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(영문) 서울행정법원 2016.06.16 2015구합67427
장기요양급여비용환수결정 취소
Text

1. The plaintiff's claim is dismissed.

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

Reasons

The details and details of the disposition are representatives operating a long-term care institution for the elderly, "B" in Seoul Special Metropolitan City, Nowon-gu, and the fifth floor according to the Welfare of Older Persons and Long-Term Care Insurance for Older Persons Act on January 2014.

The “B Elderly Welfare Center for the Aged” consists of the “family care and communal living home for the aged” (hereinafter referred to as “B Center 1”), “the home care system for the aged” (hereinafter referred to as “B Center 2), “the home care and communal living home for the aged” (hereinafter referred to as “the home care and communal living home care center for the aged”) providing facility benefits, and “the home care and home care” (hereinafter referred to as “B Center 3”).

From February 2, 2015 to February 5, 2015, the Defendant conducted a field investigation on “the details of long-term care benefits from January 2, 2014 to December 2, 2014,” and determined as follows.

A assistant nurse F in violation of the criteria for adding additional placement of human resources to the B Center 1 in violation of the item was concurrently held in B Center 1 and 2.

The number of concurrent offices shall not be included in the number of employees to be subject to additional application.

Nevertheless, the Plaintiff entered F as a contractual worker from B Center 1, and claimed additional placement of assistant nurses, and received additional allowance costs of KRW 10,458,540.

B Center 2 violation of the criteria for placement of human resources (the head of a facility) reported G to B Center 2 from May 2014 to August 2014, 2014, but G did not have worked as the head of the facility in actual B Center 2.

From May 2014 to August 2014, 2014, the Center 2 failed to meet the requirements for the placement of human resources, so the addition of expenses for long-term care benefits on the ground of additional placement of human resources should not be applied in violation of the criteria for the placement of human resources.

Nevertheless, on May 2014 to August 2014, the Plaintiff claimed expenses for long-term care benefits by applying a premium for additional placement of human resources, and was paid KRW 12,976,090.

A caregiver in violation of the criteria for additional placement of human resources was reported as a caregiver of B Center 2, but at B Center 2.

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