Nursing care health facilityWhat is (Kaigorojinhokenshisetsu)?Long-term care insuranceIs appliedNursing careWith the service, we will recover mental and physical functions and improve activities with the goal of returning to home.Facility.

またLong-Term Care Health Facility(Ryoyo ga Takai Gorojin Hokensetsu) is a long-term care service covered by long-term care insurance. Facility to do.Commonly known asLong-Term Care Health Facility or Long-Term Care Health Facility.

95% of residents of these facilitiesdementiaHave, and an additional 44.6%BedriddenState^[1]..The average length of stay was 311.3 days (2013)^[1].

Definition

Long-Term Care Insurance Law Article 8 Paragraph 28^[3]The Long-Term Care Health Facility is defined below.

Persons requiring long-term care who need support to maintain and recover their physical and mental functions and to be able to live at home (the degree of need for medical treatment is specified by the Ordinance of the Ministry of Health, Labor and Welfare). (Limited to those. In this section, simply referred to as "persons requiring long-term care"), based on the facility service plan, provide nursing care, long-term care under medical management, functional training, and other necessary medical care and daily life care. As a facility for the purpose of performing, it means a facility that has obtained the permission of the prefectural governor of Article XNUMX, paragraph XNUMX, and "nursing care health facility service" means a person requiring long-term care who enters a nursing care health facility for the elderly. On the other hand, nursing care and functional training under medical management and other necessary medical care and daily life care provided based on the facility service plan

For the purpose of recovering to a state where you can live at home, mental and physical function recovery (rehabilitation) training, daily life care such as meals, excretion, bathing, bedtime, health management, mental and physical function maintenance, attendance at hospital, acute It is a facility that aims to be able to return to life at home as much as possible by providing transportation and attendance to hospitals in the event of illness or injury, and consultation on services covered by long-term care insurance.

The following types of Long-Term Care Health Facility are recognized.

Satellite type long-term care health facility

A facility with a capacity of 29 people or less.In order to install it, it is necessary to have a separate nursing care facility for the elderly, a nursing care clinic, a hospital, and a clinic as the main facilities.

Small-scale long-term care health facility with medical institution

A facility with a capacity of 29 people or less.It is annexed to the Long-Term Care Health Facility, Long-Term Care Health Facility, hospitals, and clinics.

Long-Term Care Health Facility

Installation is permitted on the condition that it is operated integrally with the Long-Term Care Health Facility as the main body.

Long-Term Care Health Facility

Ministry of Health, Labor and WelfareIt is a business form newly established as a model after the business form conversion of the long-term care medical care bed, which aims to abolish and change the business form by March 2019, 31 (Heisei 3) due to the long-term care policy of It is difficult to live on its own at home due to illness or disability, it is not possible to receive home care by the family, it is difficult to care by the home care service provider, and it is more difficult than the care by the home care service provider. Those who need nursing care are more likely to enter the facilityQuality of life When desirable for (QOL), long-term care such as meals, excretion, bathing, sleeping, and health management, maintenance of mental and physical functions, suction of sputum, administration of water, nutrition, and medicine by instillation, water and nutrition from gastrostomy・ It is a facility for the purpose of administration of medicines, transportation to hospitals in case of acute illness / injury, end-of-life care, consultation on services covered by long-term care insurance, etc., and long-term care welfare facilities and medical treatment. It is an intermediate facility in the hospital bed.

Service type / usage pattern

• Admission.
• Short stay to stay.
• Day care service with pick-up service during the day.

Deadline for admission

In the LTCF, the placement criteria for rehabilitation staff, nurses, doctors, etc. are higher than in the LTCF, and the nursing fee is set higher than in the LTCF.Since rehabilitation is more fulfilling than nursing care facilities for the elderly and the goal is to return home as much as possible, the period of stay is not indefinite, unlike nursing care facilities for the elderly, and it is judged every three months whether to leave or continue admission. However, at presentNursing home for the elderlyThere are also residents who use it as a waiting area for admission.

The long-term care facility does not aim to return to home, and its business purpose and services include nursing care.Nursing home for the elderly,Nursing care type medical facilityAs with ,, the admission deadline is indefinite, but if the physical and mental condition exceeds the range that can be taken care of by the Long-Term Care Health Facility due to the progress or worsening of illness or disability, the patient will be discharged and will be discharged from the medical care bed. And transferred to the terminal bed.

Acute phasesick,ObstacleIf you are hospitalized at, you will be discharged.

Financial scale

• Number of facilities --3931 facilities (2013)^[1]
• Capacity-35, 2182, 1 per facility. (89.2)^[1]
• Monthly expenses-98,455 million yen (December 2012).This is 12% of the total long-term care cost^[4].

Target users

Those who have been certified as requiring nursing care 1-5.

room

• Multi-bed room-Multiple beds are installed in one room and used by multiple residents.
• Conventional Private Room-One bed is installed in one room and one resident uses one room.Previously it was expressed as a "private room", but with the advent of the unit type, it is expressed as a "conventional private room".
• Unit type semi-private room-One bed is installed in one room and one resident uses one room.The lobby, dining room, kitchenette, baths (plural), and toilets (plural), which are shared spaces, are shared by 1 living rooms, and people live together.Long-term care staff will be dedicated to each unit.The difference from the unit type private room is that when the conventional / non-unit type long-term care facility is remodeled into a unit type, the multi-bed room is divided into a private room.
• Unit-type private room-One bed is installed in one room and one resident uses one room.The lobby, dining room, kitchenette, baths (plural), and toilets (plural), which are shared spaces, are shared by 1 living rooms, and people live together.Long-term care staff will be dedicated to each unit.

