CUC Group Sustainability Report 2023

What drives CUC?

We want healthcare to be a warm hopeclose to each and every one of us.
We would like to Create Hope ThroughHealthcare so that patients can change
their anxious expressions into smiles ofrelief, face tomorrow with a positive
outlook again, and meet the end of theirlives in the way they wish.

Healthcare workers, who face patients on thefront lines of healthcare, are constantly surrounded by challenges, such as chronic labor shortages
and burdensome responsibilities.
If they, those who are supposed to be thecreators of hope, are not happy, they surely
cannot create hope for patients.

That is why we will transform the medical field.
We are a team that will not give up on that goal.

Our goals are:
To help create a society where people can live
healthy and secure lives in any country.
To provide quality medical care without leaving
anyone behind.
To spread patient-centered healthcare aroundthe world.

To transcend national borders.

Is there any hope for the future of healthcare inthis country?
We need to take a step forward in order to solve
the problems of a rapidly aging society, declining
workforce, rising medical costs, and finding
suitable successors for aging high-level managers
in medical institutions.
Our hope for the future depends on our actions
now.

We want to Create Hope Through Healthcare.

A team who gathered with the desire
to face the flaws of the healthcare industry,

The thoughts of each of us
become beacons of hopefills society with hope.

Each one of us can make changes that will light up our hearts.
Based on that,
we will passionately, swiftly, and boldly,
continue to pursue ideal medical care.

We will never give up on a hopeful future.

C U Cʼ s Views on
S o cial Iss ues■

Ra p id a ging of the p op u la tion
Percentage of population
aged 65 and over *1（Actual 2021→Forecast 2040）

Japan has a mountain of healthcare challenges. The working
population continues to decline due to the rapid aging of the
population and falling birth rate, national social security costs are
increasing, and hospitals and clinics nationwide are having problems
finding suitable successors for aging high-level managers. In addition,
many lives are being lost overseas due to the underdeveloped
healthcare environment, imbalance in healthcare standards, and rapid
increase in the number of patients with lifestyle-related diseases. We,
the CUC Group, have been facing these challenges since ourestablishment, and as we witness the formidable difficulties facing thehealthcare field, we strongly feel the need for change and are working
to deal with these issues from every possible angle.

08

29

Number of people who cannot
access end-of-life care*2
Approx.
（Forecast for 2040）

■

％

35

■

44

trillion yen

67.2

％

490,000 people

Increa sing medica l costs *4■

78（Actual 2019→Forecast 2040）

D e c r e a se in l a b o r fo r c e *3

million58.5

Hospitals with no suitable successors for aging high-level managers
Medical institutions with no suitablesuccessors for aging high-level managers*5

trillion yen

million（Actual 2017→Forecast 2040）（2017 results）

Hospitals where the head is 60 or over*6（2020 results）

68.4
68.5

%
%

*1 National Institute of Population and Social Security Research, Population Projections for Japan (2023 estimate) . 2023 *2 2011 Basic Data on Medical Care in Japan (Ministry of Health, Labour andWelfare) *3 Ministry of Health, Labour and Welfare. White Paper on Health, Labour and Welfare 2021. *4 Ministry of Health, Labour and Welfare. Overview of National Medical Expenditure. Cabinet
Office, Ministry of Finance, Ministry of Health, Labour, and Welfare. Future Outlook for Social Security Looking Ahead to 2040 (study material). 2018. *5 Japan Medical Association Research Institute.
Current Status and Issues of Medical Business Succession. 2019. *6 Ministry of Health, Labour and Welfare. Summary of Statistics on Physicians, Dentists and Pharmacists 2020.

O u r Appr oa ches toth e F u t u r e of Hea lthca re
The CUC Group operates three major businesses: management support
business for medical institutions, hospice business, and in-home nursing■

Business Brea kdown
Management support businessfor medical institutions
New services
Ma na gement
Su p p ort

business. The COVID-19 pandemic created new businesses in collaboration
with government agencies and companies, such as vaccination support
services, In-home clinical trials, and health monitoring support services. We

Hospice businessH osp ice

are also working to solve healthcare issues from all directions by verticallyproviding a wide range of services from in-patient care to home healthcare andend-of-life care.
We will continue to work together as a group to evolve the environment
surrounding healthcare and create hope for patients, healthcare workers, andVa ccina tion
Su p p ort
Services

In-home Nursing businessIn-homeN u rsing

New services
In-home Clinical
Trials, etc.

■

V e r t ic a l in t e g r a t io n o f in - ho m e n ur sin g , ho spic e s a n d m a n a g e m e n t suppo r t
fo r m e dic a l in st it ut io n s

In-patient
Care

Home
healthcare

End-of-lifecareManagement
support for
hospitals
Management
support for
dialysis clinics
Management
support for
in-home careclinicIn-homeNursingbusiness
Hospicebusiness

Provides one-stop solutions for medical
institutions, from operational support tosales expansion support.

Operation of hospices through thegroup company, CUC HOSPICE Inc.

Provides in-home nursing services
through Sophiamedi Inc.

society in Japan and around the world.

09

FY 2022 Highlights*1 Cumulative total from April 2022 to March 2023

K e y F i g ur e s of t h e CUC G ro u p*2 Figures as of March 2023■

N umber of emp loy e e s *2■

CU C I n c .

Ma n a gement su p p o rt b u s ine ss f o r m e dic a l ins t it ut i on s■

Nu mb er o f s u p p o rt ed key faci l i t i es *2102

Last year■+23

Num b er of hea lthca re w orkers recru ited withC UC ' s recru itment sup p ort *1

Doctors224

Non-physician
healthcare
professionals

689

3,008

Last year■

CU C H O S P I CE I n c .
S o phia m e di I n c .

+440

Hospice businessP ercenta ge of fema l e e m pl o y e e s *2■

Nu mb er o f f ac i l i t i es *2■

Num b er of pat i ent s *234

Last year

■

1,029

+8

Last year■

N umber of p a tients who p a sseda wa y under end-of-life ca re *1

Last year

Nu mb er o f s t at i o ns *2

86
Last year
■

+15

■

12,704
Last year

20+30

Last year

N u mber of p a tients w ho p a sseda w a y under end-of-life ca re *1

1,253
Last year+191+150,717*Total hours of service provided topatients by nurses/therapists*Therapist is a collective term for physicaltherapists, occupational therapists,and speech therapists.

¥

35.3b n¥S o phia m e di I n c .

+74

16.6 b n¥

20.3b n¥12.1 %C U C H O S P I CE I n c . 64.7 %S o phia m e di I n c .
64.6 %CU C I n c .

47.1

35.2b n

¥

154
421
393

Excludes contract and part-time
employees%

CAGR（2021.3〜2023.3）
Existing services

24.4b n

+

21.3

%

Ex ist in g S e r vic e sManagement support business,Hospice business,
In-home Nursing businessN e w S e r vic e s

COVID-19 vaccination support / in-home clinical trials,
etc.

2021. 32022.32023.3E x t e r n al E val uat i o n A wards R e ce ive d■

CU C H O S P I CE I n c .

P e r c e n t a g e o f fe m a l e m a n a g e r s *2

10

( A pr. 2022-Mar. 2023)

CUC Inc.

・Gol d aw ard i n t h e st a r t u p c a t ego r y o f t h e O N E C ARE E R Revie w Aw a r d s 2 0 2 3
・Platinum award in the Sustainability Report category and Gold award in the Annual Report category of
the LACP 2021/22 Vision Awards■

Ho u r s o f i n- h o me nursi ng care prov i d ed *1

953,536
10+1,550■%

Revenue(consolidated)0
Num b er of pat i ent s *2■30In-home Nu rsin g b u s ine ss■

Last year

39.2 %CU C H O S P I CE I n c . 77.9 %Sop hia m e di I n c .
69.0 %（billion yen）

840

+138

968

CU C I n c .

62.0

Aggregate scope of coverage: hospices that CUC Group operates

CU C I n c .

Includes contract and part-time employees*All of the above include part-time employees (excluding temporary employees).
*Data collection began this fiscal year.

453
957
1,598

A n n ua l r e c r uit m e n t c o un t *1

Sop hia medi Inc.

・Platinum award in the Annual Report category and Gold award in the ESG Report category of

the LACP 2021 Vision Awards
・Honorary Mention of International ARC Awards for Annual Report
・A d v an c ed Rec o gn it io n o f D& I Aw a r d 2 0 2 2

Ke y Poi n ts in FY20 22
Point 1

Newly Listed on the Growth Market of the Tokyo Stock Exchange
On June 21, 2023, CUC Inc. was newly listed on the Growth Market of the Tokyo Stock Exchange.
The reason for the listing is to establish a structure that will enable us to takeon greater challenges by strengthening our recruiting capabilities, acquiringsocial credibility, managing funds raised, and introducing stock-based compensation and a stock ownership plan, in order to realize our mission of Creating
Hope Through Healthcare.
In addition to our traditional stakeholders such as customers, patients, users,
employees including healthcare workers, and local communities, the management will work to meet the expectations of our shareholders. We will also continue the expansion of each of our core businesses, namely management support
business for medical institutions, hospice business, and in-home nursing business,

CUC Inc.
Corporate Officer CFO

Jun Hashimoto

as well as bringing about further hope by creating synergies among the businesses, continuing to develop new businesses, and expanding overseas businesses.

Point 2

Point 3

Head Office Functions of Group Companies Consolidated in Tamachi Office

CUC Group's Number of Employees Surpasses 3,000

On February 1, 2023, we relocatedSince its establishment, the CUC

our head office to Tamachi, Tokyo.

Group has added many colleagues as

By relocating and consolidating theit has expanded into various businesshead office functions of group com-areas and regions. As of March 2023,

panies, we aim to further strengthen

the number of employees in thecollaboration and realize our mission

group exceeded 3,000. We will con-of Creating Hope Through Health-tinue to strive for further growth andcare.

sustainable development with ourmany colleagues.

11

Contents
08

CUCʼs Views on Social Issues

Special Contents 2023

Stories of HopeESG Initiatives

50

CUC's Core Competencies
Creating Hope Through Healthcare.
Culture of the CUC Group09

Our Approaches to the Future of Healthcare

10

Key Points in FY2022

19

Value Creation Process29

Hope for Patients13

Message from Representative Director

20

List of Actions for Value Creation

35

Hope for Healthcare Workers

24

Commitment to People and Culture

43

Hope for Society

25

Criteria for Decision-Making in

26

Materiality andSocial Engagement : Identifying
Key Sustainability Issues

51

Environmental Data, People Dataand Scorecard

Business Activities

54

Policy on Corporate GovernanceSpecial Talk Session

55

Corporate Governance

56

Board of Directors and Corporate

What is the culture of the CUC Group
created around our philosophy?

Officers

About This Report
This report contains information about CUCʼs endeavors to operate its business in asustainable and responsible way. It covers our material sustainability issues that could
influence the value CUC creates for society.
*Most data is in FY2022 (Since April 2022 to March 2023), but some data may be in various durations.

1257

Executive Skill Matrix

58

Company Information

COVID-19, which stagnated society for more than
three years, seemed to have been conquered in Japan
when it was reclassified as a category 5 infectious
disease under the Infectious Control Disease Law inMay 2023. However, the waves of pandemics continue,
and the medical field remains unpredictable. Furthermore, Russia's sudden invasion of Ukraine in February
2022 not only terrified people, but also triggered a
global resource surge and energy crisis, again worsening the global economy already damaged by the
COVID-19 pandemic. The effects of this crisis havebeen felt without exception in Japan's healthcare andnursing care industries. Soaring prices for utilities,
food, and medical supplies have taken a heavy toll on
business operations, forcing many medical institutions
and nursing homes to take some kind of action. The
medical field is now facing unprecedented difficulties.
Under these circumstances, the two management
themes that we have been working on for the past year
are spreading our philosophy and evolving standardization.

Message from Represe nta tiv e D ire c t o r

The value of CUC is our human resources.
Our culture of mutual recognition andmutual improvement creates hope for healthcare.

Keita Hamaguchi
13

Message from Representative Director

In difficult times, we need a common purpose.

