Designated Facility Covered by Public Aid Providing Long-Term Care to the Elderly shall act in compliance with the standards concerning facilities and management of a Designated Facility Covered by Public Aid Providing Long-Term Care to the Elderly as prescribed in paragraph (2) of the following Article, offer an appropriate Designated Facility Covered by Public Aid Providing Long-Term Care to the Elderly according to the mental and physical condition, etc., of a Person Requiring Long-Term Care, and always engage in offering said services from the viewpoint of the person that receives Designated Facility Covered by Public Aid Providing Long-Term Care to the Elderly by implementing self-evaluation of the quality of the Provider's own Designated Facility Covered by Public Aid Providing Long-Term Care to the Elderly and other measures.
2 指定介護老人福祉施設の開設者は、指定介護福祉施設サービスを受けようとする被保険者から提示された被保険者証に、認定審査会意見が記載されているときは、当該認定審査会意見に配慮して、当該被保険者に当該指定介護福祉施設サービスを提供するように努めなければならない。
(2) A organizer of a Designated Facility Service for Long-Term Care Covered by Public Aid, 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 Designated Facility Service for Long-Term Care Covered by Public Aid, shall engage in offering said Designated Facility Covered by Public Aid Providing Long-Term Care to the Elderly of said Insured Person in consideration of said Opinion of the Certification Committee.
第八十八条 指定介護老人福祉施設は、厚生労働省令で定める員数の介護支援専門員その他の指定介護福祉施設サービスに従事する従業者を有しなければならない。
Article 88 (1) Designated Facility Covered by Public Aid Providing Long-Term Care to the Elderly shall employ the number of Long-Term Care Support Specialist or other employees that engage in said Designated Facility Service for Long-Term Care Covered by Public Aid, as determined by an Ordinance of the Ministry of Health, Labour, and Welfare.
2 前項に規定するもののほか、指定介護老人福祉施設の設備及び運営に関する基準は、厚生労働大臣が定める。
(2) In addition to the provisions as prescribed in the preceding paragraph, standards concerning facilities and management of a Designated Facility Covered by Public Aid Providing Long-Term Care to the Elderly shall be provided by the Minister of Health, Labour, and Welfare.
3 厚生労働大臣は、前項に規定する指定介護老人福祉施設の設備及び運営に関する基準(指定介護福祉施設サービスの取扱いに関する部分に限る。)を定めようとするときは、あらかじめ社会保障審議会の意見を聴かなければならない。
(3) The Minister of Health, Labour, and Welfare shall, when providing standards concerning facilities and management of a Designated Facility Covered by Public Aid Providing Long-Term Care to the Elderly prescribed in the preceding paragraph (limited to the part concerning the handling of Designated Facility Service for Long-Term Care Covered by Public Aid), hear the opinion of the Social Security Council in advance.
4 指定介護老人福祉施設の開設者は、要介護者の人格を尊重するとともに、この法律又はこの法律に基づく命令を遵守し、要介護者のため忠実にその職務を遂行しなければならない。
(4) An organizer of a Designated Facility Covered by Public Aid Providing Long-Term Care to the Elderly shall respect the personality of a Person Requiring Long-Term Care, act in compliance with this Act or an Order based on this Act, and faithfully perform said duty for a Person Requiring Long-Term Care.
(変更の届出)
(Notification of Change)
第八十九条 指定介護老人福祉施設の開設者は、開設者の住所その他の厚生労働省令で定める事項に変更があったときは、厚生労働省令で定めるところにより、十日以内に、その旨を都道府県知事に届け出なければならない。
Article 89 A organizer of a Designated Facility Covered by Public Aid Providing Long-Term Care to the Elderly shall, when the domicile of an organizer or other matters as determined by an Ordinance of the Ministry of Health, Labour, and Welfare are changed, provide notification of said fact to the prefectural governor within ten days pursuant to the provisions of an Ordinance of the Ministry of Health, Labour, and Welfare.
(報告等)
(Reporting, etc.)
第九十条 都道府県知事又は市町村長は、必要があると認めるときは、指定介護老人福祉施設若しくは指定介護老人福祉施設の開設者若しくはその長その他の従業者であった者(以下この項において「開設者であった者等」という。)に対し、報告若しくは帳簿書類の提出若しくは提示を命じ、指定介護老人福祉施設の開設者若しくはその長その他の従業者若しくは開設者であった者等に対し出頭を求め、又は当該職員に関係者に対して質問させ、若しくは指定介護老人福祉施設に立ち入り、その設備若しくは帳簿書類その他の物件を検査させることができる。
Article 90 (1) A prefectural governor or mayor of a Municipality, when it is determined to be necessary, shall order a Designated Facility Covered by Public Aid Providing Long-Term Care to the Elderly, a person that is or was an organizer, the chairperson, or other employee of a Designated Facility Covered by Public Aid Providing Long-Term Care to the Elderly (hereinafter referred to as a "Person that is or was a Organizer of a Designated Facility Covered by Public Aid Providing Long-Term Care to the Elderly, etc." in this paragraph) to report, submit or present record books and documents, request a person that is or was an organizer, the chairperson, or an employee of a Designated Facility Covered by Public Aid Providing Long-Term Care to the Elderly, etc., to appear, to direct personnel to ask questions to the relevant Person, or enter the Business Office pertaining to said appointment as service provider of said Designated Facility Covered by Public Aid Providing Long-Term Care to the Elderly in order to inspect said facility, record books and documents, or other items.
2 第二十四条第三項の規定は、前項の規定による質問又は検査について、同条第四項の規定は、前項の規定による権限について準用する。
(2) The provisions of Article 24, paragraph (3) shall apply mutatis mutandis to questions and inspections pursuant to the provisions of the preceding paragraph, and the provisions of paragraph (4) of the same Article shall apply mutatis mutandis to the authority granted pursuant to the provisions of the preceding paragraph.
(指定の辞退)
(Decline of Appointment as Service Provider)
第九十一条 指定介護老人福祉施設は、一月以上の予告期間を設けて、その指定を辞退することができる。
Article 91 A Designated Facility Covered by Public Aid Providing Long-Term Care to the Elderly may decline an appointment as service provider by offering one month or more of prior notice.
(勧告、命令等)
(Recommendation, Order, etc.)
