장기요양급여비용환수결정처분취소
1. The plaintiff's claim is dismissed.
2. The costs of lawsuit shall be borne by the Plaintiff.
1. Details of the disposition;
A. The Plaintiff established and operated the following medical care institutions (hereinafter “each of the instant medical care institutions”) which are long-term care institutions designated or deemed to be designated pursuant to the Enforcement Rule of the Long-Term Care Act for Long-Term Care Insurance (hereinafter “Long-Term Care Act”), respectively.
Each of the instant medical care institutions is part of the “Gwanjinjin Welfare Center for the Aged,” designated as a Seoul Complex Health Care Center for the simultaneous provision of facility benefits and home care benefits, which is a location for providing kinds of agencies under the name of each agency of the building of the said center, and has the fourth floor of home care benefits, such as the Magjinjin Senior Welfare Center for the long-term care of the third floor, the short-term protection of long-term care institutions for the elderly, and the weekly night protection.
B. The number of each of the instant medical care institutions is nine communal homes, 17 night protection services, and 3 short-term protection services.
C. As a result of conducting a field investigation on each of the instant medical care institutions during the period from February 19, 2012 to September, 2012, the Defendant discovered the fact that the Plaintiff received the cost of long-term care benefits for the period from October 2012 to November 2012 as follows.
(1) communal home - Short-term protection recipients of a welfare center (7 persons including A, etc. in October 2012, five persons including B, etc. in November 201; hereinafter “instant recipients”) are lodging in communal home at night and living in communal home, and the number of communal home households was nine, but the total of 11 persons living in that period exceeded two persons.
- A communal home is a facility that requires one caregiver per three admitted persons, and the number of caregivers actually registered and actually worked, even if the number of caregivers required for the period increases due to the increase in the capacity.