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(영문) 대구지방법원 2016.10.25 2015구합21775
장기요양급여비용 환수결정통보처분 취소청구
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 operates “C” (hereinafter “instant medical care institution”), which is a sanatorium for older persons, in the Gyeongcheon-gun, Gyeongcheon-gun, North Korea. The instant medical care institution was designated as a long-term care institution on May 30, 2008 pursuant to Article 31 of the Long-Term Care Insurance Act and Article 23(3) of the Enforcement Rule of the same Act.

A claim for the violation of standards for placement of human resources (289,746,940 won) - Five persons, such as caregiver D, E, F, G, and H, including a manager D, cook support, I, and J, were claimed in violation of standards for placement of human resources by omitting the standards for placement of human resources in the monthly average current number of staff members (372,670 won) - In the case of three persons, such as caregiver D, E, and H, three caregivers, in support of the duties of cooks and office, the number of nurses was calculated and claimed (2,50,000 won) - In the case of five persons, such as a recipient K, five persons, including the day on which the date of the change of class was included, despite the occurrence of a cause of reduction in the standards for placement of human resources during the six months prior to the date of the change of class, they claimed a subsidy for the improvement of class, even though there was a violation of standards for placement of human resources.

B. From February 2, 2015 to February 5, 2015, the Defendant and the Y conducted a field investigation on the details of long-term care benefits of the instant medical care institution from February 2, 2011 to November 2014, and confirmed that the Plaintiff did not adjust the cost of long-term care benefits, even if the Plaintiff violated the criteria for placement of human resources for long-term care institutions during the said period, it did not adjust the cost of benefits and claimed the cost of long-term care benefits at KRW 292,619,610.

C. On March 12, 2015, the Defendant notified the Plaintiff of a decision to recover expenses for long-term care benefits with the purport of recovering KRW 296,510,710 (including recovery outside the scope of the on-site investigation) in aggregate of the difference between the expenses for long-term care benefits and the amount of lawfully calculated prices.

(hereinafter “instant disposition”). 【The ground for recognition” has no dispute, and evidence Nos. 1 and 2 has been numbered.

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