Our commitment to creating a culture whereNow is the time to fulfill our mission of

our philosophy becomes reality

Creating Hope Through Healthcare
In order to instill our philosophy, we are currently
The COVID-19 pandemic that began in 2020 madeworking on a variety of measures, both large and small.

me rethink CUC's philosophy. It was a turbulent

One of the most distinctive is the Leader's Promise, anthree-year period in which the physical and mental

original guideline that outlines the behavior and ideas

burden on the healthcare workers who bravely facedthat CUC Partners expects from its leaders. The follow-

patients was enormous. Witnessing the overworked

ing passage is included in it.

healthcare workers and personnel, I spent days asking“The leaders who helped us create this guideline

myself, "Are we really creating hope through health-were not all successful from the start. Like all of you,care?” The conclusion I reached was that an organiza-

they struggled at first, and through trial and error, wetional culture in which we, the creators of hope, cangot the hang of things, and here we are today”. Our

work vigorously, and a philosophy that serves as ahistory is one of trial and error, of facing healthcare

purpose and a common language, are essential.

issues head-on and repeating challenges and overcom-

In April 2021, we formulated the CUC Partners

ing failures. This text, which summarizes the leadership

Philosophy* as a philosophy to be shared by the CUC

style we have developed in the process, is filled withGroup and the medical institutions that we support inour experience in confronting many changes.

management, and we have worked to instill it in all

In August 2022, we began the annual CUC Partners

organizations as a decision-making axis for manage-

AWARDS to share and honor examples that embody

ment, a guideline for human resource development,

our mission, Creating Hope Through Healthcare, at a

and a norm for daily actions. As of August 2023,

high level.

conversations and behavior in the organizations areThis is the day when the CUC Partners Philosophy isslowly but steadily changing, and examples of hopemost strongly felt, as we present how we have createdcreation that should be emulated are beginning tohopes for patients, hopes for healthcare workers, andemerge.

hopes for society. CUC Partners work in their own
different fields every day and learn how to create hopein a variety of ways.

*CUC Partners is the name of the community of CUC Group companies and the medical institutions we support.

14

CUC Partner AWARD held in August 2023,
celebrating the 9th anniversary of the company's foundingMessage from Representative Director

Two approaches to realize patient-centeredrecruiting healthcare workers, know-how on attracting

healthcare: Operational Standardization andpatients, and operations at each facility, totaling 1,126

Enhancement of Gemba-Power
Another theme we have focused on over the past year isthe development of operational standardization.
In order to sustainably provide patient-centered healthcare, tasks that rely on individual experience and skills

topics and 12,537 pages*.
*As of August 2023, one page is calculated as one A4 page.

By eliminating the individualization of work waste,
and inconsistency, we focus on the essential
business of value creation.

must be identified and standardized. We believe that by

The greatest benefit of operational standardization is thatminimizing the number of highly personalized tasks thatthe time created by eliminating the individualization of

new employees learn by watching their seniors, and bywork (where the style of doing a task becomes specific topromoting task shifting (the redistribution of tasks among

the person doing it), waste, and inconsistency can be used

health workforce teams to enable highly skilled staff tofor work that is truly necessary for the customer, region,

focus on high skill tasks) and digitalization, we cantype of work, or facility. As a result, they can concentrateenhance the ability of the frontline to improve its own

on essential and creative work, such as devising new ideas

autonomous operations. However, operational standardiza-and systems. If we are only busy with day-to-day opera-tion in the medical field is not a straightforward process.

tions, we will not be able to take on the challenge of realiz-Operational standardization has not progressed as

ing our mission of Creating Hope Through Healthcare. The

expected due to many comments from the field, such as "It

penetration of philosophy and operational standardization

is difficult to create manuals because the situation differs

are inseparable.

greatly from patient to patient" and "It is very difficult to

Operational standardization projects are not temporary,share information due to the segmented nature of the

but rather an ongoing cycle of implementation, mainte-

specialty.” We have had bitter experiences of trying andnance, and improvement, with the goal of further advance-

failing at operational standardization many times in thement. Currently, the project has developed into the Gem-

past, but after the COVID-19 pandemic, we recognized theba-Power Improvement Project. The term 'Gemba'in Japa-

importance of standardization more strongly and decid-

nese means the actual place where the work is carried out,

ed to try again by launching a project for the entire CUC

where the strategies are executed, and where the value isgroup in FY2022. Analyzing any job, the basic parts thatcreated. ʻGemba-powerʼ represents improving our work-are "natural to be able to do" and "everyone should know"

place capability and giving our staff working in ʻgembaʼ thebecome clear. However, in many medical fields, such

power to keep improving on their own, therefore bringing

basics are not manualized, and new staff members do not

us closer to our goal.

know who to ask, and it takes time to understand, result-

We are working to create a system for staff development

ing in repetition of the same mistakes, waste and duplica-

using the manuals we have created, as well as a library oftion of effort. We first focused on this basic part of thevarious good practices to improve operations, the next stepbusiness, worked on its visualization, and compiled it inafter operational standardization. Our strength is our Gem-

the form of an operations manual. We have completed

ba-Power, and we will continue to enhance the value wemanuals on a variety of topics, including the process ofprovide to patients by improving it.

15

Message from Representative Director

Philosophy Realization Roadmap
Value Creat ion Process (dr iv ing force)sp

Materiality

whleTack e issues
hcar
ealt

CUC
Partners
Philosophyea●

Pursuing the Well-Being of Patients and Healthcare Workers●

Creation of Sustainable and Innovative Healthcare●

Providing Safe and Reliable Medical Care●

Ensuring ComplianceStandardization of operations

Service development(Improvement)(Reform)

Quick decision-makingsre sdAd l isciaso

D ig it a l Ut i l i z at ion

s

e
e
w

cr

Environmentally Conscious Management

s

st

th

●

e

te

va

ue

Fo

r

Creating Hope Through Healthcare.

re

The ability toachieve goals

The unifying
force of ourphilosophy

Recognizing
social distortions

Statementcane

Identi fy and im
new solu plem
tion entsdiss the negativd r e ate impact e a n ddon hA tion
eal
r
o
p
th
ro

Missionlue

In Unity, We Can Achieve.
Our purpose is to bring solace to as many individuals as possible,

1. Digitization

3. Digital transformation

Way
01. Prioritizing Patients' Needs over Our Own Perspectives.

04. Value Personality ahead of Professional Expertise.

While there are many obstacles on the way to achieving this, we

02. Seeking Solutions, Not Making Excuses.

05. United beyond Hierarchies. One Team,

keep going, driven by our strong and unwavering commitment.

03. Pursuing Ideals, Driven by Innovation.

ensuring that patient-centered healthcare becomes the norm.

C u lt u re (cu lt u re a nd cl i mate)16

2. Digitization

Extending a Helping Hand.

Message from Representative Director

CUC's value comes from human resources.
We manage in a way that draws out
the strengths of our staff

CUC's commitment to the next new stage
In the summer of 2023, we established our CUC
Partners Promise, a commitment to our employees: A

In FY2022, we formulated a value creation process

Fulfilling Environment for Your Aspirations. This is aand materiality to realize Creating Hope Throughdeclaration of how we, the senior management,

Healthcare and announced them through our

promise to support our colleagues in their efforts to

Sustainability Report. In the following year, we orga-

realize the CUC Partners Philosophy. We will consid-

nized the positioning of key themes in CUC Partners'

er and implement various human resource and com-business strategy, such as Service Development andmunication measures to create an organizational

Digital Utilization, including the aforementioned

culture in which all CUC Partners employees canOperational Standardization, into a Road Map forwork with passion.

Realizing Our Philosophy and drew a map towardrealizing our philosophy (Figure on the left page).

Listed on the Growth Market of the Tokyo Stock
Exchange in June 2023, we will continue on our

The healthcare industry can be compared to a

growth path with our new stakeholders. In parallelsports team. Doctors, nurses, caregivers, and otherwith the expansion of our hospice business to otherprofessionals on the frontlines of the field are just likeregions of Japan and the expansion of the number ofathletes. We must create an environment that allows

medical institutions to which we provide manage-these ʻathletesʼ to perform at their maximum poten-

ment support, we will also focus on revitalizing busi-

tial, attract many patients as clients, and create aness partnerships in each region.

stage where they can celebrate each other's great

We will also accelerate our overseas expansion,

efforts and successes. The ideal organization is one

which has been difficult due to the COVID-19

in which all people fulfill their roles and where there

pandemic, and plan to expand our business not onlyis a culture of mutual improvement.

in Asia but also in the United States.

We focus on staff development, organizational

We will continue to face the challenge of constantdevelopment, and culture development becausechange in order to realize our mission of Creating

providing services and creating value to society are

Hope Through Healthcare not only in Japan but

realized through the power of human resources.

around the world.

We believe that only by believing in the potentialof healthcare providers and drawing out the power of
each individual to pursue their dreams and ideals,
can we realize our mission of Creating Hope ThroughAugust 2023

Healthcare and deliver patient-centered healthcare to

Representative Director

as many people as possible.

Keita Hamaguchi

17

2 023 Sp e c i al Fe ature : CU C's Co re Compet enc ies

Creating Hope Through Healthcare.
Culture of the CUC Group
What is the driving force behind our growth?
It is the organizational culture that has taken root in the CUC Group.
The CUC Partners Philosophy is a philosophy of the CUC Group's

CUC Partners Philosophy
MissionCreating Hope ThroughHealthcare.

employees, who work for the CUC Group and the medical institutions
they support, as well as all healthcare workers who work at the medical institutions we support.
This philosophy is the heart of our culture.

Way
01. Prioritizing Patients' Needs over
Our Own Perspectives.

Stat eme nt

02. Seeking Solutions, Not Making Excuses.
03. Pursuing Ideals, Driven by Innovation.
04. Valuing Humanity alongside Expertise.

In Unity, We Can Achieve.

05. United beyond Hierarchies. One Team,
Extending a Helping Hand.

Our purpose is to bring solace to as many individuals as possible,
ensuring that patient-centered healthcare becomes the norm.
While there are many obstacles on the way to achieving this, we
keep going, driven by our strong and unwavering commitment.

18*CUC Partners is the name of the community of CUC Group
companies and the medical institutions we support.
*To learn more about CUC Partners Philosophy, visit our website.

2023 Special Feature CUC's Core CompetenciesThe
ach abi
iev lity
eg
o

to

eu
ou nify
rp i
hi
l

f
eo
rc y
o
f
h
ng sopo

The Value Creation Process represents the driving force to realize our mission, Creating Hope Through Healthcare, as well as

recognizing social distortions, quick decision-making, and The
ability to achieve goals. This rotation of forces is strengthened byinvestment in human capital, which moves us even more power-c
Re l daciaround our philosophy: The unifying force of our philosophy,so

our ability to realize this mission. Four forces revolve stronglyog
is nizto ing
rt
ion
s

Q

ui

CUC
Partners
Philosophy

ck
-m de
ak cis
ion
in
g

Th

als

Val u e C rea tion Process

fully toward the realization of our mission.

192023 Special Feature CUC's Core Competencies

L ist of Action s f or Va lu e Cr e a ti o nInformation dissemination toexternal parties
CUC Group's activities and employment
information are posted on our website,
owned media, YouTube, and SNS.

Implementation of Philosophy
Realization Meetings

Number of articles forexternal publication:

164*Total number of external
content transmissions(excluding SNS)

*Data collection period: April 2022 - March 2023
*Data was compiled by CUC, CUC HOSPICE, and Sophiamedi.

Group management message
dissemination

We hold regular Philosophy Reali-

We share our philosophy and manage-

zation Meetings, where the manag-

ment policies through internal events

ers responsible for each businessand regular publication of internal

gather to discuss the theme ofnewsletters.

permeating our philosophy.
Total hours of Philosophy Realization Meetings: Approx.

600

Number of in-house
events:31

Number of in-housenewsletters published:

15

01.

Ability to gather
colleagues who share
our philosophy and

The unifying c o n t i n u e t o r a i s etheir spirits
force ofour philosophy*Agregate scope of coverage: in-house events held andin-house newsletters published by the Group

Philosophy education
We create opportunities to think
about our philosophy through training and reading sessions so that eachand every employee can share andput our philosophy into practice.
Total hours of philosophy training:approx.

301,200*Multiplication of hours, number of times conducted, and number of participants

Providing opportunities forindependent learning
CUC's learning support system, "Challenge!",covers the costs of purchasing books for readinggroups, obtaining qualifications, and taking
online business school courses (paid in accordance with internal regulations). Beginning in
April 2023, CUC Academia will hold lectures inwhich employees serve as lecturers in their own
areas of expertise.

Total hours of reading sessions:

1,300

approx.

Total hours of online businessschool viewing:

1,563

Total hours of CUC Academia:

1,200

approx.

*Multiplication of hours, number oftimes conducted, and number ofparticipants*Only for CUC Academia, the periodof data is April 2023 to July 2023.

