Regarding the facility standards for rehabilitation (cerebrovascular disease rehabilitation fee)
Cerebrovascular rehab fee (I)
Cerebrovascular Disease Rehabilitation Fee (I) (Calculated Days: 180 days, Points: 245 points)
| Beyond the calculated days | Insured persons requiring long-term care, etc. 147 points [118 points] up to 13 units/month If Goal-Setting Support and Management Fee is not calculated (after 60 days have passed) 132 points [106 points] *[ ] applies to cases where outpatient patients receive the service at a medical institution that has not provided long-term care insurance outpatient rehabilitation, etc., in the past year. |
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| Space requirements | It must have a dedicated functional training room where treatment and training can be sufficiently carried out (at least 160 square meters or more measured by internal dimensions). The dedicated functional training room may be used for other purposes during times other than the time slots when the said therapy is conducted. Also, the dedicated functional training room is "dedicated" only during the times when disease-specific rehabilitation, rehabilitation for children (or individuals) with disabilities, or cancer patient rehabilitation is being performed, and there is no problem with simultaneously conducting disease-specific rehabilitation, rehabilitation for children (or individuals) with disabilities, or cancer patient rehabilitation within the same functional training room. However, in cases where cardiovascular rehabilitation is performed during the same time slot, the respective facility standards must be met. In addition, when providing speech-language-hearing therapy, at least one dedicated individual therapy room (measuring 8 square meters or more based on internal dimensions) with consideration for privacy, etc., must be separately available. |
| Physician requirements | The medical institution must have at least two full-time physicians exclusively assigned to it. However, at least one of them must have three or more years of clinical experience in rehabilitation medicine for cerebrovascular diseases, etc., or have a history of attending (or lecturing at) seminars or training courses related to rehabilitation medicine for cerebrovascular diseases, etc. In addition, if two or more dedicated part-time physicians who normally work 3 or more days per week and have a scheduled working time of 24 hours or more per week are combined such that these part-time physicians are stationed during the same time slots as the working hours of full-time physicians, the actual working hours of such physicians can be converted to full-time equivalents and included in the number of full-time physicians. However, regarding cerebrovascular disease rehabilitation (I), for full-time physicians with at least 3 years of clinical experience or a history of attending (or lecturing at) training sessions or seminars, when converting these part-time physicians to full-time equivalents, it is limited to part-time physicians who also have such experience or a history of attendance (or lecturing). |
| Staffing requirements | Must satisfy all of the following (a) to (d). A: Five or more dedicated, full-time physical therapists must be on staff. However, dual-appointment with full-time physical therapists is not permitted in wards that calculate the ADL maintenance and improvement system additional fee, recovery rehabilitation ward admission fees, and community-inclusive care ward admission fees, as well as wards having hospital rooms that calculate community-inclusive care admission medical management fees; however, dual-appointment with full-time physical therapists is permitted under the disuse syndrome rehabilitation fee (I), (II), or (III), musculoskeletal rehabilitation fee (I), (II), or (III), respiratory rehabilitation fee (I) or (II), disabled child (person) rehabilitation fee, and cancer patient rehabilitation fee. B: At least three dedicated full-time occupational therapists must be on staff. However, dual service as a full-time occupational therapist is not permitted in wards that calculate the ADL maintenance and improvement system additional fee, convalescent rehabilitation ward admission fees, and community-based care ward admission fees, as well as hospital rooms having community-based care inpatient medical management fees; however, dual service as a full-time occupational therapist is permitted in disuse syndrome rehabilitation fees (I), (II), or (III), musculoskeletal rehabilitation fees (I), (II), or (III), respiratory rehabilitation fees (I) or (II), rehabilitation fees for children (individuals) with disabilities, and cancer patient rehabilitation fees. C: When providing speech-language-hearing therapy, at least one full-time speech-language-hearing therapist dedicated solely to this role must be on staff. In addition, among the items in Section 1 of Part 7 on Rehabilitation, dual roles are permitted unless otherwise specified, with respect to other items requiring a dedicated full-time speech-language-hearing therapist. (E) Have a total of 10 or more