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(영문) 서울북부지방법원 2018.05.18 2017노2470
사기
Text

The prosecutor's appeal is dismissed.

Reasons

1. The summary of the grounds for appeal (misunderstanding of facts) recognized that the Defendant committed the crime from the investigative agency to the date of the second trial of the court below. The Defendant, as the final responsible manager of the instant medical care center, received a report on the claim for medical care benefits or the employment of an employee, and decided to do so in light of the size of the employee of the said medical care center or the current status of the management of the work records, etc., the Defendant did not confirm the claim for medical care benefits easily, even though it was possible to confirm the work of the said medical care center or sanitation, and the period of the medical care benefits in this case is relatively short, and the number of claims for medical care benefits in this case also exceeds the number of times, the lower court determined otherwise by misapprehending the facts.

2. Judgment on the grounds for appeal

A. The facts charged in the instant case reveal that the Defendant, from March 2, 2009 to February 6, 2015, as the representative of “D”, a long-term sanatorium for older persons located in Gangnam-gu Seoul Metropolitan Government, the Defendant was in charge of providing services to beneficiaries by employing social workers, medical care guardians, nurses, etc., and claiming the benefits of each medical care assistance officer to the National Health Insurance Corporation (hereinafter “Corporation”), etc.

The operator of a sanatorium for older persons shall place at least 30 persons who are admitted to the sanatorium for older persons, one social worker and one physical clinic for older persons, and additionally assign one nurse for more than 100 persons, and one nurse for each 25 persons admitted to the sanatorium for older persons and one physician for medical care protection for each 2.5 persons admitted to the sanatorium for older persons, respectively.

In addition, the operator of a sanatorium for older persons may claim expenses for older persons' care in accordance with the standards for the placement of employees if the monthly working hours are at least 160 hours, and if it fails to meet the standards for the placement of employees, he/she shall claim expenses for older persons' care in accordance with the prescribed ratio, and he/she shall also claim expenses for older persons' care in addition to the standards for the placement of employees.

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