Establishment Standards of Senior Citizens’ Welfare Institutions

Link to law: http://law.moj.gov.tw/ENG/LawClass/LawAll.aspx?PCode=D0050039

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Chapter 1 General Principles

Article 1

These standards are stipulated according to paragraph 2 of Article 34 and paragraph 5 of Article 36 of the Senior Welfare Act( hereinafter referred to as “the Act”).

Article 2

Categories of Senior Citizens’ Welfare Institutions stipulated in the law are:
(1).long-term care institutions: with the following three categories:
A. long-term care: services to senior citizens with long-term chronic diseases and in need of nursing services.
B. nursing: services to senior citizens lack of capability to take care of himself or herself and in need of other’s caring, or senior citizens in need of nursing services such as nasogastric tube or catheter.
C. caring for dementia senior citizens: caring services to senior citizens who are diagnosed as middle degree dementia and capable of moving by himselves or herselves but needs caring services by doctors of neurology or Psychiatry.
(2).Domiciliary care institutions: services to senior citizens in need of care services from others, or senior citizens who can take care of himselves or herselves for daily life but without any relative with legal support obligation, or relative with legal support obligation but unable to fulfill this obligation.
(3).Other Senior Citizens’ Welfare Institutions: offering other welfare service to senior citizens.

Article 3

Establishment of Senior Citizens’ Welfare Institutions should comply with the following rules:
(1).Designs, structure, and equipments of the building should comply with Building Law and related regulations.
(2).Safety issues for fire control such as fire control equipments, fire control management, non-flame retardant substances should comply with Fire Act and related rules and regulations.
(3).The land to be used should comply with related regulations on land use control.
(4).Supply of drinking water should be sufficient and water quality should meet with quality standards for drinking water.
(5).Maintenance of cleaning and hygiene of environments and proper measures to prevent and control media and resources harmful to hygiene.
(6).Rules of other laws or regulations if such rules exists.

Article 4

In addition to the requirements stipulated in the previous Article, long term care institutions and nursing institutions should possess following qualified facilities:
(1).Dormitory:
A. Good ventilation and sufficient lights. Windows with natural lighting should be established.
B. Location in basement is not allowed.
C. There should be closets and bed side cupboards for each bed located in-doors. Emergency call system should be set up. The distance between two beds should be at least 80 centimeters wide.
D. At least one door with net-width of at least 80 centimeters.
E. For rooms with 2 or multiple beds, screens to isolate eyesight should be set up.
F. Walls separating dormitories should be high enough to connect with the ceiling closely.
G. Corridor with direct access to the dormitory without passing through the corridors of other dormitories.
(2).Bathing and hygiene facilities :
A. At least one door with net-width of at least 80 centimeters.
B. Adequate walls or curtains should be set up for bathing and hygiene facilities utilized by multiple persons.
C. Bathing and hygiene facilities should be set up in the care zones with emergency call system.
D. Bathing and hygiene facilities suitable for senior citizens lying on the beds or using wheelchairs.
(3).Facilities such as railings and handrails should be set up in locations of care zone, cafeteria, bathroom and toilet, corridor, stairs and platform. Anti-slippery measures should be set up in the floors of stairs, corridors, bathrooms and toilets with adequate lighting equipments.
(4).Food heating, storing and freezing equipments should be set up in the kitchen.
(5).For public facilities with pay phone provided, user-friendly designs should be applied to allow senior citizens of mentally or physically challenged easier access to the phone.
(6).Closets for bedding and sheets and storage facilities for personal effects and wheelchair should be set up.

Article 5

Multi-functional activity room, cafeteria, kitchen, bathing and hygiene equipments and facilities for resting during noon time should be set up for Senior Citizens’ Welfare Institutions with day-care facilities.
Area of the floor for buildings with day-care facilities should be more than 10 square meters per person.
For day-care facilities stipulated in the previous paragraph with dormitory, the floor area for the dormitory should be at least 5 square meters per person on the average.
The establishment of personnel for day-care facilities will be set up following the rules of, depending on the senior citizens being taken care, the Senior Citizens’ Welfare Institutions with the same business nature.

