Regarding the facility standards for rehabilitation (Cardiovascular Rehabilitation Fee)
Cardiovascular rehab fee (I)
Cardiovascular Disease Rehabilitation Fee (I) (Calculated days: 150 days, Points: 205 points)
| Beyond the calculated days | Up to 13 units/month |
|---|---|
| Space requirements | Having a dedicated functional training room (at least 30 square meters measured internally for hospitals, and at least 20 square meters measured internally for clinics). The dedicated functional training room may be used for other purposes during times other than the hours when the therapy is conducted. In addition, when conducting said therapy during the same time slot as other disease-specific rehabilitation, rehabilitation for children (or persons) with disabilities, or cancer patient rehabilitation in the same functional training room, it is permissible as long as the respective facility standards are met. Meeting the respective facility standards means, for example, that when cardiovascular rehabilitation and cerebrovascular disease rehabilitation, etc., are conducted during the same time slot, the area of the functional training room must be equal to or greater than the sum of the areas stipulated by the facility standards for each rehabilitation, and the necessary equipment and apparatus must not be shared, but must be provided exclusively for each type of rehabilitation. |
| Physician requirements | At a notified medical insurance institution (limited to those with departments for cardiovascular medicine or cardiovascular surgery; hereinafter the same shall apply in this section), a physician from the cardiovascular medicine or cardiovascular surgery department must be on duty at all times during the hours when cardiovascular rehabilitation is performed, and at least one full-time physician dedicated to cardiovascular rehabilitation with experience in the field must be on duty. In this case, the facility must have a system in place to receive communications in the event of a sudden change in condition of a patient undergoing cardiovascular rehabilitation, and to ensure that appropriate responses can be provided at the medical institution in question or at a collaborating medical institution. 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 | A total of two or more full-time physical therapists and full-time nurses dedicated to cardiovascular rehabilitation with experience in the field must be on staff, or two or more dedicated full-time physical therapists or dedicated full-time nurses must be on staff. In addition, it is desirable that an occupational therapist with experience in cardiovascular rehabilitation, such as training related to activities of daily living according to cardiac function, be on staff as necessary. However, in either case, one of the two persons may be a dedicated full-time worker. In addition, these persons cannot concurrently serve as assigned staff in wards that calculate the ADL maintenance and improvement system add-on, the convalescent rehabilitation ward admission fee, and the community-inclusive care ward admission fee, or wards with hospital rooms that calculate the community-inclusive care inpatient medical management fee; however, during times when cardiovascular disease rehabilitation is not being performed, they may engage in other disease-specific rehabilitation, rehabilitation for children (or persons) with disabilities, and cancer patient rehabilitation. In addition, if the implementation dates and times for cardiovascular rehabilitation and other types of rehabilitation are different, it is possible to register as a full-time staff member for the other rehabilitation. In addition, if two or more dedicated part-time physical therapists (PTs) or dedicated part-time nurses (limited to experienced PTs or nurses) who normally work 3 days or more per week and have a scheduled working hour of 24 hours or more per week are combined such that they are stationed during the same time slots as the working hours of full-time PTs or full-time nurses, the actual working hours of these part-time PTs or part-time nurses can be converted to full-time equivalents and included in the number of full-time PTs or full-time nurses, respectively. However, this is limited to a maximum of one person among the full-time staffing requirement. |
| Equipment requirements | The dedicated functional training room must be equipped with the following machines and equipment necessary to perform the therapy in question. (a) : Oxygen supply unit (a) : Defibrillator (c) : ECG monitor (d) : Treadmill or ergometer (e) : Sphygmomanometer (ka) : Emergency cart Furthermore, the said medical institution must be equipped with the following devices. Exercise stress test system |