第九十一条の二 都道府県知事は、指定介護老人福祉施設が、その行う指定介護福祉施設サービスに従事する従業者の人員について第八十八条第一項の厚生労働省令で定める員数を満たしておらず、又は同条第二項に規定する指定介護老人福祉施設の設備及び運営に関する基準に従って適正な指定介護老人福祉施設の運営をしていないと認めるときは、当該指定介護老人福祉施設の開設者に対し、期限を定めて、同条第一項の厚生労働省令で定める員数の従業者を有し、又は同条第二項に規定する指定介護老人福祉施設の設備及び運営に関する基準を遵守すべきことを勧告することができる。
Article 91-2 (1) A prefectural governor, when a Designated Facility Covered by Public Aid Providing Long-Term Care to the Elderly does not meet the fixed minimum number of employees as determined by an Ordinance of the Ministry of Health, Labour, and Welfare as set forth in Article 88 paragraph (1), with regard to the number of employees that engage in Designated Facility Service for Long-Term Care Covered by Public Aid provided by said Designated Facility Covered by Public Aid Providing Long-Term Care to the Elderly, or when it is determined that said Designated Facility Covered by Public Aid Providing Long-Term Care to the Elderly does not operate an appropriate Designated Facility Covered by Public Aid Providing Long-Term Care to the Elderly in accordance with the standards concerning facilities and management of a Designated Facility Covered by Public Aid Providing Long-Term Care to the Elderly as prescribed in paragraph (2) of the same Article, may specify a due date and recommend to an organizer of said Designated Facility Covered by Public Aid Providing Long-Term Care to the Elderly to employ the number of employees as determined by an Ordinance of the Ministry of Health, Labour, and Welfare as set forth in paragraph (1) of the same Article, or to act in compliance with standards concerning facilities and management of a Designated Facility Covered by Public Aid Providing Long-Term Care to the Elderly as prescribed by paragraph (2) of the same Article.
2 都道府県知事は、前項の規定による勧告をした場合において、その勧告を受けた指定介護老人福祉施設の開設者が同項の期限内にこれに従わなかったときは、その旨を公表することができる。
(2) A prefectural governor, in a case of providing a recommendation pursuant to the provisions of the preceding paragraph, may provide public notice of the fact that the organizer of said Designated Facility Covered by Public Aid Providing Long-Term Care to the Elderly that was issued said recommendation did not act in compliance with said recommendation within the due date as set forth in the same paragraph.
3 都道府県知事は、第一項の規定による勧告を受けた指定介護老人福祉施設の開設者が、正当な理由がなくてその勧告に係る措置をとらなかったときは、当該指定介護老人福祉施設の開設者に対し、期限を定めて、その勧告に係る措置をとるべきことを命ずることができる。
(3) A prefectural governor, when an organizer of a Designated Facility Covered by Public Aid Providing Long-Term Care to the Elderly that was issued a recommendation pursuant to the provisions of paragraph (1) does not implement the measures pertaining to said recommendation without a justifiable basis, may order to an organizer of said Designated Facility Covered by Public Aid Providing Long-Term Care to the Elderly to implement measures pertaining to said recommendation within a period specified by a due date.
4 都道府県知事は、前項の規定による命令をした場合においては、その旨を公示しなければならない。
(4) A prefectural governor, when issuing an order pursuant to the provisions of the preceding paragraph, shall issue public notice of the said fact.
5 市町村は、保険給付に係る指定介護福祉施設サービスを行った指定介護老人福祉施設について、第八十八条第二項に規定する指定介護老人福祉施設の設備及び運営に関する基準に従って適正な指定介護老人福祉施設の運営をしていないと認めるときは、その旨を当該指定介護老人福祉施設の所在地の都道府県知事に通知しなければならない。
(5) With regard to a Designated Facility Covered by Public Aid Providing Long-Term Care to the Elderly that provided Designated Facility Service for Long-Term Care Covered by Public Aid pertaining to an Insurance Benefit, a Municipality, when it is determined that said Designated Facility Covered by Public Aid Providing Long-Term Care to the Elderly does not operate an appropriate Designated Facility Covered by Public Aid Providing Long-Term Care to the Elderly in accordance with standards concerning facilities and management of a Designated Facility Covered by Public Aid Providing Long-Term Care to the Elderly as prescribed in Article 88, paragraph (2), shall provide notification of said fact to the prefectural governor that governs the location of said Designated Facility Covered by Public Aid Providing Long-Term Care to the Elderly.
(指定の取消し等)
(Rescission of Appointment as Service Provider, etc.)
第九十二条 都道府県知事は、次の各号のいずれかに該当する場合においては、当該指定介護老人福祉施設に係る第四十八条第一項第一号の指定を取り消し、又は期間を定めてその指定の全部若しくは一部の効力を停止することができる。
Article 92 (1) A prefectural governor, in a case that corresponds to any of the following items, may rescind the appointment as service provider as set forth in the main clause of Article 48, paragraph (1), item (i) pertaining to said Designated Facility Covered by Public Aid Providing Long-Term Care to the Elderly or suspend the whole or a part of the effect of said appointment as service provider by specifying the due date for compliance:
一 指定介護老人福祉施設が、第八十六条第二項第三号又は第七号のいずれかに該当するに至ったとき。
(i) when a Designated Facility Covered by Public Aid Providing Long-Term Care to the Elderly corresponds to any provision of Article 86, paragraph (2), item (iii) or item (vii);
二 指定介護老人福祉施設が、その行う指定介護福祉施設サービスに従事する従業者の人員について、第八十八条第一項の厚生労働省令で定める員数を満たすことができなくなったとき。
(ii) when a Designated Facility Covered by Public Aid Providing Long-Term Care to the Elderly becomes unable to meet the fixed minimum number of employees as determined by an Ordinance of the Ministry of Health, Labour, and Welfare as set forth in Article 88, paragraph (1), with regard to the number of employees that engage in Designated Facility Service for Long-Term Care Covered by Public Aid provided by said Designated Facility;
三 指定介護老人福祉施設が、第八十八条第二項に規定する指定介護老人福祉施設の設備及び運営に関する基準に従って適正な指定介護老人福祉施設の運営をすることができなくなったとき。
(iii) when a Designated Facility Covered by Public Aid Providing Long-Term Care to the Elderly becomes unable to operate an appropriate Designated Facility Covered by Public Aid Providing Long-Term Care to the Elderly in accordance with standards concerning facilities and management of a Designated Facility Covered by Public Aid Providing Long-Term Care to the Elderly as prescribed in Article 88, paragraph (2);
四 指定介護老人福祉施設の開設者が、第八十八条第四項に規定する義務に違反したと認められるとき。
(iv) when it is determined that an organizer of a Designated Facility Covered by Public Aid Providing Long-Term Care to the Elderly violates an obligation as prescribed in Article 88, paragraph (4);
