diff --git a/src/app.module.ts b/src/app.module.ts
index 36ee2ce..3e76fbc 100644
--- a/src/app.module.ts
+++ b/src/app.module.ts
@@ -30,6 +30,8 @@ import { StaffModule } from './staff/staff.module.js';
 import { CatalogModule } from './catalog/catalog.module.js';
 import { StorageModule } from './storage/storage.module.js';
 import { ElderModule } from './elder/elder.module.js';
+import { PlanModule } from './plan/plan.module.js';
+import { ElderSvcModule } from './elder-svc/elder-svc.module.js';
 import { AppController } from './app.controller.js';
 import { AppService } from './app.service.js';
 
@@ -57,6 +59,8 @@ import { AppService } from './app.service.js';
     CatalogModule,
     StorageModule,
     ElderModule,
+    PlanModule,
+    ElderSvcModule,
   ],
   controllers: [AppController],
   providers: [
diff --git a/src/elder-svc/dto.ts b/src/elder-svc/dto.ts
new file mode 100644
index 0000000..0d6f593
--- /dev/null
+++ b/src/elder-svc/dto.ts
@@ -0,0 +1,20 @@
+import { ApiProperty } from '@nestjs/swagger';
+import { ArrayNotEmpty, IsArray, IsIn, IsNotEmpty, IsString } from 'class-validator';
+
+/** 老人个人项目库整表覆盖入参：care_mode 为整库统一护理方式，svc_ids 落本机构 L4。 */
+export class PutElderSvcDto {
+  @ApiProperty({
+    description: '护理方式：inst_medical/inst_nursing/home_org/home_individual',
+    enum: ['inst_medical', 'inst_nursing', 'home_org', 'home_individual'],
+  })
+  @IsString()
+  @IsNotEmpty()
+  @IsIn(['inst_medical', 'inst_nursing', 'home_org', 'home_individual'])
+  careMode!: string;
+
+  @ApiProperty({ description: '本机构 L4 项目库 svc_org.id 列表', type: [String] })
+  @IsArray()
+  @ArrayNotEmpty()
+  @IsString({ each: true })
+  svcIds!: string[];
+}
diff --git a/src/elder-svc/elder-svc.controller.ts b/src/elder-svc/elder-svc.controller.ts
new file mode 100644
index 0000000..942d1e5
--- /dev/null
+++ b/src/elder-svc/elder-svc.controller.ts
@@ -0,0 +1,23 @@
+import { Body, Controller, Get, Param, Put } from '@nestjs/common';
+import { Permissions } from '../common/permissions.js';
+import { AuditLog, RequirePermissions } from '../auth/decorators.js';
+import { PutElderSvcDto } from './dto.js';
+import { ElderSvcService } from './elder-svc.service.js';
+
+@Controller('elder-svc')
+export class ElderSvcController {
+  constructor(private readonly service: ElderSvcService) {}
+
+  @Get(':elderId')
+  @RequirePermissions(Permissions.elder.svcSave)
+  get(@Param('elderId') elderId: string) {
+    return this.service.get(elderId);
+  }
+
+  @Put(':elderId')
+  @RequirePermissions(Permissions.elder.svcSave)
+  @AuditLog('elder-svc', 'save')
+  put(@Param('elderId') elderId: string, @Body() dto: PutElderSvcDto) {
+    return this.service.put(elderId, dto);
+  }
+}
diff --git a/src/elder-svc/elder-svc.module.ts b/src/elder-svc/elder-svc.module.ts
new file mode 100644
index 0000000..829aa63
--- /dev/null
+++ b/src/elder-svc/elder-svc.module.ts
@@ -0,0 +1,9 @@
+import { Module } from '@nestjs/common';
+import { ElderSvcController } from './elder-svc.controller.js';
+import { ElderSvcService } from './elder-svc.service.js';
+
+@Module({
+  controllers: [ElderSvcController],
+  providers: [ElderSvcService],
+})
+export class ElderSvcModule {}
diff --git a/src/elder-svc/elder-svc.service.spec.ts b/src/elder-svc/elder-svc.service.spec.ts
new file mode 100644
index 0000000..efca83d
--- /dev/null
+++ b/src/elder-svc/elder-svc.service.spec.ts
@@ -0,0 +1,127 @@
+import { describe, expect, it, vi } from 'vitest';
+import { ElderSvcService } from './elder-svc.service.js';
+import type { PrismaService } from '../prisma/prisma.service.js';
+import { ErrorCodes } from '../common/error-codes.js';
+import { runWithRequestContext } from '../common/context/request-context.js';
+import type { RequestContext } from '../common/context/request-context.js';
+
+const ctx: RequestContext = {
+  tenantCode: 'T001',
+  userId: 'u1',
+  username: 'admin',
+  super: false,
+  dataScope: 'all',
+  orgCode: null,
+  orgCodes: [],
+};
+
+function makeService(
+  overrides: {
+    elderFindFirst?: ReturnType<typeof vi.fn>;
+    svcOrgFindFirst?: ReturnType<typeof vi.fn>;
+    svcNationalFindFirst?: ReturnType<typeof vi.fn>;
+    svcLocalFindFirst?: ReturnType<typeof vi.fn>;
+    elderSvcFindMany?: ReturnType<typeof vi.fn>;
+    elderSvcUpdateMany?: ReturnType<typeof vi.fn>;
+    elderSvcCreate?: ReturnType<typeof vi.fn>;
+  } = {},
+) {
+  const elderFindFirst = overrides.elderFindFirst ?? vi.fn().mockResolvedValue({ id: 'e1', name: '张三' });
+  const svcOrgFindFirst =
