After a court ruled that the decision to claw back long-term care benefits was lawful, the nursing home run by the family of Kim Keon-hee, accused of fraudulently claiming about 1.4 billion won in long-term care benefits, appealed.
According to legal sources on May 4, nursing home A, operated by Kim's mother Choi Eun-sun and older brother Kim Jin-woo, filed a notice of appeal with the Seoul Administrative Court's Administrative Division 5 (Presiding Judge Lee Jeong-won) on Apr. 30.
Earlier, on Apr. 9, the court ruled against the plaintiff in a case filed by the operator of nursing home A seeking to overturn the National Health Insurance Service's decision to claw back long-term care benefit expenses.
The court found that billing long-term care expenses by making it appear as though employees who did not meet the working-hours criteria had satisfied the requirements constituted a false or otherwise fraudulent claim under the Long‑Term Care Insurance Act.
The court also said there were no problems with the procedures for the clawback decision. The nursing home argued that the National Health Insurance Service failed to fulfill its obligation to give prior notice of the on-site investigation. But the court said, "If we give notice in advance, there is a risk that those involved will destroy evidence," and found no procedural defects.
The dispute began when the National Health Insurance Service concluded that nursing home A had fraudulently claimed about 1.44 billion won in long-term care benefits from 2018 to 2025.
An investigation by the National Health Insurance Service found that the cleaners and the maintenance worker at nursing home A did not meet the monthly working-hours standards set by the Long-Term Care Insurance statutes.
According to the National Health Insurance Service, the cleaner at nursing home A performed tasks such as driving staff to and from work instead of doing laundry, which was the person's primary duty. The actual laundry was found to have been done by the maintenance worker and a caregiver. It was also found that the maintenance worker split time evenly between original facility maintenance duties and laundry.
In June last year, the National Health Insurance Service issued a clawback decision to nursing home A. The nursing home sought a stay of execution to halt the clawback until a ruling on the merits, but the request was denied at both the first instance and on appeal.
At the time, the court cited as grounds for denying the stay that the retained earnings of the family corporations represented by Kim Jin-woo reached 3.5 billion won last year. It also considered that the total value of land, buildings, and other assets held by Kim was 5.5 billion won.