The specific-office addition for home-visit care (the labor side of length of service, training, meetings and emergency response)

In short: Whether you can claim the specific-office addition for home-visit care is decided not by the number of points but by your structure and records. What you put in order are the "people" requirements — length of service, qualifications and the ratio of heavy-care users — and the "operation" requirements — individual training plans, regular meetings, an emergency-response structure and health check-ups (the standard for calculating fees for designated in-home services = Notice of the Ministry of Health, Labour and Welfare No. 19 of 2000; the points-of-note notice = Roki No. 36 of 2000). Of these, managing length of service, training plans and records, meeting minutes, and putting work rules and wage regulations in order is the domain of a Shakai Hoken Roumushi; judging the addition tier and preparing the filing documents to the designating authority is the work of a Gyoseishoshi; claiming the care-benefit fee is billing practice; and tax is for a tax accountant. This article sorts out the addition from the side of "which parts of labor you fix to obtain it."

"We want the specific-office addition, but we don't know what to prepare," and "we obtained it once, but we worry an on-site inspection will point out gaps in our records" — these are consultations we often receive from managers and operators of home-visit care. This page is for offices aiming to obtain and maintain the addition, and sorts out the structural requirements from the viewpoint of labor documents and records. Because the points, addition rate and the combination of tiers change with each care-fee revision, we do not treat the amounts themselves. Always confirm the latest requirements in the notice and the points-of-note notice.

Which parts of labor do you put in order to obtain the specific-office addition for home-visit care?

The requirements for the specific-office addition divide broadly into three layers: "personnel requirements," "structural requirements" and "heavy-care-user response requirements" (as of the FY2024 care-fee revision). The combination you must satisfy differs by tier (I–V), but the foundation to put in order as labor is almost common.

Layer	Main content (as of FY2024)	What to prepare as labor
Personnel requirements	A set ratio of care workers, or a set ratio of those with 7+ years of service, etc.	A ledger of qualifications and length of service; the basis for the full-time-equivalent calculation
Structural requirements	Creating and carrying out individual training plans; holding and recording regular meetings; documenting the emergency-response method; carrying out health check-ups; instruction and reporting by document	Training rules, training plans and records; meeting minutes; an emergency-response manual; health-check records
Heavy-care-user response	A set ratio of users needing care level 4/5, with dementia, or requiring suctioning etc.	Records of the user composition

The numbers in the requirements (ratios etc.) move with revisions. The labor knack is to be in a state where you can show it with documents and records, not just say "we meet it." For the thinking on payroll and attendance systems, see also how much does it cost to entrust payroll to a Shakai Hoken Roumushi.

How do you show the length-of-service and training-plan requirements through work rules and records?

Where the personnel requirements trip people up is the "way of counting" length of service and the qualification ratio. As a rule, ratios are produced by the full-time-equivalent method, on the average of the previous fiscal year or the three months before the month of the calculation date (points-of-note notice). In other words, the ratio moves with every hire and departure, so unless you record hires, departures and changes of employment type at each point in time, you cannot later reproduce the ratio.

• Length of service is counted as "continuous service in the same corporation." Make the hire date, employment category and scheduled working hours clear in the work rules and employment contracts
• For training, create an individual training plan for each of the care staff and the service-provision managers, and carry it out based on that plan. The plan states the purpose, content and timing (grouping by responsibility and experience is also possible)
• After carrying it out, keep a record of the date, participants and content. A plan with no record of implementation cannot show that the requirement was met

The matters to be stated in work rules are themselves set by Article 89 of the Labor Standards Act; the method of deciding, calculating and paying wages, pay raises, and matters on retirement are absolute mandatory items. If you tie the training and career structure for the addition to wages and grades, you also need to have the work rules and wage regulations in order. For the duty to create work rules, see from how many employees are work rules mandatory.

How much recording do the regular meetings and the emergency-response structure need?

Of the structural requirements, meetings and emergency response are judged not by "the fact that you do it" but by "the fact that a record remains."

Item	What is required (points-of-note notice etc.)	Records to keep
Regular meeting	Chaired by the service-provision manager, attended by care staff. Held roughly once a month or more, to convey users' conditions and points to note and to give technical guidance	Notice of the meeting, attendance, minutes (date, participants, agenda, shared items), handouts
Emergency-response structure	Document the emergency-response method (policy, contacts, response hours) and explain it to and give it to the user	Response manual; record of explanation and delivery at contract
Health check-up	Carried out for all workers, full-time or not, at least once a year at the employer's expense	Record of the check-up
Instruction and reporting	Instruction by document etc. from the service-provision manager to care staff, and a report after provision	Record of instruction and reporting

The meeting is guided by "roughly once a month or more." Because the scope in which holding it by video conference is allowed and the way to keep records can change with revisions and notices, confirm in the most recent points-of-note notice. In an on-site inspection, these minutes and the record of delivering the emergency-response document are the first documents looked at.

How do the treatment-improvement addition and the specific-office addition differ in where labor is put in order?

Even with the same "addition," the center of the documents you arrange differs. Confusing them lets you be satisfied with preparing only one side.

	Specific-office addition	Treatment-improvement addition
Focus	Structure and records — length of service, training, meetings, emergency response	Allocation of the funding for wage improvement and the wage regulations
Where labor is arranged	Training rules, minutes, length-of-service management, emergency manual	Wage regulations, the plan and results of wage improvement, career-path requirements
Role of labor	Designing the structure and building the recording mechanism	Reflecting it in wages and designing the funding allocation

The treatment-improvement addition centers on the allocation of wage funding and the wage regulations; for details see the care treatment-improvement addition and wage regulations. Understand the specific-office addition as adding another layer — "structure and records" — on top of that.