+    overrides.svcOrgFindFirst ?? vi.fn().mockResolvedValue({ id: 'svc1', srcType: 'national', srcId: 'nat1' });
+  const svcNationalFindFirst =
+    overrides.svcNationalFindFirst ?? vi.fn().mockResolvedValue({ natName: '协助翻身叩背排痰', natCode: 'L0000106010010000' });
+  const svcLocalFindFirst = overrides.svcLocalFindFirst ?? vi.fn().mockResolvedValue(null);
+  const elderSvcFindMany = overrides.elderSvcFindMany ?? vi.fn().mockResolvedValue([]);
+  const elderSvcUpdateMany = overrides.elderSvcUpdateMany ?? vi.fn().mockResolvedValue({ count: 2 });
+  const elderSvcCreate = overrides.elderSvcCreate ?? vi.fn().mockResolvedValue({ id: 'es1' });
+
+  const prisma = {
+    client: {
+      elder: { findFirst: elderFindFirst },
+      svcOrg: { findFirst: svcOrgFindFirst },
+      svcNational: { findFirst: svcNationalFindFirst },
+      svcLocal: { findFirst: svcLocalFindFirst },
+      elderSvc: {
+        findMany: elderSvcFindMany,
+        updateMany: elderSvcUpdateMany,
+        create: elderSvcCreate,
+      },
+    },
+  };
+  const service = new ElderSvcService(prisma as unknown as PrismaService);
+  return {
+    service,
+    elderFindFirst,
+    svcOrgFindFirst,
+    svcNationalFindFirst,
+    svcLocalFindFirst,
+    elderSvcFindMany,
+    elderSvcUpdateMany,
+    elderSvcCreate,
+  };
+}
+
+describe('ElderSvcService', () => {
+  it('get 按老人返回当前项目库', async () => {
+    const elderSvcFindMany = vi.fn().mockResolvedValue([{ id: 'es1', elderId: 'e1' }]);
+    const { service } = makeService({ elderSvcFindMany });
+
+    const res = await runWithRequestContext(ctx, () => service.get('e1'));
+
+    expect(elderSvcFindMany).toHaveBeenCalledWith({ where: { elderId: 'e1' } });
+    expect(res).toHaveLength(1);
+  });
+
+  it('put 整表覆盖：软删旧行 + 写新行 + snapshot svc_name/svc_code', async () => {
+    const elderSvcUpdateMany = vi.fn().mockResolvedValue({ count: 1 });
+    const elderSvcCreate = vi.fn().mockResolvedValue({ id: 'es-new' });
+    const { service } = makeService({ elderSvcUpdateMany, elderSvcCreate });
+
+    const res = await runWithRequestContext(ctx, () =>
+      service.put('e1', { careMode: 'inst_medical', svcIds: ['svc1', 'svc2'] }),
+    );
+
+    expect(elderSvcUpdateMany).toHaveBeenCalledWith({
+      where: { elderId: 'e1' },
+      data: { deletedAt: expect.any(Date) },
+    });
+    expect(elderSvcCreate).toHaveBeenCalledTimes(2);
+    expect(elderSvcCreate).toHaveBeenCalledWith({
+      data: expect.objectContaining({
+        elderId: 'e1',
+        tenantCode: 'T001',
+        svcId: 'svc1',
+        svcNameSnapshot: '协助翻身叩背排痰',
+        svcCodeSnapshot: 'L0000106010010000',
+        careMode: 'inst_medical',
+        isActive: true,
+      }),
+    });
+    expect(res).toHaveLength(2);
+  });
+
+  it('put 老人不存在 → ELDER_NOT_FOUND', async () => {
+    const elderFindFirst = vi.fn().mockResolvedValue(null);
+    const { service, elderSvcUpdateMany, elderSvcCreate } = makeService({ elderFindFirst });
+
+    await expect(
+      runWithRequestContext(ctx, () => service.put('missing', { careMode: 'inst_medical', svcIds: ['svc1'] })),
+    ).rejects.toMatchObject({ response: { code: ErrorCodes.ELDER_NOT_FOUND } });
+
+    expect(elderSvcUpdateMany).not.toHaveBeenCalled();
+    expect(elderSvcCreate).not.toHaveBeenCalled();
+  });
+
+  it('put svc_id 非本机构 L4 → 拒绝（R5）', async () => {
+    const svcOrgFindFirst = vi.fn().mockResolvedValue(null);
+    const { service, elderSvcUpdateMany, elderSvcCreate } = makeService({ svcOrgFindFirst });
+
+    await expect(
+      runWithRequestContext(ctx, () => service.put('e1', { careMode: 'inst_medical', svcIds: ['other-org-svc'] })),
+    ).rejects.toMatchObject({ response: { code: ErrorCodes.SVC_ORG_NOT_FOUND } });
+
+    expect(elderSvcUpdateMany).not.toHaveBeenCalled();
+    expect(elderSvcCreate).not.toHaveBeenCalled();
+  });
+});
diff --git a/src/elder-svc/elder-svc.service.ts b/src/elder-svc/elder-svc.service.ts
new file mode 100644
index 0000000..03f6559
--- /dev/null
+++ b/src/elder-svc/elder-svc.service.ts
@@ -0,0 +1,83 @@
+import { HttpStatus, Injectable } from '@nestjs/common';
+import { PrismaService } from '../prisma/prisma.service.js';
+import { getRequestContext } from '../common/context/request-context.js';
+import { BusinessException } from '../common/business-exception.js';
+import { ErrorCodes } from '../common/error-codes.js';
+import { PutElderSvcDto } from './dto.js';
+
+/** 解析后的个人项目库项（svcId + 名称/代码快照）。 */
+interface ResolvedSvc {
+  svcId: string;
+  svcName: string;
+  svcCode: string | null;
