Kawasaki misapplied a nursing care cost reduction program: the city will pay about ¥14.8 million for 85 people to care providers

The city misapplied a care-cost reduction

On Oct 22, 2026, Kawasaki City announced that it had been running its long-term care "user-cost reduction program by social welfare corporations" incorrectly.

The program helps people with low income who struggle to make ends meet. When they use care services run by a social welfare corporation, it lowers what they pay themselves (the 10% co-payment, meals and housing costs). Eligible people receive a "certificate" from their ward office.

Under national rules, the city decided that from April 2006, people in Tier 2 of the high-cost care benefit would not get a reduction on their 10% co-payment. This is because Tier 2 users already have a monthly cap on what they pay through the high-cost care benefit.

In practice, however, their 10% co-payment kept being reduced.

What Tier 2 of the high-cost care benefit means

The high-cost care benefit refunds the part of your care co-payment that goes over a monthly cap set by income. According to the announcement, the Tier 2 cap is ¥15,000 a month for a person living alone. If someone else in the household also uses care services and everyone in the household is exempt from municipal tax, the cap is ¥24,600 a month for the household.

85 people, about ¥14.8 million

The error affected 85 people, who used 45 facilities run by 34 corporations. Based on records from April 2006 to May 2026, the total is ¥14,807,525. The city will recalculate after extending the period to November 2026.

In effect, the facilities had absorbed these reductions. Under the State Redress Act, the city will reach settlements with the corporations and pay them directly.

The city had also paid facilities a subsidy covering part of the reductions they made (50% national, 25% prefectural, 25% city funds). For the overpaid subsidy, the city will ask corporations to return the part not past the statute of limitations, FY2016 to FY2025: ¥1,483,000 for 30 people at 6 facilities (6 corporations). It will return the national and prefectural shares to those governments.

Errors in every ward, including Saiwai

When the city checked each ward's practice in June 2026, Saiwai and Miyamae wards were applying the rule correctly, while Kawasaki, Nakahara, Takatsu, Tama and Asao wards were not. However, a later check based on benefit records found that the error had extended to all wards. The announcement does not give numbers or amounts by ward.

No unified manual

The city gives two causes:

• There was no unified city manual for Tier 2 users, and the procedure did not show both users and facilities, for example on the certificate, that the 10% co-payment would not be reduced
• The April 2006 change was not communicated to wards and facilities on an ongoing basis

The city found the problem while checking other care benefit work after it announced, on Jan 23, 2026, a separate case of unpaid high-cost care benefits.

The city will reissue certificates

The announcement does not say that affected people need to take any steps themselves. The city will apologize to and explain the situation to affected users and facilities, and will reissue certificates to affected users.

For Tier 2 users, the new certificate will state that "only housing and meal costs are reduced." Facilities will also be notified individually. From December 2026, all wards plan to follow the same manual.

Contacts

Contact the Long-Term Care Insurance Division, Aging Society Department, Health and Welfare Bureau, Kawasaki City. The press release lists phone 044-200-2641, and the city's announcement page lists the division's phone as 044-200-2678.