What Works From Abroad
Before landing and after
Most of the facility search can be done before your parent boards the plane, but almost nothing about it can be made final until they live at a registered address in Japan.
Families usually call us at the point where a parent has decided to come back to Japan, or to move there for the first time, and the adult children abroad want a bed lined up before the flight. A common version: a parent who has lived abroad for decades is now unsteady on their feet and wants to live near relatives in Japan, and the family's question is how much of the placement can be settled before the flight.
The split is fairly clean. Shortlisting, phone and email enquiries, sending a medical summary, asking about admission conditions and medical limits, and in some private homes holding a room can all happen from abroad. Resident registration, enrolment in long-term care insurance, the care-need certification and any public-facility application can only start after arrival, because each one needs the one before it and the first needs your parent physically living at the address.
This article covers that split and the clocks that follow arrival. The wider move is planned in moving to Japan with elderly parents, and a former resident re-entering the system will find the order of re-registration in returning to Japan to retire. The general pre-move list sits in the checklist before moving to Japan with elderly parents, and the six facility types are compared in depth in nursing homes in Japan for foreign families.
Shortlisting from abroad
The Ministry of Health, Labour and Welfare runs a national register of licensed care providers, the Care Service Information Disclosure System (kaigokensaku), which anyone can search from overseas.
The system lets you pick a prefecture and then search by area and by service type, including special nursing homes, geriatric health facilities, paid homes with the care-included designation, dementia group homes and serviced senior housing. Each provider page shows the operator, the address, staffing and the services it is licensed for. Treat it as a register rather than a vacancy board. Availability still has to be asked directly.
Two filters save the most time. Start with the municipality: the system's own explanation says community-based services, which include dementia group homes, are in principle for people living in the municipality where the facility sits, while other services can be used across municipal lines. So if your parent will register in one city, a group home in the neighbouring city is usually off the list. Then filter on medical need. If your parent uses oxygen, insulin injections or a feeding tube, filter early for facilities with nursing staff on site, because that is the condition most likely to end a conversation later.
Municipal websites add a layer the national register lacks. Some cities publish their own lists of special nursing homes with the application method and the way places are prioritised. The procedure varies by municipality, so read the page for the city where your parent will actually register, and note its long-term care insurance section phone number for later.
Pre-consultation by phone or email
Facilities in Japan generally accept an enquiry from a family member abroad, and a short written summary of your parent's situation makes that enquiry far more useful.
Send the summary before the call, in Japanese if you can manage a translation, and keep it to one page: age, nationality and planned arrival month, the city where your parent will register, current diagnoses, current medications with doses, mobility, continence, memory, any recent hospital stays, and who in the family will be the contact person in Japan. A facility that sees that page can tell you in one conversation whether the enquiry is worth continuing.
- Admission conditions (nyukyo joken): which care levels they accept, and whether they admit a person before a certification is issued
- Medical support (iryo taio): which procedures their nurses can handle, night-time nursing cover, and the partner clinic
- Dementia: whether they accept wandering or night-time agitation, and at what point they would ask for a transfer
- Waiting list: whether one exists, how it is ordered, and whether an overseas family can be placed on it
- Documents: what medical paperwork they need before an interview, and in what language
- Guarantor and fees: their guarantor requirement and the fee table, in writing
Medical records and translation
Foreign medical records with a Japanese translation help at two points: the facility's pre-screening and the first appointment with a Japanese doctor, but they do not replace any Japanese document.
At the pre-screening stage, a translated discharge summary or specialist letter lets the facility's nurse judge medical fit before anyone travels. Facilities typically ask for a health check form or a doctor's referral letter (shinryo joho teikyosho) written in Japan before admission, so the overseas records are a preview, and the facility will still want its own form completed by a doctor in Japan.
The more important use is the certification. The care-need certification relies on a doctor's opinion letter (shujii ikensho), which the municipality requests directly from your parent's attending doctor in Japan. If there is no attending doctor, the municipality's explanation says your parent has to be examined by a designated doctor instead, and there is no charge to the applicant for the opinion letter. A doctor who has never seen your parent writes a thin opinion, and a thin opinion tends to understate need.
