From 2008 to 2014, we experienced 40 respiratory failure cases which required long-term ventilation in the post-ICU in Kakeyu Hospital. They had been referred to our hospital from acute care hospitals and most of them had been transferred on our regional medical cooperation system. Initially, we used long-term care beds for them, but as the number of serious cases increased, we moved them to acute care beds. As regards main causes of respiratory failure, post cardiac arrest syndrome topped the list with 12 cases, followed by chronic obstructive pulmonary disease, intractable neurological diseases and cervical cord injury. All these cases combined, the number came to 30 cases, accounting for 75% of all. The shortest stay in hospital was made by a patient with brain stem lymphoma. It was only 12 days, but the longest was made by a patient with post meningoencephalitis 6 years. Our care consisted not only ventilation and medical care but also giving a bath, walking with a type of wheelchair, and sunbathing at the rooftop of our hospital. In May 2014, we renovated the post-ICU from an acute care division to a physical disability patient ward. As the elderly population will increase, it is expected that the need for acute care will augment in parallel with an increase to the number of post cardiac arrest syndrome and the demand of long-term ventilation. Therefore, the community care system will need the post-ICU for cooperation with acute care hospitals.