Regarding the facility standards for rehabilitation (Musculoskeletal Rehabilitation Fee)
Musculoskeletal rehab fee (I)
Musculoskeletal Rehabilitation Fee (I) (Calculated days: 150 days, Points: 185 points)
| Beyond the calculated days | Insured persons requiring long-term care, etc. 111 points [89 points] up to 13 units/month If goal-setting support and management fee is not calculated (after 50 days) 100 points [80 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 at least 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 hours when the 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. |
| Physician requirements | At least one full-time physician dedicated to the facility who has experience in musculoskeletal rehabilitation must be on staff at the subject medical institution. In addition, it is desirable that a physician with experience in musculoskeletal rehabilitation is a physician with at least three years of experience in musculoskeletal rehabilitation or a physician who has completed appropriate training related to musculoskeletal rehabilitation. The requirement can be considered satisfied if two or more part-time physicians with experience in musculoskeletal rehabilitation, who regularly work 3 days or more per week and have a scheduled working time of 24 hours or more per week, are combined so that these part-time physicians are stationed during the same time slots as the working hours of a full-time physician. |
| Staffing requirements | A total of 4 or more full-time physical therapists or full-time occupational therapists exclusively assigned to the role must be on duty. In addition, the said dedicated worker cannot hold a concurrent position as a full-time physical therapist or full-time occupational therapist in a ward that calculates the ADL Maintenance and Improvement System Addition, Recovery Phase Rehabilitation Ward Admission Fee, and Community-Inclusive Care Ward Admission Fee, or in a ward that has hospital rooms that calculate the Community-Inclusive Care Ward Inpatient Medical Management Fee, but may hold a concurrent position as a full-time physical therapist or full-time occupational therapist for Cerebrovascular Diseases, etc. Rehabilitation Fee (I), (II), or (III), Disuse Syndrome Rehabilitation Fee (I), (II), or (III), Respiratory Rehabilitation Fee (I) or (II), Child (Disabled Person) Rehabilitation Fee, and Cancer Patient Rehabilitation Fee. 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. By combining two or more dedicated part-time physical therapists (PTs) or part-time occupational therapists (OTs) who regularly work 3 or more days per week and have a scheduled working time of 24 hours or more per week, and deploying these part-time PTs or part-time OTs during the same time slots as the working hours of full-time PTs or full-time OTs respectively, the actual working hours of these part-time PTs or part-time OTs can be converted to full-time equivalents and included in the number of full-time PTs or full-time OTs. However, the number of staff whose hours can be converted to full-time equivalents and included in the full-time PT or full-time OT count is limited to a maximum of one person for each position within the full-time staffing requirement. |
| Equipment requirements | Equipped with the following devices, etc., for treatment and training. Various measuring instruments (goniometers, hand dynamometers, etc.), sphygmomanometers, parallel bars, posture correction mirrors, various wheelchairs, various walking aids, etc. |
| 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. |
Musculoskeletal rehab fee (II)
Musculoskeletal Rehabilitation Fee (II) (Calculated days: 150 days, Points: 170 points)
| Beyond the calculated days | Insured persons requiring long-term care, etc. 102 points [82 points] up to 13 units/month When the target setting support and management fee is not calculated (after 50 days) 92 points [74 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. Furthermore, the dedicated functional training room is considered "dedicated" only during the times when disease-specific rehabilitation, rehabilitation for children (or individuals) with disabilities, and cancer patient rehabilitation are being conducted, and there is no objection to conducting disease-specific rehabilitation, rehabilitation for children (or individuals) with disabilities, or cancer patient rehabilitation simultaneously 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. |
| Physician requirements | At least one full-time physician dedicated to the facility who has experience in musculoskeletal rehabilitation must be on staff at the subject medical institution. In addition, it is desirable that a physician with experience in musculoskeletal rehabilitation is a physician with at least three years of experience in musculoskeletal rehabilitation or a physician who has completed appropriate training related to musculoskeletal rehabilitation. The requirement can be considered satisfied if two or more part-time physicians with experience in musculoskeletal rehabilitation, who regularly work 3 days or more per week and have a scheduled working time of 24 hours or more per week, are combined so that these part-time physicians are stationed during the same time slots as the working hours of a full-time physician. |
