장기요양급여비용환수처분취소
1. The Defendant’s disposition to recover expenses for long-term care benefits rendered to the Plaintiff on October 18, 2013 is revoked.
2. The costs of lawsuit shall be.
1. Details of the disposition;
A. The Plaintiff and B operate a long-term care institution that provides visit care and visiting bathing in the trade name of the Seodaemun-gu Seoul Metropolitan Government “Cmedical care center” (hereinafter “instant medical care institution”).
B. The Defendant and the head of Seodaemun-gu Seoul Metropolitan Government (hereinafter referred to as the “Seoul Metropolitan Government”) omitted and indicated it as the “head of Seodaemun-gu,” and the head of Seodaemun-gu, other than the head of the Gu indicated it in the above manner) conducted on-site investigations with regard to the instant medical care institution from February 10, 2011 to April 13, 2013 on the period of investigation from June 10 to June 13, 2013.
C. On October 18, 2013, the Defendant notified the Plaintiff of the reimbursement decision of KRW 57,435,260 of the cost of long-term care benefits on the following grounds, etc.
(hereinafter “instant disposition”). Chapter I of the former Notice on Long-Term Care Benefit Expenses, etc. (amended by the Ministry of Health and Welfare No. 2013-160, Oct. 16, 2013; hereinafter “instant Notice”) for violation of the principle of home visit benefit (related to beneficiary D and E) (hereinafter “instant notice”).
I. Although Paragraph 3 of the aforementioned Article provides that the expenses for long-term care benefits provided to beneficiaries admitted to social welfare facilities under other Acts and subordinate statutes shall not be calculated, D and E provided visit care services to “F” (designated on December 1, 2005, hereinafter “instant facilities”) as welfare facilities for persons with disabilities, as well as to provide visiting care services while entering such facilities. Many outside G, etc., who provided visiting care services, provided visiting care services to the instant facilities in the form of performing duties such as preparation, provision, cleaning, etc. for all visitors (nine persons) visiting the instant facilities.
If a beneficiary provides a visiting care service by increasing the number of service days and the number of times, the visiting care service is provided to H even though the content of the actual service is prepared according to the notice of this case and the relevant claim is based on this.