+}
+
+/**
+ * 老人个人项目库（ltc_elder_svc）业务服务。
+ *
+ * PUT 为整表覆盖：先查老人 → 校验每个 svc_id 落本机构 L4（越界拒绝）→
+ * 软删旧的 ltc_elder_svc 行（留档）→ 写新行（snapshot svc_name/svc_code）。
+ */
+@Injectable()
+export class ElderSvcService {
+  constructor(private readonly prisma: PrismaService) {}
+
+  /** 当前（未软删）个人项目库。 */
+  get(elderId: string) {
+    return this.prisma.client.elderSvc.findMany({ where: { elderId } });
+  }
+
+  /** 整表覆盖保存个人项目库。 */
+  async put(elderId: string, dto: PutElderSvcDto) {
+    await this.assertElderExists(elderId);
+    const resolved = await this.resolveSvcItems(dto.svcIds);
+    // 软删旧行留档（care_mode 变更/重新保存均重制旧库）。
+    await this.prisma.client.elderSvc.updateMany({
+      where: { elderId },
+      data: { deletedAt: new Date() },
+    });
+    const ctx = getRequestContext()!;
+    const rows = [];
+    for (const item of resolved) {
+      rows.push(
+        await this.prisma.client.elderSvc.create({
+          data: {
+            elderId,
+            tenantCode: ctx.tenantCode,
+            svcId: item.svcId,
+            svcNameSnapshot: item.svcName,
+            svcCodeSnapshot: item.svcCode,
+            careMode: dto.careMode,
+            isActive: true,
+          },
+        }),
+      );
+    }
+    return rows;
+  }
+
+  /** 校验每个 svc_id 落本机构 L4，并解析名称/代码快照。 */
+  private async resolveSvcItems(svcIds: string[]): Promise<ResolvedSvc[]> {
+    return Promise.all(
+      svcIds.map(async (svcId) => {
+        const svcOrg = await this.prisma.client.svcOrg.findFirst({ where: { id: svcId } });
+        if (!svcOrg) {
+          throw new BusinessException(ErrorCodes.SVC_ORG_NOT_FOUND, '机构项目不存在', HttpStatus.NOT_FOUND);
+        }
+        if (svcOrg.srcType === 'local') {
+          const local = await this.prisma.client.svcLocal.findFirst({ where: { id: svcOrg.srcId } });
+          return { svcId, svcName: local?.localItemName ?? '', svcCode: null };
+        }
+        const national = await this.prisma.client.svcNational.findFirst({ where: { id: svcOrg.srcId } });
+        return { svcId, svcName: national?.natName ?? '', svcCode: national?.natCode ?? null };
+      }),
+    );
+  }
+
+  private async assertElderExists(elderId: string) {
+    const elder = await this.prisma.client.elder.findFirst({ where: { id: elderId } });
+    if (!elder) {
+      throw new BusinessException(ErrorCodes.ELDER_NOT_FOUND, '老人档案不存在', HttpStatus.NOT_FOUND);
+    }
+  }
+}
diff --git a/src/plan/dto.ts b/src/plan/dto.ts
new file mode 100644
index 0000000..f8449aa
--- /dev/null
+++ b/src/plan/dto.ts
@@ -0,0 +1,134 @@
+import { ApiProperty, ApiPropertyOptional } from '@nestjs/swagger';
+import { Type } from 'class-transformer';
+import {
+  IsArray,
+  IsBoolean,
+  IsDateString,
+  IsIn,
+  IsInt,
+  IsNotEmpty,
+  IsOptional,
+  IsString,
+  Min,
+  ValidateNested,
+} from 'class-validator';
+
+/** 计划项（svc_plan_item）入参。svc_id 引用本机构 L4（svc_org.id）。 */
+export class PlanItemInputDto {
+  @ApiProperty({ description: '本机构 L4 项目库 svc_org.id' })
+  @IsString()
+  @IsNotEmpty()
+  svcId!: string;
+
+  @ApiPropertyOptional({ description: '频次类型：daily/weekly_n/monthly_n/as_needed' })
+  @IsOptional()
+  @IsString()
+  freqType?: string;
+
+  @ApiPropertyOptional({ description: '频次值（如每周 3 次填 3）' })
+  @IsOptional()
+  @IsInt()
+  freqValue?: number;
+
+  @ApiPropertyOptional({ description: '单次时长（分钟）' })
+  @IsOptional()
+  @IsInt()
+  durationMin?: number;
+
+  @ApiPropertyOptional({ description: '拍照档位：must/optional/free', enum: ['must', 'optional', 'free'] })
+  @IsOptional()
+  @IsIn(['must', 'optional', 'free'])
+  photoTier?: string;
+
+  @ApiPropertyOptional({ description: '注意事项' })
+  @IsOptional()
+  @IsString()
+  cautionNote?: string;
+
+  @ApiPropertyOptional({ description: '是否医疗护理类' })
+  @IsOptional()
+  @IsBoolean()
+  isMedical?: boolean;
+
+  @ApiPropertyOptional({ description: '是否要求持证' })
+  @IsOptional()
+  @IsBoolean()
+  needCert?: boolean;
+}
+
+/** 制定服务计划入参。plan_status 由服务端定（制定=draft），不接受前端传入。 */
+export class CreatePlanDto {
+  @ApiProperty({ description: '老人 ID' })
+  @IsString()
+  @IsNotEmpty()
+  elderId!: string;
+
+  @ApiProperty({ description: '计划周期起（YYYY-MM-DD）' })
+  @IsDateString()
+  planPeriodStart!: string;
+
+  @ApiProperty({ description: '计划周期止（YYYY-MM-DD）' })
+  @IsDateString()
+  planPeriodEnd!: string;
+
+  @ApiProperty({ description: '护理等级：care_1/care_2/care_3', enum: ['care_1', 'care_2', 'care_3'] })
+  @IsString()
+  @IsNotEmpty()
+  careLevel!: string;
+
+  @ApiProperty({
+    description: '护理方式：inst_medical/inst_nursing/home_org/home_individual',
