Home-visit Care Operators Face Financial Woes: Urgent Efforts Needed to Secure Staff, Stabilize Revenue

Editorial

17:15 JST, March 22, 2026

Demand for home-visit care is rising as the nation’s population ages. Nevertheless, cases in which service providers fell into financial difficulties that forced them to file for bankruptcy or go out of business have occurred one after another.

This is largely due to a persistent shortage of care workers. The government must identify relevant issues and develop an environment in which people can live with peace of mind even in old age.

According to a private credit research company, 556 home-visit care providers filed for bankruptcy or went out of business last year, setting a new record high for the fourth consecutive year. The main reasons are believed to be a labor shortage and deteriorating business conditions due to rising prices.

The issue of a labor shortage is not limited to nursing service providers. Companies generally try to secure staff by improving their terms of employment. But it is hard to improve working conditions in the nursing care industry because the fees paid to service providers are set by the government.

The average monthly salary for nursing care workers in 2024 was ¥300,000 — about ¥80,000 lower than the average across all industries.

Nursing care involves a great deal of physically demanding tasks, such as assisting with bathing, and workers are entrusted with the lives of service users. It is hard to say that their pay is commensurate with work that bears such heavy responsibilities.

Last year, the government decided to increase wages for caregivers by moving up the schedule to revise nursing care fees next fiscal year, but this raise will be limited to a maximum of ¥20,000 per month. Further improvement in their work conditions is an urgent task.

There are currently about 1.1 million users of home-care visits, and that number has been on the rise. In contrast, it is estimated that the nursing care industry as a whole will face a shortage of about 570,000 caregivers in fiscal 2040.

Given that, the government last year permitted foreign nationals who hold the residence status of specified skilled workers to engage in home-visit care.

Home-visit care involves one-on-one interaction with service users, and therefore requires communication in Japanese and the ability to respond flexibly to users’ requests. Service providers need to improve training programs for foreign caregivers.

Supporting the management of home-visit care providers is also an important issue.

Particularly in depopulated areas where service users are widely scattered, care workers spend significant time traveling, which often limits the number of visits they can make. As the fees paid to service providers are based on a pay-for-performance system determined by the number of home visits and the time spent on the service, providers in depopulated areas find it difficult to make a profit.

If a user suddenly cancels a home-visit care service due to illness or other reasons, this results in an unexpected revenue loss for a provider. Many providers report that such cases have put a strain on their businesses.

The government is considering introducing — only in depopulated areas — a flat-rate system under which fees are paid based on the number of service users, regardless of the number of home visits or time spent. Factors such as workers’ travel time should also be taken into account, to ensure providers gain earnings in a stable manner.

(From The Yomiuri Shimbun, March 22, 2026)