| Staffing requirements | Must satisfy any one of the following (a) to (c). However, in any of the cases from A to C, concurrent service is not permitted with a full-time physical therapist or full-time occupational therapist in wards that calculate the ADL Maintenance and Improvement Support System Addition, the Convalescent Rehabilitation Ward Admission Fee, and the Community-Inclusive Care Ward Admission Fee, as well as wards with hospital rooms that calculate the Community-Inclusive Care Ward Inpatient Medical Management Fee; however, concurrent service is permitted with a full-time physical therapist or full-time occupational therapist in Cerebrovascular Disease Rehabilitation Fee (I), (II), or (III), Disuse Syndrome Rehabilitation Fee (I), (II), or (III), Respiratory Rehabilitation Fee (I) or (II), Child (Disabled Person) Rehabilitation Fee, and Cancer Patient Rehabilitation Fee. In addition, if 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 providing health insurance are less than the prescribed working hours established by the said medical institution, engaging in other duties outside of the implementation hours of such rehabilitation is permitted. A: Two or more dedicated full-time physical therapists must be on staff. A: Two or more dedicated, full-time occupational therapists must be on staff. C: A total of two or more full-time dedicated physical therapists and full-time dedicated occupational therapists must be on duty. By combining two or more dedicated part-time physical therapists (PTs) or part-time occupational therapists (OTs) who regularly work 3 or more days per week and have a scheduled working time of 24 hours or more per week, and deploying these part-time PTs or part-time OTs during the same time slots as the working hours of full-time PTs or full-time OTs respectively, the actual working hours of these part-time PTs or part-time OTs can be converted to full-time equivalents and included in the number of full-time PTs or full-time OTs. However, the number of staff whose hours can be converted to full-time equivalents and included in the full-time PT or full-time OT count is limited to a maximum of one person for each position within the full-time staffing requirement. Also, for the time being, only in cases where a nurse, licensed practical nurse, massage and finger-pressure therapist (anma-massage-shiatsu-shi), or judo therapist who has completed appropriate training related to musculoskeletal rehabilitation works as a full-time, dedicated staff member, and a system is secured to perform the therapy under the supervision of a physician with experience in musculoskeletal rehabilitation, it is permitted to notify the authorities as if a physical therapist were on duty. However, the said massage and finger-pressure therapist, etc., cannot hold concurrent positions related to respiratory rehabilitation fees (II), etc. |
| Equipment requirements | Equipped with the following devices, etc., for treatment and training. Various measuring instruments (goniometers, hand dynamometers, etc.), sphygmomanometers, parallel bars, posture correction mirrors, various wheelchairs, various walking aids, etc. |
| Other requirements | 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. |
Musculoskeletal rehab fee (III)
Musculoskeletal Rehabilitation Fee (III) (Calculated days: 150 days, Points: 85 points)
| Beyond the calculated days | Insured persons requiring long-term care, etc. 51 points [41 points] Up to 13 units/month If the target setting support and management fee is not calculated (after 50 days) 46 points [38 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 (measuring at least 45 square meters by internal dimensions) where treatment and training can be sufficiently conducted. The dedicated functional training room may be used for other purposes during times other than the time slot in which the said therapy is provided. Furthermore, 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 it is acceptable to simultaneously conduct disease-specific rehabilitation, rehabilitation for children (or individuals) 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. |
| 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 | At least one dedicated, full-time physical therapist or full-time occupational therapist must be on duty. However, dual appointment with full-time staff in wards that calculate the ADL maintenance and improvement system add-on, the recovery rehabilitation ward admission fee, and the community-based comprehensive care ward admission fee, as well as hospital rooms that calculate the community-based comprehensive care ward admission management fee, is not permitted. However, dual appointment with full-time staff in cerebrovascular disease rehabilitation fee (I), (II), or (III), disuse syndrome rehabilitation fee (I), (II), or (III), respiratory rehabilitation fee (I) or (II), disabled child (person) rehabilitation fee, and cancer patient rehabilitation fee is permitted. In addition, in cases where the days and hours during which disease-specific rehabilitation (excluding cardiovascular rehabilitation), rehabilitation for children/persons with disabilities, and cancer patient rehabilitation are performed at the medical institution in question do not meet 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. By combining two or more part-time physical therapists (PTs) or part-time occupational therapists (OTs) who work regularly three or more days per week and have a scheduled working hours of 24 hours or more per week, and deploying these part-time PTs or part-time OT s during the same time slots as the working hours of full-time PTs or full-time OTs, respectively, the actual working hours of these part-time PTs or part-time OTs can be converted to full-time equivalents and included in the number of full-time PTs or full-time OTs. |
| Equipment requirements | Equipped with the following devices, etc., for treatment and training. walking aids, exercise mats, treatment tables, heavy weights such as sandbags, and various measuring instruments |
| Other requirements | 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. |
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