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(영문) 수원지방법원 2015.11.24 2015구합234
장기요양급여비용환수처분 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. The Plaintiff is a person who operates the C Care Center (hereinafter “C Care Center”) as a long-term care institution under Article 2 subparag. 4 of the Act on Long-Term Care Insurance for the Aged-gu, Gyeyang-gu and the 7th century.

B. As a result of an on-site investigation (total 25 months from August 14, 2014 to August 17, 2014) of the details of long-term care benefits of the instant medical care center jointly with Goyang-si, the Defendant determined that the Plaintiff unduly claimed expenses for long-term care benefits of KRW 57,578,910 in total as follows:

The details of violation of the standards for placement of human resources D shall be registered as a caregiver in violation of the details of violation of the standards for the placement of human resources from July 26, 2012 to May 28, 2013; while the caregiver E shall be rated as a caregiver in violation of the standards for additional placement of human resources from June 19, 2012 to June 30, 2013, despite the absence of the fact that he/she actually worked as a caregiver and provided benefits as a caregiver, the Plaintiff was registered as a caregiver without the reduction of expenses, even though he/she mainly performed his/her duties, such as facility management, etc. of the medical care center in this case, without the reduction of expenses (the nurseF, G, and H). However, even if there were grounds for reduction in the expenses for additional placement of human resources, he/she may not apply the additional placement of human resources, it shall not be subject to the reduction of expenses due to the occurrence of the violation of the standards for additional placement of human resources before June 2013.

C. On February 25, 2015, the Defendant issued a disposition to recover expenses for long-term care benefits of KRW 57,578,910 (hereinafter “instant disposition”) to the Plaintiff based on Article 43(1)3 of the Act on Long-Term Care Insurance for the Aged.

[Ground of recognition] Facts without dispute, Gap evidence 1, 3, and 13, and the purport of the whole pleadings

2. Whether the instant disposition is lawful

A. From June 19, 2012, E is a summary of the cause of the Plaintiff’s claim.

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