Aim: By describing the practice of a Japanese nurse practitioner, this descriptive case study discusses role development and outcomes before and after the intervention.

Background: One of the first Japanese nurse practitioners intervened at a nursing home during the government-designated trial period for nurse practitioner practice.

Conclusion: Because of the nurse practitioner’s meticulous observation and timely care provision to the residents in collaboration with the physician and the other staff in the facility, comparative data showed improvement in daily health status management of every resident and decreased deterioration of residents’ health conditions requiring ambulance transfer and hospitalization.