Opening a fee-charging home for the elderly with care: the setup notification and the designation as a specified facility

In short: to open a fee-charging home for the elderly "with care", you stack two procedures. One is the setup notification for a fee-charging home for the elderly under Article 29, paragraph 1 of the Act on Welfare of the Elderly (Act No. 133 of 1963): you notify, in advance, the prefectural governor of the place where you intend to set up the facility (in designated cities and core cities, the mayor). The other is the designation for specified-facility resident daily-life care defined in Article 8, paragraph 11 of the Long-Term Care Insurance Act (Act No. 123 of 1997); under Article 70, paragraph 1 of that Act, the prefectural governor (in designated cities and core cities, the mayor) designates it per office. The staffing, facility and operation standards are set in the Standards concerning the staffing, facilities and operation of designated in-home service businesses (Ordinance of the Ministry of Health and Welfare No. 37 of 1999), Article 174 onward, and the core is that nursing and care staff must number at least one per three care-needing users (on a full-time-equivalent basis, the so-called 3-to-1). This article organises the flow, requirements and schedule of the notification and the designation, and who to ask for which part. Conformity with the standards and eligibility for designation are decided by the designating authority's review, and our office does not guarantee designation. Premises, building, fire, labour and tax are each contracted separately as an independent business.

When and to whom do you file the setup notification for a fee-charging home for the elderly?

A fee-charging home for the elderly is a facility that admits elderly persons and provides any of the following: care with bathing, toileting or meals; the provision of meals; housework such as laundry and cleaning; or health management (Article 29, paragraph 1 of the Act on Welfare of the Elderly). A person intending to set one up must, in advance, notify the prefectural governor of the place where the facility is to be set up (in designated cities and core cities, the mayor; the same below). The point is that it is a prior notification, not one made after opening.

Fee-charging homes for the elderly are operated in the following types according to the services provided (the classification in the Ministry of Health, Labour and Welfare's "Standard Guidance Guidelines for the Establishment and Operation of Fee-charging Homes for the Elderly"). "With care" refers to one that has obtained the designation for specified-facility resident daily-life care under long-term care insurance.

Type	Outline	Position of care
Fee-charging home with care	Has the designation for specified-facility resident daily-life care	Care provided by the facility's staff as a long-term care insurance service
Residential fee-charging home	No specified-facility designation	Residents individually contract external in-home services
Healthy-type fee-charging home	Departure is premised if care becomes necessary	No care provided

The setup notification is filed with time to spare before the business starts. How many months before the planned start date it must be filed differs by municipality's practice, and some prefectures require a prior consultation. Confirm the timing, forms and attached documents on the relevant municipality's official page. Operating without notification may draw guidance or an improvement order under the Act on Welfare of the Elderly.

What are the requirements for the designation for specified-facility resident daily-life care?

To call yourself "with care", you obtain, per office, the designation for specified-facility resident daily-life care defined in Article 8, paragraph 11 of the Long-Term Care Insurance Act. The designation is made under Article 70, paragraph 1 of that Act by the prefectural governor, and the applicant is in principle required to be a corporation. The staffing, facility and operation standards are set in the Standards concerning the staffing, facilities and operation of designated in-home service businesses (Ordinance No. 37 of 1999), Article 174 onward (staffing in Article 175), and are given concrete form by each municipality's ordinance. The basic placement of staff is as follows.

Role	Approach to placement (full-time-equivalent)
Nursing and care staff	At least the number of care-needing users divided by 3 (3-to-1). Nursing staff: at least one for up to 30 users, and at least one more per 50 users for 31 or more
Life consultant	At least one per 100 users; at least one of them full-time
Functional-training instructor	At least one (may hold a concurrent post in some cases)
Plan preparer (care manager)	One per 100 users as a standard, and at least one placed; may hold a concurrent post in some cases
Manager	One dedicated full-time person (may hold a concurrent post if there is no hindrance)

The "3-to-1" of nursing and care staff is counted on a full-time-equivalent basis. How to arrange night shifts and night duty, how to translate the full-time-equivalent into a roster, and how to prepare work rules and the agreement on overtime and holiday work are matters of labour design and the field of a certified social insurance and labour consultant. This is contracted with us separately as an independent business (for the details of facility labour, see also the certified social insurance and labour consultant's columns on our sister site). The calculation and claim of long-term care rewards are handled by the operator or a billing agent, and accounting and tax are the field of a tax accountant.

Where do you look for building-side standards such as room area, common areas and barrier-free design?

