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(영문) 서울행정법원 2015.08.13 2014구합21967

장기요양급여비용환수결정취소

Text

1. The plaintiff's claim is dismissed.

2. The costs of lawsuit shall be borne by the Plaintiff.

Reasons

Details of the disposition

The Plaintiff is a person who operates the “C Care Center” (hereinafter referred to as the “C Care Center”), a long-term care institution under the Act on Long-term Care Insurance for the Aged-gu, Daejeon (hereinafter referred to as the “Act”).

A request for an excess of the prescribed number of caregivers: 193,529,930 won 1); D, in violation of the standards for placement of human resources for caregivers, violates the standards for placement of human resources: (a) from January 1, 2013 to January 31, 2013; (b) from May 1, 2013 to July 31, 2014; and (c) from November 5, 2012 to March 31, 2013; and (b) the Defendant did not request for additional adjustment of the prescribed number of caregiver benefits in accordance with the standards for the calculation of the prescribed number of caregiver benefits; and (d) the Defendant did not request for additional adjustment of the prescribed number of caregiver benefits in violation of the standards for the calculation of the prescribed number of caregiver benefits in spite of the fact that he/she performed the duties solely for the care benefits from April 17, 2013 to July 31, 2014.

8. By November 14, 201, the Plaintiff discovered that the instant medical care benefit costs were unfairly claimed against the instant medical care center, as follows: (a) the instant on-site investigation conducted on the instant medical care center (from November 2012 to June 2014; hereinafter “instant on-site investigation”).

On September 24, 2014, pursuant to Article 43(1)3 of the Act, the Defendant issued a disposition to recover expenses for long-term care benefits of KRW 216,483,600 in total to the instant medical care center.

(hereinafter referred to as “instant restitution disposition”). [Grounds for recognition] A] without dispute, entry of Gap evidence 1 and Eul evidence 1 (including numbers; hereinafter the same shall apply) and the overall purport of the pleading, and whether the disposition in this case is legitimate or not, the duties of the plaintiff’s caregiver as well as the support to the physical activities of the recipients.