Article 6

Regarding the standards for floor areas of institutions and facilities, the calculation does not include space of parking lot and dormitories for employees. As for the rule on the floor of dormitory, the floor areas of bathroom and toilet are not included in the calculation.

Article 7

Scales for long term care or nursing institutions set up by various levels of governments and registered as foundations will be limited to the capacity of accommodating more than 50 but lower than 200 senior citizens. However, institutions got permissions and had started operation before Feb.1st 2007 is not limited.
Scales for small size long term care or nursing institutions range from more than 5 to less than 50 senior citizens accommodated.

Article 8

One full-time president(director) should be employed for long term care and nursing institutions. He or she will be in charge of the business for the institution and supervise his or her subordinate to fulfill their duties. Following personnel should also be set up:
(1).Nursing personnel: responsible for nursing business and records.
(2).Social workers: responsible for business related to social work.
(3).Care givers: responsible for taking care of the daily life of the senior citizens.
(4).Other professionals related to the services provided.
Qualifications for the personnel listed on the previous paragraph should comply with rules related to the qualification and training for senior welfare professionals. Records of the above personnel will have to be reported to competent authorities for reference within 30 days of employment. The same applies when there are changes in the personnel.
Unless otherwise stipulated in these standards, personnel from subparagraph 1 to 3 in paragraph 1 should work full-time while personnel of subparagraph 4 could be either full-time or contracted personnel.
More than 1/4 of the social workers stipulated in subparagraph 2 of paragraph 1 should possess social worker certificate. For care givers stipulated in subparagraph 3, the number of foreign care givers should not exceed 1/2 of the total caregivers unless otherwise stipulated in these standards.

Chapter 2 Long term caring institutions

Section 1 Long term care institutions

Article 9

Floor area of the long term care institutions should be, calculated according to the number of senior citizens, more than 16.5 square meters per person.

Article 10

In addition to rules stipulated in Article 4, facilities of long term care institutions should also qualify for the following:
(1).Dormitory:
A. Floor area per person should be more than 7 square meters. The number of beds should not exceed 6 beds per room.
B. Handrail and height-adjustment gears should be set up on each bed. The distance between the end of the bed and the wall should be at least 1 meter.
C. Simple hygiene facilities should be set up on each room for institutions with more 50 senior citizens accommodated.
(2).The nursing station should be equipped with the followings:
A. Preparation room and working cart.
B. Closet for nursing records and closet for medicine and medical equipments.
C. Adequate equipments for emergency rescue: oxygen, nasal passage, artificial air passage, oxygen mask, sucking equipments, laryngoscopes, inner tube for air passage, resuscitation bags, regular emergency medicines.
D. Wheelchair.
E. Pollutant processing equipments.
(3).Width of the aisle in the nursing area should be at least 140 centimeters and the width should be at least 160 centimeters for aisles with dormitories on either side.
(4).Locations for daily activities: Cafeteria, space and facilities needed for recreational activities should be set up with the average space per person of at least 4 square meters.
(5).Air conditioning equipments.
(6).Slopes specialized for transport stretcher or wheelchair should be located on the steps of main aisles.
(7).There should be body-freezing equipments for institutions with morgue.
Institutions stipulated in the previous paragraph are entitled to set up physical therapy room or occupational therapy room depending on their business needs.