+    enum: ['inst_medical', 'inst_nursing', 'home_org', 'home_individual'],
+  })
+  @IsString()
+  @IsNotEmpty()
+  careMode!: string;
+
+  @ApiProperty({ description: '计划项目列表', type: [PlanItemInputDto] })
+  @IsArray()
+  @ValidateNested({ each: true })
+  @Type(() => PlanItemInputDto)
+  items!: PlanItemInputDto[];
+
+  @ApiPropertyOptional({ description: '每周次数（居家类）' })
+  @IsOptional()
+  @IsInt()
+  @Min(0)
+  weekFreq?: number;
+
+  @ApiPropertyOptional({ description: '每月小时数（居家类）' })
+  @IsOptional()
+  @IsInt()
+  @Min(0)
+  monthHours?: number;
+
+  @ApiPropertyOptional({ description: '附加项数（≤5）' })
+  @IsOptional()
+  @IsInt()
+  @Min(0)
+  extraItemCount?: number;
+
+  @ApiPropertyOptional({ description: '计划依据快照（json）' })
+  @IsOptional()
+  planBasis?: unknown;
+}
+
+/** 变更计划入参：change_from_plan_id 指向被变更的旧计划。 */
+export class ChangePlanDto extends CreatePlanDto {
+  @ApiProperty({ description: '被变更的旧计划 ID' })
+  @IsString()
+  @IsNotEmpty()
+  changeFromPlanId!: string;
+}
+
+/** 计划确认入参（老人/家属确认，确认后计划转 active）。 */
+export class ConfirmPlanDto {
+  @ApiProperty({ description: '老人确认' })
+  @IsBoolean()
+  confirmElder!: boolean;
+
+  @ApiPropertyOptional({ description: '家属确认（可选）' })
+  @IsOptional()
+  @IsBoolean()
+  confirmGuardian?: boolean;
+}
diff --git a/src/plan/plan-rule.ts b/src/plan/plan-rule.ts
new file mode 100644
index 0000000..93c8aa5
--- /dev/null
+++ b/src/plan/plan-rule.ts
@@ -0,0 +1,30 @@
+/** 昆明属地项数规则（care_mode × care_level → 最少项数）。州市无规则 → 只提示不拦。 */
+export const ITEM_COUNT_RULE = {
+  inst_medical: { care_1: 18, care_2: 15, care_3: 13 },
+  inst_nursing: { care_1: 18, care_2: 15, care_3: 13 },
+  home_individual: { care_1: 15, care_2: 13, care_3: 10 },
+  home_org: null, // 居家机构上门：按周次/月时长，不按项数
+} as const;
+
+/** 附加项上限。 */
+export const EXTRA_MAX = 5;
+
+/**
+ * 属地项数校验：返回是否满足与提示文案。
+ * - 无规则（州市/未配置）→ 只提示不拦；
+ * - 项数不足或附加项超限 → ok=false。
+ */
+export function checkItemCount(
+  careMode: string,
+  careLevel: string,
+  itemCount: number,
+  extraCount: number,
+): { ok: boolean; hint: string } {
+  const rule = (ITEM_COUNT_RULE as Record<string, Record<string, number> | null>)[careMode];
+  if (rule === null || rule === undefined) return { ok: true, hint: '州市项数规则待属地实施细则明确' };
+  const min = rule[careLevel];
+  if (min === undefined) return { ok: true, hint: '' };
+  if (itemCount < min) return { ok: false, hint: `当前护理方式/等级需 ≥${min} 项` };
+  if (extraCount > EXTRA_MAX) return { ok: false, hint: `附加项最多 ${EXTRA_MAX} 项` };
+  return { ok: true, hint: '' };
+}
diff --git a/src/plan/plan.controller.ts b/src/plan/plan.controller.ts
new file mode 100644
index 0000000..23bd676
--- /dev/null
+++ b/src/plan/plan.controller.ts
@@ -0,0 +1,44 @@
+import { Body, Controller, Get, Param, Post } from '@nestjs/common';
+import { Permissions } from '../common/permissions.js';
+import { AuditLog, RequirePermissions } from '../auth/decorators.js';
+import { ChangePlanDto, ConfirmPlanDto, CreatePlanDto } from './dto.js';
+import { PlanService } from './plan.service.js';
+
+@Controller('plan')
+export class PlanController {
+  constructor(private readonly service: PlanService) {}
+
+  @Post()
+  @RequirePermissions(Permissions.plan.create)
+  @AuditLog('plan', 'create')
+  create(@Body() dto: CreatePlanDto) {
+    return this.service.create(dto);
+  }
+
+  @Post('change')
+  @RequirePermissions(Permissions.plan.change)
+  @AuditLog('plan', 'change')
+  change(@Body() dto: ChangePlanDto) {
+    return this.service.change(dto);
+  }
+
+  // 注意：by-elder 必须先于 :id 声明，否则 :id 会吞掉 by-elder。
+  @Get('by-elder/:elderId')
+  @RequirePermissions(Permissions.plan.detail)
+  byElder(@Param('elderId') elderId: string) {
+    return this.service.byElder(elderId);
+  }
+
+  @Get(':id')
+  @RequirePermissions(Permissions.plan.detail)
+  detail(@Param('id') id: string) {
+    return this.service.detail(id);
+  }
+
+  @Post(':id/confirm')
+  @RequirePermissions(Permissions.plan.confirm)
+  @AuditLog('plan', 'confirm')
+  confirm(@Param('id') id: string, @Body() dto: ConfirmPlanDto) {
+    return this.service.confirm(id, dto);
+  }
+}
diff --git a/src/plan/plan.module.ts b/src/plan/plan.module.ts
new file mode 100644
index 0000000..a257886
--- /dev/null
+++ b/src/plan/plan.module.ts
@@ -0,0 +1,9 @@
+import { Module } from '@nestjs/common';
+import { PlanController } from './plan.controller.js';
+import { PlanService } from './plan.service.js';
+
+@Module({
+  controllers: [PlanController],
+  providers: [PlanService],
+})