Timing matters too. In the ministry's figures for applications filed between April 2023 and March 2024, the median insurer took 17.9 days from requesting the doctor's opinion to receiving it, the longest single stage of the process, compared with 10.3 days from requesting the home-visit assessment to carrying it out. Booking a first appointment with a Japanese clinic in the arrival week, and handing over the translated records there, is the most practical way to shorten that stage.
What Facilities Can Promise
Informal indication versus waiting list
Before arrival, a facility can usually give an informal view of fit and, in some private homes, a reservation on its own terms; it cannot give a binding acceptance.
Three things are missing until your parent is in Japan: the face-to-face interview (mendan) that most facilities hold before admission, a referral letter or health form from a doctor in Japan, and for most facility types the care-need certification. Without those, the most a facility can honestly say is that the person sounds like someone they could accept, subject to the interview. Write down who said it and when, and treat it as a reason to call again after arrival.
Public special nursing homes (tokuyo) work differently from private homes. The ministry's admission guideline limits new admission in principle to people at care level 3 or above since 1 April 2015, allows people at care levels 1 or 2 only by special admission with the municipality's involvement, and directs homes to admit those with the highest need first. Admission is therefore decided by assessed need rather than by the date an application arrived, and an application without a certification has nothing to be assessed against.
Private homes have more room to move. Some will hold a room against a deposit or a provisional application form (kari moshikomi), and the terms of that hold, including whether the deposit is refunded if the interview goes badly, are set by the operator. Ask for those terms in writing before paying anything.
Facility types compared
The facility type decides whether a certification is needed at all, and therefore how much of the search can be fixed from abroad.
Read the second column as the gate and the third as what the gate means for timing. Every row where a certification is required pushes the real decision past arrival plus the certification period. Rows where the operator sets the conditions are the only ones where something can be agreed before the flight, which is why families with a parent who needs a bed on arrival tend to look at private homes first and treat a special nursing home as a later move.
| Facility type | Certification needed | Pre-register from abroad | What they will ask for |
|---|---|---|---|
| Special nursing home (tokuyo) | Care level 3 or above in principle; levels 1 and 2 only by special admission | No; the application needs the certificate showing the level | Insurance certificate, health information, family and home situation |
| Geriatric health facility (rouken) | Care level 1 to 5; there is no preventive version for support levels | No; admission is usually arranged after certification, often from a hospital | Referral letter from a doctor in Japan, recent tests, medication list |
| Dementia group home | Support level 2 or a care level; the service is for people with dementia | No; residence in the same municipality comes first | Dementia diagnosis, insurance certificate, proof of registration in the city |
| Care-included paid home (kaigo-tsuki yuryo) | Set by the operator; the covered care portion needs a certification | Informal enquiry, sometimes a held room on the operator's terms | Health form, guarantor, payment plan, interview |
| Residential paid home (jutaku-gata yuryo) | Set by the operator; outside care services are billed to insurance after certification | Informal enquiry, sometimes a held room on the operator's terms | Health form, guarantor, payment plan, interview |
| Serviced senior housing (sa-ko-ju) | None for the rental contract itself | Ask; some operators will discuss a lease ahead of arrival | Identity documents, deposit, guarantor, health information |
Self-pay homes without certification
Private paid homes and serviced senior housing can admit a person before certification when the operator's own conditions allow it, but the care portion is then paid privately until the certification arrives.
Long-term care insurance pays for covered services only once a certification exists, and its effect runs back to the application date. A parent who moves into a residential paid home or serviced senior housing before certification is therefore paying rent, meals and any care in full, and only the covered care from the application date onward can later be billed at the insured rate. Ask the home exactly which charges change once a care level is issued.
Serviced senior housing is a registered rental housing system for older single people and couples. The ministry's explanation sets out its minimum features: as a rule private units of at least 25 square metres, barrier-free construction, and daily safety checks and life consultation by a care professional on site at least during the day. The only money the operator may receive is a deposit, rent and service charges, with no key money, and prepaid rent must be refunded on a pro-rata basis if the contract ends within three months of moving in. Care comes from outside providers your parent chooses, unless the building holds the care-included designation.
A short paid stay before signing tells you more than any brochure. How that works and what it typically costs is covered in trial stays at Japanese care facilities.
After Arrival
Registration comes first
Every public step begins with the moving-in notification at the city or ward office, and that notification cannot be filed before your parent is in Japan.