Article 11

For long term care institutions, in addition to the president(director), personnel should be established according to the following rules:
(1).Nursing personnel: At least one staff on duty at any time. One staff for every 15 senior citizens attended. For the number of senior citizens less than 15, it would be treated as 15 senior citizens attended. For institutions with day-care services, one more staff should be added with the providing of services of every 20 senior citizens.
(2).Social workers: At least one social worker for less than 100 senior citizens attended. For institution attending more than 100 senior citizens, one more social worker shall be added for every 100 more senior citizens attended. Full time or contracted social workers should be applied to institutions attending less than 49 senior citizens. Contracted social workers should provide at least 2 days of services every week.
(3).Care givers: One staff for every 5 senior citizens attended for day-care services. The number of senior citizens would be treated as 5 if the senior citizens attended are less than 5 people. One staff for every 15 senior citizens attended for night-care services. The number of senior citizens would be treated as 15 if the senior citizens attended are less than 15 people. Staffs on night duty should be ROC citizens and the number of these staffs could be counted together with nursing staffs.
Institutions of the previous paragraph are entitled to employ full time or contracted doctor, physical therapy personnel, occupational therapy personnel or nutritionist depending on their business needs.

Article 12

Senior citizens attended by the long term care institutions should be diagnosed by doctor and at one visit per month by the doctor depending on the medical needs of the senior citizens.

Article 13

Long term care institutions should, following laws related to medical staffs, keep good record of dossier abstracts from referral services and doctor’s diagnosis as well as record of nursing history.
The dossier abstract and the record of nursing history shall be managed by designated staff.

Section 2 Nursing institutions

Article 14

Floor area of nursing institutions set up by various levels of the governments and registered as foundations( hereinafter referred to as public and foundation nursing institutions) should be, calculated according to the number of senior citizens accommodated, more than 16.5 square meters per person.
Floor area for small size care institutions should be, calculated according to the number of senior citizens accommodated, more than 10 square meters per person.

Article 15

Facilities of public and foundation nursing institutions should comply with rules stipulated in Article 4 as well as the rules of the followings:
(1).Dormitory:
A. Floor area should be more than 7 square meters per person. Maximum number of beds for every room is 6.
B. Simple hygiene facilities should be set up in every dormitory for institutions with more than 50 senior citizens accommodated.
(2).Nursing station: should be equipped with preparatory room, service stand, treatment trolly, closet for nursing record, closet for medicine and medical equipments,adequate equipments for emergency rescue.
(3).Location for daily activities: Space and equipments needed for facilities such as cafeteria and recreational activities should be set up with floor area of more than 4 square meters per person.
(4).Other facilities: Space and facilities such as pollutant processing room, laundry room, and so on.
Institutions stipulated in the previous paragraph are entitled to establish space and equipments for physical therapy room, occupational therapy room, social service room, locations for religious services, hospice care room, emergency observation room, meal offering services, waste cremation, and so on depending on their business needs.

Article 16

For public and foundation nursing institutions, in addition to the president(director), personnel should be established according to the following rules:
(1).Nursing personnel: At least one staff on duty at any time. One staff for every 20 senior citizens attended. For the number of senior citizens less than 20, it would be treated as 20 senior citizens attended.
(2).Social workers: At least one social worker for less than 100 senior citizens attended. One more staff shall be added for every 100 more senior citizens attended. Full time or contracted social workers should be applied to institutions attending less than 49 senior citizens. Contracted social workers should provide at least 2 days of services every week.
(3).Care givers: One staff for every 8 senior citizens attended for day-care services. The number of senior citizens would be treated as 8 if the senior citizens attended are less than 8 people. One staff for every 25 senior citizens attended for night-care services. The number of senior citizens would be treated as 25 if the senior citizens attended are less than 25 people. Staffs on night duty should be ROC citizens and the number of these staffs could be counted together with nursing staffs.
Institutions accepting senior citizens in need of nursing services such as nasogastric tube or catheter should establish personnel according to the rules stipulated in Article 11.
Institutions stipulated in paragraph 1 are entitled to establish administrative staff, full time or contracted doctor, physical therapy personnel, occupational therapy personnel, nutritionist, or other personnel depending on their business needs.