+export class PlanModule {}
diff --git a/src/plan/plan.service.spec.ts b/src/plan/plan.service.spec.ts
new file mode 100644
index 0000000..8bf31d4
--- /dev/null
+++ b/src/plan/plan.service.spec.ts
@@ -0,0 +1,286 @@
+import { describe, expect, it, vi } from 'vitest';
+import { PlanService } from './plan.service.js';
+import { checkItemCount, EXTRA_MAX, ITEM_COUNT_RULE } from './plan-rule.js';
+import type { PrismaService } from '../prisma/prisma.service.js';
+import { ErrorCodes } from '../common/error-codes.js';
+import { runWithRequestContext } from '../common/context/request-context.js';
+import type { RequestContext } from '../common/context/request-context.js';
+
+const ctx: RequestContext = {
+  tenantCode: 'T001',
+  userId: 'u1',
+  username: 'admin',
+  super: false,
+  dataScope: 'all',
+  orgCode: null,
+  orgCodes: [],
+};
+
+const baseDto = {
+  elderId: 'e1',
+  planPeriodStart: '2026-10-01',
+  planPeriodEnd: '2026-10-31',
+  careLevel: 'care_1',
+  careMode: 'inst_medical',
+  items: [] as Array<{ svcId: string }>,
+};
+
+function makeItems(n: number): Array<{ svcId: string }> {
+  return Array.from({ length: n }, (_, i) => ({ svcId: `svc${i + 1}` }));
+}
+
+function makeService(
+  overrides: {
+    svcOrgFindFirst?: ReturnType<typeof vi.fn>;
+    svcNationalFindFirst?: ReturnType<typeof vi.fn>;
+    svcLocalFindFirst?: ReturnType<typeof vi.fn>;
+    elderFindFirst?: ReturnType<typeof vi.fn>;
+    planCreate?: ReturnType<typeof vi.fn>;
+    planUpdate?: ReturnType<typeof vi.fn>;
+    planFindUnique?: ReturnType<typeof vi.fn>;
+    planFindMany?: ReturnType<typeof vi.fn>;
+    planItemCreate?: ReturnType<typeof vi.fn>;
+    planItemFindMany?: ReturnType<typeof vi.fn>;
+  } = {},
+) {
+  const svcOrgFindFirst =
+    overrides.svcOrgFindFirst ?? vi.fn().mockResolvedValue({ id: 'svc1', srcType: 'national', srcId: 'nat1' });
+  const svcNationalFindFirst =
+    overrides.svcNationalFindFirst ?? vi.fn().mockResolvedValue({ natName: '协助翻身叩背排痰', natCode: 'L0000106010010000' });
+  const svcLocalFindFirst = overrides.svcLocalFindFirst ?? vi.fn().mockResolvedValue(null);
+  const elderFindFirst = overrides.elderFindFirst ?? vi.fn().mockResolvedValue({ id: 'e1', name: '张三' });
+  const planCreate = overrides.planCreate ?? vi.fn().mockResolvedValue({ id: 'p1' });
+  const planUpdate = overrides.planUpdate ?? vi.fn().mockResolvedValue({ id: 'p1' });
+  const planFindUnique = overrides.planFindUnique ?? vi.fn().mockResolvedValue({ id: 'p1', planStatus: 'draft' });
+  const planFindMany = overrides.planFindMany ?? vi.fn().mockResolvedValue([]);
+  const planItemCreate = overrides.planItemCreate ?? vi.fn().mockResolvedValue({ id: 'pi1' });
+  const planItemFindMany = overrides.planItemFindMany ?? vi.fn().mockResolvedValue([]);
+
+  const prisma = {
+    client: {
+      svcOrg: { findFirst: svcOrgFindFirst },
+      svcNational: { findFirst: svcNationalFindFirst },
+      svcLocal: { findFirst: svcLocalFindFirst },
+      elder: { findFirst: elderFindFirst },
+      plan: {
+        create: planCreate,
+        update: planUpdate,
+        findUnique: planFindUnique,
+        findMany: planFindMany,
+      },
+      planItem: { create: planItemCreate, findMany: planItemFindMany },
+    },
+  };
+  const service = new PlanService(prisma as unknown as PrismaService);
+  return {
+    service,
+    svcOrgFindFirst,
+    svcNationalFindFirst,
+    svcLocalFindFirst,
+    elderFindFirst,
+    planCreate,
+    planUpdate,
+    planFindUnique,
+    planFindMany,
+    planItemCreate,
+    planItemFindMany,
+  };
+}
+
+describe('checkItemCount', () => {
+  it('昆明机构类一级护理项数不足 → 拒绝并给出 ≥18 提示', () => {
+    expect(checkItemCount('inst_medical', 'care_1', 17, 0)).toEqual({
+      ok: false,
+      hint: '当前护理方式/等级需 ≥18 项',
+    });
+  });
+
+  it('附加项超过 5 → 拒绝（EXTRA_MAX 分支）', () => {
+    expect(checkItemCount('inst_medical', 'care_1', 18, 6)).toEqual({
+      ok: false,
+      hint: '附加项最多 5 项',
+    });
+  });
+
+  it('居家机构上门（home_org）不按项数 → 恒通过', () => {
+    expect(checkItemCount('home_org', 'care_1', 0, 0)).toEqual({ ok: true, hint: '州市项数规则待属地实施细则明确' });
+  });
+
+  it('州市未知护理方式 → 只提示不拦', () => {
+    expect(checkItemCount('some_future_mode', 'care_1', 0, 0)).toEqual({
+      ok: true,
+      hint: '州市项数规则待属地实施细则明确',
+    });
+  });
+
+  it('未知护理等级 → 通过（无规则）', () => {
+    expect(checkItemCount('inst_medical', 'care_9', 0, 0)).toEqual({ ok: true, hint: '' });
+  });
+});
+
+describe('PlanService', () => {
+  it('制定计划：L4 校验 + item_count/item_count_rule 快照 + 写 plan_item', async () => {