dedicated workers from (A) to (C) working. In addition, in cases where the days and hours during which disease-specific rehabilitation (excluding cardiovascular rehabilitation), rehabilitation for children (or individuals) with disabilities, and cancer patient rehabilitation are provided at the said medical institution do not reach the prescribed working hours established by the said medical institution, personnel may engage in other duties outside of the implementation hours of the said rehabilitation. In addition, if two or more part-time physical therapists (PTs), occupational therapists (OTs), or speech-language-hearing therapists (STs) who are dedicated to their roles—working normally 3 days or more per week and with a scheduled working time of 24 hours or more per week—are combined so that they are stationed during the same time slots as the working hours of full-time PTs, OTs, or STs respectively, the actual working hours of these part-time PTs, OTs, or STs can be converted to full-time equivalents and included in the number of full-time PTs, OTs, or STs, respectively. However, when calculating the full-time equivalent to include them in the number of full-time physical therapists, occupational therapists, or speech-language-hearing therapists, in the case of cerebrovascular disease rehabilitation (I), it is limited to up to 4 physical therapists, 2 occupational therapists, and 1 speech-language-hearing therapist among the full-time staff. |
| Equipment requirements | To perform the therapy in question, the following facilities, equipment, and instruments must be provided. Walking aids, training mats, treatment tables, sandbags and other weights, various measuring instruments (goniometers, hand dynamometers, etc.), sphygmomanometers, parallel bars, tilt tables, posture correction mirrors, various wheelchairs, various walking aids, various braces (long/short leg braces, etc.), household equipment, equipment for various activities of daily living, etc. However, when providing speech-language-hearing therapy, equipment such as audiometric testing devices, voice recording and playback devices, and video recording systems must be available. |
| Other requirements | In cases where only speech-language-hearing therapy is provided, regardless of the above criteria, if all of the following criteria from A to D are met, the facility shall be deemed to meet the criteria for Cerebrovascular Disease Rehabilitation Fee (I). A: At least one full-time physician exclusively assigned to the role must be on staff. A: At least three full-time, dedicated speech-language-hearing therapists are on staff. C: Must have a dedicated individual treatment room with consideration for shielding, etc. (measuring 8 square meters or more internally). E: Must be equipped with instruments and apparatus required for speech-language-hearing therapy, such as audiometers, audio recording and playback devices, and video recording systems. Records related to rehabilitation (physician's instructions, implementation time, training content, person in charge, etc.) must be stored centrally for each patient and must be viewable by medical staff at all times. △ Regular conferences are held with participating multidisciplinary staff members in charge. |
Cerebrovascular rehab fee (II)
Cerebrovascular Disease Rehabilitation Fee (II) (Calculated days: 180 days, Points: 200 points)
| Beyond the calculated days | Long-term care insured persons, etc. 120 points [96 points] Up to 13 units/month If the target setting support and management fee is not calculated (after 60 days), 108 points [86 points] *[ ] applies to cases where outpatient patients receive the service at a medical institution that has not provided long-term care insurance outpatient rehabilitation, etc., in the past year. |
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| Space requirements | It must have a dedicated functional training room where treatment and training can be sufficiently implemented (at least 100 square meters or more by internal measurement for hospitals, and 45 square meters or more by internal measurement for clinics). The dedicated functional training room may be used for other purposes during hours other than the time slots when the said therapy is performed. In addition, the dedicated functional training room is considered "dedicated" only during the hours when disease-specific rehabilitation, rehabilitation for children (or individuals) with disabilities, or cancer patient rehabilitation is being performed, and there is no problem in simultaneously conducting disease-specific rehabilitation, rehabilitation for children (or individuals) with disabilities, or cancer patient rehabilitation within the same functional training room. However, in cases where cardiovascular rehabilitation is performed during the same time period, the facility standards for each must be met. In addition, when providing speech-language-hearing therapy, at least one dedicated individual therapy room (measuring 8 square meters or more based on internal dimensions) with consideration for privacy, etc., must be separately available. |
