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(영문) 부산지방법원 2018.02.08 2017구합2722
장기요양급여비용환수처분취소
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. From November 23, 2015, the Plaintiff is operating a medical welfare facility for the aged (hereinafter “instant medical care center”) as stipulated by the Long-Term Care Insurance Act for the Aged in Ulsan-gun, Ulsan-gun, Ulsan-do.

B. From March 6, 2017 to March 9, 2017, the Defendant conducted a field investigation on the details of long-term care benefits of the instant medical care center (the period subject to the investigation: the period from January 6, 2016 to January 2017; hereinafter “instant field investigation”) jointly with the head of Ulsan-si, determined that the Plaintiff unduly claimed and received the expenses for long-term care benefits in total amount of KRW 16,124,60, in violation of the criteria for placement of human resources and the criteria for additional placement of human resources, and on March 17, 2017, the Defendant sent a scheduled notice of recovery of KRW 16,124,600 to the Plaintiff.

A caregiver D had not worked for a certain period of time on October 2016, 2016, and December 2016, E had not worked for a caregiver; E had not worked for a some period of time on July 2016; from September 2016, to December 2016, the caregiver F had not worked for a some period of time; however, while G had not worked for a caregiver even if he/she violated the standards for placement of caregiver personnel by reporting the work hours differently from the fact, he/she had not worked for a caregiver during the period of time from January 2016 to March 2016; H had not worked for a caregiver during which he/she had not worked for a certain period of time from October 2016 to 2016; while H had not worked for a caregiver during the period of time from October 16, 2016 to 200; and had not worked for a specific period of time from October 2016 to 16, 2016.

C. Upon submitting the Plaintiff’s written opinion, on June 21, 2017, the Defendant: (a) on September 201, 2016, the number of visitors to the instant medical care center was six and two caregivers; (b) on October 2016, the number of admitted inmates increased to nine and the number of admitted inmates became insufficient; and (c) on the other hand, long-term care benefits are provided.

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