五 第二十八条第五項の規定により調査の委託を受けた場合において、当該調査の結果について虚偽の報告をしたとき。
(v) when a Designated Facility Covered by Public Aid Providing Long-Term Care to the Elderly is entrusted with an investigation pursuant to the provisions of Article 28, paragraph (5), and submits a false report regarding the result of said investigation;
六 施設介護サービス費の請求に関し不正があったとき。
(vi) when an Allowance for Long-Term Care Facility Service is wrongly requested;
七 指定介護老人福祉施設が、第九十条第一項の規定により報告又は帳簿書類の提出若しくは提示を命ぜられてこれに従わず、又は虚偽の報告をしたとき。
(vii) when a Designated Facility Covered by Public Aid Providing Long-Term Care to the Elderly is ordered to report, submit or present record books and documents pursuant to the provisions of Article 90, paragraph (1), but disobeys said order or submits a false report;
八 指定介護老人福祉施設の開設者又はその長若しくは従業者が、第九十条第一項の規定により出頭を求められてこれに応ぜず、同項の規定による質問に対して答弁せず、若しくは虚偽の答弁をし、又は同項の規定による検査を拒み、妨げ、若しくは忌避したとき。ただし、当該指定介護老人福祉施設の従業者がその行為をした場合において、その行為を防止するため、当該指定介護老人福祉施設の開設者又はその長が相当の注意及び監督を尽くしたときを除く。
(viii) when the organizer, the chairperson, or an employee of a Designated Facility Covered by Public Aid Providing Long-Term Care to the Elderly is requested to appear pursuant to the provisions of Article 90, paragraph (1), but does not respond or does not reply to questions pursuant to the provisions of the same paragraph or submits a false reply, or refuses, interrupts, or interferes with an inspection pursuant to the provisions of the same paragraph, however, provided that this provision shall not apply when an employee of said Designated Facility Covered by Public Aid Providing Long-Term Care to the Elderly performed said act and an organizer or the chairperson of said Designated Facility Covered by Public Aid Providing Long-Term Care to the Elderly was faithfully providing reasonable care and supervision in order to prevent said act of said employee;
九 指定介護老人福祉施設の開設者が、不正の手段により第四十八条第一項第一号の指定を受けたとき。
(ix) when an organizer of a Designated Facility Covered by Public Aid Providing Long-Term Care to the Elderly is appointed to provide service as set forth in the main clause of Article 48, paragraph (1) by wrongful means;
十 前各号に掲げる場合のほか、指定介護老人福祉施設の開設者が、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又はこれらの法律に基づく命令若しくは処分に違反したとき。
(x) in addition to the cases listed in the preceding items, when an organizer of a Designated Facility Covered by Public Aid Providing Long-Term Care to the Elderly violates this Act, another Act concerning citizens' health and medical care and public aid as provided by a Cabinet Order, or an Order or disposition of a matter based on these Acts;
十一 前各号に掲げる場合のほか、指定介護老人福祉施設の開設者が、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とき。
(xi) in addition to the cases listed in the preceding items, when an organizer of a Designated Facility Covered by Public Aid Providing Long-Term Care to the Elderly performs a wrongful or significantly unjustifiable act concerning In-Home Service, etc.;
十二 指定介護老人福祉施設の開設者の役員又はその長のうちに、指定の取消し又は指定の全部若しくは一部の効力の停止をしようとするとき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があるとき。
(xii) when any Officers or chairperson of the organizer of a Designated Facility Covered by Public Aid Providing Long-Term Care to the Elderly performs a wrongful or significantly unjustifiable act concerning In-Home Service, etc., within five years and the appointment as service provider is rescinded or the whole or a part of the effect of the appointment as service provider is suspended due to said act.
2 市町村は、保険給付に係る指定介護福祉施設サービス又は第二十八条第五項の規定により委託した調査を行った指定介護老人福祉施設について、前項各号のいずれかに該当すると認めるときは、その旨を当該指定介護老人福祉施設の所在地の都道府県知事に通知しなければならない。
(2) With regard to a Designated Facility Covered by Public Aid Providing Long-Term Care to the Elderly that provided Designated Facility Service for Long-Term Care Covered by Public Aid pertaining to an Insurance Benefit or the implementation of an entrusted investigation pursuant to the provisions of Article 28, paragraph (5), a Municipality, when it determines said Designated Facility Service for Long-Term Care Covered by Public Aid corresponds to any provision of the items in the preceding paragraph, shall provide notification of said fact to the prefectural governor that governs the location of said Designated Facility Covered by Public Aid Providing Long-Term Care to the Elderly.
(公示)
(Public Notice)
第九十三条 都道府県知事は、次に掲げる場合には、その旨を公示しなければならない。
Article 93 A prefectural governor, in the following cases, shall issue public notice of the said fact:
一 第四十八条第一項第一号の指定をしたとき。
(i) when an appointment as service provider as set forth in the main clause of Article 48, paragraph (1), item (i) is determined;
二 第九十一条の規定による第四十八条第一項第一号の指定の辞退があったとき。
(ii) when the appointment as service provider as set forth in Article 48, paragraph (1), item (i) is declined pursuant to the provisions of Article 91;
三 前条第一項又は第百十五条の二十九第六項の規定により第四十八条第一項第一号の指定を取り消し、又は指定の全部若しくは一部の効力を停止したとき。
(iii) when an appointment as service provider as set forth in Article 48, paragraph (1), item (i) is rescinded pursuant to the provisions of paragraph (1) of the preceding Article or Article 115-29, paragraph (6), or the effect of the whole or a part of an appointment as service provider is suspended.
第二款 介護老人保健施設
Subsection 2 Long-Term Care Health Facilities
(開設許可)
(Approval for Establishment)
第九十四条 介護老人保健施設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。
Article 94 (1) A person that intends to establish a Long-Term Care Health Facility shall obtain approval of the prefectural governor pursuant to the provisions of an Ordinance of the Ministry of Health, Labour, and Welfare.
2 介護老人保健施設を開設した者(以下「介護老人保健施設の開設者」という。)が、当該介護老人保健施設の入所定員その他厚生労働省令で定める事項を変更しようとするときも、前項と同様とする。
(2) The provisions of the preceding paragraph shall apply to when a person that established a Long-Term Care Health Facility (hereinafter referred to as a "Organizer of a Long-Term Care Health Facility"), intends to change the fixed limit of the number of persons who may be admitted to said Long-Term Care Health Facility and other matters as determined by an Ordinance of the Ministry of Health, Labour, and Welfare.