The facility standard is set in Ordinance No. 37 of 1999 (Article 176 and others) and given concrete form by the guidance guidelines. A care room is in principle a private room, and the floor area per resident is in principle at least 13 square metres (the area of the private portion, excluding corridors and common areas). As common areas, a dining room, a functional-training room, a bath, toilets, a medical room or health-management room, a nursing/care staff room and a lounge are provided according to the services offered. Barrier-free features such as corridor width, elimination of level differences and handrails, and securing of evacuation routes are also required.

Point to check	Main requirement
Care room	In principle a private room; floor area per resident in principle at least 13 square metres
Common facilities	Dining room, functional-training room, bath, toilets, medical room or health-management room, etc.
Barrier-free	Corridor width, elimination of level differences, handrails, wheelchair-accessible toilets and baths
Use / fire protection	Conformity with the use (home for the elderly) under the Building Standards Act; whether a change-of-use confirmation application is required
Fire-protection equipment	Falls under Appended Table 1, item (6)(ro) of the Order for Enforcement of the Fire Service Act; automatic fire-alarm equipment, sprinkler equipment, etc.

When you convert an existing building, a change-of-use confirmation application under the Building Standards Act may be required; whether it is needed and its design are for a licensed architect (the designer). The need for fire-protection equipment (automatic fire-alarm equipment, sprinkler equipment, fire-alarm equipment that notifies the fire authority, etc.) and the fire consent are for the fire department. The first-line check of use zone and area is handled by the real estate company; our company provides the property information and does not make the building-confirmation or fire judgement.

How do you build the schedule from the setup notification to designation and opening?

The setup notification (Act on Welfare of the Elderly) and the specified-facility designation (Long-Term Care Insurance Act) are separate procedures, but in practice you prepare them in parallel. Because things are easily sent back if the order is reversed, start the prior consultation early. The general flow is as follows.

1. Fix the business plan and funding plan and establish a corporation (add the establishment and operation of a fee-charging home for the elderly and specified-facility resident daily-life care to the purpose in the articles of incorporation).
2. Choose premises and confirm conformity with room area, common areas, the Building Standards Act and the Fire Service Act.
3. Hold a prior consultation with the prefecture (the designating authority) (for both the notification and the designation).
4. Secure nursing and care staff, a life consultant, a functional-training instructor, a plan preparer and a manager.
5. File the setup notification for the fee-charging home for the elderly.
6. File the designation application and attached documents for specified-facility resident daily-life care.
7. After document examination and on-site confirmation, receive the designation (in many municipalities, as of the first day of a month) and open.

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Many municipalities grant designation as of the first of the month, and the submission deadline for the designation application is generally set in the month or two months before the desired date. Because deadlines, forms and required documents differ by designating authority, always confirm on the relevant municipality's official page. Typical documents are the full set of notification forms, the designation application and appendix, the corporation's certificate of registered matters and articles of incorporation, the office floor plan, photographs and lease, the operation rules, the workers' forms-of-duty list with certificates of qualification, the careers of the manager and plan preparer, the income and expenditure budget and various written pledges. Within the scope of administrative-scrivener work, Yotsuba Administrative Scrivener Office supports the preparation of the notification, the designation application, the appendix and attached documents, the organisation of prior-consultation materials and the drafting of the operation rules. The final judgement of conformity and eligibility for designation is made by the designating authority's review.

Who should you ask for the notification, designation, building, fire, labour and tax?

Opening a fee-charging home for the elderly with care crosses several fields of expertise. The roles are divided as follows.

• Preparation of the setup notification, designation application, appendix and attached documents, and support for prior consultation → Yotsuba Administrative Scrivener Office (administrative scrivener)
• Selection, lease and important-matters explanation of business premises, and the first-line check of use zone and area → Yotsuba Real Estate Co., Ltd.
• The change-of-use confirmation application and design, conformity of room area and barrier-free features, and checking the inspection certificate → a licensed architect (the designer)
• Judgement on whether automatic fire-alarm and sprinkler equipment are required, and fire consent → the fire department and a fire-equipment engineer
• Employment contracts, work rules, working-hour management including night shifts and night duty, and social-insurance application that meet the staffing standards → a certified social insurance and labour consultant
• Corporate establishment and change registration → a judicial scrivener
• Corporate accounting, tax and tax calculation, and the bookkeeping accompanying long-term care reward claims → a tax accountant
• Individual legal judgement on rights, obligations and disputes → an attorney

Yotsuba Administrative Scrivener Office and Yotsuba Real Estate Co., Ltd. are separate businesses. Our office handles only support for the notification and designation application as an independent business, and premises, building, fire, labour, registration and tax are contracted separately with each qualified professional or counter. Our office receives no referral fee. See also Designation for daily-life care and the premises requirements, which deals with the designation and premises requirements of disability welfare services, and The designation application and staffing of a home-visit nursing station, which relates to securing nursing staff. For the whole picture of licensing, see Licensing Services; for the flow of engagement, see Engagement Flow; and for fees, see Fee Schedule.