Article 17

In addition to the rule stipulated in Article 4, facilities of small size nursing institutions should also comply with the following rules:
(1).Dormitory: Floor area should be more than 5 square meters per person. Maximum number of beds for each room is 6.
(2).Nursing station: nursing record closet and adequate equipments for emergency rescue should be set up.
(3).Location of daily activities: Multi-functional space and facilities should be set up.
(4).Toilet: At least one toilet for man and two toilets for woman for every 16 senior citizens attended. The number would be treated as 16 if the actual number of senior citizens attended is less. Another set of toilet for man and two toilets for woman will be added for any additional 16 senior citizens.
The added toilets specified in preceding paragraph 4 can be replaced by removable potty seats.

Article 18

For small size nursing institutions, in addition to the president(director), personnel should be established according to the following rules:
(1).Nursing personnel: At least one staff on duty at any time. One staff for every 20 senior citizens attended. For the number of senior citizens less than 20, it would be treated as 20 senior citizens attended.
(2).Care givers: One staff for every 8 senior citizens attended for day-care services. The number of senior citizens would be treated as 8 if the senior citizens attended are less than 8 people. One staff for every 25 senior citizens attended for night-care services. The number of senior citizens would be treated as 25 if the senior citizens attended are less than 25 people. Staffs on night duty should be ROC citizens and the number of these staffs could be counted together with nursing staffs.
Institutions accepting senior citizens in need of nursing services such as nasogastric tube or catheter should establish personnel according to the rules stipulated in Article 11.
Institutions stipulated in the first paragraph are entitled to employ full time or contracted social workers or other personnel.

Article 19

Institutions accepting senior citizens in need of nursing services such as nasogastric tube or catheter should apply for approval from competent authorities. The number of senior citizens stated above should not exceed 1/2 of the total number originally approved. Article 12 and Article 13 will also be applied.

Article 20

Floor area, facilities and establishment of personnel for small size nursing institutions registered as foundations will apply the rules stipulated in the 1st paragraph of Article 14, Article 15 and Article 16.

Section 3 Institutions caring for dementia senior citizens

Article 21

Floor area for institutions caring for dementia senior citizens should be, calculated according to the number of senior citizens accepted, more than 16.5 square meters per person.

Article 22

Institutions caring for dementia senior citizens should apply unit caring pattern. Basically, the number of senior citizens attended per unit shall not be more than 16 persons.

Article 23

Facilities for institutions caring for dementia senior citizens should comply with the rules stipulated in Article 4 and the followings:
(1).Dormitory:
A. Floor area should be more than 7 square meters per person with one senior per room in principle. Each room shall not be equipped with more than four beds; the number of beds of all rooms for four senior citizens shall not exceed half of beds of the total units. Rooms for two senior citizens or more shall be equipped with barriers for the separation of personal living space.
B. Simple hygiene facilities should be set up in each dormitory.
C. Entrance and exit of each dormitory should connect with aisles or living rooms. Definite division between dormitories should be set up. Objects such as screen or curtain are not allowed to be used to divide dormitories.
(2).Nursing station: should be equipped with preparatory room, task platform, treatment trolly, nursing record closet, closet for medicine and medical equipments, and adequate equipments for emergency rescue.
(3).Basic facilities for the daily life of every unit should, in addition to dormitory, include living room, cafeteria, simply kitchen, bathing and hygiene facilities (lavatories, bathroom and toilets) and other necessary facilities.
(4).Locations for daily activities: space and equipments needed for recreational activities should be established.
(5).Other facilities: space and equipments such as waste processing room and laundry room.
Institutions stipulated in the previous paragraph are entitled to establish space and equipments needed for physical therapy room, occupational therapy room, social service room, religious gathering location, caring room for dying senior citizens, emergency observation room, meal service room and waste cremation room depending on business needs.

