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(영문) 대구고등법원 2016.06.24 2014누6617
장기요양급여비용 환수결정통보처분 취소
Text

1. The plaintiff's appeal is dismissed.

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

Purport of claim and appeal

1...

Reasons

1. Details of the disposition;

A. The Plaintiff operates the “C” (hereinafter “instant medical care institution”) under the Welfare of Older Persons Act, which is a sanatorium for older persons under the Welfare of Older Persons Act. The instant medical care institution was designated as a long-term care institution on May 20, 208 pursuant to Article 31 of the Act on Long-Term Care Insurance for Older Persons.

B. On March 5, 2014 to March 3, 17, 2014, the Defendant and the head of Si/Gun conducted a field investigation on the details of long-term care benefits from the instant medical care institution on February 2, 2011 to January 17, 2014, and the long-term care institution determined that the instant medical care institution did not deny the provision of benefits, despite the Plaintiff’s demand for placement of a certain number of caregiver compared to the admitted person pursuant to Article 31(2) of the Long-Term Care Insurance Act, Article 23(2)2 of the Enforcement Rule of the same Act, Article 35(3) of the Welfare of the Aged Act, and Article 22(1) [Attachment Table 4]6 of the Enforcement Rule of the same Act, (a) caregiver, E, F, and H were in exclusive charge of cooking, and (b) the Institute did not work for 160 hours a month while managing its duties as a caregiver, and (c) the J did not violate the provision of benefits.

Pursuant to Article 43 of the Long-Term Care Insurance Act for Long-Term Care (Evidence No. 1), excessive expenses for long-term care benefits paid due to unfair or erroneous claims shall be deducted from the computer offsetting when paying expenses for long-term care benefits (or cash notice) and the main time is to be recovered.

On January 3, 2014, when the predetermined amount to recover expenses for long-term care benefits is determined, the main time is to send a separate notice of scheduled recovery and a detailed statement of scheduled recovery.

[Attachment 21, 21, 389, 366,300, including computerized offsetting in violation of criteria for human resources assignment, etc., as well as K 1 K 13,230,780 on the grounds of recovery of the original decision on the redemption of the redemption of the redemption of the sequence 13,230,780 "21,409,80" means "424,06,960.

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