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(영문) 울산지방법원 2017.11.23 2016구합5949
노인의료복지시설 경고(1차)처분 및 장기요양기관 업무정지(124일)처분취소
Text

1. All of the plaintiff's claims are dismissed.

2. The costs of lawsuit shall be borne by the Plaintiff.

Reasons

1. Details of the disposition;

A. The Plaintiff established and operated a C Welfare Center (29 visitors, 2-19 current employees, hereinafter “instant welfare center”), which is a sanatorium for older persons designated as a long-term care institution under the Act on Long-Term Care Insurance for Older Persons in Ulsan-gun, Ulsan-gun, Ulsan-gun.

B. From March 28, 2016 to March 31, 2016, the Defendant and the National Health Insurance Corporation conducted an on-site investigation into the instant welfare center. On June 1, 2016, the National Health Insurance Corporation notified the Defendant of the fact that the Plaintiff unduly claimed and received expenses for benefits in total amounting to KRW 56,537,650, in violation of the following standards for assignment of human resources and additional placement of human resources:

◆ 인력배치기준 위반 간호조무사 D은 2015. 6. 퇴사한 달의 근무시간을 늘려서 신고하였고, 원고는 2015. 5.과 2015. 10. 간호조무사로 근무하지 아니하였음에도 근무한 것으로 근무시간을 허위로 신고하여 인력배치기준을 위반하였음에도 급여청구시 감액조정하지 않고 10,331,700원을 부정 청구하여 지급받음 ◆ 인력추가배치 가산기준 위반 조리원 E이 2015. 3. 2. 입사하여 격일로 출근하였음에도 매일 출근한 것으로 근무시간을 허위로 작성하여 2015. 4., 2015. 6.부터 2015. 11.까지, 2016. 1., 2016. 2. 인력추가배치, 필요수 인력배치, 야간직원 배치강화 가산을 받아 46,205,950원을 부정 청구하여 지급받음

C. On July 19, 2016, the Defendant issued a warning to the Plaintiff on the basis of Article 43(1)1 of the Welfare of Older Persons Act, and issued a disposition of business suspension of a long-term care institution (from August 18, 2016 to December 19, 2016) on the basis of Article 37(1)4 of the Act on Long-Term Care Insurance for Older Persons (hereinafter “instant disposition”).

[Reasons for Recognition] Unsatisfy, Gap evidence 1, 2, 3, 14 and Eul evidence 1 to 8 (including branch numbers; hereinafter the same shall apply).

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