3 都道府県知事は、前二項の許可の申請があった場合において、次の各号(前項の申請にあっては、第二号又は第三号)のいずれかに該当するときは、前二項の許可を与えることができない。
(3) 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:
一 当該介護老人保健施設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。
(i) when a person that intends to establish said Long-Term Care Health Facility is not a local government, a medical juridical person, a social welfare juridical person, or other person as determined by an Ordinance of the Minister of Health, Labour, and Welfare;
二 当該介護老人保健施設が第九十七条第一項に規定する施設又は同条第二項に規定する人員を有しないとき。
(ii) when said Long-Term Care Health Facility does not possess a facility as prescribed in Article 97, paragraph (1) or the number of personnel as prescribed in paragraph (2) of the same Article;
三 第九十七条第三項に規定する介護老人保健施設の設備及び運営に関する基準に従って適正な介護老人保健施設の運営をすることができないと認められるとき。
(iii) when it is determined that the Long-Term Care Health Facility cannot properly manage the Long-Term Care Health Facility in accordance with standards pertaining to facilities and management as prescribed in Article 97, paragraph (3);
四 申請者が、禁錮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。
(iv) when the applicant is punished by imprisonment without compulsory labor or to a more severe penalty, and said execution of the penalty has not been completed or has not yet expired;
五 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。
(v) 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;
六 申請者が、第百四条第一項又は第百十五条の二十九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老人保健施設を管理する者(以下「介護老人保健施設の管理者」という。)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老人保健施設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。
(vi) when the applicant has been rescinded approval pursuant to the provisions of Article 104, paragraph (1) or Article 115-29, paragraph (6) and five years have not elapsed from the date of said rescission (in a case when a person that has been rescinded for said appointment as service provider is a juridical person, including a person that is or was an Officer of said juridical person or who managed the established Long-Term Care Health Facility (hereinafter referred to as "Manager of a Long-Term Care Health Facility") and within sixty days prior to the date of notification pursuant to the provisions of Article 15 of the Administrative Procedures Act pertaining to said rescission and five years have not elapsed from the date of said rescission, and in a case when a person that has been rescinded said approval, is a person as determined by an Ordinance of the Minister of Health, Labour, and Welfare, but not a juridical person, including a person that is or was a Manager of a Long-Term Care Health Facility, which was established by said person, within sixty days prior to the date of said notification and five years have not elapsed from the date of said rescission;
七 申請者が、第百四条第一項又は第百十五条の二十九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百五条において準用する医療法第九条第一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。
(vii) when the applicant who provided notification of abolishment pursuant to the provisions of Article 9, paragraph (1) of the Medical Care Act as applied mutatis mutandis pursuant to Article 105 from the date of notification pursuant to the provisions of Article 15 of the Administrative Procedures Act pertaining to rescission of approval pursuant to the provisions of Article 104, paragraph (1) or Article 115-29, paragraph (6) to the date when said approval is rescinded or when it is determined not to rescind the approval (except for a person that has a reasonable basis for said abolishment) and five years have not elapsed from the date of said notification;
八 前号に規定する期間内に第百五条において準用する医療法第九条第一項の規定による廃止の届出があった場合において、申請者が、同号の通知の日前六十日以内に当該届出に係る法人(当該廃止について相当の理由がある法人を除く。)の役員若しくはその開設した介護老人保健施設の管理者又は当該届出に係る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(当該廃止について相当の理由がある者を除く。)の開設した介護老人保健施設の管理者であった者で、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。
(viii) in a case when abolishment pursuant to the provisions of Article 9, paragraph (1) of the Medical Treatment Act as applied mutatis mutandis pursuant to Article 105 within the period as prescribed in the preceding paragraph was duly provided by notification, when the applicant was an Officer of a juridical person pertaining to said notification (except for a juridical person that has a reasonable basis for said abolishment) or an established Manager of a Long-Term Care Health Facility, within sixty days prior to the date of notification as set forth in the same item, or is not a Manager of a Long-Term Care Health Facility established by a non-juridical person among those who are provided by the Minister of Health, Labour, and Welfare as set forth in item (i) pertaining to said notification (except for a juridical person that has a reasonable basis for said abolishment) and five years have not elapsed from the date of said notification;
九 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。
(ix) 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;
十 申請者が、法人で、その役員等のうちに第四号から前号までのいずれかに該当する者のあるものであるとき。
(x) when the applicant is a juridical person and any said Officer, etc., corresponds to any provision of item (iv) in the preceding item;
十一 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九号までのいずれかに該当する者のあるものであるとき。
(xi) when the applicant is not a juridical person among those who are provided by the Minister of Health, Labour, and Welfare as set forth in item (i), and any person that manages said Business Office and other employees provided by a Cabinet Order are defined by item (iv) to item (ix).
4 都道府県知事は、営利を目的として、介護老人保健施設を開設しようとする者に対しては、第一項の許可を与えないことができる。
(4) A prefectural governor may not provide approval as set forth in item (i) to a person that intends to establish a Long-Term Care Health Facility for the purpose of profit;
5 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。)における介護老人保健施設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老人保健施設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。
(5) In a case when an approval as set forth in paragraph (1) and an approval as set forth in paragraph (2) (limited to those pertaining to increase of the maximum number of persons who may be admitted to the facility; hereinafter the same shall apply in this paragraph and the following paragraph) is applied, the prefectural governor, when it is determined that total number of maximum number of persons who may be admitted to Long-Term Care Health Facility in the area (which means an area provided by said prefecture pursuant to the provisions of Article 118, paragraph (2), item (i)) including the location of facility pertaining to said application has already reached the total number of necessary number of persons who may be admitted to the Long-Term Care Health Facility in the area as prescribed by the Prefectural Insured Long-Term Care Support Project Plan provided by said prefecture pursuant to the provisions of paragraph (1) of the same Article, or will exceed said total number by establishment of the facility pertaining to said application or increase 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 accomplishment of said Prefectural Insured Long-Term Care Support Project Plan, may not provide an approval as set forth in paragraph (1) or an approval as set forth in paragraph (2).
6 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。
(6) A prefectural governor, when he or she intends to provide an approval as set forth in paragraph (1) or an approval as set forth in paragraph (2), shall provide notice of matters as determined by an Ordinance 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.
(許可の更新)
(Renewal of Approval)
第九十四条の二 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。
Article 94-2 (1) Approval as set forth in paragraph (1) of the preceding Article, if it is not renewed within a period of six years, shall cease to be effective when said period expires.
2 前項の更新の申請があった場合において、同項の期間(以下この条において「許可の有効期間」という。)の満了の日までにその申請に対する処分がされないときは、従前の許可は、許可の有効期間の満了後もその処分がされるまでの間は、なおその効力を有する。
(2) In a case of approval of renewal as set forth in the preceding paragraph, when a final determination of the application does not occur prior to the expiry of the period as set forth in the same paragraph (hereinafter referred to as "Effective Period of Approval" in this Article), the prior appointment as service provider shall remain effective after expiry of the Effective Period of Approval until a determination is reached regarding said application.
3 前項の場合において、許可の更新がされたときは、その許可の有効期間は、従前の許可の有効期間の満了の日の翌日から起算するものとする。
(3) In a case as set forth in the preceding paragraph, when the approval is renewed, said Effective Period of Approval shall be from the date following the date of expiry of the prior Effective Period of Approval.
4 前条の規定は、第一項の許可の更新について準用する。
(4) The provisions of the preceding Article shall apply mutatis mutandis to renewal of appointment as service provider as set forth in paragraph (1).
(介護老人保健施設の管理)
(Management of a Long-Term Care Health Facility)
第九十五条 介護老人保健施設の開設者は、都道府県知事の承認を受けた医師に当該介護老人保健施設を管理させなければならない。
Article 95 (1) An Organizer of a Long-Term Care Health Facility shall employ physicians approved by the prefectural governor to manage said Long-Term Care Health Facility.