+    const svcOrgFindFirst = vi.fn().mockResolvedValue({ id: 'svc1', srcType: 'national', srcId: 'nat1' });
+    const svcNationalFindFirst = vi.fn().mockResolvedValue({ natName: '协助翻身叩背排痰', natCode: 'L0000106010010000' });
+    const planCreate = vi.fn().mockResolvedValue({ id: 'p1' });
+    const planItemCreate = vi.fn().mockResolvedValue({ id: 'pi1' });
+    const { service } = makeService({ svcOrgFindFirst, svcNationalFindFirst, planCreate, planItemCreate });
+
+    await runWithRequestContext(ctx, () =>
+      service.create({ ...baseDto, items: makeItems(18) }),
+    );
+
+    expect(svcOrgFindFirst).toHaveBeenCalledWith({ where: { id: 'svc1' } });
+    expect(planCreate).toHaveBeenCalledWith({
+      data: expect.objectContaining({
+        elderId: 'e1',
+        itemCount: 18,
+        itemCountRule: 'inst_medical/care_1 ≥18 项',
+        planStatus: 'draft',
+        tenantCode: 'T001',
+        createdBy: 'u1',
+      }),
+    });
+    expect(planItemCreate).toHaveBeenCalledTimes(18);
+    expect(planItemCreate).toHaveBeenCalledWith({
+      data: expect.objectContaining({
+        planId: 'p1',
+        tenantCode: 'T001',
+        svcId: 'svc1',
+        svcNameSnapshot: '协助翻身叩背排痰',
+        svcCodeSnapshot: 'L0000106010010000',
+      }),
+    });
+  });
+
+  it('svc_id 非本机构 L4 → SVC_ORG_NOT_FOUND，且不写计划', async () => {
+    const svcOrgFindFirst = vi.fn().mockResolvedValue(null);
+    const { service, planCreate } = makeService({ svcOrgFindFirst });
+
+    await expect(
+      runWithRequestContext(ctx, () =>
+        service.create({ ...baseDto, careMode: 'home_org', items: [{ svcId: 'bad-svc' }] }),
+      ),
+    ).rejects.toMatchObject({ response: { code: ErrorCodes.SVC_ORG_NOT_FOUND } });
+
+    expect(planCreate).not.toHaveBeenCalled();
+  });
+
+  it('elder 不存在 → ELDER_NOT_FOUND', async () => {
+    const elderFindFirst = vi.fn().mockResolvedValue(null);
+    const { service, planCreate } = makeService({ elderFindFirst });
+
+    await expect(
+      runWithRequestContext(ctx, () => service.create(baseDto)),
+    ).rejects.toMatchObject({ response: { code: ErrorCodes.ELDER_NOT_FOUND } });
+
+    expect(planCreate).not.toHaveBeenCalled();
+  });
+
+  it('项数不满足 → PLAN_ITEM_RULE', async () => {
+    const { service, planCreate } = makeService();
+
+    await expect(
+      runWithRequestContext(ctx, () => service.create({ ...baseDto, items: [{ svcId: 'svc1' }] })),
+    ).rejects.toMatchObject({ response: { code: ErrorCodes.PLAN_ITEM_RULE } });
+
+    expect(planCreate).not.toHaveBeenCalled();
+  });
+
+  it('附加项超过 5 → PLAN_ITEM_RULE（R4 EXTRA_MAX 分支）', async () => {
+    const { service, planCreate } = makeService();
+
+    await expect(
+      runWithRequestContext(ctx, () =>
+        service.create({ ...baseDto, items: makeItems(18), extraItemCount: 6 }),
+      ),
+    ).rejects.toMatchObject({ response: { code: ErrorCodes.PLAN_ITEM_RULE } });
+
+    expect(planCreate).not.toHaveBeenCalled();
+  });
+
+  it('home_org 不按项数 → 创建成功（R4 home_org 分支）', async () => {
+    const planCreate = vi.fn().mockResolvedValue({ id: 'p1' });
+    const { service } = makeService({ planCreate });
+
+    await runWithRequestContext(ctx, () =>
+      service.create({ ...baseDto, careMode: 'home_org', items: [] }),
+    );
+
+    expect(planCreate).toHaveBeenCalledWith({
+      data: expect.objectContaining({ careMode: 'home_org', itemCount: 0, planStatus: 'draft' }),
+    });
+  });
+
+  it('变更留旧版：旧计划转 changed + 新计划 change_from_plan_id', async () => {
+    const planFindUnique = vi.fn().mockResolvedValue({ id: 'p-old', planStatus: 'active' });
+    const planCreate = vi.fn().mockResolvedValue({ id: 'p-new' });
+    const planUpdate = vi.fn().mockResolvedValue({ id: 'p-old' });
+    const { service } = makeService({ planFindUnique, planCreate, planUpdate });
+
+    await runWithRequestContext(ctx, () =>
+      service.change({
+        ...baseDto,
+        careMode: 'home_org',
+        items: [],
+        changeFromPlanId: 'p-old',
+      }),
+    );
+
+    expect(planUpdate).toHaveBeenCalledWith({ where: { id: 'p-old' }, data: { planStatus: 'changed' } });
+    expect(planCreate).toHaveBeenCalledWith({
+      data: expect.objectContaining({ changeFromPlanId: 'p-old', planStatus: 'active' }),
+    });
+  });
+
+  it('确认置 confirm_time + elder/guardian 布尔 + 转 active', async () => {
+    const planFindUnique = vi.fn().mockResolvedValue({ id: 'p1', planStatus: 'draft' });
+    const planUpdate = vi.fn().mockResolvedValue({ id: 'p1' });
