Differences between normal, large and small scale and the services they provide
There are three types of day rehabilitation facilities: "small-scale," "normal-scale," and "large-scale," and each has different staff deployment standards, user capacity, and available services. Accurately understanding these differences is the first step in helping users and their families choose the optimal rehabilitation environment.
For example, the size of the facility you should choose will differ depending on whether you are looking for a "person with a high level of nursing care needs and who requires medical care" or a "person who is relatively independent and aims to participate in society." The following table summarizes the characteristics of each facility size, the specific services that can be provided, and the differences in the staff allocated.
Comparison table of rehabilitation facilities by size
| Size classification |
Estimated capacity |
Required job placement |
Examples of services available |
Flexibility |
| Small scale |
Approximately 10 to 18 people |
At least one nurse, at least one physical therapist, occupational therapist, etc. |
Individual rehabilitation, transportation, lunch, light recreation, etc. |
Highly flexible |
| normal size |
Approximately 19-39 people |
1 doctor (part-time available), nurses, PTs, and OTs |
Functional training, ADL improvement support, oral and nutritional care, group exercises, etc. |
Wide range of users |
| Large scale |
40 or more |
Doctors, nurses, physical therapists, occupational therapists, speech-language pathologists (as needed) |
Dementia care, short-term intensive rehabilitation, equipment use training, nutrition, excretion, oral guidance, etc. |
Planning is required |
As mentioned above, as the size of a facility increases, the types of professionals available and the services that can be provided increase, but the "flexibility of individualized care" tends to decrease. Small-scale facilities allow for close support in a family-like atmosphere, but large-scale facilities are "centered on standardized programs," so the type should be selected according to the personality and rehabilitation goals of the users.
In addition, the "facility standards" and "conditions for calculating premiums" set by the Ministry of Health, Labor and Welfare also vary depending on the size of the facility. For example, the "individual functional training premium" and "rehabilitation management premium" require a certain number of staff members and the creation of training records, which may be difficult for small facilities to meet.
As a result, even if the same "Care Level 2" person is attending a facility, the "quality and breadth of support available" will vary greatly depending on the size and structure of the facility. Therefore, when choosing a facility, it is important to check not only "ease of access" and "drop-off area," but also the number of professionals, division of roles, and depth of support provided.
Checkpoints for tours
When choosing a rehabilitation facility, it is extremely important to actually visit the facility. Information that is not listed in brochures or on official websites, such as the atmosphere of the facility, the responsiveness of the staff, and the cleanliness of the rehabilitation environment, can only be known by actually visiting the facility. Below, we have compiled a checklist of the main points to check when visiting the facility.
| Check items |
Key points to check |
| Level of facilities |
The size of the functional training space, the cleanliness of the toilets and sinks, and the presence or absence of safety measures |
| Staff |
How often do they greet you and smile? Are they polite regardless of how busy they are? |
| Food quality |
Menu details, allergy support, whether or not a nutritionist supervises |
| Transportation system |
Pick-up area, boarding method, safety management system (supervision, boarding and alighting support) |
| Individuality of training content |
Is there individualized care based on a rehabilitation plan, rather than a uniform approach? |
| Availability of recreational activities |
Are there programs to stimulate motivation in daily life, such as seasonal events and creative activities? |
| Atmosphere and cleanliness |
Smell, brightness, room temperature control, and display design |
| User's facial expression |
Are you being animated or passive? |
It is especially important to check the "long-term care insurance service plan" and "rehabilitation plan" during the tour to see how detailed they are. Whether individual functional training is just a nominal feature, and whether continuous evaluations and plan updates are carried out by professionals are important points to assess the quality of the facility.
In addition, families with dementia or elderly people living alone should check whether the facility is set up to charge for "dementia support surcharges," "transportation surcharges," "short-term intensive rehabilitation surcharges," etc. Because differences in systems and staff deployment standards are directly linked to surcharges, the content of support available can vary greatly depending on whether or not surcharges are available.
By going through such detailed checks, you can select a facility that you can visit with peace of mind in the long term, rather than simply choosing one because there is vacancy. In particular, for those with clear rehabilitation goals, asking specific questions such as "whether or not there is a full-time functional training instructor" and "how many days a physical therapist is available" will lead to a choice you will not regret.
