beta
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 business regarding the establishment and operation of social welfare facilities under the Social Welfare Services Act, and is operating a long-term care institution, which is a sanatorium for older persons (hereinafter “instant medical care center”), from October 2013 to the name of “a happy medical care center” in the Gangwon-gu, Gangwon-gu.
B. On November 9, 2015, the Defendant conducted a field investigation with the National Health Insurance Corporation on the Plaintiff from November 9 to December 12, 2015, and on January 19, 2016, issued a disposition for 66 days of business suspension to the Plaintiff on the ground that “the instant medical care personnel claims for home care and facility care costs by fraud or other improper means, thereby falling under Article 37(1)4 of the Act on Long-Term Care Insurance for the Aged (hereinafter “instant disposition”), and the specific grounds for the instant disposition are as follows.
(1) From October 2013 to April 2015, the Plaintiff reported that A performed the duties of caregivers for more than 160 hours a month during which one caregiver is deemed to have worked at the instant medical care center (i.e., 160 hours before December 31, 2014, and 8 hours after January 1, 2015, excluding the relevant month’s holidays, etc.; hereinafter “legal working hours”).
However, A actually performs duties such as inspection of fire safety facilities, facility repairs, and waste management at the instant medical care center during the above period, and the hours of the caregiver's duties are not more than two hours a day.
Thus, A cannot be recognized as a caregiver who worked at the medical center of this case during the above period.
(2) The Plaintiff reported that B worked as a caregiver at the instant medical care center on November 2014 to March 2015; CA on April 2015; D on May 6, 2015; and E on June 7, 2015, respectively.
However, in fact, each of the above persons is at the Medical Care Center of this case during the above period.