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(영문) 서울행정법원 2016.09.29 2016구합56608
장기요양급여비용 환수결정통보처분 취소청구
Text

1. The plaintiff's claim is dismissed.

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

Reasons

1. Details of the disposition;

A. On March 22, 2005, the Plaintiff is a juristic person established for the purpose of carrying out the business of establishing and operating social welfare facilities under the Social Welfare Services Act, and is operating a long-term care institution for older persons (hereinafter “instant medical care center”) under the name of “B medical care center” from October 2013 to Gangwon-gu.

B. On February 29, 2016, the Defendant notified the Plaintiff that “The expenses for long-term care benefits paid excessively to the instant medical care center shall be recovered from the Plaintiff pursuant to Article 43 of the Act on Long-Term Care Insurance for the Aged.”

(hereinafter “instant disposition”). The grounds for the instant disposition are as follows.

1) From October 2013 to April 2015, the Plaintiff is deemed to have worked as one caregiver each month at the instant medical care center from October 2015 (160 hours each month before December 31, 2014; and 8 hours each month multiplied by the number of working days after January 1, 2015, excluding the relevant month’s legal holiday, etc.; hereinafter “legal working hours”).

(1) As seen earlier, C filed a report on the operation of a caregiver’s duties. However, during the pertinent period, C actually performed duties, such as inspection of fire-fighting and safety facilities, repair of facilities, and waste management, and the hours of performing the duties of caregiver’s care workers do not exceed a maximum of two hours per day. As such, C cannot be recognized as a caregiver who worked at the instant medical care center during the pertinent period (hereinafter “reasons for Disposition 1”).

(2) The Plaintiff reported that D was a caregiver from November 2014 to March 2015, E was in April 2015, F was in May and June 2015, and G was in June and July 2015, respectively.

However, each of the above persons (hereinafter collectively referred to as “D, etc.”) actually performed cooking duties in the instant medical care center during each of the above periods.

If so, D, etc. are involved in each of the above periods.

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