2 前項の規定にかかわらず、介護老人保健施設の開設者は、都道府県知事の承認を受け、医師以外の者に当該介護老人保健施設を管理させることができる。
(2) Notwithstanding the provisions of the preceding paragraph, an Organizer of a Long-Term Care Health Facility may obtain approval of the prefectural governor and direct a person other than a physician to manage said Long-Term Care Health Facility.
(介護老人保健施設の基準)
(Standards of a Long-Term Care Health Facility)
第九十六条 介護老人保健施設の開設者は、次条第三項に規定する介護老人保健施設の設備及び運営に関する基準に従い、要介護者の心身の状況等に応じて適切な介護保健施設サービスを提供するとともに、自らその提供する介護保健施設サービスの質の評価を行うことその他の措置を講ずることにより常に介護保健施設サービスを受ける者の立場に立ってこれを提供するように努めなければならない。
Article 96 (1) A Organizer of a Long-Term Care Health Facility shall act in compliance with the standards concerning facilities and management of a Long-Term Care Health Facility as prescribed in paragraph (3) of the following Article, offer appropriate Long-Term Care Health Facility Service 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 Long-Term Care Health Facility Service by implementing self-evaluation of the quality of the Provider's own Long-Term Care Health Facility Service and other measures.
2 介護老人保健施設の開設者は、介護保健施設サービスを受けようとする被保険者から提示された被保険者証に、認定審査会意見が記載されているときは、当該認定審査会意見に配慮して、当該被保険者に当該介護保健施設サービスを提供するように努めなければならない。
(2) A Organizer of a Long-Term Care Health Facility, 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 Long-Term Care Health Facility Service, shall engage in offering said Long-Term Care Health Facility Service of said Insured Person in consideration of said Opinion of the Certification Committee.
第九十七条 介護老人保健施設は、厚生労働省令で定めるところにより、療養室、診察室、機能訓練室、談話室その他厚生労働省令で定める施設を有しなければならない。
Article 97 (1) A Long-Term Care Health Facility shall possess, pursuant to the provisions of an Ordinance of the Ministry of Health, Labour, and Welfare, a medical care room, consultation room, functional training room, lounge and other facilities as determined by an Ordinance of the Ministry of Health, Labour, and Welfare.
2 介護老人保健施設は、厚生労働省令で定める員数の医師、看護師、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を有しなければならない。
(2) A Long-Term Care Health Facility shall employ the fixed minimum number, as determined by an Ordinance of the Ministry of Health, Labour, and Welfare, of physicians, nurses, Long-Term Care Support Specialists, and employees that engage in long-term care or other operations.
3 前二項に規定するもののほか、介護老人保健施設の設備及び運営に関する基準は、厚生労働大臣が定める。
(3) In addition to the provisions as prescribed in the preceding two paragraphs, standards concerning facilities and management of a Long-Term Care Health Facility shall be provided by the Minister of Health, Labour, and Welfare.
4 厚生労働大臣は、前項に規定する介護老人保健施設の設備及び運営に関する基準(介護保健施設サービスの取扱いに関する部分に限る。)を定めようとするときは、あらかじめ社会保障審議会の意見を聴かなければならない。
(4) The Minister of Health, Labour, and Welfare, when providing standards concerning facilities and management of a Long-Term Care Health Facility as prescribed in the preceding paragraph (limited to the part concerning the handling of a Long-Term Care Health Facility Service), shall hear the opinion of the Social Security Council in advance.
5 介護老人保健施設の開設者は、要介護者の人格を尊重するとともに、この法律又はこの法律に基づく命令を遵守し、要介護者のため忠実にその職務を遂行しなければならない。
(5) An Organizer of a Long-Term Care Health Facility shall respect the personality of a Person Requiring Long-Term Care, act in compliance with this Act or an Order based on this Act, and faithfully perform said duty for a Person Requiring Long-Term Care.
(広告制限)
(Restraint of Advertisement)
第九十八条 介護老人保健施設に関しては、文書その他いかなる方法によるを問わず、何人も次に掲げる事項を除くほか、これを広告してはならない。
Article 98 (1) With regard to a Long-Term Care Health Facility, regardless of documents or any other methods, no person shall advertise the Facility, except for the following matters:
一 介護老人保健施設の名称、電話番号及び所在の場所を表示する事項
(i) matters that display the name, telephone number, and location of a Long-Term Care Health Facility;
二 介護老人保健施設に勤務する医師及び看護師の氏名
(ii) names of physicians and nurses who are employed at the Long-Term Care Health Facility;
三 前二号に掲げる事項のほか、厚生労働大臣の定める事項
(iii) in addition to matters listed in the preceding two items, matters as determined by an Ordinance of the Minister of Health, Labour, and Welfare;
四 その他都道府県知事の許可を受けた事項
(iv) other matters approved by the prefectural governor.
2 厚生労働大臣は、前項第三号に掲げる事項の広告の方法について、厚生労働省令で定めるところにより、必要な定めをすることができる。
(2) The Minister of Health, Labour, and Welfare, with regard to method of advertisement of matters listed in the preceding three items, pursuant to the provisions of an Ordinance of the Ministry of Health, Labour, and Welfare, may specify necessary matters.
(変更の届出)
(Notification of Change)
第九十九条 介護老人保健施設の開設者は、第九十四条第二項の規定による許可に係る事項を除き、当該介護老人保健施設の開設者の住所その他の厚生労働省令で定める事項に変更があったときは、厚生労働省令で定めるところにより、十日以内に、その旨を都道府県知事に届け出なければならない。
Article 99 A Organizer of a Long-Term Care Health Facility, except for matters pertaining to approval pursuant to the provisions of Article 94, paragraph (2), when the domicile of a Organizer of said Long-Term Care Health Facility or other matters as determined by an Ordinance of the Ministry of Health, Labour, and Welfare are changed, shall provide notification of said fact to the prefectural governor within ten days pursuant to the provisions of an Ordinance of the Ministry of Health, Labour, and Welfare.
(報告等)
(Reporting, etc.)
第百条 都道府県知事又は市町村長は、必要があると認めるときは、介護老人保健施設の開設者、介護老人保健施設の管理者若しくは医師その他の従業者(以下「介護老人保健施設の開設者等」という。)に対し報告若しくは診療録その他の帳簿書類の提出若しくは提示を命じ、介護老人保健施設の開設者等に対し出頭を求め、又は当該職員に、介護老人保健施設の開設者等に対して質問させ、若しくは介護老人保健施設に立ち入り、その設備若しくは診療録、帳簿書類その他の物件を検査させることができる。
Article 100 (1) A prefectural governor or mayor of a Municipality, when it is determined to be necessary, shall order a person that is or was an organizer of a Long-Term Care Health Facility, a manager of a Long-Term Care Health Facility, physician and other employee (herein referred to as a "Organizer of a Long-Term Care Health Facility, etc.") to report, submit or present medical records or record books and documents, request a Organizer of a Long-Term Care Health Facility, etc., to appear, to direct personnel to ask questions of a Organizer of a Long-Term Care Health Facility, etc., or enter Long-Term Care Health Facility in order to inspect said facilities, record books and documents, or other items.
