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Some care facilities retain top gov't ratings despite confirmed abuses

Published: 14 Apr. 2026, 07:00

Older adults rest outside the wall of Tapgol Park in Jongno District, central Seoul, on June 14, 2021. [NEWS1]

Dozens of long-term care facilities in Korea retained top government ratings despite confirmed cases of abuse of older adults, a state audit has found, raising questions about oversight of the country’s nursing homes.

Of those, 29 facilities also received additional payments totaling about 800 million won ($538,000).

Although 50 out of 410 care facilities were found to have abused older patients between 2020 and 2023, they were still awarded an “A” grade in evaluations regularly conducted by the National Health Insurance Service, according to the Board of Audit and Inspection (BAI) report released on Sunday.

Moreover, nearly 75 percent of facilities with confirmed abuse cases — 299 in total — received a grade of “D” or higher, avoiding the lowest rating.

In one case from January 2022, a nursing aide at a long-term care facility in Daegu was found to have shaken an older patient and struck her to force her to finish her meals more quickly, according to an official investigation.

That same facility received the highest possible rating in a government evaluation the following year.

The discrepancy stems in part from how facilities are assessed.

The audit found that under internal rules, the insurance service assigns the lowest rating, “E,” only when local governments impose administrative penalties such as business suspensions.

However, even that standard has not been consistently applied. Of 90 facilities that faced administrative sanctions during four rounds of evaluations between 2020 and 2023, 16 were not given the lowest grade.

Older adults pass through a subway barrier at Jongno 5-ga Station in central Seoul on April 8. [YONHAP]

The findings suggest that facilities can pass formal evaluations even after cases of staff members abusing patients have been confirmed by investigative agencies.

The audit also highlighted broader gaps in welfare programs for older adults, from staffing irregularities to flaws in benefit allocation.

Between 2019 and June 2024, at least 113 certified caregivers were themselves classified as needing long-term care, meaning that they had difficulty performing everyday activities without assistance. More than half were receiving care from other caregivers, and in 14 cases, the caregiver required a higher level of care than the patient that they were assigned to assist.

The audit also flagged blind spots in the basic pension system.

As of 2023, nine older adults with more than 500 million won in overseas financial assets were still receiving pension payments. Under current rules, those kinds of assets — along with virtual currencies — are not included when calculating eligibility for the system.

Regional disparities further complicate access.

Residents in satellite cities in the Seoul metropolitan region, where housing costs often exceed those of other regional cities, are still classified as living in smaller municipalities. As a result, more of their assets are counted in eligibility assessments, which makes them appear richer on paper and renders it harder for them to qualify for benefits.

The audit comes as Korea’s welfare system faces mounting pressure from a rapidly aging population, with the number of recipients and total spending on long-term care insurance and basic pensions rising sharply.

But oversight has not kept pace, according to the audit board.

“The number of beneficiaries and expenditures is increasing rapidly with aging,” it said, warning of persistent concerns over poor management of care services, improper billing and welfare payments to high-asset individuals.

It called on the Ministry of Health and Welfare and related agencies to draw up measures to address the gaps.

This article was originally written in Korean and translated by a bilingual reporter with the help of generative AI tools. It was then edited by a native English-speaking editor. All AI-assisted translations are reviewed and refined by our newsroom.
BY HA JUN-HO [[email protected]]