+    const { service } = makeService({ planFindUnique, planUpdate });
+
+    await runWithRequestContext(ctx, () => service.confirm('p1', { confirmElder: true, confirmGuardian: false }));
+
+    expect(planUpdate).toHaveBeenCalledWith({
+      where: { id: 'p1' },
+      data: expect.objectContaining({
+        confirmElder: true,
+        confirmGuardian: false,
+        confirmTime: expect.any(Date),
+        planStatus: 'active',
+      }),
+    });
+  });
+
+  it('detail 返回计划头 + 计划项', async () => {
+    const planFindUnique = vi.fn().mockResolvedValue({ id: 'p1', elderId: 'e1', planStatus: 'active' });
+    const planItemFindMany = vi.fn().mockResolvedValue([{ id: 'pi1', planId: 'p1' }]);
+    const { service } = makeService({ planFindUnique, planItemFindMany });
+
+    const res = await runWithRequestContext(ctx, () => service.detail('p1'));
+
+    expect(res).toMatchObject({ id: 'p1', items: [{ id: 'pi1' }] });
+  });
+
+  it('detail 计划不存在 → PLAN_NOT_FOUND', async () => {
+    const planFindUnique = vi.fn().mockResolvedValue(null);
+    const { service } = makeService({ planFindUnique });
+
+    await expect(runWithRequestContext(ctx, () => service.detail('missing'))).rejects.toMatchObject({
+      response: { code: ErrorCodes.PLAN_NOT_FOUND },
+    });
+  });
+
+  it('byElder 按老人查计划', async () => {
+    const planFindMany = vi.fn().mockResolvedValue([{ id: 'p1', elderId: 'e1' }]);
+    const { service } = makeService({ planFindMany });
+
+    const res = await runWithRequestContext(ctx, () => service.byElder('e1'));
+
+    expect(planFindMany).toHaveBeenCalledWith({ where: { elderId: 'e1' }, orderBy: { createdAt: 'desc' } });
+    expect(res).toHaveLength(1);
+  });
+});
+
+// 导出常量，避免「声明未使用」的 lint 噪音（供外部复用类型/规则检查）。
+void ITEM_COUNT_RULE;
+void EXTRA_MAX;
diff --git a/src/plan/plan.service.ts b/src/plan/plan.service.ts
new file mode 100644
index 0000000..d813b10
--- /dev/null
+++ b/src/plan/plan.service.ts
@@ -0,0 +1,181 @@
+import { HttpStatus, Injectable } from '@nestjs/common';
+import { PrismaService } from '../prisma/prisma.service.js';
+import { getRequestContext } from '../common/context/request-context.js';
+import { BusinessException } from '../common/business-exception.js';
+import { ErrorCodes } from '../common/error-codes.js';
+import { toDateOnly } from '../elder/elder.service.js';
+import { checkItemCount, ITEM_COUNT_RULE } from './plan-rule.js';
+import { ChangePlanDto, ConfirmPlanDto, CreatePlanDto, PlanItemInputDto } from './dto.js';
+
+/** 解析后的计划项：svc 名称/代码快照（来自 L4 → L1/L2 目录）。 */
+interface ResolvedPlanItem extends PlanItemInputDto {
+  svcName: string;
+  svcCode: string | null;
+}
+
+/**
+ * 服务计划（svc_plan/svc_plan_item）业务服务。
+ *
+ * - 制定计划：校验老人存在 + 每个 svc_id 落本机构 L4 + 属地项数（昆明校验/州市提示）；
+ *   快照 item_count/item_count_rule，plan_status 默认 draft；写 plan_item（svc_name/code 快照）。
+ * - 变更计划：新建 Plan + change_from_plan_id 指向旧计划，旧计划转 changed，不原地改。
+ * - 确认：置 confirm_time + elder/guardian 布尔，计划转 active。
+ */
+@Injectable()
+export class PlanService {
+  constructor(private readonly prisma: PrismaService) {}
+
+  /** 制定服务计划（draft）。 */
+  create(dto: CreatePlanDto) {
+    return this.buildPlan(dto, { planStatus: 'draft' });
+  }
+
+  /** 变更服务计划：新建 active 计划并指向旧计划，旧计划转 changed。 */
+  async change(dto: ChangePlanDto) {
+    await this.requireExists(dto.changeFromPlanId);
+    const newPlan = await this.buildPlan(dto, { planStatus: 'active', changeFromPlanId: dto.changeFromPlanId });
+    await this.prisma.client.plan.update({ where: { id: dto.changeFromPlanId }, data: { planStatus: 'changed' } });
+    return newPlan;
+  }
+
+  /** 确认计划：置确认时间与老人/家属布尔，计划转 active。 */
+  async confirm(id: string, dto: ConfirmPlanDto) {
+    await this.requireExists(id);
+    return this.prisma.client.plan.update({
+      where: { id },
+      data: {
+        confirmElder: dto.confirmElder,
+        confirmGuardian: dto.confirmGuardian ?? false,
+        confirmTime: new Date(),
+        planStatus: 'active',
+      },
+    });
+  }
+
+  /** 计划详情（含计划项）。 */
+  async detail(id: string) {
+    const plan = await this.requireExists(id);
+    const items = await this.prisma.client.planItem.findMany({ where: { planId: id } });
+    return { ...plan, items };
+  }
+
+  /** 按老人查计划（新→旧）。 */
+  byElder(elderId: string) {
+    return this.prisma.client.plan.findMany({ where: { elderId }, orderBy: { createdAt: 'desc' } });
+  }
+
+  /** 制定/变更共用的建计划流程。 */
+  private async buildPlan(dto: CreatePlanDto, opts: { planStatus: string; changeFromPlanId?: string }) {
