A court has ruled that the decision to reclaim long-term care benefits from a nursing home operated by the family of first lady Kim Keon-hee was lawful, citing fraudulent claims.
The Seoul Administrative Court's Fifth Administrative Division (Presiding Judge Lee Jeong-won) on Thursday ruled against the operator of Nursing Home A in a lawsuit seeking to overturn a long-term care benefit clawback order issued by the National Health Insurance Service (NHIS). Nursing Home A is operated by Kim's mother Choi Eun-soon and her brother Kim Jin-woo.
The NHIS conducted an on-site investigation of Nursing Home A from March 2022 to February of last year. The investigation found that a sanitation worker and a facility manager had claimed benefits as if they had met their monthly required work hours, even though they had not. In June last year, the NHIS ordered the nursing home to return 1.44 billion won ($1.05 million) in long-term care benefit payments.
The nursing home argued that "the sanitation worker and facility manager worked as a team and shared duties, so they should be considered to have met their respective monthly required work hours," and filed an administrative lawsuit.
However, the court rejected the nursing home's argument. The court stated, "The law distinguishes the specific duties of sanitation workers and facility managers, and in principle, care benefits can only be claimed when each meets their respective monthly required work hours." The court added, "Recognizing routine task-sharing as meeting the work hour requirement would effectively allow care facility employees to work in roles different from those they registered."
During the proceedings, the nursing home also claimed procedural defects, including a violation of the obligation to provide advance notice before on-site investigations. The court rejected this argument as well. The court ruled, "Given the nature of on-site investigations that rely on statements from related parties, advance notice could raise concerns about evidence destruction." It added, "The reasons for the clawback were documented in the monthly clawback decision statements attached to the disposition notice, and there is no obstacle to pursuing administrative remedies if the disposition is contested."