2 第二十四条第三項の規定は、前項の規定による質問又は立入検査について、同条第四項の規定は、前項の規定による権限について準用する。
(2) The provisions of Article 24, paragraph (3) shall apply mutatis mutandis to questions and inspections pursuant to the provisions of the preceding paragraph, and the provisions of paragraph (4) of the same Article shall apply mutatis mutandis to the authority granted pursuant to the provisions of the preceding paragraph.
3 第一項の規定により、介護老人保健施設の開設者等に対し報告若しくは提出若しくは提示を命じ、若しくは出頭を求め、又は当該職員に介護老人保健施設の開設者等に対し質問させ、若しくは介護老人保健施設に立入検査をさせた市町村長は、当該介護老人保健施設につき次条、第百二条、第百三条第三項又は第百四条第一項の規定による処分が行われる必要があると認めるときは、理由を付して、その旨を都道府県知事に通知しなければならない。
(3) Pursuant to the provisions of paragraph (1), the mayor of the Municipality that ordered a Organizer of a Long-Term Care Health Facility, etc., to report, submit, or present records, or appear, to direct personnel to ask questions of a Organizer of a Long-Term Care Health Facility, etc., or enter the Long-Term Care Health Facility for inspection, when it is determined that it is necessary to terminate said Long-Term Care Health Facility pursuant to the provisions of the following Article, Article 102, Article 103, paragraph (3), or Article 104, paragraph (1), shall provide notification of said fact to the prefectural governor indicating said reasons.
(設備の使用制限等)
(Restriction on Use of Facility)
第百一条 都道府県知事は、介護老人保健施設が、第九十七条第一項に規定する施設を有しなくなったとき、又は同条第三項に規定する介護老人保健施設の設備及び運営に関する基準(設備に関する部分に限る。)に適合しなくなったときは、当該介護老人保健施設の開設者に対し、期間を定めて、その全部若しくは一部の使用を制限し、若しくは禁止し、又は期限を定めて、修繕若しくは改築を命ずることができる。
Article 101 A prefectural governor, when a Long-Term Care Health Facility does not possess the facilities as prescribed in Article 97, paragraph (1) or does not conform with the standards concerning facilities and management of a Long-Term Care Health Facility as prescribed in paragraph (3) of the same Article (limited to the part concerning said Facility) to a Organizer of a Long-Term Care Health Facility, may restrict or prohibit the use of the whole or a part of said facility within a period limited by a due date, or order to repair or modify said facility within the period limited by a due date.
(変更命令)
(Order to Change)
第百二条 都道府県知事は、介護老人保健施設の管理者が介護老人保健施設の管理者として不適当であると認めるときは、当該介護老人保健施設の開設者に対し、期限を定めて、介護老人保健施設の管理者の変更を命ずることができる。
Article 102 (1) A prefectural governor, when it is determined that a Manager of a Long-Term Care Health Facility is inappropriate as a Manager of a Long-Term Care Health Facility, may order the Organizer of said Long-Term Care Health Facility to change the Manager of the Long-Term Care Health Facility within a period limited by a due date.
2 厚生労働大臣は、前項に規定する都道府県知事の権限に属する事務について、介護老人保健施設に入所している者の生命又は身体の安全を確保するため緊急の必要があると認めるときは、都道府県知事に対し同項の事務を行うことを指示することができる。
(2) The Minister of Health, Labour, and Welfare, with regard to the affairs pertaining to the authority of a prefectural governor as prescribed in the preceding paragraph, when it determines the urgent necessity to ensure life and the physical safety of a person that may be admitted to a Long-Term Care Health Facility, may order the prefectural governor to conduct the affairs as set forth in the same paragraph.
(業務運営の勧告、命令等)
(Recommendation, Order, etc., of Business Operations)
第百三条 都道府県知事は、介護老人保健施設が、その業務に従事する従業者の人員について第九十七条第二項の厚生労働省令で定める員数を満たしておらず、又は同条第三項に規定する介護老人保健施設の設備及び運営に関する基準(運営に関する部分に限る。以下この条において同じ。)に適合していないと認めるときは、当該介護老人保健施設の開設者に対し、期限を定めて、第九十七条第二項の厚生労働省令で定める員数の従業者を有し、又は同条第三項に規定する介護老人保健施設の設備及び運営に関する基準を遵守すべきことを勧告することができる。
Article 103 (1) A prefectural governor, when it is determined that a Long-Term Care Health Facility does not meet the fixed minimum numbers as prescribed in an Ordinance of the Ministry of Health, Labour, and Welfare as set forth in Article 97, paragraph (2) with regard to the number of employees that engage in said business and that the Facility does not meet the standards concerning facilities and management of a Long-Term Care Health Facility as prescribed in paragraph (3) of the same Article (limited to the part concerning management; the same shall apply hereinafter in this Article), may recommend to the Organizer of said Long-Term Care Health Facility to employ the fixed minimum number of employees as prescribed in an Ordinance of the Ministry of Health, Labour, and Welfare as set forth in Article 97, paragraph (2) within the period limited by a due date, and to comply with the standards concerning facilities and management of a Long-Term Care Health Facility as prescribed in paragraph (3) of the same Article.
2 都道府県知事は、前項の規定による勧告をした場合において、その勧告を受けた介護老人保健施設の開設者が、同項の期限内にこれに従わなかったときは、その旨を公表することができる。
(2) A prefectural governor, in a case of providing a recommendation pursuant to the provisions of the preceding paragraph, may provide public notice of the fact that the Organizer of said Long-Term Care Health Facility that is issued said recommendation did not act in compliance with said recommendation within the due date as set forth in the same paragraph.
3 都道府県知事は、第一項の規定による勧告を受けた介護老人保健施設の開設者が、正当な理由がなくてその勧告に係る措置をとらなかったときは、当該介護老人保健施設の開設者に対し、期限を定めて、その勧告に係る措置をとるべきことを命じ、又は期間を定めて、その業務の停止を命ずることができる。
(3) A prefectural governor, when a Organizer of a Long-Term Care Health Facility that was issued a recommendation pursuant to the provisions of paragraph (1) does not implement the measures pertaining to said recommendation without a justifiable basis, may order the Organizer of said Long-Term Care Health Facility to implement measures pertaining to said recommendation within a period specified by a due date or to suspend said operation for a period of time.
4 都道府県知事は、前項の規定による命令をした場合においては、その旨を公示しなければならない。
(4) A prefectural governor, when issuing an order pursuant to the provisions of the preceding paragraph, shall issue public notice of said fact.