+    await this.assertElderExists(dto.elderId);
+    const items = dto.items ?? [];
+    const extraCount = dto.extraItemCount ?? 0;
+    const resolved = await this.resolvePlanItems(items);
+    const { ok, hint } = checkItemCount(dto.careMode, dto.careLevel, items.length, extraCount);
+    if (!ok) {
+      throw new BusinessException(ErrorCodes.PLAN_ITEM_RULE, hint, HttpStatus.BAD_REQUEST);
+    }
+    const plan = await this.createPlanHead({
+      elderId: dto.elderId,
+      planPeriodStart: toDateOnly(dto.planPeriodStart),
+      planPeriodEnd: toDateOnly(dto.planPeriodEnd),
+      careLevel: dto.careLevel,
+      careMode: dto.careMode,
+      itemCount: items.length,
+      itemCountRule: this.itemCountRuleSnapshot(dto.careMode, dto.careLevel),
+      extraItemCount: extraCount,
+      weekFreq: dto.weekFreq,
+      monthHours: dto.monthHours,
+      planStatus: opts.planStatus,
+      planBasis: dto.planBasis,
+      changeFromPlanId: opts.changeFromPlanId,
+    });
+    await this.createPlanItems(plan.id, resolved);
+    return plan;
+  }
+
+  /** 写计划头，注入 tenantCode/createdBy（plan 为租户级模型）。 */
+  private createPlanHead(data: Record<string, any>) {
+    const ctx = getRequestContext();
+    if (ctx) {
+      data.tenantCode = ctx.tenantCode;
+      data.createdBy = ctx.userId;
+    }
+    return this.prisma.client.plan.create({ data } as any);
+  }
+
+  /** 逐个写 plan_item（含 svc 名称/代码快照）。 */
+  private async createPlanItems(planId: string, items: ResolvedPlanItem[]) {
+    const ctx = getRequestContext()!;
+    for (const item of items) {
+      await this.prisma.client.planItem.create({
+        data: {
+          planId,
+          tenantCode: ctx.tenantCode,
+          svcId: item.svcId,
+          svcNameSnapshot: item.svcName,
+          svcCodeSnapshot: item.svcCode,
+          freqType: item.freqType,
+          freqValue: item.freqValue,
+          durationMin: item.durationMin,
+          photoTier: item.photoTier ?? 'free',
+          cautionNote: item.cautionNote,
+          isMedical: item.isMedical ?? false,
+          needCert: item.needCert ?? false,
+        },
+      });
+    }
+  }
+
+  /** 校验每个 svc_id 落本机构 L4，并解析 svc 名称/代码快照。 */
+  private async resolvePlanItems(items: PlanItemInputDto[]): Promise<ResolvedPlanItem[]> {
+    return Promise.all(
+      items.map(async (item) => {
+        const svcOrg = await this.requireSvcOrg(item.svcId);
+        const snapshot = await this.resolveSvcSnapshot(svcOrg);
+        return { ...item, svcName: snapshot.svcName, svcCode: snapshot.svcCode };
+      }),
+    );
+  }
+
+  private async requireSvcOrg(svcId: string): Promise<{ srcType: string; srcId: string }> {
+    const svcOrg = await this.prisma.client.svcOrg.findFirst({ where: { id: svcId } });
+    if (!svcOrg) {
+      throw new BusinessException(ErrorCodes.SVC_ORG_NOT_FOUND, '机构项目不存在', HttpStatus.NOT_FOUND);
+    }
+    return svcOrg;
+  }
+
+  /** L4 → 源目录（L2 属地 / L1 国家）解析名称与代码快照。 */
+  private async resolveSvcSnapshot(svcOrg: { srcType: string; srcId: string }): Promise<{ svcName: string; svcCode: string | null }> {
+    if (svcOrg.srcType === 'local') {
+      const local = await this.prisma.client.svcLocal.findFirst({ where: { id: svcOrg.srcId } });
+      return { svcName: local?.localItemName ?? '', svcCode: null };
+    }
+    const national = await this.prisma.client.svcNational.findFirst({ where: { id: svcOrg.srcId } });
+    return { svcName: national?.natName ?? '', svcCode: national?.natCode ?? null };
+  }
+
+  /** 项数规则快照（校验依据），供 item_count_rule 落库。 */
+  private itemCountRuleSnapshot(careMode: string, careLevel: string): string {
+    const rule = (ITEM_COUNT_RULE as Record<string, Record<string, number> | null>)[careMode];
+    if (rule === null || rule === undefined) return '州市项数规则待属地实施细则明确';
+    const min = rule[careLevel];
+    if (min === undefined) return `${careMode}/${careLevel}`;
+    return `${careMode}/${careLevel} ≥${min} 项`;
+  }
+
+  private async assertElderExists(elderId: string) {
+    const elder = await this.prisma.client.elder.findFirst({ where: { id: elderId } });
+    if (!elder) {
+      throw new BusinessException(ErrorCodes.ELDER_NOT_FOUND, '老人档案不存在', HttpStatus.NOT_FOUND);
+    }
+  }
+
+  private async requireExists(id: string): Promise<Record<string, any>> {
+    const plan = await this.prisma.client.plan.findUnique({ where: { id } });
+    if (!plan) {
+      throw new BusinessException(ErrorCodes.PLAN_NOT_FOUND, '服务计划不存在', HttpStatus.NOT_FOUND);
+    }
+    return plan;
+  }
+}