Research and Development activities at“Roken”
Japan Association of Geriatric Health Services Facilities (Zenroken) has been involved inresearch and development activities in the field of geriatric medicine and care.
For example, in order to promote elderly people’s social participation, Zenroken has developed acare-management system using the ICF staging, which is a geriatric assessment scale of elderly
functioning based on the World Health Organization’s International Classification of Functioning,
Disability and Health (ICF)(2). The rate of patients who could return home has increased in Roken
facilities using this system.
(1)	Toba, K., et al. Intensive rehabilitation for dementia improved cognitive function and reduced
behavioral disturbance in geriatric health service facilities in Japan. Gerontol Geriatr Int,2014.14(1): p. 206-211(2)	Okochi, J., et al., Staging of mobility, transfer and walking functions of elderly persons basedon the codes of the International Classification of Functioning, Disability and Health. BMC
Geriatr, 2013. 13: p. 16.

Geriatric HealthServices Facilityin Japan

How to use the services of“Roken”
In order to use the services covered by long-term care insurance, the applicant or his/her family member applies for authorization at long-term care insurance service
department of their local Ward Office or District Health and Welfare Station. When theapplication passes, they will proceed to ask a local care-manager or a social worker forthe vacancy and the eligibility of institutional or at home care services. There are three
types of long-term care insurance facilities as shown below*.

*Long-term Care Insurance Facility
Facilities which provide services with the long-term care insurance system are called “longterm care insurance facilities”, Geriatric Health Services Facility (Roken), Welfare Facility for theElderly requiring long-term care, and Sanatorium Type Medical Care Facility for the elderly persons
requiring care. Compared with other types of facilities, Geriatric health services facilities arecharacterized by its multidisciplinary professional collaboration and also by a large number ofphysical therapists, occupational therapists and speech therapists in service.
Facility and Personnel Standards
Welfare Facility for the Elderly
Requiring Long-term care

Sanatorium Type Medical Care
Facility for the Elderly Requiring
Care

Rehabilitation, nursing and/or
care to help enable them to return
homeLife services for the elderly inneed of care

Medical and nursing care, andlong-term treatment

Eligible users

The elderly whose illness is stableand does not require hospitaltreatment yet which requires
rehabilitation, nursing or care.

People requiring long-term careand who are unable to live athome

For patients requiring nursing
care, and whose acute-phasetreatment is over yet require longterm recuperation under constant
medical management

Organization
standards(per 100residents)•Physician (regular employee): 1•Nurses: 9•Care staff(Care worker): 25•Physical therapist, occupationaltherapist, speech therapist: 1•Care manager: 1•Assistant counselors, etc.
(Nursing staff account for about
2/7 of total nursing / care staff,
while care staff account for theremaining 5/7)

•Physician (either visiting orregular employee): 1•Nurses: 3•Care staff(Care worker): 31•Care manager: 1•Daily life counselors, etc•Physician: 3•Nurses: 17•Care staff(Care worker): 17•Care manager: 1•Pharmacist, Dietitian, etc.

329.2days (277.6days)

1474.9days (1465.1days)

Facility type

Geriatric Health Services Facility

Fundamental
function

Mean length of stay

Facility and Personnel Standards(Details as of September 30, 2010 revision)*Average stay: As of Sept. 2010. ( ) indicates 2007 figures.

4

Japan Association of Geriatric Health Services Facilities
412.0days (427.2days)

6F Kokuryushibakoen Bldg,2-6-15 Shibakoen,Minato-ku,
Tokyo 105-0011,Japan
Phone;03-3432-4165 Fax;03-3432-4172
http://www.roken.or.jp/

Date of Issue: February 2015

What is a Geriatric HealthServices Facility (“Roken”)
Background of“Roken”
As trends shifted from large households to nuclear and urbanized family compositions, theJapanese government saw the need for a better elderly care system. In the 1980’s, the need for a newand unique community-based health care system was recognized. The government then put inplace a wide range of programs that fit people’s diverse life-styles, such as various programs topromote health care, medical care, and welfare.
A notion called “Chukan Shisetsu,” an intermediary facility between hospitals, homes, and nursing
homes, was proposed by the Ministry of Health and Welfare in 1985. The government in 1986
systematized the “Geriatric Health Care Facility,” after the revision of the Public Aid for the Aged
Act, and the facilities were put in place in 1988. The facilities provide new and unique services,which include both medical and welfare services for the elderly.
Over 357,000 elderly people used the service of more than 4000 Roken facilities in 2014. Alongwith the expanding demand for institutional care, it is crucial to achieve high-quality care in order
to assist their optimal quality of life.
Number of facilities and total capacity nation wide
The total capacity

Number of facilities[ Facilities ][ten thousand beds]

4,000

35

3,500

30

3,000

25

2,500

20

2,000

15

1,500
1,000

10500

50

1990

1992

1994

1996

1998

2000

2002

2004

2006

2008

2010

2014

0

The Idea and Role of“Roken”
The Long-term Care Insurance Act wasenacted in April 2000 and the Geriatric HealthCare Facility became the "Geriatric HealthService Facility (Roken)" thereafter. Its original
slogan, to "improve the user's function to enable
them to go back home," is still in place today.
The mission of “Roken” is to enable a personunder a Condition of Need for Long-Term Careto live a long and meaningful life. In order toachieve this mission,
2Services of Geriatric Health Service Facility
Institutional Services
The elderly may be admitted to the facility so long as their
medical conditions are stable, and may stay until they areable to return home. The facility will provide medical care,rehabilitation, and nursing. In addition, it may provide
daily care services such as bathing, meals, bodily wasteelimination, etc.

Short Stay Services
The elderly may be admitted to the facility for a shortperiod of time, to relieve caregivers at home, or torecondition the elderly.

Out patient Rehabilitation
The elderly may utilize the facility for rehabilitation
therapies by a therapist.

1

2
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Rehabilitation at“Roken”“Roken” provides professional rehabilitation by registered physical therapists, occupational
therapists and speech therapist. Intensive rehabilitation in an early stage of disability is very effective
for elderly care. Moreover, the rehabilitation for elderly people with dementia is unique and hasbeen proven effective by multicenter collaborative researches (1).

Function of Geriatric Health Services Facilities
Convalescence rehabilitation
hospital

Geriatric Health Services Facilities

Acute hospital"Roken" will :1. Respect the dignity, while taking into
consideration the safety of its clients
2. Give any necessary medical treatment,
nursing, care, and rehabilitation
3. Help enable clients to go back home
4. Support an independent lifestyle, whileliving at homein-homeCare house
Fee-charging home for the elderly
Group home

5. Collaborate with family members,
communityandotherrelevantorganizations

3