Article 24

For institutions caring for dementia senior citizens, in addition to the president(director), personnel should be established according to the following rules:
(1).Nursing personnel: At least one staff on duty at any time. One staff for every 20 senior citizens attended. For the number of senior citizens less than 20, it would be treated as 20 senior citizens attended.
(2).Social workers: At least one social worker for less than 100 senior citizens attended. One more staff shall be added for every 100 more senior citizens attended. Full time or contracted social workers should be applied to institutions attending less than 49 senior citizens. Contracted social workers should provide at least 2 days of services every week.
(3).Care givers: One staff for every 3 senior citizens attended for day-care services. The number of senior citizens would be treated as 3 if the senior citizens attended are less than 3 people. One staff for every 15 senior citizens attended for night-care services. The number of senior citizens would be treated as 15 if the senior citizens attended are less than 15 people. Number of staffs on night duty should be counted together with nursing staffs.
Part time personnel could be employed for care givers stipulated in the 3rd clause of the previous paragraph. However, the number of part time personnel should not exceed 1/3 of the total number of care givers. In addition, part time care giver should provide at least 16 hours of service time every week. Establishment for full time or part time personnel should be regular and hiring of foreign nursing personnel is not allowed.
Institution stipulated in the 1st paragraph are entitled to establish administrative personnel, full time or contracted doctor, physical therapy staff, occupational therapy staff, nutritionist, or other personnel depending on business needs.

Chapter 3 Domiciliary caring institutions

Article 25

Floor area of domiciliary caring institutions set up by various levels of the governments and registered as foundations( hereinafter referred to as public and foundation domiciliary caring institutions) should be, calculated according to the number of senior citizens accommodated, more than 20 square meters per person.
Floor area for small size domiciliary caring institutions should be, calculated according to the number of senior citizens accommodated, more than 10 square meters per person.

Article 26

Facilities for domiciliary caring institutions should comply with the rules stipulated in Article 4 and the followings:
(1).Dormitory:
A. Floor area should be more than 7 square meters per person with the maximum number of 3 beds for each dormitory.
B. Simple hygiene facilities should be set up in each dormitory.
C. Entrance and exit of each dormitory should connect with aisles or living rooms. Definite division between dormitories should be set up. Objects such as screen or curtain are not allowed to be used to divide dormitories.
(2).Nursing station: should be equipped with nursing record closet, closet for medicine and medical equipments, and adequate equipments for emergency rescue.
(3).Locations for daily activities: Cafeteria, guest room, reading room, leisure and recreation activities room, religious services locations and other necessary facilities or equipments should be set up. Floor space for guest room, reading room, leisure and recreation activities room should be more than 6 square meters per person.
Institutions of the previous paragraph are entitled to set up occupational therapy room, social service room, gym, observation and protection room and other facilities depending on business needs.

Article 27

For public and foundation domiciliary caring institutions, in addition to the president(director), personnel should be established according to the following rules:
(1).Nursing personnel: At least one staff on duty at any time.
(2).Social workers: At least one social worker for less than 80 senior citizens attended. For institutions attending more than 80 senior citizens, one more staff shall be added for every 80 more senior citizens attended. Full time or contracted social workers should be applied to institutions attending less than 49 senior citizens. Contracted social workers should provide at least 2 days of services every week.
(3).Care givers: One staff for every 15 senior citizens attended for day-care services. The number of senior citizens would be treated as 15 if the senior citizens attended are less than 15 people. One staff for every 35 senior citizens attended for night-care services. The number of senior citizens would be treated as 35 if the senior citizens attended are less than 35 people. Personnel on night-care duty should be ROC citizen and the number of such staffs should be counted together with nursing staffs.
Institutions of the previous paragraph are entitled to set up counselor, administrative personnel, full time or contracted doctor, occupational therapy personnel, nutritionist and other personnel depending on business needs.

Article 28

Facilities for small size domiciliary caring institutions should comply with rules of Article 4 and the followings:
(1).Dormitory: Floor area should be more than 5 square meters per person with the maximum number of 3 beds for each dormitory.
(2).Locations for daily activities: Space and equipments for multi-functional activities should be set up.
(3).Other equipments: Facilities such as Nursing record closet and adequate equipments for emergency rescue should be set up depending on actual needs.