CULTURE

Medical field driven
management
The CUC Group has a large numberof healthcare workers who comeacross issues in the medical field andaim to solve them. We are able tocreate medical care from the patient's
point of view because we are confronted with the scenes of life on adaily basis.
Number of main healthcare
workers in the CUC group:

1,809*Breakdown: 935 nurses, 451 therapists,
423 caregivers (excluding temporary employees)*As of March 2023

20

Recognizing
socialdistortions

02.

The ability to identify
various healthcare
issues and their negative effects, and to
think independently
about how to solvethemThe ability to persevere and not give up
until the end, nomatter how difficult
the situation

04.
The ability
to achieve
goals

Creating a system to measure the realization of the philosophy
Through the Way Letter, a biannual 360-degree evaluation for
managers, and a monthly survey of proprietary indicators using
the Geppo (*) employee condition check tool, we quantify the
degree of penetration and implementation of our philosophy.
*Courtesy of Human Capital Technology, Inc.

3.67

3.97

Change in Philosophy April 2022
March 2023
→ Implementation
Penetration Score
Implementation
5 stage rating*Aggregation scope of coverage limited to CUC

within the organization, we can eliminate wasteful practices andcreate time to focus on highly specialized work.
Number of themes:

1,126

Number of pages:

12,537

Conduct training for management andsupervisors
We offer a variety of training programs to enhance
management skills so that executives and managers
can make decisions quickly and accurately.
Total number of training hours:

15,500approx.

*Multiplication of hours, number of times conducted, and number of participants

Ability to quickly
select an option tosolve a problem andtake action

Quickdecisionmaking

03.

ees who wish to transfer can submit a transfer request to
any group company or department that is seeking staff.
Use of the "Dream"
application system

Number ofapplications

32

Number oftransfers

10*Calculation period: Total of October 2022 and April 2023

The annual CUC Partners AWARDS, which honors teams

By standardizing common tasks into manuals that can be shared

Breakdown of completed
manuals

Twice a year, we have a "Dream" system whereby employ-

Implementation of internal praise events

Improvement of on-site capabilities
through standardization*One page is calculated as one A4 page.
*As of August 2023

Provide opportunities for career planningand individuals who embody our philosophy, is an important opportunity to share our exemplary behavior throughthe sharing of various case studies.
CUC Partners AWARDS
2023

CULTURE

Number of entries:

88

Strength of diverse professions andcollaborations

The CUC Group brings together professionals from a wide range offields, from medical professionals to business professionals. By
sharing their knowledge with each other in management, humanresources, IT, and other different specialties, multifaceted discussions can proceed swiftly.

Training to enhance medical skills
and knowledge
Study groups and training sessions are held to hone
medical expertise and skills and to improve judgment.
Total number of medical skills
and knowledge training hours:

approx.

72,600*Multiplication of hours, number of times conducted,
and number of participants21

2023 Special Feature CUC's Core Competencies

Spe cific A ction E xa mpl e s
ACTION 01

C r eati ng a system to deve l o p

The leaders of each organization play a central role in instilling the CUC Partners Philosophy into

leaders who embody ou r p h il o so p h y

Way Letter Feedback Result

Prioritizing
Patients'
Needs
over...

Seeking
Solution s,
Not
MakingExcuses.

PursuingId
eals,Drive
nbyInnovation.

the thoughts and actions of each and every employee, and CUC is taking various steps to develop
organizational leaders as champions of the philosophy.

The Leader's Promise, a textbook for becoming a leader

Value
Personality
ahead ofProfessional...

Unitedbeyondhierarch
ies. One
Team...

Averageabout six months interviewing and analyzing
senior leaders who play active parts in each【５】Very much executed.

50 %

53 %

50 %

31 %

50 %

47 %

out actions in accordance with the Way. Lead-role to depict the image of an ideal leader in

ers are responsible for encouraging members

our organization.The "Leader's Promise" is a【４】Well executed.

50 %

40 %

44 %

44 %

25 %

41 %

while also being aware of any concerns they

textbook for becoming a CUC Partners leader,

may have. However, this is not an easy task forcompiled with advice and examples of success-【３】Executed as
an individual.

0%

7%

6%

19 %

13 %

9%

newly appointed leaders, as there are manyes and failures by senior leaders who are

obstacles to overcome. Therefore, we spentactive in CUC Partners.

【２】Executed,
but not enough.

0%

0%

0%

6%

13 %

4%

【１】Not executed.

0%

0%

0%

0%

0%

0%

4.50

4.47

4.44

4.00

4.13

4.30

Average*Above is a sample Way Letter feedback sheet

Way Letter, a survey to measure the level of implementation of the Way
This is an original evaluation survey

stationed. We named it Way Letter because

conducted twice a year for managers. Each

it is a system whereby the leaders receive

leader receives feedback from superiors,

messages from many colleagues on whatcolleagues, team members, and even staff

they expect from their leaders in the future.

of the medica institution where they are22

In the medical world, employees must face
daily challenges and conflicts in order to carry

2023 Special Feature CUC's Core Competencies

ACTION 02

ACTION 03

P h i l o s o p h y T alk : a dis cus s ion of philosophy t ha t

Fost er a c ult u r e o f p r a i se a nd c r e a t e

t r an s c e n d s de partm e ntal and ag e ba rriers

a posit iv e wo r kp l a c e

As one of our efforts to spread our philoso-

employees are expected to participate by the

Since our founding, we have valued a culture of

foster a sense of unity. In addition to events, thephy, we have been holding PhilosophyTalk, a

end of the fiscal year. Positive comments

recognizing employees who have performed well,

CUC Group is also working to enhance

participatory online talk session for all CUC

from participants include, "It was a goodand initiatives that embody our philosophy. Theremotivation and work quality by regularly sharing

employees since April 2023. PhilosophyTalk

opportunity to reflect on my daily activities,"

are numerous opportunities for recognition,

episodes and images of individuals who haveis an event in which employees discuss theand "I was able to deepen exchanges withincluding a major annual CUC Partners-wide awards

been recognized for their performance throughWa y i n s m a l l g r o u p s . A s o f J u l y 2 0 2 3 ,people from other departments.”

event, as well as best practice sharing sessions withininternal newsletters and owned media of eachapproximately 100 employees have alreadyeach group company and department. In the CUC

group company. We will continue to raise theparticipated in the event, and all CUC

Group, which has a diverse mix of medical

morale of the organization through these

professionals and business-colored professionals,

opportunities and create an environment inthese events allow employees with different

which each individual can grow in a positive

specialties to learn about each other's efforts and tomanner.

23

2023 Special Feature CUC's Core Competencies

C o m mit men t to Peop le a nd Cul tur e
The nine years of history since CUC's founding is

CUC Group executives and physicians fromfull of examples of developing people and taking on

supported medical institutions, and HOPE, aorganizational challenges through our philosophy.

program that is now the foundation for theWe established the mission of Creating HopeThrough Healthcare at the time when CUCʼsdevelopment of the next generation of management
leaders.

number of employees exceeded 100. This wasAfter the COVID-19 pandemic from the beginningbecause our business style requires organizationalof 2020, we fully realized the need to create an

management across multiple locations from afarorganization where employees are motivated toand it was essential to have a philosophy that would

work. This is why we developed the CUC Partnerʼs

serve as the axis for all our decisions.

Philosophy as a system of principles to be upheld

Since the establishment of our Mission in 2017,

by CUC and the medical institutions that wemanagement has focused on developing leaders

support. As of 2023, we are using this philosophy as

who will promote its philosophy.This is partly

the foundation for our organizational development,

facilitated through leadership activities including

including recruitment, evaluation, and training.

CUC Partners Promise
A Fulfilling Environment for Your Aspirations.
C r ea te a n envir onment wher e ea ch ind ivid ua l ca nf eel f ulfilled in their wor k a nd pur sue their d r ea ms a nd id ea ls.
Our P ro m i s e is embod ied by a pled g e between senior ma na g ement a nd
employees to pr omote our philosophy.

the Future Conference, a management camp for

Hi story of Philosophy M a na ge m e nt
Aug 2014

M3 Doctor Support Corporation (nowM e s s ag e f r om th e o ffice r in ch arge
Sep 2021

CUC Inc.) founded
Jan 2017

Formulation of our Mission -held (and regularly held thereafter)
Aug 2022

Creating Hope Through Healthcare
1st Future Conference held (andregularly held thereafter)

Mar 2023

May 2019 1 s t H O P E C o n f e r e n c e h e l d ( a n dregularly held thereafter)
Aug 2019

Company name changed to CUC Inc.

Apr 2021

Announcement of CUC Partners
Philosophy

24

1st Philosophy Realization Conference

Everyone who gathers at CUC Partners

environment where each and every

Announcement of Materiality

supports the CUC Partners Philosophy,

employee feels fulfilled in their work

(important items)

and through its embodiment, we are

and can fulfill their dreams and ideals.

Establishment of Leader's Promise

working on a daily basis to realize

Going forward, we will further

Leader's School (to be held regularly

Creating Hope Through Healthcare.

accelerate our efforts for people andthereafter)
Aug 2023

Everything is created by people.

Formulation of CUC Partners
Promise (Promise to all workers)

In order to promote this philosophy

organizations, using the CUC Partners

system as a whole, we have established

Promise as a guideline for

the CUC Partners Promise as a promiseorganizational development andbetween CUC's management and all of

personnel system design.

our employees: We will create an

CUC Inc.
Corporate Officer
CHROToshio Matsuura2023 Special Feature CUC's Core Competencies

Criteria for Decision-Making in Business Activities
There are three simple concepts that we always refer towhen making decisions in our business activities.

Be P as s ionate , Be S ucce s sful, Be Support ed.
We believe that where these three concepts overlap forms the criteria
for decision-making in business activities.
We believe that the power to change society will be born.

The inspiration for these words was the challenge we faced during the COVID-19 pandemic
supporting the vaccination effort.
In May 2021, as the period of the state of emergency was extended in many areas, including
Tokyo, vaccination was expected to be the decisive factor in the fight against COVID-19. The
then-Prime Minister Suga announced a target of 1 million vaccinations per day in order tocomplete vaccination of all elderly people who wanted to be vaccinated by the end of July of
the same year. While local governments across the country were promoting vaccinations and

Be Passionate

Be Supported

Is this a theme that

Can we get support from

we can be passionate about?

our peers and society?

companies were promoting workplace vaccinations, many local governments were struggling tooperate vaccination centers and to secure the necessary doctors and nurses, so vaccinations
were not progressing as smoothly as expected.
Although we had never encountered this situation before, we decided to support this hugevaccination support project. Behind this speedy implementation was the strong desire of thesenior management and project members to "do something to help individuals highly affectedby the pandemic" and "contribute to the acquisition of herd immunity in Japan."
The passion of the parties involved, the experience and execution capabilities of the CUC

Be Successful
Is the competitive advantageof the business clear?

Group in the medical industry, and the dedication of the medical professionals, government
officials, and partner companies who cooperated with us, resulted in a significant contribution
to the number of vaccination slots we were able to provide throughout Japan, which totaled
3.88 million (cumulative total from June 2021 to March 2023).
This experience is the source of inspiration of "Be Passionate, Be Successful, Be Supported.";without any one of the three elements, great challenges cannot be overcome. That is why wewill continue to say these words.

25

Special Talk Session

What is the culture of the CUC Group
created around our philosophy?
The CUC Group brings together a variety of professionals, from medical professionals to business professionals.
Here three employees of different ages and who undertake different roles discuss our culture.

Philosophy is an important link between diverse values｜What do you think is CUC's unique culture?

P h i l o s o p h y, i n t h e s e n s e t h a t m e d i c a lThis is the challenge of the medical industry.

professionals and business professionals can

Kuno: After a long career in the medical field asspeak a common language.

a Biomedical Equipment Technician, I joined

Make your philosophy
a habit and change
your approach

CUC and moved into a business position
supporting medical institutions from the
back-office, so I understand how both the
medical professionals and the businessprofessionals feel.

together in a single organization to create

Even if we take the example of solving a single｜How do you understand the CUC Partners

services. It is amazing that even though the

problem, the medical professionals in the fieldOishi: I am currently in charge of planning theorganization is made up of people from different

and the business professionals may not agree

hospice project. I feel that our culture aims tobackgrounds, everyone is unwavering in theirwith each other because they view issues

Kuwaki:Whenever I provide management support tobalance emotional thinking, "I want to see myfundamental desire to provide good medical caredifferently. That is why I believe that the best

medical institutions, my approach always centers onpatients smile," with logical thinking to grow ourto patients.

way to create solutions to the most problematic

philosophy. Medical management involves people

issues is to engage in dialogue with a common

from many different departments and backgrounds;

goal: what is best for the patient.

because it is a diverse organization, the team canbusiness.

