이 책은 노인요양사업은 하고 싶으나 어디서부터 무엇을 어떻게 해야 할지 막막해하는 분들을 위해서 만들어졌습니다. 특히 소규모 시설 또는 기관을 설립하려는 분들은 자금 사정 때문에 컨설팅 업체를 알아보기도 힘들 것입니다. 어쩔 수 없이 발품을 팔고 수많은 시행착오를 겪을 수밖에 없습니다. 그런데 고생한 만큼 성과가 좋으면 다행이지만 미처 파악하지 못한 부분 때문에 금전적ㆍ시간적 손해는 물론이고 정신적 스트레스에 시달릴 가능성이 높습니다.
노인요양사업은 처음부터 끝까지 수많은 법령과 규칙 등으로 얽혀 있기 때문에 업무를 파악하기가 결코 쉽지가 않습니다. 특히, 공공기관과 사람을 상대로 하는 사업이다 보니 일반 사업을 연상하고 쉽게 생각해서는 곤란합니다. 또한 전통적인 사회복지사업과도 차이가 있습니다. 조그마한 실수 하나에도 거액의 손해를 볼 수 있기 때문에 순수한 마음만으로 추진하기도 어렵기 때문입니다.
한 번도 가보지 않은 길을 헤치고 나간다는 것은 항상 힘겹기 마련이지만 노인요양사업은 더욱 그런 것 같습니다. 아마도 사업을 시작하기로 마음먹은 시점부터 수많은 난관에 봉착하게 될 것이고 너무나 많은 시행착오를 겪으며 겨우겨우 나아가게 될 것입니다.
필자들은 대학에서 학생들을 가르치고 있는 교수이지만 노인요양기관을 설립하고 성공적으로 운영해 본 경험을 가지고 있습니다. 특히 어린 대학생이 아닌 늦깎이 성인 학생들을 상대로 가르치다 보니 자연스럽게 노인요양기관 설립 과정을 자주 접하게 되었습니다. 이런 과정에서 컨설팅 업체에 의뢰할 경우 적게는 100만원, 많게는 2천만 원까지 비용을 지불해야 한다는 것도 알게 되었습니다. 그 많은 비용을 지불한 결과 성공적으로 기관 설립을 마치고 상당한 매출을 올리고 있는지 궁금할 따름입니다. 본서를 출판하기로 결심한 것도 이처럼 과도한 컨설팅 비용과도 무관치 않습니다.

본서는 이미 노인요양사업에 관심을 갖고 있는 사람들에게 초점을 맞추었습니다.

따라서 노인장기요양보험제도가 무엇이고, 대상자는 몇 등급까지 있고, 시설과 기관의 종류는 무엇인지 등 매우 기초적인 부분은 생략했습니다. 이런 것들은 노인장기요양보험 홈페이지에 들어가면 모두 알 수 있는 내용이기 때문입니다. 이 책을 사서 봐야겠다고 마음먹은 사람이라면 이미 어느 정도의 상식은 갖추고 있을 것입니다.
이 책은 노인요양사업을 할 것인지 결심하는 데 도움을 주고자 하며, 막상 시작하려고 해도 어디서부터 무엇을 어떻게 해야 할지 막막한 분들에게 친절한 안내서가 되려고 합니다. 그러다 보니 어떤 부분에서는 지나치다 싶을 정도로 자세하게 설명하기도 합니다. 연령대와 학력 그리고 경험 등이 모두 다르기 때문에 이를 고려한 것입니다. 어느 부분에서는 마치 논문을 보는 것처럼 숫자와 계산, 표 등 눈을 어지럽게 하는 것들도 있습니다. 혹자는 왜 이런 복잡한 것까지 제시하느냐고 할지 모르겠으나 다 이유가 있습니다. 이 책에서 제시하고 주장하는 것들이 터무니없거나 대충 생각나는 대로 작성한 것이 아니라 명확한 근거와 기준에서 나온 것임을 밝히기 위해서입니다.
이 책은 ｢노인장기요양기관의 설립과 운영｣이라는 테마 중 ‘설립’에 초점을 두었습니다. 따라서 후속작인 ‘운영’ 편도 함께 참고하면 좋을 것 같습니다. 이 책은 ‘설립’ 편인만큼 왜 이 사업을 해야 하는지에 대한 이유, 요양기관 운영 시 예상 수입산출방법을 제시했고, 건축이나 리모델링을 앞둔 분들이 꼭 알아야 할 내용과 지자체에 제출할 설립신고서 작성 요령, 설립 직후 행정적 사항 및 직원 채용 전 반드시 알아야 할 지식을 담고 있습니다.
모쪼록 노인요양시설이나 노인재가기관을 설립하고자 하는 분들에게 조금이나마 도움이 되기를 바랍니다.

