Top > We look for from organization > Health and Welfare Department Nursing Care Insurance Section > Application > 5-3. Change notification forms of care service office (home, facility)
Update day:2018Year02MON15SUN 08Time54Share
We change report of care service office of
When change occurred in report matters such as name, the location, administration official regulations about care service office catching designation from Kurume-shi, it is necessary to report within ten days from change day.
About establishment permission matter change application, manager approval application of care for the elder healthcare facility, you apply one month before before change, and you receive permission, approval, and please change.
About change with building works of care for the elder healthcare facility, in the case of change permission application, fee of 33,000 yen is necessary.
You download application, and please submit to reception counter directly.
|Thing necessary for procedure||
You accompany change notification form and confirm thing which is necessary for "notification of change check list" depending on kind and contents for change of service by all means as attached documents may be necessary, and please attach in notification of change. Please contact reception counter if you have any questions.
Notification of change, check list (care for the elder welfare institution, care for the elder healthcare facility, care medical treatment model medical facilities) (97 kilobytes)
Reference style, please download 5-1 from page of new designation application of care service office (home, facility)
Establishment permission matter change application relations in care for the elder healthcare facility
Manager approval application (notification of change is necessary, too) in care for the elder healthcare facility
・Figure of organization system (any style)
・Copy of doctor driver's license of manager
・Copy of minutes of the board of directors which decided the matter concerned
Designated change application relations in care medical treatment model medical facilities
The sixth floor of the city hall Nursing Care Insurance Section phone number: 0942-30-9247
From weekdays 8:30 a.m. to 5:15 p.m. (except holiday, the year-end and New Year holidays)
Health and Welfare Department Nursing Care Insurance Section
Phone number 0942-30-9247 FAX number: 0942-36-6845 E-mail (form)