Philosophy?

In the CUC Group, medical professionals who

Kuwaki: Medical care is a job that isdeliver services directly to patients and businessparticularly close to human life. Each person

professionals who support the business structure

who works in this field has a strong sense of

Kuwaki: I think there is great value ina common language and decision-making criteria. I

from the headquarters and back-office work closely

responsibility, and this kind of structure can becommunicating our philosophy, the CUC Partners

believe that philosophy is the key to this.

only come together if discussions are conducted with

Shintaro Kuno

Kaori Oishi

Susumu Kuwaki

CUC Inc.
Dialysis Clinic
Department

CUC HOSPICE Inc.
Corporate Planning
Department andDevelopment Department

CUC Inc.
Executive Medical
Adviser of Hospital
Department

She joined CUC as a
new graduate in 2022. In
her first year, she wastransferred to CUC
HOSPICE, a groupcompany, where she wasin charge of formulating
management plans, andplanning the opening of
new facilities.

After working for hospitals
and consulting firms, hejoined CUC's Hospital
Department in 2021 as aphysician and consultant.
He is involved in hospitalmanagement support andrevitalization support.

After working as a
Biomedical Equipment
Technician at a hospitaland a dialysis clinic, hejoined CUC in 2021.
Currently, he supports
dialysis clinics from both
inside and outside byplanning the optimizationof operations and humanresource development in
the Dialysis Clinic
Department.

26

prone to conflict due to differing points of view.

Kuno: Because it is important, we want to make it

and rising costs of goods and services.

more accessible, but some people see philosophy as

Thatʼs why we create an opportunity forsomething sublime or untouchable, so I dare to tellchange and give a gentle push. I have the sensejokes related to it.

that if there is a trigger, the medical field will

For example, "You were talking about many teams,
weren't you? lol" in relation to "One Team" in Thechange in a flash. Of course, this requires a
spirit of constant change on one's part.

Way in our philosophy. When we put it into words
on a daily basis, we become closer to the philosophy

Kuwaki: I see CUC's job as one of creating

and our team's thinking and actions change, so I'll

difference through change. And sometimes

continue to make jokes consciously.

someone has to move forward in order to create
big changes. When I get involved with new

Oishi: It is true that more and more people in our

hospitals through management support, I tell thecompany are talking about "Way" as if it were a

medical staff that I want them to value "quality"Change Until Change."

be involved in the process of stabilizing

speech habit. Maybe they donʼt even realize they are

and quantity" of services. The quality of medicalcare delivered to each patient is of course

Creating smiles as well as

operation after the opening.

doing it.

Hope Through Healthcare

Kuno: This is a bit abstract, but I want to bringwill not grow unless the quantity is increased.
That is why I keep calling on everyone to think｜What themes do you want to focus on in the

medical field, there is a shortage of personnel

How does each person
make a change｜What are your thoughts on CUCsʼ keyword,"Change?”Kuno: It is generally said that the medical industry
is averse to change, but I don't think that is true. I
feel that there are many people who don't knowwhat to do about issues, want to know how tochange, or want a chance to change.
In conversations with medical professionals in theclinics we support, staff, especially those in their
20s and 30s, tell us, "It's not good enough as it is." Ibelieve they have a heightened sense of crisis about
the future in the face of negative reimbursement

important, but the value and scope of provisionof ways to increase the quantity. Increasing theq u a n t i t y r e q u i r e s i n g e n u i t y, s o c h a n g e s w i l ls u r e l y o c c u r. T h i s w i l l u l t i m a t e l y l e a d t o
profitability and benefit the staff.
Oishi: CUC has the phrase "Change Until

more smiles to the medical field. In today's

future?

and fees paid to medical institutions by the

Kuwaki: As someone in my mid-40s, I am

there are not many bright topics. In times likeg o v e r n m e n t a r e d e c r e a s i n g y e a r b y y e a r, s ointerested in the transfer of knowledge to thethese, I think it is important for us to remember

next generation and the organizational

to smile.

development that goes along with it. I would like

By creating change in the medical field one by

Change" which is the origin of our company

to further expand the potential of CUC byone, I want people to smile and say, "I'm glad I

name. I take this phrase to mean work through it

nurturing the next generation.

got to work with you.” Beyond that, there will be

until it pays off. In my work to open a new
facility, I have to formulate a basic strategy andthen repeatedly fine-tune it, but if I do aa future where Creating Hope ThroughOishi: My priority is to complete the opening of

Healthcare will be realized. I am sure that the

new facilities. There are seven new facilities

future will be filled with many smiling faces. I

half-hearted PDCA cycle, the entire strategy

scheduled to open this fiscal year, so there is abelieve that we can create hope for society byb e c o m e s u n c l e a r. I d o n ' t l i k e t o d o t h i n g s

lot of work to be done. Since I am in charge ofbringing smiles to the faces of patients andhalfway, so I want to be responsible and finish

selecting candidate sites for opening, I cannot

healthcare workers.

the project. I am very familiar with the phrase

stop. Once this work is complete, I would like to27

Stories of Hope

Demand for home healthcare accelerates
in super-aging Japan
Japan is now entering a super-aging society period more extreme
than any other country in the world. This will be a "multi-death■

Death dynamics in Japan
Number of deaths per year (thousands)
Actual Estimated1,800

society" where the number of deaths will increase, and population

1,600

decline will accelerate.

1,400

The number of deaths in Japan is on the rise and is projected to

1,200

peak at about 1.7 million per year in 2040. Presently about 60% of

1,000

the population would like to spend their final days at home when

800

they are dying (*1), but the currentsystems and places to accept them
are insufficient, and 70% of people died in hospitals in 2020 (*2).
Home healthcare is needed to solve these problems. Home

Deaths will continue
to increase until 2040

Annual deaths are expected to peak

at1.7million

600
400
1990 2000 2010 2020 2030 2040 2050 2060

healthcare plays an important role in which doctors and nurses visit
patients and support them so that they can live their own lives in*The data until 2020 is based on "Vital Statistics (2021)" by the Ministry of Health, Labour andtheir own homes, facilities, and other familiar places.

mortality estimates" by the National Institute of Population and Social Security Research.

Welfare, and after 2030 is based on "Population Estimates for Japan (2023): Median birth and*1 Ministry of Health, Labour and Welfare. Results of the 2022 Survey on Attitudes Toward Medical Care and Care in the Final Stage of Life (Report). 2022.
*2 Ministry of Health, Labour and Welfare. Vital statistics of Japan, 2021. 2021.

For a future in which everyone can choose
home healthcare when they need it
While demand for home healthcare is growing, there are challenges to its
widespread use. The number of clinics providing home healthcare has remained

Hope forPatients

flat, while since 2014, the number of hospitals providing home healthcare has
begun to increase, but still only accounts for about 36% of all hospitals.
Since its establishment, CUC has supported the operation and establishmentof new medical institutions that provide home healthcare. Through thenationwide development of in-home nursing stations and hospice-type
residences by group companies, CUC has also contributed to strengthening
regional cooperation. We will continue our efforts to promote home healthcareso that patients in the community can continue to live their lives in their own
way.

■

Number of medical institutions providing home healthcare
36.1%

Percentage of all hospitals
31.6%
30,00025,00020,000

29.4%

31.7%

Percentage of all clinics
21.4%

32.2%

28.0%

22.1%

30

22.4%

21.8%

21.6%

18.9%

25
20

Number of clinics
providing home healthcare

15,000（％）
35

15

10,00010
Number of hospitals
providing home healthcare

5,000

5

2005

2008

2011

2014

2017

2020

0

* Ministry of Health, Labour and Welfare. Current Status of Home Healthcare in 2022.

29

Hope for Patients

CUC HOSPICE Inc. operates hospices for people with cancer and incurable diseases. We provide
reliable care support and in-home nursing services for residents from daily care to end-of-life care.

S to r i es f rom Pa tients a nd S ta f f

My mother, who had just moved into the hospice was not energetic
due to Parkinson's disease. She had many tubes connected to her

S TO RY 01 Hospice Business From Ms. S. K.'s family
The couple were able to enjoy cherry blossoms
together, something which they
thought would never happen.

body and had difficulty eating by mouth. The staff worked very hard

We want to continue to watch over them as they live
together for many years to come.

to provide rehabilitation for her, and she has gradually been able toI will never forget the look of joy on Ms. S's

eat food by mouth. In addition, upon my motherʼs admission, myface when she drank water for the first time in afather, who had been suffering from a chronic illness, also moved intolong time after two months of rehabilitation.

the same facility, and they were both able to receive care in the same

What made Ms.K. even more energetic was theroom together. Having my father by her side helped my mother topresence of her spouse. I feel that having him byregain her energy, and they were able to enjoy cherry blossom

her side is the best therapy for her. Recently weviewing together, something which they had thought might not be

took a picture of them holding hands and looking

possible this year. Please continue to watch over them both warmly.

happy under the cherry blossoms. We would liketo continue to watch over Mr. and Ms.K.

30

Minami Saito
CUC HOSPICE Inc.
CaregiverHope for Patients

S TORY 02 Hospice Business From Ms. K. O.'s family
They fulfilled my mother's last wish to
grow seasonal flowers.
My mother suffers from amyotrophic lateral sclerosis (ALS), which
progresses quickly, and she was depressed after moving into thehospice. After a period of labored breathing and around the time
morphine was started, my mother, who had temporarily regained herenergy, said she wanted to grow flowers. Hearing this, the staff
worked hard to assist my mother to fulfill her wish, and thanks totheir efforts, she was able to sow sunflower and morning glory seeds
in her garden on a sunny day. After that, my mother spent her timelooking forward to the pictures we would send of the flowers being
watered. A few days after placing the pot in her room for her to could
enjoy the flowers growing in the facility, she quietly departed. Thankyou for fulfilling my mother's last wish.

Thinking about the resident and the family
We want to be close to both.
Ms. O looked forward to seeing the flowers growevery day, even as her disease progressed. Even
after her passing, the potted flowers in her room
continued to grow, so our staff recorded photos of

DATAthem and later gave them to Ms. O's family along

Hospice business datawith the harvested seeds, which they were very
happy to receive. It was a very valuable experience
for me to be able to support Ms. O's zest for life andto be able to be involved in easing her family's
grief, which made this job very rewarding.

■Junko Ueki
CUC HOSPICE Inc.
Nurse

Number of facilities:

34■

Nurses/Caregivers:776■

Ca pa c it y :1,358*As of March 2023
*Aggregate scope of coverage: hospices that CUC Group operates

31

Hope for Patients

Sophiamedi operates in-home nursing stations nationwide. Home nurse andtherapists visit patients' homes and provide nursing care.

STO RY 03 In-home Nursing Business From Ms. H.O.
I remember how I used to feel when
I was younger, and I feel very energetic.
About six months ago, I broke my hip and was bedridden for awhile, but I have gradually recovered while receiving nursing
care and rehabilitation back at home, and now I am able to takea 15-minute walk on a nice day. I am practicing my movementswith the staff so that I can take a bath by myself. When the staff
come to visit me, they remind me of my younger days, and it
cheers me up. I am grateful to all of you.

I am energized by the efforts
made in daily rehabilitation.
She always says to me, “Your coming here makes

32

Sophiamedi Inc.

me feel cheerful, and most of all, itʼs fun.” The

Physical Therapist

visiting staff members are also energized by Ms. O's

Shinnosuke
Sunagadaily efforts in her rehabilitation to cope with life athome.

Hope for Patients

S TO RY 04 In-home Nursing Business From Mr. A. I.'s family
Many of them have experiencein pediatric nursing, so we can rely on them.
My son has a tracheostomy and I started using the in-homenursing service. I am able to take care of him at home bytalking to the nurses and getting help doing things that would
be difficult for me to do alone, such as changing dressingsand bathing him. I trust them because they are all very kindand helpful. There are many staff members of the samegeneration as myself, people with child-rearing experience,and people with experience in pediatric nursing, so they giveme advice from various angles and are very helpful.

I would like to continue to watch over

DATA■

In-home nursing stations (*1)

86In-home Nursing business data■

Total number of patients (*2):

12,704■

Nurses/Therapists (*3) :

1,033

■

Hours providing in-homenursing care (*4) :953,536*1 Number of in-home nursing stations served by the Group*2 Number of patients visited in March 2023
*3 Therapist is a collective term for physical therapists, occupational therapists, and speech therapists.
*4 Total hours nurs es and therapists provided services to patients. Total hours of care within the past 12 months.

his growth while discussing
the best way to spend time.
Always smiling, sometimes crying, they show
us various expressions every time we visit them. I
try to discuss with the mother what is the most
comfortable way for her to spend her time and*As of March 2023

take care of her son. I would like to continue towatch his growth.

