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1. On March 31, 2015, the Defendant’s disposition to recover expenses for long-term care benefits against the Plaintiff KRW 226,848,315 is revoked.
2.
Reasons
1. Details of the disposition;
A. The Plaintiff is operating a “Cstore” designated as a long-term care institution under the Act on Long-Term Care Insurance for the Long-Term and Long-Term, Seoul Special Metropolitan City (hereinafter “instant sanatorium”).
B. On February 2, 2015 through December 5, 2015, the Defendant: (a) conducted a field investigation on the instant sanatorium (the period subject to investigation: the period from October 2, 2012 to December 2014; hereinafter “instant field investigation”); (b) performed physical therapy D from May 2, 2012 to December 160 hours from December 2014; and (c) performed duties for less than 160 hours from June 2013 to December 2014 by receiving medical care benefits for less than 160 hours each month; and (d) determined that the institution subject to the reduction in expenses for benefits for six months from the date on which the rating change falls, was paid a grade improvement subsidy for E even if it failed to receive the rating improvement subsidy.
C. On March 31, 2015, the Defendant issued a scheduled notice to recover the long-term benefit expense with the purport that the amount of KRW 270,415,910, out of the expenses for long-term care benefits paid to the instant sanatorium pursuant to Article 43 of the Long-Term Care Insurance Act, shall be recovered unfairly.
As a result, the Plaintiff submitted its opinion to the Defendant, the Defendant refunded KRW 39,49,55 on May 7, 2015, and additionally recovered KRW 5,847,590 on May 27, 2015.
The Plaintiff filed an objection, but the Defendant rendered a decision to dismiss the objection on June 25, 2015.
E. After filing the instant lawsuit, the Defendant additionally recovered KRW 9,915,630 from the Plaintiff on October 26, 2015.
[26,848,315 won (226,348,315 won among them) remaining after the refund and additional redemption as above from the date of March 31, 2015, among the notice of expected restitution of March 31, 2015, is due to a violation of criteria for placement of human resources, and the remainder is.