Japan nursing care regulatory reforms

The Japanese Ministry of Health, Labour and Welfare has introduced several proposals to reform nursing care standards and compensation systems to address labor shortages and operational inefficiencies.

Initial proposals focused on easing staffing requirements for fee-based nursing homes and dementia group homes. These measures include expanding the eligibility of residents for certain facilities and allowing for “on-call” systems during nighttime hours rather than requiring constant on-site presence. The Ministry also suggested utilizing monitoring technology to allow for reduced staffing levels in dementia group homes. While industry groups have welcomed this flexibility, some experts have raised concerns regarding resident safety and potential response times during emergencies.

Regarding fee-based nursing homes, the Ministry proposed expanding the scope of eligible residents to include those with dementia or specific medical needs, even if they do not meet current “moderate to severe” thresholds. To prevent unfair practices, the proposal prohibits forcing residents to use specific affiliated medical offices or care managers.

Subsequent proposals addressed the home-visit care sector, aiming to reform the compensation system ahead of the 2027 fiscal year. These reforms include recognizing assessments conducted by managers and allowing for online interviews via ICT to reduce administrative burdens. Additionally, the Ministry proposed replacing the “same building reduction” system with a new structure that compensates providers based on actual travel costs, business scale, and service frequency.

Further administrative reforms include plans to simplify the long-term care certification renewal process. Approved by the Social Security Council, this initiative aims to reduce the administrative burden on local governments by expanding eligibility for simplified procedures to include those with a previous certification period of six months or more, affecting approximately 60,000 cases annually.