Ai Mashima
Sophiamedi Inc.

Nurse

33

Hope for Patients

CUC

Reflecting patient feedback in quality improvement
Support for implementation of NPS (Net Promoter Score) surveys
As part of our efforts to promote patient-centered healthcare, we support the patient satisfaction
initiatives of the medical institutions we support. A prime example is the Net Promoter Score (NPS)
survey conducted by the medical institutions we support.The NPS survey is a questionnaire thatasks patients, their families, local nursing homes, and partner institutions to rate their level of trustin home healthcare services on an 11-point scale from 0 to 10. The program is being implemented
at CUC-supported in-home care clinics nationwide, and the results are used to evaluate andimprove home healthcare services. We contribute to improving the quality of healthcare at the
medical institutions we support by assisting in the tabulation and analysis of NPS survey results.

DATA■

Number of supported medical institutions we assist with NPS surveys:

52*As of March 2023

Feedback from patients and local partner institutions
Improving the quality of medical care
Informa tion on s u p p o rte d m e dic a l instit u tio n

Our clinic has been conducting NPS surveys twice a year since 2020.
By conducting NPS surveys of patients and their families, as well as
nursing homes and home care support offices, we are also able toascertain the evaluations of patients and the institutions with which theywork in the community. The results of the NPS survey are shared with

34

Sapporo Home Care Clinic Soyokaze

our clinic's doctors to improve the quality of their practice. In the future,

A clinic in Sapporo, Hokkaido that provides home healthcare,we would like to capture more detailed trends in the medical services

in-home nursing, and home care support 24 hours a day, 365

sought by patients. We believe that the quality ofdays a year. We provide compassionate home medical care toservices can be further enhanced by strengthening information linkage

Director of Sapporo

everyone in the local community.

with CUC and analyzing the data from various perspectives.

Soyokazehome healthcare

Mr.

Tomoya Iida

Home Care Clinic

Shortage of healthcare workers increases burden on the frontline
As Japan's population ages, with a peak in■

Trends in the ratio of job offers to job seekers

2040, domestic demand for healthcare
increases while the supply of human

The ratio of job openings in healthcare occupations is
2 to 3 times higher than that of all other occupations.

4resources falls short. In the medical field, theworkload of each individual healthcare
w o r k e r, s u c h a s d o c t o r s a n d n u r s e s , i s
becoming heavier, and the normalization of
overwork and the resulting increase in the3

2number of people leaving the profession areserious social issues. It is predicted that there

1

2.90
2.15

3.28

3.09

2.06

1.04

1.14

2.27
1.34

will be a shortage of approximately 1.87
million* healthcare workers by 2030, and the0healthcare delivery system must respond to
the growing demand for healthcare.
* Persol Research Institute. Labour Market Future Estimates 2030. 2018.

2021

Public Health
Nurses andMidwives

2.33

2.20

2.11

MedicalTechnicians

2022

Doctors andPharmacists

Average of
all occupations

2023*1 Ministry of Health, Labour, and Welfare. General Employment Placement Situation (Employment Security Service
Statistics) 2021, 2022, 2023
*Effective job openings to job seekers ratio: The number of jobs available per one job seeker.

Diverse and flexible work environment
resulting from changing work styles
The CUC Group has many healthcare workers in the
medical field, including nurses, therapists*, and caregivers.
In order to provide high quality medical care to patients, it

Hope forHealthcare Workers

is essential to have a sustainable work environment where
healthcare workers can continue to feel fulfilled in theirwork. For this reason, we have various systems in place thatallow employees to work actively over the long term inaccordance with their respective lifestyles. We deliver bettermedical care to patients by putting smiles on the faces ofhealthcare workers.
*Therapist is a collective term for physical therapists, occupational therapists,and speech therapists.

Examples of Work Support Systems
One-hour paid leave

Re-employment certification
for former employees

Babysitting assistance

Assistance for purchasing
health equipment, etc.

LGBTQ support - marriage,
childcare, and careers
Kokoromiru system(long-term leave support system)

Secondary employment system(permitted under certain conditions)

Mental health support(as of July 2023)*System details are set individually by each CUC Group company.

35

Hope for Healthcare Workers

CUC Management Support Division

Total support for medical institutions■

General medical institutions■

Supported medical institutions

from daily operations to business growth
Board Chairman

In 2020, 68.5% of hospital managers in Japan were over 60 years old (*1), and 68.4% (*2) ofmedical institutions were at risk of not being able to continue their business due to a lack of

Head of Management

suitable successors for aging high-level managers. In addition, it is becoming increasingly difficult
to recruit healthcare workers as Japan's workforce continues to shrink. To address these issues,

Strategic
Planning

CUC provides comprehensive medical management support by sending management support

Management

MedicalCare

Board Chairman
Head of Management
Strategic
Planning

Management

personnel to medical institutions that operate hospitals, in-home care clinic, dialysis clinics, eye

Strategy
Development
Support

Medical
Care
Operational
Support with
Headquarters
Functionsclinics, and pediatric clinics. We provide comprehensive support for management functions ranging
from assistance in formulating business strategies to business administration, marketing, humanresources and recruitment, IT, accounting and general affairs. We also provide sales growth
support through M&A, PMI, conversion of hospital beds, and opening of clinics to ensure stable
growth of medical institutions. By supporting the transformation of medical institutions, we will

DATA

bring patient-centered healthcare to as many people as possible and increase the job satisfaction ofhealthcare workers.

■

Number of supported key facilities

102*As of March 2023

*1 "Summary of Statistics on Physicians, Dentists, and Pharmacists in 2020" (Ministry of Health, Labour and Welfare, 2020)*2 "Current Status and Issues of Medical Business Succession" (Japan Medical Association Research Institute for Policy Studies)

To enhance the job satisfaction of each and every employee
To be an organization in which employees can grow sustainably
In the nine years since CUC's inception, the number of medical institutions we havesupported has grown each year. As of July 2023, there are 105 locations. As ourorganization grows in size, we feel it is important to return once again to our roots andbuild an organization centered on our philosophy. In order to provide good medical careto patients, it is essential that medical staff and CUC employees themselves are motivatedto work in the medical field. To this end, we will focus on creating a work environment
where all employees can work with a sense of sustainable growth while valuing ourphilosophy. We will futher invest a lot in spreading our ideas and developing our staff.
Moreover, we will make an internal environment where the young and new recruits can
showcase their skills quickly and continuously. We will enhance the job satisfaction ofeach employee and increase the value we provide to patients and healthcare workers.

36

Kenichiro Hori
CUC Inc.
Corporate Officer
General Manager ofManagement Support
Division

Hope for Healthcare Workers

Episodes of employees working to build the organization of a medical institution

Acting as a bridge between management and the frontline

Because home healthcare operates 365 days a year,

For better healing medical care for patients

Supporting the smooth operation of hospitals

we take care of our staff

Supporting the management of ophthalmology clinics

We provide operational support to a general hospital

Since January of this year, I have been in charge of a

We provide management support mainly toin Aichi Prefecture for the reorganization of hospital

in-home care clinic that we support in Toyama. The local

ophthalmology clinics that provide treatment andbed functions. This support is provided from all

people had been looking forward to the opening of thissurgery for cataracts and other diseases. If the role ofperspectives, including that of patients, healthcare

clinic, so it was rewarding to be able to support it from its

home healthcare is to provide medical care that looks

workers, and management, and includes things such

start-up. Since I am originally from the area, I have always

after patients for the rest of their lives, the mainas creating a comfortable working environment for

felt the disparity in medical services between urban andpurpose of our outpatient care is to treat their illnesses

employees and cooperating with local medical

rural areas, and was happy to have the opportunity toand injuries. It is rewarding to be involved in medical

institutions. What is important to me in my work is tocontribute to my hometown. What is important to us incare that leads to tangible symptom improvement forconnect the management philosophy of the hospital

supporting the clinic is to deal with each healthcare worker

patients. For example, Iʼm delighted to see patientsʼ

with the aspirations of the healthcare workers in theindividually. While home visitation is reassuring to patients

faces light up when they have undergone cataract

medical field. Close communication on a daily basis

because it is available 24 hours a day, 365 days a year, fromsurgery, and their vision has improved. The Outpatient

allows us to identify concerns and problems in the field

the perspective of the workers, it is a service that requires

Clinic Department is a new organization that has only

in a timely manner and to be the first on site to resolve

ingenuity in the way they work, as working hours can easily

been up and running for less than two years. In theissues as they arise. We think that by correctly funding

balloon. That is why I believe it is important to create an

daily activities, we can invest in better hospitalenvironment in which healthcare workers can work

equipment and staff training. This will raise thenumber of satisfied employees and, consequently,
improve medical care for patients.

Koji Horimoto
CUC Inc.

comfortably by carefully having daily conversations andHospital Department

keeping our antennae up to ensure that the burden is not

Management Support
Divisiondisproportionately placed on certain staff members.

Riko Hirata
CUC Inc.

future, we hope to support the creation of a moreadvanced medical care delivery system by further

Home Healthcare

solidifying the foundation of the clinic, including

Department

medical treatment flow, measures to attract patients,

Management Support
Divisionand a system for human resource development.

Takuma Sugo
CUC Inc.
Outpatient Clinic
Department
Management Support
Division37

Hope for Healthcare Workers

Sophiamedi

Aiming for an organization based on appreciation and empathy,

Promoting relationships in which staﬀ members accept themselves
as they are and support and respect each other

we promote well-being in the medical profession

The group aims to improve job satisfaction and retention rates by creating a workplace where healthcare

In recent years, the word well-being has become a key word in the way we work and live. This concept

professionals can work with enthusiasm. Great Place To Work®, a professional organization that conducts researchmeans a good state of being, not only physically and mentally, but also socially. Medical professionals, whoand analysis on job satisfaction in approximately 100 countries around the world, proposes ﬁve components of job

deal with patients' lives on a daily basis, sometimes self-sacriﬁce out of regard for their patients. Althoughsatisfaction: pride, solidarity, trust, respect, and fairness. We focus particularly on pride and solidarity and work to

the need for in-home medical care is increasing in Japan, there is a serious shortage of human resources,

improve them. In FY2022, 565 new employees joined the company. As a result of these initiatives, the index forwith approximately 120,000 home care nurses needed in 2025（*1）compared to 60,000 in 2020（*2）. The

solidarity in the employee satisfaction survey increased by 0.5 points. On the other hand, since there was a decline

aging of the population has necessitated the acceptance of seriously ill patients at home, as a result in-homein the overall evaluation of job satisfaction and the index for pride, in FY2023 we will evolve existing initiatives andstrengthen measures to ensure that new employees feel comfortable in their work immediately after joining thenursing services are required to be available 24 hours a day, 365 days a year and to make emergency visitscompany. In order to continue to provide better care to clients, it is extremely important to have a sense of pride ineven late at night or early in the morning, making the heavy physical and mental burden on the medical

their work and their own well-being based on trusting relationships with their peers. We believe that improving thestaﬀ a major issue. In response to these issues, Sophiamedi introduced a work system in 2020, "WOW!",

job satisfaction of our employees will lead to higher quality care and client satisfaction. That is why we are commit-

which supports a balance between work and private life. Furthermore, we have established a specialized

ted to creating a workplace where each individual can think about and choose how to work happily for themselves.

department, the Well-Being Promotion Group, which aims to improve the health and well-being of staﬀ.
*1 Japan Visiting Nurse Foundation: Current Status and Future of Home-Visit Nursing Care 2023 Edition*Workplace survey on "Solidarity" index*2 Ministry of Health, Labour and Welfare: Overview of the Year 2020 Health Administration Report (Employment Medical Personnel)

52.5% in 2023 (2022: 52.0%)

Mami Miyazi
Sophiamedi Inc.

