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{"sheet":"訪問介護","index":0,"n_rows":31,"n_cols":25,"rows_kept":31,"cut":false,"hidden":false,"merged":[[14,27,14,28],[14,29,14,30],[14,17,14,18],[14,19,14,20],[14,21,14,22],[14,23,14,24],[14,25,14,26],[13,21,13,22],[13,23,13,24],[13,25,13,26],[13,27,13,28],[13,29,13,30],[26,24,27,30],[30,1,31,8],[30,9,31,30],[22,1,23,8],[22,16,23,23],[26,1,27,23],[28,1,29,23],[28,24,29,30],[24,16,25,23],[24,24,25,30],[22,9,23,15],[22,24,23,30],[24,1,25,8],[24,9,25,15],[15,1,16,6],[20,1,21,8],[20,9,21,15],[20,16,21,23],[20,24,21,30],[15,7,16,8],[15,11,16,12],[15,21,16,22],[15,19,16,20],[15,17,16,18],[15,29,16,30],[15,27,16,28],[15,25,16,26],[15,23,16,24],[1,1,2,30],[5,7,6,30],[9,1,10,6],[9,7,10,12],[9,13,10,30],[5,1,6,5],[13,1,13,6],[14,1,14,6],[13,7,13,8],[13,9,13,10],[13,11,13,12],[14,7,14,8],[14,9,14,10],[14,11,14,12],[13,13,13,14],[13,15,13,16],[13,17,13,18],[13,19,13,20],[15,9,16,10],[15,15,16,16],[15,13,16,14],[14,13,14,14],[14,15,14,16]]}
[]
[null,"指定訪問介護事業所事前提出書類"]
[]
[]
[]
[null,"〇　事業所名"]
[]
[]
[null,"〇　利用者数"]
[null,"直近1ヶ月間の延べ\nサービス提供時間数",null,null,null,null,null,null,null,null,null,null,null,"　時間（提供票（利用表）の合計時間）"]
[]
[]
[null,"〇　サービスの提供状況"]
[null,"提供年"]
[null,"提供月"]
[null,"利用者数"]
[]
[null,"（注）　利用者数は、介護報酬請求に係る実利用者数を記入してください。（直近12か月分）"]
[]
[]
[null,"初回加算",null,null,null,null,null,null,null,"有　・　　無",null,null,null,null,null,null,"生活機能向上連携加算",null,null,null,null,null,null,null,"有　・　　無"]
[]
[null,"認知症専門ケア加算",null,null,null,null,null,null,null,"有　・　　無",null,null,null,null,null,null,"特別地域訪問介護加算",null,null,null,null,null,null,null,"有　・　　無"]
[]
[null,"緊急時訪問介護加算",null,null,null,null,null,null,null,"有　・　　無",null,null,null,null,null,null,"口腔連携強化加算",null,null,null,null,null,null,null,"有　・　　無"]
[]
[null,"中山間地域等における小規模事業所加算（地域に関する状況）",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"　該当　・　非該当"]
[]
[null,"中山間地域等における小規模事業所加算（規模に関する状況）",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"　該当　・　非該当"]
[]
[null,"特定事業所加算",null,null,null,null,null,null,null,"有［　　Ⅰ　・　　Ⅱ　・　　Ⅲ　・　　Ⅳ　・　　Ⅴ］・　　無"]