| Physician requirements | The said health insurance medical institution must have at least one full-time physician dedicated exclusively to it. If two or more dedicated part-time physicians who regularly work 3 or more days per week and have a scheduled working time of 24 hours or more per week are combined such that these part-time physicians are deployed during the same time slots as the working hours of a full-time physician, it can be considered that the relevant criteria are met. |
| Staffing requirements | Must satisfy all of the following (a) to (d). A: At least one dedicated full-time physical therapist must be on staff. However, while concurrent service as a full-time physical therapist is not permitted in wards that calculate the ADL maintenance and improvement system additional fee, the convalescent rehabilitation ward admission fee, and the comprehensive care ward admission fee, as well as hospital rooms that calculate the comprehensive care inpatient medical management fee, concurrent service as a full-time physical therapist is permitted for disuse syndrome rehabilitation fee (I), (II), or (III), musculoskeletal rehabilitation fee (I), (II), or (III), respiratory rehabilitation fee (I) or (II), disabled child (or person) rehabilitation fee, and cancer patient rehabilitation fee. A: At least one full-time dedicated occupational therapist must be on staff. However, while dual appointment with a full-time occupational therapist in a convalescent rehabilitation ward is not permitted, dual appointment with a full-time occupational therapist is permitted for disuse syndrome rehabilitation fees (I), (II), or (III), musculoskeletal rehabilitation fees (I), (II), or (III), respiratory rehabilitation fees (I) or (II), disabled child (person) rehabilitation fees, and cancer patient rehabilitation fees. C: When providing speech-language-hearing therapy, at least one full-time speech-language-hearing therapist dedicated solely to this role must be on staff. In addition, among the items in Section 1 of Part 7 on Rehabilitation, dual roles are permitted unless otherwise specified, with respect to other items requiring a dedicated full-time speech-language-hearing therapist. E: Four or more full-time workers listed in A to C are working in total. In addition, if the days and hours during which disease-specific rehabilitation (excluding cardiovascular rehabilitation), rehabilitation for children (individuals) with disabilities, and cancer patient rehabilitation are provided at the said medical institution do not meet the predetermined working hours established by the said medical institution, personnel may engage in other duties outside of the implementation hours of the said rehabilitation. By combining two or more part-time physical therapists (PTs), occupational therapists (OTs), or speech-language-hearing therapists (STs) dedicated to their roles—who routinely work 3 or more days per week and have a scheduled working time of 24 hours or more per week—such that these part-time PTs, OTs, or STs are respectively deployed during the same time slots as the working hours of a full-time PT, full-time OT, or full-time ST, the actual working hours of these part-time PTs, OTs, or STs can be converted to full-time equivalents and included in the number of full-time PTs, full-time OTs, or full-time STs, respectively. However, in the case of cerebrovascular disease rehabilitation (II), the number of full-time physical therapists, occupational therapists, or speech-language-hearing therapists that can be converted to full-time equivalents and included in the full-time staff count is limited to up to one person each for physical therapists, occupational therapists, and speech-language-hearing therapists among the full-time staff. |
| Equipment requirements | To perform the therapy in question, the following facilities, equipment, and instruments must be provided. Walking aids, training mats, treatment tables, heavy weights such as sandbags, various measuring instruments (goniometers, hand dynamometers, etc.), sphygmomanometers, parallel bars, tilt tables, posture correction mirrors, various wheelchairs, various walking aids, various braces (long and short leg braces, etc.), household equipment, various activities of daily living equipment, etc. However, when providing speech-language-hearing therapy, equipment such as audiometric testing devices, voice recording and playback devices, and video recording systems must be available. |
| Other requirements | Records related to rehabilitation (doctor's instructions, implementation time, training details, person in charge, etc.) must be stored centrally for each patient and be accessible at all times by medical personnel. △ Regular conferences are held with participating multidisciplinary staff members in charge. |
Cerebrovascular rehab fee (III)
Cerebrovascular Disease Rehabilitation Fee (III) (Calculated days: 180 days, Points: 100 points)