■

Group Manager of

Fou r i n it iat ives of t he Wel l-Bei ng Promot ion Group

01. Thank You E-mails

02. Story of Caring for Lives

03. Wellbeing Awards

Well-Being Promotion Group

04. Follow-up for new employees

DATA■

The "Thank You E-mails" program collects

Stories of actual episodes between staﬀ

This program recognizes oﬃces that

To ensure that employees feel comfortable working

messages from staﬀ members at each stations

and clients are shared in monthly online

implemented outstanding measures toimmediately after joining the company, we provide

who wish to express their appreciation andmeetings attended by all employees. The

deepenstaﬀ

training, and regular follow-up e-mails. In addition, medical

share them to the desired colleagues via

total number of likes from staﬀ was 1,619

members, thereby accelerating thesestaﬀ who have been with the company for less than one

e-mail on their behalf. In FY2022, 1,182

in ﬁscal year FY2022.

eﬀorts. Exemplery eﬀorts are shared toyear are oﬀered the opportunity to have a support chat tostations nationwide.

talk about any concerns or issues they have . Pulse Survey

messages were received.

relationships

amongscores improved for 76.5% of these staﬀ.

38

Employee satisfaction from Pulse Survey

Response rate

Average point（5-point scale）

82.2percent 3.5(last year: 79.5%)（last year: 3.5）

*Total period: April 2022 to March 2023
*Pulse Survey: Monthly questionnaire survey to measurestaﬀ health, human relations, job satisfaction, etc.

Hope for Healthcare Workers

CU C

In the highly challenging area of physician recruitment support,

Reducing task individualization,
Project to improve on-site capabilities for patient-centered healthcare

Almost 50% more full-time physicians were recruited
The standardization of medical recruitment, which is directly related to the qualityof medical care, is one of the focal points of the project to improve Gemba-power. In

Since our founding, we have worked hard to solve problems inJapanese means the actual place where the work is carried out,

various healthcare fields, including providing management

where the strategies are executed, and where the value is created.

support to medical institutions nationwide, as well as operating

ʻGemba-powerʼ represents improving our workplace capability andin-home nursing and hospice businesses. What emerged was agiving our staff working in ʻgembaʼ the power to keep improving

sense that, due to the labor-intensive nature of the business andon their own, therefore bringing us closer to our goal. By

the serious shortage of labor, it is easy to fall into a negative

promoting standardization of operations and technology in every

spiral of increased workload per worker, which results from the

medical field and enhancing autonomous and continuous

individualization of work（where the style of doing a task

improvement capabilities in the field, we aim to achieve a state

becomes specific to the person doing it）, over-reliance on

where we can continuously provide high value services tailored tocertain staff to do particular tasks, and the difficulty other staff

each individual patient in various situations. While there are a

year, it has resulted in an increase in the number of candidates, a reduction in theface doing tasks that have been individualized. In response towide range of initiatives, the first year of the project has focusedtime to hire, an improvement in the speed of hiring decisions, and an almost 50%

this situation, the CUC Group as a whole launched theon three main themes: medical staff recruitment, patient attraction

increase in the number of full-time physicians hired compared to the same period

Gemba-Power Improvement Project in April 2022. 'Gemba' inactivities, and operational management.

last year. There is still room for improvement, and we will continue to strengthen ourparticular, the recruitment support operations for full-time physicians were highly
challenging due to their specialty focused nature and scarcity. Therefore, we havepositioned it as the most important theme of the project. In the standardization ofoperations, we defined the ideal workflow, clarified and standardized the required
recruitment information and evaluation criteria for interviews, and redeveloped therecruitment management system. In standardization of technology, we brought
together knowledge by analyzing the know-how accumulated by each of ourexperienced recruiters. All of these are reflected in the manual, which iscontinuously being updated. Although the initiative has been in place for less than aability to recruit physicians and provide patient-centered healthcare.

Teppei Taguchi
CUC Inc.
Gemba-Power Support Team
Corporate Strategy Department

DATA■

Number of pages:

12,537

Breakdown of manuals created■

Number of themes:

1,126*As of August 2023
*Total volume of manuals produced by the CUC Group,
including manuals developed by the Gemba Power Improvement Project39

Hope for Healthcare Workers

CU C Grou p

Diverse career paths
for healthcare workers

Employees pursuing diverse careers in the CUC Group■The CUC Group has a large number of healthcare professionals. There are a wide variety ofpositions, ranging from those that deal directly with patients, such as nurses, therapists, andcaregivers, to back-office positions that support the management of medical institutions. In addition,

Ca se1

Nursing assistant, then facility manager, then to human resources.
Hospice experience came in handy for recruitment

some of our employees are licensed physicians and nurses who work in business positions. We take

When I first joined the company, I worked as a

into account each individual's desire to take on new challenges. We provide opportunities andnursing assistant. In my second year with theencourage our employees to take them on. We also have a culture that provides opportunities forcompany, when I had finished raising my children

those who raise their hands. There are many opportunities for job transfers from medical to businessand began to think about my own personal growth, an

positions. We will actively create an environment where healthcare workers can expand their careersopportunity arose to gain experience as a facility

in a positive manner.

manager. I had no prior experience, but my desire to
try it out outweighed my fear to take the plunge. I“DREAM” in terna l re c ru itm e nt sys t e mrealized the difficulty of managing a facility withmany staff and community members, and thesatisfaction of working as a team to create a goodf a c i l i t y. A t t h e s a m e t i m e , I b e c a m e s t r o n g l ymotivated to spread hospice-type housing, which isOnce a year, this system allows those who wish to transfer the opportunity to submit a request to
move to any CUC Group company or department seeking staff. Employees can choose to transfer toa different department or even to a different group company.

DATA
■

40

Nurses：935

CUC HOSPICE Inc.

Number of healthcare workers in the CUC Group■

Therapists：

451■

desperately needed in the community, throughout
Japan. Since April of this year, I have been working in

Recruitment Teama n e w p o s i t i o n a s a h u m a n r e s o u r c e o f f i c e r,

Human Resources Department

contributing to the spread of hospices throughrecruiting activities. In the future, I would like toincrease the number of people I work with throughout
Japan.

Caregivers：

423

Yukari Kimura*Number of employees excluding temporary
employees as of March 31, 2023■Cas e 2■

Ca se3

Diversity healthcare managementm as seen through nursing andGetting involved in disaster preparedness support

hospital management support

in the community as a specialist in disaster nursing

Yasuhito Yabu
CUC HOSPICE Inc.
Head of Operational Management Department*Seconded from CUC Inc. in April 2023.

After obtaining my nursing license in college, I

After graduating from university, I worked in theworked at a university hospital for about 5 years.

emergency room and at a critical care center, but

While working there, I wanted to acquire skills in

because my hometown was hit by the Great East Japan

healthcare institution management, so I went toEarthquake, I studied disaster nursing in graduate

graduate school to obtain an MBA. Once I left theschool and became certified as a disaster nursing

clinical field, I decided to move to CUC in order tospecialist. I joined Sophiamedi because I wanted to behelp d ea l wit h domest ic medical issues from a

involved in disaster preparedness in the homebusiness perspective. At CUC, I have been providing

healthcare field and contribute to the community.

management support to the hospitals it supports forSince joining the company, while working as a homeabout five years, and since April of this year, I havenurse, I have been a member of the Disaster Response

been overseeing the operation of hospices andProject, creating Business Continuity Plans and disasterin-home nursing services nationwide at CUC Hospice.

manuals for each business site, and educating the

I feel that the appeal of the CUC Group is that there
are many opportunities for licensed medical
professionals like myself to participate in thebusiness. New ideas can be generated from both

Chiho Konno
Sophiamedi Inc.

community on disaster preparedness. I feel that theexperience and learning I have gained while working

QM Promotion Group and Disaster Responsewith clients, their families, and community

Project Team Quality Management Division

stakeholders through in-home nursing has been put tomedical and business perspectives, and the value ofgood use as a disaster nursing specialist. We would like

medical care can be expanded.

to further strengthen our disaster countermeasures in
the future.

41

Hope for Healthcare Workers

CU C

Provide a safe workplace for all healthcare Workers.

■

Advancement of risk management in the frontline of healthcare
The healthcare field is fraught with various risks, including medical accidents, spreadof infectious diseases, disasters, and customer harassment. In recent years, these

Focus Theme 1■

Focus Theme 2

medical accidents in the home healthcare field

Conducting anti-harassment training to

Medical safety Initiatives

ensure the safety of healthcare workers

In the area of home healthcare, it tends to be difficult

In the medical field, the increase in the number ofto accumulate knowledge about medical safety because

healthcare workers forced to take leave or leave their

the services are provided in the patient's home, anjobs due to verbal abuse or violence has become aproblems have become social issues. For healthcare workers working in the medical

environment with limited medical resources, andsocial issue. According to the 2017 Nursing Staff Survey

field, such a risk-exposed environment leads to a significant psychological burden,

because each clinic is small in size. That is why we areconducted by the Japan Nursing Association, 52.8% ofmaking it difficult to work in a sustainable manner. The CUC Group has established astrengthening our comprehensive support system toall nursing staff have experienced some form of violence

prevent medical accidents at the in-home care clinics

or harassment in the workplace in the past year.

risk management department to protect the work environment for healthcare workers.
Risks are classified into four categories: medical safety, BCP measures, infection control,and customer harassment. Each team works with the medical institutions they support toachieve safety for both patients and healthcare workers.

Supported Medical Institutions：1 0 2
Incident&accident
Reporting and Consultation*As of March 2023

we support. An example is the monthly incident and

The Anti-harassment Team conducts anti-harassment

accident sharing meeting. Sharing case studies withtraining to ensure a safe and secure work environment.

other staff members at the supported medical

We create awareness of the issue and how to deal withinstitutions enables the discussion of ideas forit through the use of case studies and inform healthcare

preventing recurrence. We also develop operational

workers at supported medical institutions about the

manuals to prevent medical accidents. By systematizing

policy for dealing with harassment when it is confirmed.

these efforts, we hope to provide a safe and secure

We will continue to provide more opportunities toenvironment for both patients and healthcare workers.

improve our knowledge in order to avoid occurrences.

Risk Management Support

Ami Shigematsu

Kaito Fukunaka

CUC Inc.

CUC Inc.

Medical Safety Team

(proposals for workflow improvement,
information sharing meetings, etc.)

Anti-harassment Team

Risk Management Support Department

Risk Management Support Department

Management Support Division

In charge of Risk Management Support
Medical Safety

42

BCP Measures

Infection
Control Measures

Customer
Harassment
Measures

DATA

Medical Safety Information
Sharing Meetings

Medical Safety Information ■ Total number
Sharing Meetingsof participants:■

12

approx.

660*Total period: April 2022 - March 2023

Management Support Division

DATA■

Anti-harassment training for
supported medical institutions

Number of times
implemented:

16■

Total numberof participants:
approx.

570*Total period: January 2022 - March 2023

National healthcare expenditure and ratio

■

（%）

45

10.0

40

Japan's healthcare expenditure has been increasing year after year. Although it temporarily fell

9.0

35

by approximately 1.4 trillion yen year-on-year in 2020, partly due to the impact of the COVID-19

8.0
7.0

30

pandemic, it increased by approximately 2 trillion yen in the following year, 2021, reaching an

25

all-time high (see graph on the right). Due to the aging of society, medical expenses are estimated

6.0

GDP ratio

5.0

20

to grow to approximately 78 trillion yen by 2040 (*1).
In order to curb these medical costs, there is an urgent need to reduce the number of hospital

4.0

National health expenditure

15

3.0

10

beds and shift to home healthcare. By shifting those who can be cared for at home from

2.0

5

1.0

in-patient care to home care, the CUC Group aims to limit the rise of medical and nursing care0

costs. Through the management support service for medical institutions (*2) and the operation of1955 1960 1965 1970 1975 1980 1985 1990 1995 2000 2005 2010 2015 2020

0.0

Ratio to Gross Domestic Product (GDP)（Trillion yen）

National health expenditure

to Gross Domestic Product(GDP)yearly

National healthcare expenditure and ratio to Gross Domestic Product(GDP)yearly* Ministry of Health, Labour and Welfare ・Annual National Medical Expenses vs. Gross

hospice-type residences and in-home nursing stations, the CUC Group will promote the spread

Domestic Product Rate 1954-2021

of home healthcare throughout Japan and contribute to curbing social security costs.
*1 Cabinet Secretariat, Cabinet Office, Ministry of Finance, Ministry of Health, Labour, and Welfare. Future Outlook for Social Security Looking Ahead to 2040 (study material) 2018.
*2 We provide management strategy development, business administration support, marketing support, staffing, IT, accounting and general affairs support, and human resources and recruitment support. In addition, we
also provide one-time services such as support for opening new clinics, conversion of hospital beds, and M&A/PMI (Post Merger Integration: integration process after business merger) on a one-time fee basis.

