ADL Maintenance Addition

Due to the revision of nursing care fees for the fiscal year 2021, new additions for ADL maintenance (1) and (2) have been established.
For more details, please refer to the information below and the reference materials.

About ADL Maintenance Additions (1) and (2)

• I. ADL Maintenance Addition (1)
  Must meet all of the following criteria.
  1. The total number of evaluation subjects (those whose evaluation target usage period at the relevant business or facility exceeds 6 months) must be 10 or more.
  2. For all evaluation subjects, evaluate ADL in the sixth month starting from the month of service utilization, and if there is no service utilization in the sixth month, evaluate in the last month of service utilization. Measure the value based on that evaluation (hereinafter referred to as "ADL value") and submit the measurements to the Ministry of Health, Labor and Welfare for each month to which the measurement date belongs.
  3. The average value of the ADL gain, calculated based on certain criteria using the value obtained by subtracting the ADL value measured in the month of the start of use from the ADL value measured in the sixth month starting from the month following the start of use, must be 1 or more.
• Lo ADL Maintenance Addition (2)
  Must meet all of the following criteria.
  1. It must comply with the standards of 1 and 2.
  2. The average ADL gain of the evaluation subjects is 2 or more.

Evaluation Target Period and Calculation Period

Evaluation Period

Period from the date of notification until 12 months later

Calculation Period

The period from the month following the expiration date of the evaluation period to within December (the calculation can only start after the evaluation period has ended)

Submission Documents and Submission Deadlines

Submitted Documents

• Change Notification Form (Form No. 2)
• List of Conditions Related to Nursing Care Benefit Cost Calculation

• Matters Related to Business Office Designation (Home Care Support, Community-Based Services, Preventive Care Support)
  Form Publication Page

Submission Deadline

By the 15th of the month prior to the scheduled date for obtaining the addition

About ADL Maintenance Addition (3) (Community-Based Day Care)

As of March 31, 2021, facilities that have submitted notifications related to the ADL maintenance addition prior to the revision due to the FY2021 nursing care fee revision can continue to calculate until March 31, 2023. However, it is not possible to calculate the ADL maintenance addition (1) and (2) simultaneously.

Reference Materials

• Q&A on the 2021 Nursing Care Fee Revision (Vol. 3) (March 26, 2021) (PDF 1.4MB)
• Procedures and Sample Forms for ADL Maintenance Addition (PDF 546.9KB)