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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 operating a C medical care center for senior citizens under the Welfare of Older Persons Act (hereinafter “instant medical care center”) and a “D hospital,” which is a health care institution under the National Health Insurance Act (hereinafter “instant hospital”), in the Si/Gu of Seongdong-gu, Sungnam-si.
On October 8, 2010, the instant medical care center was designated as a long-term care institution pursuant to Article 31 of the former Long-Term Care Insurance Act (amended by Act No. 12067, Aug. 13, 2013; hereinafter the same) from the Defendant.
B. As a result of the instant on-site investigation (the target period: from January 1, 2011 to December 2013; hereinafter “instant on-site investigation”) conducted on the instant medical care center from March 10, 201 to April 14, 201, the Defendant and the National Health Insurance Corporation confirmed that the Plaintiff unfairly claimed KRW 52,682,82,90 (the percentage of expenses for long-term care benefits) by claiming for additional placement of human resources due to the lack of any reason for additional placement of human resources or any other reason for reduction, as follows: (a) in violation of the standards for placement of human resources for physical care workers from April 201 to December 2013; and (b) in violation of the standards for placement of human resources for caregiver, the Defendant and the National Health Insurance Corporation claimed expenses without reduction; and (c) from January 10, 2011 to April 14, 2011 to claim for additional placement of human resources;
[1] The physical therapy E had worked at the instant hospital from January 201 to December 2013 and had been registered as working at the instant hospital for at least 160 hours a month, even if the pertinent hospital did not work at the hospital.
(hereinafter “Grounds for Disposition 1”). (2) Nursing (n) Company F from January 201 to June 2011; G from March 2012 to January 2013; H from October 2012 to January 2013; and I from August 2011 to September 9, 2011; and J from October 201 to May 2012.