Who handles the structural preparation, the filing and the fee billing for the addition?

The work around the specific-office addition divides by responsibility. Deciding who does what at the outset keeps the documents from being doubled.

What is done	Whose domain
Putting work rules, wage regulations and training rules in order; managing length of service and qualifications; building the recording mechanism for meetings, training and emergency response; attendance management	Shakai Hoken Roumushi (this office)
Preparing the filing documents to the designating authority (the structure filing) that match the judged addition tier	Gyoseishoshi (四葉行政書士事務所 is an independent business entity; it is contracted separately from the Shakai Hoken Roumushi office)
The care-benefit-fee (fee) billing practice; handling returns and errors	The office's billing staff or a billing agent
Tax and settlement	Tax accountant

Building the structure and the recording mechanism for the addition is the work of a Shakai Hoken Roumushi. Preparing the filing documents is the work of a Gyoseishoshi, and 四葉行政書士事務所 is an independent business entity, so it is contracted separately from the Shakai Hoken Roumushi office. Fee billing and tax divide by their respective handlers.

What can 四葉社会保険労務士事務所 do?

四葉社会保険労務士事務所, in Kohinata, Bunkyo City, handles sorting out the structural requirements of the specific-office addition, building the mechanism for training rules, training plans and records, the operation of regular meetings and the form of the minutes, managing length of service, qualifications and the full-time equivalent, putting work rules and wage regulations in order, and documenting the emergency-response structure. For the wage regulations of the treatment-improvement addition, see the care treatment-improvement addition and wage regulations; for putting work rules in order, see from how many employees are work rules mandatory. Consultation is free. For fees, see the fee schedule; for frequently asked questions, see the FAQ.

Frequently asked questions

Q. Can we obtain the specific-office addition by fixing the work rules?
A. Work rules alone are not enough. Work rules and wage regulations are the foundation, but the addition can only be claimed once you show, with documents and records, several requirements — individual training plans and their implementation records, minutes of the regular meetings, documenting and delivering the emergency-response method, and the ratios of length of service and qualifications. Practically, start by taking stock of what your existing records can show.

Q. Do we have to hold a meeting every month?
A. The points-of-note notice asks for a meeting, aimed at conveying users' conditions and points to note and at technical guidance, held roughly once a month or more. Because the form of holding it (whether video conference is allowed) and the way to keep records can change with revisions and notices, please confirm in the most recent points-of-note notice. What to keep is the meeting notice, attendance, minutes and handouts.

Q. Can we count experience at a previous company toward length of service?
A. As a rule, length of service is counted as continuous service in the same corporation. Ratios are produced by the full-time-equivalent method, on the average of the previous fiscal year or the three months before the month of the calculation date. Because the ratio moves with hires, departures and changes of employment category, keeping a record at each point in time is the key to maintaining the requirement.

Q. Can we also entrust the addition filing to a Shakai Hoken Roumushi?
A. Building the structure and the recording mechanism for the addition is the work of a Shakai Hoken Roumushi, but preparing the filing documents (the structure filing) submitted to the designating authority is the work of a Gyoseishoshi. 四葉行政書士事務所 is an independent business entity and is contracted separately from the Shakai Hoken Roumushi office. Fee billing and tax divide to the billing staff and the tax accountant respectively.

Sources

• The standard for calculating the amount of fees for designated in-home services (Notice of the Ministry of Health, Labour and Welfare No. 19 of 2000) = the calculation standard for the specific-office addition for home-visit care
• The notice on points of note in implementation accompanying the establishment of the standard for calculating fees for designated in-home services etc. (Roki No. 36 of 2000) = the interpretation of each requirement of the specific-office addition (individual training plans, regular meetings, documenting the emergency-response method, health check-ups, the method of calculating the ratios of length of service and qualifications, etc.)
• The standard on personnel, equipment and operation of designated in-home service businesses (Ministry of Health and Welfare Ordinance No. 37 of 1999) = the operation standard for home-visit care (the basis for meetings, instruction and reporting, and emergency response)
• Labor Standards Act (Act No. 49 of 1947), Article 89 = the absolute mandatory items of work rules (the method of deciding, calculating and paying wages and pay raises; matters on retirement, etc.)
• The specifics of the addition's requirements (a meeting roughly once a month or more, a health check-up at least once a year, ratios such as 7+ years of service and the care-worker ratio, and a set ratio of heavy-care users) are confirmed from the FY2024 points-of-note materials published by the Tokyo Metropolitan Bureau of Social Welfare (as of September 2026). Because the points, addition rate and the combination of tiers change with the care-fee revision, confirm the latest notice and points-of-note notice when claiming

This article does not decide whom to consult. Putting work rules, wage regulations and training rules in order, managing length of service and qualifications, and building the recording mechanism for meetings, training and emergency response are the work of a Shakai Hoken Roumushi. Preparing the filing documents to the designating authority is the work of a Gyoseishoshi; fee billing is billing practice; and tax is the work of a tax accountant. For fees when consulting 四葉社会保険労務士事務所, see the fee schedule; for frequently asked questions, see the FAQ.

This article is general information. A judgment on individual circumstances is made by a qualified professional after a consultation. Written by Joji Uramatsu (Shakai Hoken Roumushi, Gyoseishoshi, Registered Real Estate Transaction Specialist).