Promoting patient-centered healthcare abroad, creatinga world where everyone has access to quality medical care
As populations increase and lifestyles change due to economic growth, cases oflifestyle-related diseases such as diabetes increase, and greater health awareness andmedical care becomes necessary. However, public healthcare spendings in Southeast
Asian countries are lower than that of developed countries, with healthcare spending as a

Hope forRatio of total healthcare expenditure to GDP

Total healthcare expenditure as % of GDP
15

13.3
10.9

10

7.5

percentage of Gross Domestic Product (GDP) averaging 4.4% in 2020, compared to 13.3%
in the major developed countries (G7 member countries). The healthcare systems in each

6.1

5country are far from adequate, and there is a lack of high-quality healthcare services. In
response to this situation, CUC is expanding overseas in order to provide high-quality,

5.1 4.7
4.4 4.1
3.7 3.4

2.7 2.4

Brunei

Laos

Indonesia

Myanmar

Malaysia

Thailand

VietnamPhilippines*World Health Organization. World health statistics 2023.

SingaporeStarting with Southeast Asia, we aim to realize our mission of Creating
Hope Through Healthcare worldwide.

Cambodiasocieties and a country where people have a long and healthy life expectancy*.

0Japa npatient-oriented healthcare cultivated in Japan, one of the world's leading super-aged

G7 Average

Society■*World Health Organization. Global Health Expenditure Database Key Statistics 2020.
*The G7 average is the average of G7 member countries including Japan.

43

Hope for Society

CUC HOSPICE

Restoring hope for patients with incurable diseases
Hospice business "ReHOPE" brand relaunch

CUC Hospice relaunched its business brand as ReHOPE in June
2023. This is due to the dire social need for our services in theworld. With the advent of a death-ridden society, there is a
shortage of places to provide end-of-life care for many people.
Those in the terminal stages of cancer and those withneurological incurable diseases, may find it especially hard to beable to receive end-of-life care in appropriate places.Although thenumber of patients with cancer and incurable diseases in Japan
has reached 5.69 million (*), there is a lack of end-of-life care forthose who are highly dependent on medical care, and thissituation calls for immediate change. Against this backdrop, we
decided to change the brand name to reflect our determination to
spread hospice services that enable people living with illness tolook forward to their lives. We will continue to promote ReHOPE
throughout the country.
* The total number of cancer patients is 4.66 million based on the "Summary of Patient Survey(Fixed Number) in 2020" (Ministry of Health, Labour and Welfare) and the number of patients withdesignated intractable diseases is 1.03 million based on the "FY2020 Health Administration Report"(Ministry of Health, Labour and Welfare).

44■

Statistics on the future number of deaths and places of death
1.6

Results

Estimates

Hospice as a place to restore hope,million

1.4

in Japan and around the world
Shortage of beds
in institutions:

1.2

490,000

1.0

are not left alone and can look forward to a better future. To

0.8

this end, we are expanding our hospice business throughout
No.of deaths inmedical institutions:
about

0.6

980,000

0.4

Japan and the world with the vision, "We will help people tolive the way they want to live and create places where they
can be hopeful.” With this vision, we are expanding our
hospice business throughout Japan and the world.

0.2
0

We want to help those who are confused and grieving in
the face of serious illnesses so that they and their families

At ReHOPE, our team of highly specialized staff supports
ʻ70 ʻ80 ʻ90

ʻ00

ʻ10 ʻ20 ʻ30 2040

*Ministry of Health, Labor, and Welfare. Central Social Insurance Medical
Council. Basic Data on Healthcare in Japan [Internet]. 2011
*Estimates based on Vital Statistics until 2007 and Future Population
Projections after 2008.

No.of deaths inpatientʼs homes:
about

200,000

and fulfills the wishes of individuals who want to eat what
they like, feel the seasons, and spend time with their families
and pets. As a leading company in the new end-of-life carefield, we will continue to take on new challenges.

CUC Inc,
Corporate Officer
CUC HOSPICE Inc.
President andRepresentative Director

Masaaki InoueHope for Society

CUC Home Healthcare Department

Connecting medical corporations, pharmacies, and nursing homes
Polypharmacy Improvement Project

Polypharmacy, a situation in which elderly patients take many

Corporation, one of the recipients of our support, launched a project to improvemedications at the same time, causing adverse events, has long been

polypharmacy in November 2022 in cooperation with local pharmacies, andconsidered a problem. In addition, as healthcare costs continue to rise innursing homes. This is an initiative in which physicians and pharmacists inJapan, excessive drug prescribing will lead to further financial strain.

charge propose drug reductions and drug modifications to Heiikukai

The Polypharmacy Improvement Project began

Although improving polypharmacy has its benefits, the act of reducing

patients who have issues with taking multiple medications. The results ofas one of CUC's efforts to achieve its goal of bettermedications leads to patient anxiety, which requires explanation fromthis initiative will be used as a starting point to make similar proposals tohome healthcare. Heiikukai, which has long been

appropriate medical providers and social awareness.

many other medical institutions in the future.

concerned about the impact of multiple drug use

CUC, in collaboration with the physicians of Heiikukai Medical

Aiming to realize better home healthcare
through support for drug reduction

on the health of patients, its affiliated pharmacies,*Patient consent was confirmed prior to the projectnursing homes, and CUC worked together as ateam on this project to improve the quality of life
(QOL) of patients. CUC was responsible for project■

management and analysis. Looking back on the

Polypharmacy Improvement Project management structure

project period of approximately six months, we

DATA■

Number of patients
included in the study:

53■

have identified trends in the drug reduction

Results of efforts at nursing home A

process. In the future, we will monitor the■

Number of cases that led todrug reduction:

21

Percentage of patients taking more than 5 drugs

71.7
67.9

prognosis of patients who have reduced their
Physician's decision to
reduce medication andproposal of medication
reduction to the patient

Selection of drug reduction
targets by pharmacists andproposal of drug reduction
to patients

Observation of patients'
lifestyle and review ofdrug changes％ before the project started →project with other supported medical corporations.

CUC Inc.

％ after the project started*Total period: December 2022 - March 2023

medication, accumulate evidence, and expand theHome Healthcare Department
Management Support Division

Overall project design and system development

Muneo Sakuyama

45

Hope for Society

CUC Overseas Operations Department

Overseas business initiatives to face global healthcare challenges

20192022.9Started medical institution

Invested in Nhi Dong 315

support for hospitals in Vietnam

in Vietnam

2022

2020

Aiming to solve global
healthcare issues
and spread standardized
medical services

46

2023.72019.12

Established CUC America Inc.
in the U.S.

2023
2023

2020.12023.3

Started management support for dialysis

Established CUC CIPTA HUSADA, a joint venture

treatment facilities in Indonesia

to operate and manage dialysis facilities in Indonesia

In order to become a company that is needed by people around thereasonable and appropriate-quality medical care. In Indonesia, we beganworld, and to solve the unbalanced global demand for medical care,

supporting local dialysis operations through a joint venture with a local

CUC began its overseas expansion in 2019. As the first step, we havepartner in January 2020; we launched a second joint venture in March 2023.

expanded into Vietnam and Indonesia.

In addition, as a new challenge for change, we plan to launch a

In Southeast Asia, the medical care delivery system is largely

general medical clinic in Ho Chi Minh City, Vietnam, by the end of

bifurcated into private hospitals for the wealthy and public hospitals

FY2023 by CUC's subsidiary in Vietnam. In the future, we plan torun by national, provincial, and other public organizations, and there

establish similar clinics mainly in the Ho Chi Minh City area to build a

is a lack of institutions that meet the demand from the middle class. In

network to support local medical care. In Indonesia, we plan to develop

addition, the rapid increase in the population of patients withour business in new areas such as ophthalmology and nursing care inlifestyle-related diseases is having an impact, and is assumed toaddition to the dialysis field.

become a major social issue in the near future.

Our mission is to contribute to the realization of a better society by

To address these healthcare challenges, we began supporting local

reducing medical issues that may occur in various parts of the world

medical institutions in Vietnam in December 2019. In Vietnam, we areas foreseen in Japan, a country with an advanced aging population.

supporting the medical group Hoan Hao General Hospital in the

In order to deliver quality medical care to as many patients as

operation of two general hospitals and one clinic as of July 2023.

possible, we envision a business model for medical services that will

They are a private medical group that is characterized by providing

set a new standard.

Takamichi
TanabeCUC Inc.
Director COO
Head of Overseas
Operations
Department

Plans to open a local family clinic"Tokyo Family Clinic" in Vietnam

2023

■

Employees tackling healthcare challenges in Southeast Asia

Overcoming language and value barriers

Contributing to the extension of healthy life expectancy in Vietnam

We want to support the healthcare system for local people

with the launch of a family clinic

We provide operational support to Hoan Hao General Hospital, a medical

I joined the CUC Group with a desire to develop quality medicalgroup in Vietnam, to provide safe and reliable medical care. For example, we

care in Vietnam. While demand for medical care is increasing inare promoting various initiatives such as renovation of the hospital to create

Vietnam, the medical system remains outdated in many areas, anda comfortable treatment space, improvement activities by conducting patient

there is an overconcentration of patients in public hospitals in urban

surveys and providing feedback to the staff, and implementation ofareas. Most of the population tends to prefer large hospitals, which

workplace environment improvement activities such as the Japanese concept

are known for their advanced medical equipment and excellentof hygiene management and 5S（*）. In introducing Japanese-style medical

doctors, and many people have little trust in local private medical

services, what is important to us is to consider what is the best medical careinstitutions and choose not to go to the hospital until their condition

for local people. It is also important to develop the capacity of the Vietnamese

worsens. The "Tokyo Family Clinic," which is scheduled to open thisstaff so that they can become the main actors in the Vietnamese business. I
would like to support a good medical system through close communication

Sanako Mihashi

based on an understanding of the different cultural assumptions.

CUC Inc.

*Slogans used to maintain and improve the workplace environment; Sort, Systematize, Shine, Standardize, Sustain

Department

Overseas Operations

year, is a clinic that aims to provide the same quality of medical careprovided in Japan in Vietnam. We will implement this while placing
importance on the CUC Group's strengths of speed and hands-on
approach.

Vu Manh Kha
Change Until Change Healthcare Ltd
Vice Development Director

47

Hope for Society

CUC Vaccination Support ProjectContributed to the acquisition of mass immunity in Japan
Support for vaccination against COVID-19 infection

DATA■

Since 2021, CUC has been providing operational support services for vaccination against COVID-19 infection for municipalities andapprox.

companies. This includes executing comprehensive operational support for safe and secure vaccinations, securing vaccination sites,
designing the vaccination process, securing medical supplies and medical institutions to administer the vaccinations, assisting withstaff recruitment, and providing human resource management support. Although the scale of support was reduced in May 2023 withthe change in the status of COVID-19 under the Infectious Diseases Control Law(*) to a category 5 infectious disease, CUC's ability andNumber of vaccinations
contracted to administer:

■

3.88

■

million doses

Number of supported
companies:

25

Number of municipalities
supported:

22■

Number of healthcare
workers recruited:
more than

8,200*Total period: June 2021 - March 2023

know-how to swiftly launch projects in response to society's needs has become a major strength of the company.
*Act on Prevention of Infectious Diseases and Medical Care for Patients Suffering from Infectious Diseases

Things we can do for the future society after experiencing
an unprecedented emergency
At the start of the project in 2021, this service was being implemented
during a time of intense tension that did not exist in normal times. However,
we have gradually established a stable service system as we have supported
vaccination programs for many municipalities and companies. We wereable to support the provision of a cumulative total of approximately 3.88
million vaccinations over a period of approximately two years because of
the efforts of our project members toward our mission to contribute to theacquisition of mass immunity in Japan. We are pleased to have been able tohelp control the spread of infection in Japan. Although this service is being
scaled back in the future, we will continue to contribute to the communityand society by leveraging our experience in responding quickly and flexibly
to the medical needs of local governments and companies.

Ryutaro Nakajima
CUC Inc.
Project Manager ofVaccination Support Project*Name of department as of March 2023.