| Other requirements | Records related to rehabilitation (doctor's instructions, exercise prescription, duration, training details, staff in charge, etc.) must be stored centrally for each patient and always be accessible for viewing by medical staff. △ Conferences involving multidisciplinary staff in charge are held regularly. △ A system capable of performing emergency surgery or emergency angiography is ensured at the notifying medical institution providing insurance or an affiliated other medical institution (limited to those with departments of cardiology or cardiovascular surgery; hereinafter the same applies in this section). △ The notifying medical institution providing insurance or an affiliated other medical institution has submitted a notification for the emergency and critical care admission fee or the specific intensive care unit management fee, and the relevant treatment room can be used for emergencies in patients arising from the implementation of cardiovascular rehabilitation. |
Cardiovascular rehab fee (II)
Cardiovascular Rehabilitation Fee (II) (Calculation days: 150 days, Points: 125 points)
| Beyond the calculated days | Up to 13 units/month |
|---|---|
| Space requirements | Must have a dedicated functional training room (at least 30 square meters measured by internal dimensions for hospitals, and at least 20 square meters measured by internal dimensions for clinics). The dedicated functional training room may be used for other purposes outside the hours during which the said therapy is conducted. In addition, when conducting said therapy during the same time slot as other disease-specific rehabilitation, rehabilitation for children (or persons) with disabilities, or cancer patient rehabilitation in the same functional training room, it is permissible as long as the respective facility standards are met. Meeting the respective facility standards means, for example, that when cardiovascular rehabilitation and cerebrovascular disease rehabilitation, etc., are conducted during the same time slot, the area of the functional training room must be equal to or greater than the sum of the areas stipulated by the facility standards for each rehabilitation, and the necessary equipment and apparatus must not be shared, but must be provided exclusively for each type of rehabilitation. |
| Physician requirements | At the notified insurance medical institution, during the time periods when cardiovascular rehabilitation is performed, at least one physician in charge of cardiovascular medicine or cardiovascular surgery (including part-time physicians) and at least one physician with experience in cardiovascular rehabilitation (including part-time physicians) must be on duty. |
| Staffing requirements | At least one full-time physical therapist or nurse with experience in cardiovascular rehabilitation must be on staff. In addition, it is desirable to have an occupational therapist on staff who has experience related to cardiovascular rehabilitation, such as training concerning activities of daily living according to cardiac function, as necessary. However, regarding dedicated full-time staff, while they cannot concurrently serve as assigned personnel in wards that calculate the ADL maintenance and improvement system additional fee, the recovery phase rehabilitation ward hospitalization fee, and the community-inclusive care ward hospitalization fee, or in wards with hospital rooms that calculate the community-inclusive care hospitalization medical management fee, there is no objection to them engaging in other disease-specific rehabilitations, rehabilitation for children (persons) with disabilities, and cancer patient rehabilitation during times when cardiovascular disease rehabilitation is not being performed. In addition, if the implementation dates and times for cardiovascular rehabilitation and other types of rehabilitation are different, it is possible to register as a full-time staff member for the other rehabilitation. |
| Equipment requirements | The dedicated functional training room must be equipped with the following machines and equipment necessary to perform the therapy in question. (a) : Oxygen supply unit (a) : Defibrillator (c) : ECG monitor (d) : Treadmill or ergometer (e) : Sphygmomanometer (ka) : Emergency cart Furthermore, the said medical institution must be equipped with the following devices. Exercise stress test system |
| Other requirements | Records related to rehabilitation (doctor's instructions, exercise prescription, duration, training details, staff in charge, etc.) must be stored centrally for each patient and always be accessible for viewing by medical staff. △ Conferences involving multidisciplinary staff in charge are held regularly. △ A system capable of performing emergency surgery or emergency angiography is ensured at the notifying medical institution providing insurance or an affiliated other medical institution (limited to those with departments of cardiology or cardiovascular surgery; hereinafter the same applies in this section). △ The notifying medical institution providing insurance or an affiliated other medical institution has submitted a notification for the emergency and critical care admission fee or the specific intensive care unit management fee, and the relevant treatment room can be used for emergencies in patients arising from the implementation of cardiovascular rehabilitation. |
For inquiries regarding rehabilitation facility standards (Cardiovascular Disease Rehabilitation Fee)
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