Article 29

For small size public and foundation domiciliary caring institutions, in addition to the president(director), personnel should be established according to the following rules:
(1).Nursing personnel: At least one staff on duty at any time.
(2).Care givers: One staff for every 15 senior citizens attended for day-care services. The number of senior citizens would be treated as 15 if the senior citizens attended are less than 15 people. One staff for every 35 senior citizens attended for night-care services. The number of senior citizens would be treated as 35 if the senior citizens attended are less than 35 people. Personnel on night-care duty should be ROC citizen and the number of such staffs should be counted together with nursing personnel.
Institutions of the previous paragraph are entitled to set up full time or contracted social worker or other necessary personnel depending on business needs.

Article 30

Establishment of floor area, facilities and personnel for small size public and foundation domiciliary caring institutions should follow the rules of the 1st paragraph of Article 25, Article 26 and Article 27.

Chapter 4 Other Senior Citizens’ Welfare Institutions

Article 31

Recreation institutions and service institutions established before Feb. 1st, 2007 are entitled to provide services, in addition to the offering of in-house and community services stipulated in Article 17 and Article 18 of the law, such as settlement services, learning and recreation services of recreation, art and skill, temporary senior citizen care services, voluntary services and short term protection depending on their business needs.

Article 32

Indoor floor area for recreation institutions and service institutions established before Feb. 1st, 2007 should be more than 200 square meters with the following facilities:
(1).Office, social worker office or service office.
(2).Multi-functional activities room.
(3).Classroom.
(4).Hygiene facilities .
(5).Other necessary facilities related to services.
Facilities of subparagraph 2 and 3 of previous paragraph could be adjusted and combined for use depending on actual situation. Facilities such as conference room, counseling room, reading room for library, hygiene and safety room could be established depending on the business needs.
Institutions offering catering services on the first paragraph should set up cafeteria and kitchen. Institutions offering services such as day-care services, temporary caring services, short term protection and accommodation facilities should set up dormitory, equipments for bathing and hygiene, cafeteria, kitchen and multi-functional activities room.

Article 33

Recreational institutions and service institutions set up before Feb. 01, 2007 should establish at least one staff from the following personnel:
(1).Director.
(2).Social worker.
(3).Administrative personnel or service personnel.
Establishment of personnel for institutions of the previous paragraph offering services of home-caring or community-caring projects should follow related rules.

Chapter 5 Supplementary Provisions

Article 34

Long term care institutions and domiciliary care institutions adopting combined processing method should comply with the following rules:
(1).Standards for facilities and personnel for institutions with individually utilized areas and planning for fixed compartments and independent areas should follow rules stipulated in Chapter 2 and Chapter 3 respectively.
(2).Standards for facilities and personnel for institutions without fixed compartment and planning for independent area should be higher.
Scales for institutions of the previous paragraph should be calculated respectively according to various standards. Scale for the institutions with original establishment approval should exceed 1/2.

Article 35

Senior Citizens’ Welfare Institutions shall follow these standards when establishing, expanding or moving.

Article 36

Pending cases of new establishment, expansion, moving, restoring business and change of person in charge which applied to governments of municipality and county(city) according to related laws before Feb. 1st, 2007 can apply rules of these standards amended and implemented on June 17th, 1998.

Article 37

Senior Citizens’ Welfare Institutions not qualified for these standards but were approved and established before Feb. 1st, 2007 should complete improvement tasks within 5 years of the implementation date of the amendments for these standards. Cases of failure to complete improvement within deadline will be handled in accordance with the Act. Senior Citizens’ Welfare Institutions stipulated in the previous Article will follow the same Act.
Senior Citizens Welfare Institutions in remote areas, outlying islands, aboriginal areas which were approved and established before Feb. 1st, 2007 but with difficulty to carry out improvements in accordance with these standards may submit project of exempting from the requirements stipulated in preceding provisions to the competent authority of municipal or county (city) for review as well as for the approval from the Central competent authority.

Article 38

These standards will be implemented starting from the promulgation date.
Provisions of the standard amended on December 3rd, 2012 will be enacted since July 31, 2012.