Yokohama's guidance for people moving in from abroad is typical: the notification is due within 14 days of starting to live at the new address, and it cannot be filed before returning to Japan or before entry. A Japanese national shows a passport or flight record confirming the return date; a foreign national shows the residence card. A proxy holding a letter of attorney can file, which helps if your parent is too tired to queue in the first week.
Long-term care insurance follows the registration. For a person aged 65 or over, municipal guidance such as Takamatsu's states that insured status starts on the moving-in date, that the new insurance certificate is sent by post, and that premiums are charged from that month. A foreign parent who registers with a residence card is enrolled through the same registration, and if their residence status is unusual it is worth confirming eligibility with the municipality's long-term care section on the day of registration.
Health insurance is re-entered at the same counter, and the premium and card-gap issues that catch returnees are covered in re-enrolling in health and long-term care insurance.
Certification and its clock
The certification application can be filed as soon as the insurance certificate is in hand, and the law sets 30 days as the standard processing period.
The application goes to the municipality where your parent is registered. An assessor then visits to interview your parent, the municipality requests the doctor's opinion, a computer produces a first judgment, and a review board makes the final decision. The ministry's explanation states that notice of the result is given in principle within 30 days of application, and a first certification is valid for six months in principle, set between 3 and 12 months depending on the person's condition.
In practice the period runs longer in many places. MHLW's figures for applications filed between April 2023 and March 2024, covering 1,559 insurers, put the median insurer average at 39.3 days from application to decision, with the slowest averaging 80.6 days. In the median municipality only 21.4 percent of applications were decided within 30 days. Plan for about six weeks and be pleased if it is shorter.
Two rules make the wait less costly. The certification takes effect from the application date, and services can be provided during the application under a provisional care plan. The provisional route carries a risk: if the result comes back lower than the plan assumed, or as not certified, part or all of the cost becomes the family's bill. Even so, the application date, not the decision date, is the one that matters for cost, which is why it belongs in the first or second week after arrival. What each level means and how the assessment interview works is set out in care levels in Japan.
Which city becomes the insurer
Where your parent registers on arrival decides which municipality pays for their care later, because of the special address rule (jushochi tokurei).
Under the special address rule, a person who moves their registration from one municipality directly into a covered facility in another keeps the first municipality as insurer, and keeps using that city's insurance certificate. Takamatsu City's explanation lists the covered types as special nursing homes, geriatric health facilities, care medical facilities, paid homes, low-cost homes such as care houses, serviced senior housing that provides care, meals, housework or health management, and care homes. Dementia group homes are not on the list.
For a parent arriving from abroad there is usually no previous Japanese municipality, so the rule does not apply to the first registration. It starts to matter if your parent first registers at a sibling's home in one city and later enters a facility in another: the first city stays the insurer for the covered types. A group home in the second city, by contrast, generally requires registration in that city, so the move itself becomes the precondition. If your parent is later certified and then moves city, the same guidance says the certification carries over only if the application is made at the new municipality within 14 days of the moving-in date. The practical detail of that kind of move is in moving a parent to a facility in another city.
A Realistic Timeline
Four stages from abroad
Laid out as stages, the facility search for a parent arriving from abroad looks like this; timings are indicative and vary by municipality.
The calendar to share with siblings is arrival week plus about six weeks before the care level is known, based on the 39.3-day median. Anything that needs a care level, a special nursing home application for example, belongs after that line. Anything that does not, such as a private home's interview or a lease for serviced senior housing, can be lined up before the flight.
| Stage | What happens | Who acts | What it unlocks |
|---|---|---|---|
| Before departure | Shortlist in kaigokensaku, send the one-page summary and translated records, call or email facilities, agree any private room hold in writing, book a clinic appointment | Family abroad, facilities | An informal view of fit and, for some private homes, a held room |
| Arrival week | Moving-in notification within 14 days, health insurance, insured status from the moving-in date, first clinic visit with translated records | Parent or proxy, city or ward office, clinic | Insurance certificate by post and a doctor who knows the parent |
| Weeks 2 to 6 | Certification application, home-visit assessment, doctor's opinion, facility interview and trial stay | Municipality, doctor, facility | Coverage dated from the application; a provisional care plan if services start early |
| After certification | Care level issued; public-facility applications, contract with the chosen home, facility care plan | Facility care manager, family | Insured care at the assessed level and access to tokuyo or rouken where the level allows |
If the bed is not ready
If no facility can take your parent on arrival, the first weeks need a separate plan for care before certification.