| Beyond the calculated days | Insured persons requiring long-term care, etc. 60 points [48 points] up to 13 units/month If target setting support and management fee is not calculated (after 60 days) 54 points [43 points] *[ ] applies to cases where outpatient patients receive the service at a medical institution that has not provided long-term care insurance outpatient rehabilitation, etc., in the past year. |
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| Space requirements | It must have a dedicated functional training room where treatments and training can be sufficiently carried out (at least 100 square meters or more measured by internal dimensions for hospitals, and 45 square meters or more measured by internal dimensions for clinics). The dedicated functional training room may be used for other purposes during times other than the time slots when the said therapy is conducted. Also, the dedicated functional training room is "dedicated" only during the times when disease-specific rehabilitation, rehabilitation for children (or adults) with disabilities, or cancer patient rehabilitation is being provided, and there is no problem with simultaneously conducting disease-specific rehabilitation, rehabilitation for children (or adults) with disabilities, or cancer patient rehabilitation in the same functional training room. However, in cases where cardiovascular rehabilitation is performed during the same time period, the facility standards for each must be met. In addition, when providing speech-language-hearing therapy, there must be at least one separate dedicated individual therapy room (measuring 8 square meters or more internally) with consideration given to privacy and shielding, and if only speech-language-hearing therapy is provided, the dedicated facilities specified in the preceding paragraph are not required as long as said individual therapy room is available. |
| Physician requirements | At least one full-time specialist physician is on staff. If two or more dedicated part-time physicians who regularly work 3 or more days per week and have a scheduled working time of 24 hours or more per week are combined such that these part-time physicians are deployed during the same time slots as the working hours of a full-time physician, it can be considered that the relevant criteria are met. |
| Staffing requirements | Must have at least one full-time dedicated physical therapist, full-time occupational therapist, or full-time speech-language-hearing therapist on duty. However, concurrent service with full-time staff in wards calculating the ADL maintenance and improvement system addition, convalescent rehabilitation ward hospitalization fees, and community-inclusive care ward hospitalization fees, as well as hospital rooms calculating community-inclusive care hospitalization medical management fees, is not permitted; however, concurrent service with full-time staff in disuse syndrome rehabilitation fees (I), (II), or (III), musculoskeletal rehabilitation fees (I), (II), or (III), respiratory rehabilitation fees (I) or (II), disabled child (or person) rehabilitation fees, and cancer patient rehabilitation fees is permitted. In addition, in the case of a speech-language-hearing therapist, concurrent holding of posts is permitted, except where otherwise provided for, with respect to other items in Section 1 (Rehabilitation) of Part 7 that require a dedicated full-time speech-language-hearing therapist. In addition, in cases where the days and hours during which disease-specific rehabilitation (excluding cardiovascular rehabilitation), rehabilitation for children (or persons) with disabilities, and cancer patient rehabilitation are performed at the medical institution concerned fall short of the prescribed working hours established by the said medical institution, personnel may engage in other duties outside of the implementation hours of such rehabilitation. If part-time physical therapists, occupational therapists, or speech-language-hearing therapists who work regularly for 3 or more days per week and have a scheduled working hour of 24 hours or more per week are combined in numbers of 2 or more for each respective profession, and these part-time physical therapists, occupational therapists, or speech-language-hearing therapists are stationed during the same time slots as the working hours of full-time physical therapists, occupational therapists, or speech-language-hearing therapists, it can be deemed that the respective standards are met. |
| Equipment requirements | To perform the therapy in question, the following facilities, equipment, and instruments must be provided. Walking aids, training mats, treatment tables, heavy weights such as sandbags, and various measuring instruments, etc. However, when conducting speech-language-hearing therapy, audiometry equipment, audio recording and playback devices, video recording systems, etc. must be available. |
| Other requirements | Records related to rehabilitation (doctor's instructions, implementation time, training details, person in charge, etc.) must be stored centrally for each patient and always be accessible for viewing by medical staff. △ Regular conferences are held with participating multidisciplinary staff members in charge. |
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