Management of Nonprofit Organization (special nursing homes) in the Competitive Environment

2000年4月，日本实施了“长期护理保险”，特殊疗养院面临着激烈的竞争。从现在开始，许多家庭必须降低运营成本，提高护理服务质量才能生存。也就是说，在福利服务中引入组织管理的理念是非常必要的。因此，在本研究中，我们从组织结构的角度来关注“团体照护单位”(一种照护服务形式)。到目前为止，该理念被护理福利研究者认为是一种实施精细护理的结构，但在本研究中，我们解释了该结构具有实施单独护理服务的服务控制功能。并从再造的角度对养老院的管理进行了分析，探讨了在降低成本的同时提高服务质量的可能性。即，建立护理服务水平，重新考虑护理时间表，工作时间表中的出勤水平，选择后备护理人员，为他们分配单独的护理服务。

In Japan "Long-Term Care Insurance" was enforced in April 2000, special nursing homes were under the competitive environment. From now on, many homes must reduce operating costs and improve their quality of care services to survive. That is to say, it is necessary to introduce the idea of organizational management into welfare services.So in this research, we took notice of the "group care units" (one of care service forms) from the point of view of organizational structures. The idea was regarded as a structure to practice fine care by care welfare researchers so far, but in this research we explained the structure has the service control functions to practice separate care services. And we analyzed management of special nursing homes from the reengineering standpoint, discussec the possibility to cope with both cost reduction and excellent service quality.In conclusion, the reengineering of special nursing homes is consisted of the following processes. Namely, establishment of care service level, rethinking of a care timetable, levelness of attendance in a working timetable, selection of reserved care workers, assignment separate care services to them.