1. The plaintiff's claim is dismissed.

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

Details of the disposition

The Plaintiff is a person who operates the “C” (hereinafter “instant long-term care institution”) under Article 31 of the Act on Long-Term Care Insurance for the Aged of Older Persons (hereinafter “the instant long-term care institution”) as a sanatorium for older persons under Article 34(1)1 of the Welfare of Older Persons

From July 2, 2018 to July 5, 2018, the Defendant conducted an on-site investigation as to whether the instant long-term care institution’s claim for expenses for long-term care benefits is appropriate, along with the astronomical market.

(hereinafter “instant on-site investigation.” On October 4, 2018 based on the result of the instant on-site investigation, the Defendant rendered a decision to recover the amount pursuant to Article 43 of the Act on Long-Term Care Insurance for the Plaintiff (hereinafter “Act”) on the grounds that the Plaintiff was unfairly claimed and paid KRW 51,546,600 for expenses for long-term care benefits as follows:

(hereinafter “instant disposition”). 1. A claim (hereinafter “instant disposition”) violating the standards for placement of human resources (H13, 6,831,440 won in total) was received each of the expenses for long-term care benefits in violation of the standards for placement of human resources (from August 26, 2013 to October 12, 2016; 2 from January 9, 2017 to October 31, 2017; and (3) as if a caregiver performed the duties of each custodian during the said period, he/she reported to the Defendant as if he/she performed the duties of caregiver upon meeting the monthly standard working hours; and (4) October 2016 [15.3 working persons (4.37%) and October 2017 [17.82 working persons (0.98%) compared to the number of compulsory working personnel];

2. A claim that violates the criteria for additional placement of human resources (H15, total 44,610,310 won);

A. D. Although performing the duties of each custodian from August 26, 2013 to October 12, 2016, and (2) from January 9, 2017 to October 31, 2017, D, as if a caregiver had performed the duties of caregiver for each of the above periods, he/she shall report to the Defendant as if he/she performed the duties of caregiver by meeting the monthly standard working hours as a caregiver for each of the above periods, and as if he/she performed the duties of caregiver, from May 2015 to May 2016, 2016, May 7, 2016, 2016, May 7, 2016, August 8, 2016, October, 2017, respectively.