FAQ

Q. Is only one of the setup notification and the specified-facility designation enough?
A. To call yourself "with care" and have the facility's staff provide care as a long-term care insurance service, you need both the setup notification under Article 29, paragraph 1 of the Act on Welfare of the Elderly and the designation for specified-facility resident daily-life care under the Long-Term Care Insurance Act. Without the designation, it becomes a residential type, and residents individually contract external in-home services. Because staffing, facilities and procedures differ with the type, confirm this in the prior consultation.

Q. Can a service-supported housing for the elderly (sakoju) also obtain the specified-facility designation?
A. A service-supported housing for the elderly that meets certain requirements may be included in specified facilities, but the registration destination, jurisdiction and notification may differ from a fee-charging home for the elderly. Which framework to use varies with the business plan and premises, so confirm with the relevant municipality's guide and prior consultation. We support the organisation of the framework within the scope of administrative-scrivener work, but eligibility for designation is decided by the designating authority's review.

Q. Can I consult the administrative scrivener about night-shift arrangements and staff working hours?
A. Meeting the staffing standard and the employment contracts, work rules, working-hour management including night shifts and night duty, and social-insurance application of those staff are separate matters. The latter is the field of a certified social insurance and labour consultant, who contracts with us separately as an independent business. Our office supports the documentary side of the designation application.

Q. Can I use an existing building?
A. Besides room area, common areas and barrier-free features, a change-of-use confirmation application under the Building Standards Act or additional fire-protection equipment may be required. The change-of-use judgement is confirmed with a licensed architect (the designer) and the need for fire-protection equipment with the fire department. Premises are with the real estate company and building confirmation with the architect, each contracted separately as a separate business.

Sources (Primary Information)

• e-Gov Law Search, "Act on Welfare of the Elderly" (Act No. 133 of 1963), Article 29, paragraph 1 (notification of a fee-charging home for the elderly) (accessed 2026-09-26)
• e-Gov Law Search, "Long-Term Care Insurance Act" (Act No. 123 of 1997), Article 8, paragraph 11 (definition of a specified facility and specified-facility resident daily-life care) and Article 70, paragraph 1 (designation of a designated in-home service provider) (accessed 2026-09-26)
• e-Gov Law Search / Ministry of Health, Labour and Welfare, "Standards concerning the staffing, facilities and operation of designated in-home service businesses" (Ordinance of the Ministry of Health and Welfare No. 37 of 1999), Article 174 onward, Article 175 (staffing for specified-facility resident daily-life care) and Article 176 (facilities) (accessed 2026-09-26)
• Ministry of Health, Labour and Welfare, "Standard Guidance Guidelines for the Establishment and Operation of Fee-charging Homes for the Elderly" (room floor area in principle at least 13 square metres, etc.) (accessed 2026-09-26)
• e-Gov Law Search, "Order for Enforcement of the Fire Service Act", Appended Table 1, item (6)(ro) (automatic fire-alarm equipment, sprinkler equipment, etc.) (accessed 2026-09-26)
• The guides of each prefecture, designated city and core city for the setup notification of a fee-charging home for the elderly and the designation application for specified-facility resident daily-life care (deadlines, forms and required documents) (accessed 2026-09-26)

This article is general information and does not guarantee individual acceptance of the setup notification, eligibility for the specified-facility designation, conformity with the staffing, facility and operation standards, conformity of room area or barrier-free features, the need for a change-of-use confirmation application or fire-protection equipment, or the application schedule. The final review of the acceptance of the notification and of the designation is made by the designating authority (prefecture, designated city or core city). Confirm whether a change-of-use confirmation application is required and its design with a licensed architect (the designer), the need for fire-protection equipment and fire consent with the fire department, and the deadlines, forms and required documents on the relevant municipality's official page. Selection, lease and important-matters explanation of business premises are handled by Yotsuba Real Estate Co., Ltd.; employment contracts, working-hour management including night shifts and night duty, and social-insurance application meeting the staffing standards by a certified social insurance and labour consultant; corporate establishment and change registration by a judicial scrivener; accounting and tax by a tax accountant; and individual legal judgement on rights, obligations and disputes by an attorney, each as an independent business under a separate contract. Our office receives no referral fee. Individual judgements are made by a qualified professional after a meeting. Written by Joji Uramatsu, administrative scrivener and licensed real estate broker.