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(영문) 의정부지방법원 2015.07.14 2014구합1494
장기요양급여비용 환수처분 취소
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 January 25, 2012 to February 5, 2014, the Plaintiff operated a medical care and communal living home facility for the elderly (hereinafter “instant medical care center”) under the name of “C” in the name of “C” during the period from January 25, 2012 to February 5, 2014.

B. From April 21, 2014 to February 24, 2014, the Defendant conducted an on-site investigation on the entire long-term care insurance for the instant medical care center during the pertinent period from February 2, 2012 to February 2, 2014.

C. As a result of an on-site investigation, the Defendant confirmed the violation of Article 43 of the Act on Long-Term Care Insurance for the Plaintiff.

1) Before February 2012 and March 3, 2012, May 1 through 11 of the same year, and March 2013 through May 5 of the same year, the term “the first dispute period” (hereinafter referred to as “instant first dispute period”).

(2) As the instant medical care center did not have worked for the instant medical care center, the instant medical care center violated the criteria for placement of three caregivers, and accordingly, the Plaintiff was paid KRW 100 of the cost of long-term care benefits even though the Plaintiff claimed the cost of long-term care benefits to reduce the cost of long-term care benefits. 2) The instant medical care center did not work for the instant medical care center on April 2012 and January 2013 (hereinafter “the second medical care period”), and the instant medical care center was three caregivers during the said period. Thus, even if the instant medical care center did not additionally place a caregiver, the Plaintiff was paid a surcharge of KRW 5% on the ground that the instant medical care center added the cost of long-term care benefits.

3 Assistants E from April 17, 2013 to the same year

5. Until March 31, 200, the instant medical care center violated the criteria for placement of human resources of one assistant nurse during the pertinent period, and thus, the Plaintiff claimed expenses for long-term care benefits by reducing the cost of long-term care benefits but claiming 100% of the expenses.

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