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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 established “B” and “C” at the window of Changwon-si, Changwon-si, and was designated as a sanatorium for older persons under the Long-Term Care Insurance Act for Older Persons B from the Changwon-si market, and C as a short-term care institution for older persons.
B. On November 21, 201, from November 25, 201 to November 25, 2011, the National Health Insurance Corporation inspected the details of benefits (the period subject to the investigation: the period from September 1, 2010 to September 30, 201) and notified the Plaintiff of the unfair claim for expenses for long-term care benefits in violation of the criteria for placement of human resources, and the details of calculation of the unfair claim for expenses for long-term care benefits and administrative disposition as follows to the Changwon City Mayor on January 25, 2012, and issued a disposition to recover the sum of KRW 38,591,340 to the Plaintiff, and the sum of KRW 5,60,380 to C (hereinafter “instant restitution disposition”).
A person shall be appointed.
1. Details of violation;
(a) Amount of unfair claims: 38,592,670 won;
B. Details 1 of the offense: (a) 24,448,520 won - A long-term care institution shall place and operate human resources in accordance with the criteria for placement of human resources according to Article 22(1) of the Enforcement Rule of the Welfare of Older Persons Act and Article 23 of the Enforcement Rule of the Long-Term Care Insurance Act; and (b) where a person violates the criteria for placement of human resources pursuant to the notification on expenses for long-term care benefits, etc., the expenses for long-term care benefits must be reduced and calculated; (c) even though the actual working hours are less than 160 hours a month, or a caregiver (E,F), a social worker (G and H) has not reported differently from the fact that he/she has worked as a full-time worker for at least 160 hours, without reducing the expenses for care benefits; (d) 14,144,150 won in violation of the criteria for calculation; and (e) when a long-term care institution claims for the expenses for long-term care benefits based on the details of the expenses for benefits.
A person shall be appointed.