Facility requirements

• The minimum number of medical professionals required to be assigned per 100 users
  • Full-timeDoctor1 person,nurse9 caregivers (care worker) 25 people,physical therapist,Occupational therapist or Speech therapist1 person,Care support specialist1 person, 1 support counselor
• Professionals other than the above that are not specified in the requirements
  • Visiting caregiver,Registered dietitian,Social worker,Such

Equipment to be installed

Living room (multi-bed room capacity is 4 people or less in principle),Cafeteria,Kitchen,bathroom, Toilet,Toilet, Functional training room, medical office, lobby, hall, office

Admission procedure

The applicant or the agent (spouse, child, etc.) submits an application for admission to each business operator, and the degree of care required, mental and physical condition, and current stay of the person requiring long-term care who is the applicant for admission. Factors that determine admission priority, such as location / length of stay, status of medical care and long-term care received, and status of family caregivers at home, are quantified, and the admission priority of waiters is set based on the total numerical value. To do.There is no unified application system for countries, prefectures, and municipalities.

The number of people waiting to enter is unknown because there are no detailed statistics, but it is estimated that the number is small compared to the welfare facilities for the elderly.^[5]Since it is unknown when they can enter, applicants are waiting to apply for multiple facilities in or around the desired area in order to accelerate the time when they can enter and increase the possibility of entering. There is no unified application system for the national, prefectural, and municipal governments, and it is necessary to enter the Long-Term Care Health Facility that is applying for admission due to the death of applicants / waiting persons, admission to other facilities, or hospitalization. Even if the application has disappeared, there is no obligation to notify the Long-Term Care Health Facility where the applicant is applying for admission that the need for admission has disappeared or the cancellation of the application. Since it is estimated that there are many cases in which only applicants have already applied and are waiting for admission, it is estimated that the actual number of waiting people is less than the nominal number.^[5].

User's burden

The cost paid by the user is 10% of the nursing care fee according to the degree of care required and the type of living room + food expenses + living expenses according to the type of living room.^[6][7][8].

For low-income earners, there are three levels of exemption for food and living expenses depending on the income level, and the exemption is borne by the municipality, which is the basic municipality.^[6][7][8].

The total of household medical expenses + long-term care expensesHigh medical expensesOn the other hand, four levels of self-pay limit are set according to the total income level of the household, payment of high medical expenses exceeding the limit is exempted, and the exemption is borne by public medical insurance.^[9][10][11].

When receiving long-term care covered by public long-term care insurance, the self-pay portion of the long-term care fee set by the long-term care health + the self-pay portion of the medical fee set by the medical insurance, food expenses, living expenses or room charges when admitted or hospitalized Payments such as occur.For low-income earners, food and living expenses will be exempted from food and living expenses according to the income level, and the government will bear the exemption.^[6][7][8]If you receive medical care covered by public medical insurance, you can use the four-step out-of-pocket limit system according to the household's total income level for the high-cost medical care that is the sum of the household's medical expenses and long-term care expenses. Medical insurance will cover the excess of the self-pay limit.^[9][10][11]If you use all available social security systems, you may not be able to receive the necessary care or medical care due to the income of the person or household due to the income level of the person or family, or it is necessary for the care or medical care of the person. There is no situation in which a spouse or child is forced to bear the cost.^{[6][7][8][9][10][11]}.

Out-of-pocket expenses for long-term care insurance

Long-Term Care Health Facility's Long-Term Care Health Facility + Long-Term Care Health Facility's self-pay nursing care fee by room type

Long-Term Care Health Facility Long-Term Care Health Facility Needs Long-Term Care Health Facility + Long-Term Care Health Facility's Long-Term Care Health Facility

Self-pay reduction and exemption criteria based on income level

Out-of-pocket limits for food and living expenses based on income level

Income level first stage entrance fee

Income level first stage entrance fee

Income level first stage entrance fee

Income level first stage entrance fee

Admission fee for the first stage of medical treatment income level

Admission fee for the first stage of medical treatment income level

Admission fee for the first stage of medical treatment income level

Admission fee for the first stage of medical treatment income level

Classification of income levels that set out-of-pocket limits for high-cost medical expenses

Annual out-of-pocket limit for high-cost medical care based on income level

footnote

Related item

• Long-term care insurance method,Elderly Welfare Act
• リ ハ ビ リ テ ー シ ョ ン,
• Nursing home for the elderly,Nursing care type medical facility
• Group home for the elderly with dementia,Small-scale multi-functional home care
• ,End-of-life bed,
• National Association of Health Facilities for the Elderly

外部 リンク

• Standards for personnel, facilities and equipment, and operation of Long-Term Care Health Facility - e-Gov Law Search
• Welfare/Health/Medical Information-WAM NET --Welfare and Medical Service
• Nursing care establishment / life-related information search -Ministry of Health, Labor and Welfare
• National Association of Health Facilities for the Elderly