5 市町村は、保険給付に係る介護保健施設サービスを行った介護老人保健施設について、第九十七条第三項に規定する介護老人保健施設の設備及び運営に関する基準に適合しなくなったと認めるときは、その旨を当該介護老人保健施設の所在地の都道府県知事に通知しなければならない。
(5) With regard to a Long-Term Care Health Facility that provides Long-Term Care Health Facility Service pertaining to an Insurance Benefit, a Municipality, when it is determined that said Long-Term Care Health Facility does not conform with standards concerning facilities and management of a Long-Term Care Health Facility as prescribed in Article 97, paragraph (3), shall provide notification of said fact to the prefectural governor that governs the location of said Long-Term Care Health Facility.
(許可の取消し等)
(Rescission of Approval, etc.)
第百四条 都道府県知事は、次の各号のいずれかに該当する場合においては、当該介護老人保健施設に係る第九十四条第一項の許可を取り消し、又は期間を定めてその許可の全部若しくは一部の効力を停止することができる。
Article 104 (1) A prefectural governor, in a case that corresponds to any of the following items, may rescind the approval as set forth in Article 94, paragraph (1) pertaining to said Long-Term Care Health Facility or suspend the whole or a part of the effect of said appointment as service provider within the period limited by a due date:
一 介護老人保健施設の開設者が、第九十四条第一項の許可を受けた後正当の理由がないのに、六月以上その業務を開始しないとき。
(i) when a Organizer of a Long-Term Care Health Facility does not commence said operation for six months or more after obtaining approval as set forth in Article 94, paragraph (1) without a reasonable basis;
二 介護老人保健施設が、第九十四条第三項第四号、第五号、第十号又は第十一号のいずれかに該当するに至ったとき。
(ii) when a Long-Term Care Health Facility corresponds to any provision of Article 94, paragraph (3), item (iv), item (v), item (x), or item (ix);
三 介護老人保健施設の開設者が、第九十七条第五項に規定する義務に違反したと認められるとき。
(iii) when it is determined that an Organizer of a Long-Term Care Health Facility violates an obligation as prescribed in Article 97, paragraph (5);
四 介護老人保健施設の開設者に犯罪又は医事に関する不正行為があったとき。
(iv) when an Organizer of a Long-Term Care Health Facility committed a crime or act of dishonesty concerning medical business;
五 第二十八条第五項の規定により調査の委託を受けた場合において、当該調査の結果について虚偽の報告をしたとき。
(v) when a Long-Term Care Health Facility is entrusted with an investigation pursuant to the provisions of Article 28, paragraph (5) and submits a false report regarding the result of said investigation;
六 施設介護サービス費の請求に関し不正があったとき。
(vi) when an Allowance for Long-term care Facility Service is wrongly requested;
七 介護老人保健施設の開設者等が、第百条第一項の規定により報告又は診療録その他の帳簿書類の提出若しくは提示を命ぜられてこれに従わず、又は虚偽の報告をしたとき。
(vii) when an Organizer, etc., of a Long-Term Care Health Facility is ordered to report, submit or present medical records or record books and documents pursuant to the provisions of Article 100, paragraph (1), but disobeys said order or submits a false report;
八 介護老人保健施設の開設者等が、第百条第一項の規定により出頭を求められてこれに応ぜず、同項の規定による質問に対して答弁せず、若しくは虚偽の答弁をし、又は同項の規定による検査を拒み、妨げ、若しくは忌避したとき。ただし、当該介護老人保健施設の従業者がその行為をした場合において、その行為を防止するため、当該介護老人保健施設の開設者又は当該介護老人保健施設の管理者が相当の注意及び監督を尽くしたときを除く。
(viii) when an Organizer, etc., of a Long-Term Care Health Facility is requested to appear pursuant to the provisions of Article 100, paragraph (1) but does not respond or does not reply to questions pursuant to the provisions of the same paragraph or submits a false reply, or refuses, interrupts, or interferes with an inspection pursuant to the provisions of the same paragraph, however, provided that this provision shall not apply when an employee of said Long-Term Care Health Facility performed said act and the Organizer of the Long-Term Care Health Facility or said Manager of a Long-Term Care Health Facility was faithfully providing reasonable care and supervision in order to prevent said act of said employee;
九 前各号に掲げる場合のほか、介護老人保健施設の開設者が、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又はこれらの法律に基づく命令若しくは処分に違反したとき。
(ix) in addition to the cases listed in the preceding items, when an Organizer of a Long-Term Care Health Facility violates this Act, another Act concerning citizens' health and medical care and public aid as provided by a Cabinet Order, or an Order or disposition of a matter based on these Acts;
十 前各号に掲げる場合のほか、介護老人保健施設の開設者が、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とき。
(x) in addition to the cases listed in the preceding items, when an Organizer of a Long-Term Care Health Facility performs a wrongful or significantly unjustifiable act concerning In-Home Service, etc.;
十一 介護老人保健施設の開設者が法人である場合において、その役員又は当該介護老人保健施設の管理者のうちに許可の取消し又は許可の全部若しくは一部の効力の停止をしようとするとき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があるとき。
(xi) in a case when an Organizer of a Long-Term Care Health Facility is a juridical person, when any of said Officer, etc., or said Manager of a Long-Term Care Health Facility performs a wrongful or significantly unjustifiable act concerning In-Home Service, etc., within five years and the appointment as service provider is rescinded or the whole or a part of the effect of the appointment as service provider is suspended due to said act;
十二 介護老人保健施設の開設者が第九十四条第三項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、その管理者が許可の取消し又は許可の全部若しくは一部の効力の停止をしようとするとき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。
(xii) in a case when a Organizer of a Long-Term Care Health Facility is not a juridical person among those provided by the Ministry of Health, Labour, and Welfare as set forth in Article 94, paragraph (3), item (i), a manager of said Provider performs a wrongful or significantly unjustifiable act concerning In-Home Service, etc., within five years and the appointment as service provider is rescinded or the whole or a part of the effect of the appointment as service provider is suspended due to said act.
2 市町村は、第二十八条第五項の規定により委託した調査又は保険給付に係る介護保健施設サービスを行った介護老人保健施設について、前項各号のいずれかに該当すると認めるときは、その旨を当該介護老人保健施設の所在地の都道府県知事に通知しなければならない。
(2) With regard to a Long-Term Care Health Facility that conducts an entrusted investigation or provided Long-Term Care Health Facility Service pertaining to an Insurance Benefit pursuant to the provisions of Article 28, paragraph (5), a Municipality, when it determines said Long-Term Care Health Facility corresponds to any provision of the items in the preceding paragraph, shall provide notification of said fact to the prefectural governor that governs the location of said Long-Term Care Health Facility.