48

ESG Initiatives

Materiality and Social Engagement : Identifying Key Sustainability Issues
There are five important themes that we are committed to, in order to Create Hope Through Healthcare. We identify the

From the Director in chargemateriality necessary to realize the management philosophy by comprehensively discussing what is important and the degree

Within the context of the global transition to a sustainable society we areto which it is important for society, stakeholders and our company by reference to SASB(*1) and GRI(*2) and other standards.

working to create value in the healthcare area under these materiality themes,

We strive to provide important environmental, social and governance information to society and stakeholders.

and in FY2022 we appointed a director in charge of each of the five items and*1SASB Standards: Standards for the standardization of non-financial information disclosure led by the Sustainability Accounting Standards Board (SASB) in 2018.

formulated an ideal action plan for each. As a new initiative, a project team

*2GRI Standard: The international standard established by the Global Reporting Initiative (GRI). It is used to report the economic, environmental, and social impact of an organization to the
publicunder the direct control of the director has been established to expand theE nv i ro nme n tal l y Cons cious
Man ag ement50

S o ci al

S o ci al

Purs ui ng t h e Well-

Creation of Sustainable

Being of P a t i ent s a nd
Hea lthc a r e Wo r k er s

and Innovative
Healthcare

CUC Inc.

measures already implemented in some group businesses, and study sessions

Corporate Officer

have been held within CUC Partners to solicit ideas from a wide range of

President andemployees. Going forward, we plan to promote initiatives based on this action

Representativeplan throughout the group and report on the progress of each.

E nvir onme nt

Aya ItoS ocialP r ov id in g S af e an d

R e l iab l e M e d ic al C ar e

Sophiamedi Inc.

Director and CEO

G overnance

En s u r in g C om pl ian c e

The global environment and medical care

We will pursue an ideal future in which

We would like to provide medical

We aim to realize a society in which

We will ensure that all directors andare inseparable, including infectious

everyone involved in healthcare,resources to as many people asas many people as possible can live

employees have a high sense of

diseases and natural disasters. We aim toincluding ourselves, can fulfill their

possible in a sustainable manner. To

with peace of mind, and we will

ethics and responsibility, comply

be an environmentally advanced company

individual wishes and live happily. We

address these complex andcontinue to create the following

with all rules and regulationsin healthcare by reducing greenhouse gas

will provide optimal healthcare so thatintertwined issues, we pursue thepatient-centered healthcare: toincluding laws, ordinances, social

emissions, switching to renewable energy,

patients can live their lives as they

ideal form of healthcare and create

provide safe and secure medical carenorms and corporate ethics, andand reducing waste emissions.

wish, and healthcare workers can takeinnovative medical services by

to patients under any circumstances,

practice proper corporate

pride in their work and feel fulfilled inincorporating new technologies andand to maintain normal social

governance to ensure that they act

their jobs.

ways of thinking, based on

activities despite new infectious

in a compliance-conscious manner.

outsidethe-box thinking.

diseases or natural disasters.

ESG Initiatives

Environmental DataFYE Mar. 2023

*1 Data on a consolidated basis for CUC, CUC Hospice and Sophiamedi Inc. for the fiscal year ended March 31, 2023 (April 1, 2022 to March 31, 2023). Includes lighting, outside air conditioning units, and dedicated power outlets.
*2 Calculated on a market basis. Note that emissions on a location basis are 2,032.4 (t-CO2). (FY Mar.2023)

FYE Mar. 2023

*3 Data on a consolidated basis for CUC, CUC Hospice and Sophiamedi Inc. for the fiscal year ended March 31, 2023 (April 1, 2022 to March 31, 2023). Includes lighting, outside air conditioning units, and dedicated power outlets.

People Data and Scorecard

51

ESG Initiatives

Total
Retirement Rate(employee)

52

Male
FemaleESG Initiatives

53

ESG Initiatives

Policy on Corporate Governance

From the Director in charge

The Group believes that ensuring sound, transparent and efficient management is necessary to realize its mission of Creating

The CUC Group aims to Create Hope Through Healthcare through the

Hope Through Healthcare and to continuously increase its corporate value. It considers continuing to strengthen corporate

enhancement of corporate value. In the current fiscal year, we strengthened

governance to be one of the Group's key management tasks. To achieve this, every effort is made to ensure compliance withcollaboration among businesses by consolidating the head office functions oflaws, regulations and norms. Furthermore, appropriate information sharing and the monitoring of the effectiveness andgroup companies into a single location in February, and further fortified our

efficiency of business execution and the decision-making are carried out, primarily by the Board of Directors and the Audit
Committee. In addition, M3 Corporation, the Company's largest shareholder, is a controlling shareholder as its shareholding
ratio exceeds a majority. The Company endeavors to establish a fair decision-making process to ensure that the interests ofminority shareholders are not undermined when conducting transactions with the controlling shareholder.

corporate governance structure through our initial listing on the Growth Marketof the Tokyo Stock Exchange in June. Furthermore, in order to respond to therecent rapid changes in the business environment and to achieve further
growth, CUC has appointed new Corporate Officers. The CUC Group as a wholewill continue its efforts to strengthen corporate governance with the aim of
implementing transparent, sound, fair, and efficient management.

Governance Framework

CUC Inc.
Director CAO

Tomomi
Oketani

General Meeting of Shareholders
Appointment / Dismissal
Compensation Advisory Committee
Risk and Compliance Committee

Advice/Proposal

Board of Directors

Audit andSupervisory Committee

Director
ReportSelection / Dismissal /Supervision

ReportRepresentative Director

Information Security Committee

Cooperation

Appointment / Dismissal

Give Direction

CUC Group Companies

54

Cooperation

Internal Audit Department
Audit

Give Direction / Supervision

Accounting Auditor

Audit

Cooperation

ReportManagement Meetings

Cooperation

Appointment / Dismissal

Audit

Audit

ESG Initiatives

Outline of the corporate governance system and reasons for its adoption
The companyʼs adoption of audit-committee system allows the directors to be responsible of auditing and

Board of Directors makes decisions regarding important business operations in accordance with the Board of

supervising the execution of duties. By giving the Audit Committee members voting rights at Board of Directors

Directors Regulations and the Rules on Administrative Authority, in addition to matters stipulated by law and themeetings, we are strengthening the supervisory function of the Board of Directors and further enhancing corporate

Articles of Incorporation. It also supervises the execution of business by the directors. In addition to regular Audit

governance. Delegating important business execution decisions to the direcroes further, prompt and flexible

Committee meetings, which are held once a month in principle, company's Audit Committee holds extraordinary

management is possible. To ensure that checks and balances in decision-making and monitoring function

Audit Committee meetings as necessary. The Audit Committee works closely with the internal audit andeffectively, the company has adopted a system that emphasizes decision-making at meetings.

accounting auditors by exchanging information and opinions as needed, as well as by holding regular three-way

In principle, the Board of Directors meets once a month, and extraordinary meetings are held as necessary. The

meetings to improve audit functions.

Corporate Governance
Organizational structure

Company with Audit
and Supervisory Committee

Chairman of the Board

Keita Hamaguchi
Number of

6 (including 3 Audit &Board Members

Supervisory Board Members)

Percentage
Directorof Female Directors
Percentage
of Outside Directors
Term of Office

Audit and Supervisory

Percentage

Committee Membersof Outside Directors

16.7%

33.3%

Number of Meetings
Director
Board of Directors Meetings
for FYE March 2023

Attendance Rate
Audit Committee
Member Attendance Ratet

Audit and Supervisory12
100.0%
100.0%

Number of Meetings

13

Attendance Rate

100.0%

Committee Meetings
for FYE March 2023

1 yearNumber of Corporate Officers

5

66.7%

Accounting Auditor

PricewaterhouseCoopers Aarata LLC*As of July 1, 2023

55

ESG Initiatives

Board of Directors and Corporate Officers

Representative Director CEO

Director COO

Director CAO

Director(Audit Committee Member)

Keita Hamaguchi

Takamichi Tanabe

Tomomi Oketani

Founder andJoined the company in 2015

Joined the company inRepresentative Director,

Overseeing overseas

2015

Corporate Officer, M3,

CUC Inc.

management support

Overseeing the Group'sInc.

business for medical

administrative divisions asinstitutions as Director

Director and General

Hirofumi Oba

Manager

Director(Audit Committee Member)

Director(Audit Committee Member)

Yuki Mitsuhara

Ryoichi Yonemura

Representative of Keep

Former Auditor, Kirin

Moms Smiling (NPO)

Company, Limited

Corporate Officer

Corporate Officer

Aya Ito

Masaaki Inoue

Joined Sophiamedi Corp.

Joined CUC HOSPICE Inc.

in 2019

in 2022

Appointed as the

Appointed President andPresident andRepresentative Director ofRepresentative Director of

the company in the same

Sophiamedi and CEO inyear

February 2022

56

Corporate Officer CFO

Corporate Officer

Corporate Officer CHRO

Jun Hashimoto

Kenichiro Hori

Toshio Matsuura

Joined the company in 2021

Joined the company in 2021

Joined the company in 2022

Overseeing the Group's

Overseeing the domestic

Overseeing the human

CEO： Chief Executive Officer

financial, investment, investor

management support

resources strategy, including

relations, and public relations

business for medical

recruitment and training of

COO： Chief Operating Officer

strategies as General Manager

institutions as Generalhuman resources as Generalof Corporate Strategy

Manager of Management

Manager of Human

Department

Support Division

Resources Department

List of CxO

CAO： Chief Administrative Officer
CFO： Chief Financial Officer
CHRO：Chief Human Resource Officer

ESG Initiatives

Executive Skill Matrix
In order to strengthen monitoring and supervision of business execution and to discuss strategies toincrease corporate value in the medium to long term, the Company's Board of Directors as a whole isstriving to optimize the balance of knowledge and experience, diversity, and its size.

"Sustainability," and "Healthcare Experience." The skills matrix is designed to ensure that the Board of
Directors is comprised of individuals with appropriate knowledge and experience in these areas.
The knowledge and experience that are important to the Company's Board of Directors will be

To this end, we have defined the knowledge and experience that we believe is particularly important

reviewed from time to time in light of updated management policies and the business environment.

to the Board of Directors at this time as "Corporate Leadership," "Sales ＆ Marketing," "Finance /Investment," "Human Resources," "Legal / Governance / Risk Management," "Multinational Experience,"

Representative
Director

Director

Director

Keita Hamaguchi

Takamichi Tanabe

Tomomi Oketani

Corporate Leadership

◎

○

○

Sales ＆ Marketing○◎

Finance / Investment○

Human Resources○

Multinational Experience

○

○

○

Ryoichi Yonemura

◎
◎

○

○

○
○

○

Sustainability
Healthcare Experience

Yuki Mitsuhara

◎
○

○
◎

○

Hirofumi Oba○○

Legal / Governances / Risk Management

Director (Audit
Director (Audit
Director (Audit
Committee Member) Committee Member) Committee Member)

○
○

○

○

○

57

Company Information

Company Name

CUC Inc.

Established

August 8, 2014

Representative Director

Keita Hamaguchi

CapitalJPY 6,808 million（*As of June 2023）

Main Business

Management Support Business for medical institutions

Sophiamedi Inc.

Hospice Business

Tsurumi-ekimae Contact Co., Ltd.

In-home Nursing BusinessToseki Research & Development Co., Ltd.

Address

15F Tamachi Station Tower N,
3-1-1 Shibaura, Minato-ku, Tokyo 108-0023

Group Companies
A&N Inc.
CUC i-DATA Inc.
CUC FOODS Inc.
CUC PROPERTIES Inc.
CUC HOSPICE Inc.

Nature Inc.
Medical Pilot Inc.
You Inc.
Wakakusa Contact Co., Ltd.
CHANGE UNTIL CHANGE HEALTHCARE COMPANY LIMITEDCHANGE UNTIL CHANGE MANAGEMENT SERVICES JOINT STOCK COMPANY
CHANGE UNTIL CHANGE MEDICAL SERVICES COMPANY LIMITEDCHANGE UNTIL CHANGE VIETNAM COMPANY LIMITEDCUC America Inc.
CUC SINGAPORE PTE.LTD.
PT CUC CIPTA HUSADA
PT GRHAMEDS CUC HEALTHCARE(As of July 31, 2023)

58

CUC Group Sustainability Report 2023
Publication of the first edition in October, 2023
【Published by】
CUC Inc.
15F Tamachi Station Tower N,
3-1-1 Shibaura, Minato-ku,
Tokyo 108-0023【Corporate website】
https://www.cuc-jpn.com/en/【Note】
This report was prepared for the purpose of providing
corporate and other information about our company and does
not constitute an offer or solicitation of any stock or othersecurities issued by our group, whether in Japan or overseas.
This report contains forward-looking statements as well as
past and present facts. As such, they involve certain risks anduncertainties and should not be relied upon unduly. This
report contains statements of information derived from orbased on external sources, including information about themarkets in which we operate. These statements are based on
statistical or other information obtained from external sources
cited herein, which we have not independently verified andcannot guarantee their accuracy or completeness. We assume
no obligation to update or revise any information containedin this report based on future events.