That bridge period, with its own options and costs, is a topic in itself, and it is easier to plan once the facility shortlist above exists. Keep the clinic appointment and the certification application on schedule either way, since both clocks run regardless of where your parent sleeps. The options for that gap, from self-pay short stays to a provisional care plan, are set out in care before certification after arriving in Japan.
The public windows are free and should be used directly: the municipal long-term care section, the community general support center, and the facilities themselves. Where Japan Care Concierge helps is the work in between, making the calls in Japanese across time zones, translating the medical summary, and attending the interview on the family's behalf. That is what our facility search support covers, and the first conversation tells you which of these steps you can handle yourselves.
Frequently asked questions
How far ahead of the flight should we start contacting care facilities in Japan?
Start once the arrival month and the city of registration are fixed, since community-based services such as group homes are in principle limited to residents of that municipality. Send a one-page summary first, then ask about admission conditions, medical support, waiting lists and documents. Expect only an informal view of fit until your parent has been interviewed and, for most facility types, certified after arrival.
Will a special nursing home put my mother on its list while she still lives overseas?
Generally no. New admission to a special nursing home is limited in principle to care level 3 or above, and homes admit by assessed need rather than application date, so an application without a certification cannot be ranked. The certification itself can only be applied for after she registers in Japan and receives her insurance certificate.
Who writes the doctor's opinion for the care certification when my father only has records from overseas?
Translated records help a facility pre-screen and help a Japanese doctor understand his history, but they do not replace Japanese documents. The municipality requests the doctor's opinion letter for the certification from his attending doctor in Japan, or from a designated doctor if he has none, and in the ministry's figures for applications filed between April 2023 and March 2024 that stage took a median of 17.9 days.
Is there any cost penalty for applying for certification a few weeks after arrival instead of straight away?
Yes, in effect. The certification takes effect from the application date, so covered care can only be billed at the insured rate from that date. Care received before the application is paid in full. Filing in the first or second week after the moving-in notification keeps that private-pay window short.
Which municipality pays for care if my parent registers at my brother's flat and later enters a home in another city?
Under the special address rule, the first city usually stays the insurer when the move is into a covered facility such as a special nursing home, a geriatric health facility, a paid home, or qualifying serviced senior housing. Dementia group homes are excluded and generally require registration in the group home's own city.
How Japan Care Concierge can help
We prepare the care and medical side of a move: continuity of treatment, insurance enrolment, and the support waiting on arrival. Certification cannot be filed before the resident registration exists, so the order of these steps decides the timeline.
Primary and official references
We checked 10 primary or official sources below before writing this article. Rules, costs, and local procedures change by municipality and over time. Confirm the linked official source before a final decision. Last source check: 2026-10-04.
- MHLW Care Service Information Disclosure System: service types and community-based services (Japanese)
- MHLW Care Service Information Disclosure System: steps to using care services (Japanese)
- MHLW: Guideline on admission to special nursing homes, 2023 revision notice (Japanese)
- MHLW: certification effective date and provisional care plans (page 3, Japanese)
- MHLW: Certification review periods, Social Security Council LTCI committee paper (Japanese, PDF)
- Nagaokakyo City: provisional care plan (zantei care plan) handling (Japanese, PDF)
- MHLW Care Service Information Disclosure System: serviced senior housing (Japanese)
- Yokohama City: Moving-in notification from abroad (Japanese)
- Takamatsu City: Long-term care insurance status changes and the special address rule (Japanese)
- MHLW Care Service Information Disclosure System: dementia group homes (Japanese)
About this article
This page is general orientation, not medical, legal or individual care advice. Japan Care Concierge is operated with the care-service experience of Social Welfare Corporation Shinkou Fukushikai, established in 1999, which runs elderly care facilities and services in Kanagawa under the Cross Heart name. We take no referral fees from facilities or providers. We do not provide medical treatment, diagnosis, emergency response or hands-on care. Japan has 1,559 long-term care insurers and each sets its own rules and timelines, so confirm your own case with the municipal long-term care insurance desk or your local community support center. The publication and update dates above are actual dates. How we research, source, and correct content is described in our editorial policy.