3 厚生労働大臣は、第一項に規定する都道府県知事の権限に属する事務について、介護老人保健施設に入所している者の生命又は身体の安全を確保するため緊急の必要があると認めるときは、都道府県知事に対し同項の事務を行うことを指示することができる。
(3) The Minister of Health, Labour, and Welfare, with regard to the affair that belongs to the authority of the prefectural governor as prescribed in paragraph (1), when it determines the urgent necessity to secure life and the physical safety of a person that may be admitted to the Long-Term Care Health Facility, may order the prefectural governor to conduct the affairs as set forth in the same paragraph.
医療法の準用)
(Mutatis Mutandis Application of the Medical Care Act)
第百五条 医療法第八条の二第二項及び第九条の規定は、介護老人保健施設の開設者について、同法第十五条第一項及び第三項の規定は、介護老人保健施設の管理者について、同法第三十条の規定は、第百一条から前条までの規定に基づく処分について準用する。この場合において、これらの規定に関し必要な技術的読替えは、政令で定める。
Article 105 The provisions of Article 8-2, paragraph (2) and Article 9 of the Medical Care Act shall apply mutatis mutandis to an Organizer of a Long-Term Care Health Facility and the provisions of Article 15, paragraph (1) and paragraph (3) of the same Act shall apply mutatis mutandis to a Manager of a Long-Term Care Health Facility, and the provisions of Article 30 of the same Act shall apply mutatis mutandis to the disposition of a matter based on the provisions of Article 101 to the preceding Article. In this case, necessary technical replacement of the terms of these provisions shall be provided by a Cabinet Order.
医療法との関係等)
(Relationship, etc., with the Medical Care Act)
第百六条 介護老人保健施設は、医療法にいう病院又は診療所ではない。ただし、医療法及びこれに基づく命令以外の法令の規定(健康保険法国民健康保険法その他の法令の政令で定める規定を除く。)において「病院」又は「診療所」とあるのは、介護老人保健施設(政令で定める法令の規定にあっては、政令で定めるものを除く。)を含むものとする。
Article 106 A Long-Term Care Health Facility shall not be a hospital or a clinic as used in the Medical Care Act, however, provided that the terms "hospital" and "clinic" in the Medical Care Act and provisions of laws and regulations other than orders based on the Medical Care Act (except for the Health Insurance Act, National Health Insurance Act and provisions provided by a Cabinet Order as set forth in other laws and regulations) shall include a Long-Term Care Health Facility (in the provisions of laws and regulations provided by a Cabinet Order, except for those provided by a Cabinet Order).
第三款 指定介護療養型医療施設
Subsection 3 Designated Medical Long-Term Care Sanatoriums
(指定介護療養型医療施設の指定)
(Appointment as Service Provider of a Designated Medical Long-Term Care Sanatorium)
第百七条 第四十八条第一項第三号の指定は、厚生労働省令で定めるところにより、療養病床等を有する病院又は診療所(以下この条において「療養病床病院等」という。)であって、その開設者の申請があったものについて行う。
Article 107 (1) Appointment as service provider as set forth in Article 48, paragraph (1), item (iii) shall be provided, pursuant to the provisions of an Ordinance of the Ministry of Health, Labour, and Welfare, to a hospital or a clinic that possesses Sanatorium Ward, etc., (hereinafter referred to as "Sanatorium Ward Hospital, etc." in this Article) for which Organizer submitted for said appointment as service provider.
2 前項の申請は、第四十八条第一項第三号の指定に係る療養病床等の入所定員を定めてするものとする。
(2) The application as set forth in the preceding paragraph shall be implemented by specifying the maximum number of persons who may be admitted to the Sanatorium Ward, etc., pertaining to an appointment as service provider as set forth in Article 48, paragraph (1), item (iii).
3 都道府県知事は、第一項の申請があった場合において、当該療養病床病院等が次の各号のいずれかに該当するときは、第四十八条第一項第三号の指定をしてはならない。
(3) A prefectural governor, in a case of an application as set forth in paragraph (1), when said Sanatorium Ward Hospital, etc., corresponds to any of the following items, shall not provide appointment as service provider as set forth in Article 48, paragraph (1), item (iii):
一 第百十条第一項に規定する人員を有しないとき。
(i) when it does not employ the personnel provided by Article 110, paragraph (1);
二 第百十条第二項に規定する指定介護療養型医療施設の設備及び運営に関する基準に従って適正な介護療養型医療施設の運営をすることができないと認められるとき。
(ii) when it is determined that said Sanatorium Ward Hospital, etc., cannot properly manage the Sanatorium Medical Care Facilities for the Elderly Requiring Care in accordance with standards pertaining to management of a Designated Medical Long-Term Care Sanatorium as prescribed in Article 110, paragraph (2);
三 当該療養病床病院等の開設者が、禁錮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。
(iii) when a Organizer of said Sanatorium Ward Hospital, etc., is punished by imprisonment without compulsory labor or to a more severe penalty and said execution of the penalty has not been completed or has not yet expired;
四 当該療養病床病院等の開設者が、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。
(iv) when a Organizer of said Sanatorium Ward Hospital, etc., 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;
五 当該療養病床病院等の開設者が、第百十四条第一項又は第百十五条の二十九第六項の規定により指定を取り消され、その取消しの日から起算して五年を経過しない者(当該指定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療養病床病院等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、当該指定を取り消された者が法人でない療養病床病院等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療養病床病院等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。
(v) when an organizer of said Sanatorium Ward Hospital, etc., rescinds its appointment as service provider pursuant to the provisions of Article 114, paragraph (1) or Article 115-29, paragraph (6) and five years have not elapsed from the date of said rescission (in a case when a person that rescinds said appointment as service provider is a juridical person, including an Officer of said juridical person or a manager of the established Sanatorium Ward Hospital, etc., within sixty days prior to the date of notification pursuant to the provisions of Article 15 of the Administrative Procedures Act pertaining to said rescission and five years have not elapsed from the date of said rescission, and in a case that a person that rescinds said appointment as service provider is not a juridical person, including a person that is or was a manager of said Sanatorium Ward Hospital, etc., within sixty days prior to said notification and five years have not elapsed from the date of said rescission);
六 当該療養病床病院等の開設者が、第百十四条第一項又は第百十五条の二十九第六項の規定による指定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の規定による指定の辞退をした者(当該指定の辞退について相当の理由がある者を除く。)で、当該指定の辞退の日から起算して五年を経過しないものであるとき。
(vi) when an organizer of said Sanatorium Ward Hospital, etc., is a person that declined an appointment as service provider pursuant to the provisions of Article 113 from the date of notification pursuant to the provisions of Article 15 of the Administrative Procedures Act pertaining to the rescission of appointment as service provider pursuant to the provisions of Article 114, paragraph (1) or Article 115-29, paragraph (6) to the date when said appointment as service provider is rescinded or when it is determined not to rescind the approval (except for a person that has a reasonable basis for said abolishment) and five years have not elapsed from the date of said decline of appointment as service provider;
七 前号に規定する期間内に第百十三条の規定による指定の辞退があった場合において、当該療養病