2021년 2월 3일
저자 일동

CHAPTER 01 노인요양사업의 이해
1. 노인요양사업 폐업률의 진실∙16
1) 노인요양사업, 너무 늦은 것이 아닐까? ·······································································16
2) 장기요양기관은 꾸준히 증가했다 ·················································································17
3) 폐업률이 50% 또는 70% ···························································································18
4) 장기요양기관 폐업률은 실제 10% 미만 ·····································································21
5) 노인요양시설에 대한 부정적 이미지 ············································································23
2. 위기는 기회다∙25
1) 공공시설 확대에 기죽을 필요 없다 ·············································································25
2) 장기요양 대상자는 계속해서 늘어나고 있다 ·······························································28
3) 노인요양사업에 대한 투자는 계속될 것이다 ·······························································31
4) 실버산업이 기다리고 있다 ····························································································33
3. 노인요양사업, 어떻게 준비할 것인가∙35
1) 수익을 무시할 수는 없다 ·····························································································35
2) 신중하게 준비하면 된다 ·······························································································36
3) 노인요양사업이 자영업보다 유리하다 ··········································································37
4) 선택의 폭이 비교적 다양하다 ······················································································38

CHAPTER 02 노인요양사업 수익산출
1. 노인요양사업의 매출구조∙42
1) 노인요양사업에서 매출이란? ························································································43
2) 월 한도액과 1일당 급여비용 ························································································45
2. 노인요양사업의 지출비용∙49
1) 비용(고정 지출) 중 인건비 비중 ··················································································49
2) 인건비 지출비율 ············································································································51
3. 요양시설의 수익은 얼마나 나올까?∙52
1) 인건비 지출비율에 따른 수익 계산 ·············································································52

2) 최저임금을 적용한 노인요양공동생활가정의 수익산출 ················································54
3) 보조금으로 운영되는 시설의 종사자 인건비 ·······························································57
4) 최저임금을 기준으로 한 노인요양시설의 수익산출 ·····················································59
5) 종사자 직위/직급/직책에 따른 차등 임금 적용 ··························································63
4. 방문요양서비스 매출 및 수익∙67
1) 재가기관 매출 산출의 어려움 ······················································································67
2) 방문요양서비스만 제공했을 때 매출 ············································································69
3) 방문요양 단독 제공 시 수익 산출(인건비 지출비율 기준) ·········································73
4) 방문요양 단독 제공 시 수익 산출(최저임금 기준) ······················································76
5. 방문목욕서비스 매출 및 수익∙81
1) 방문목욕은 최저임금이 무의미하다 ··············································································82
2) 인건비 지출비율 적용 시 수익 ····················································································83
6. 주야간보호기관 매출 및 수익∙86
1) 주야간보호기관 매출 ·····································································································86
2) 주야간보호 단독 제공 시 수익 산출 ···········································································88

CHAPTER 03 요양기관 법적 기준 및 입지조건
1. 사업 종류에 따른 규모∙98
1) 노인복지법 시행규칙을 살펴보자 ·················································································98
2) 자본금 없어도 방문서비스는 가능하다 ········································································99
3) 시설(기관) 유형별 최소 면적 ·····················································································103
4) 기본적으로 갖추어야 할 시설 ····················································································103
5) 시설(기관) 병설 시 공용공간 ·····················································································105
2. 장기요양기관 설치 기준 검토∙106
1) 사무실과 의료 및 간호사실 ························································································106
2) 침실 ·····························································································································107
3) 물리(작업)치료실, 프로그램실, 식당, 주방 ································································112
4) 화장실, 세면장 및 목욕실, 세탁장 및 건조장 ··························································114
5) 바닥재 ·························································································································116
6) 경사로 및 승강기 ········································································································116

7) 소방시설 및 자동개폐장치 ··························································································117
8) 스프링클러 설치해야 하나? ························································································119
9) 장애인 및 노인의 편의증진 시설(설비) ·····································································121
10) 일조량 ·······················································································································122
11) 채광(조명) ·················································································································123
12) 환기(공기질) ··············································································································124
13) 실내온도 및 방습 ·····································································································125
14) 급수설비 및 먹는물 기준 ·························································································125
3. 시설 입지조건 확인∙127
1) 건물을 마련하는 3가지 방법 ·····················································································127
2) 땅만 있다고 다 되는 것이 아니다 ·············································································129
3) 자연환경이 잘 보존된 지역 ························································································130
4) 조망이 좋은 부지 ········································································································131
5) 강변, 호수, 습지 등은 피하자 ·················································································132
6) 고압 송전철탑 근처는 피하는 게 좋다 ······································································132
7) 주변에 축사 등 혐오시설을 조심하자 ········································································133
8) 순환골재가 깔린 부지는 피하자 ·················································································134
9) 교통 여건을 고려하자 ·································································································134
10) 진입로 여부 ··············································································································136
11) 도로에 바짝 붙어 있는 부지 ···················································································137
12) 각종 위험 요소가 있는지 확인하자 ·········································································138
13) 상수도 ·······················································································································139
14) 지하수 개발 ··············································································································140
15) 전기와 전화 등이 가능한 지역인가? ·······································································141

CHAPTER 04 요양기관 건축
1. 시설 부지의 용도 파악∙144
1) 용도지역이란? ·············································································································144
2) 용도지구 ······················································································································147
3) 용도구역 ······················································································································148
4) 지목(地目) ·················································································································149
5) 용도지역ㆍ지구ㆍ구역, 지목 간 땅값 차이 ·······························································150

2. 부지에 관한 각종 서류 검토∙151
1) 토지이용계획 확인서 ···································································································151
2) 개발행위제한정보 파악 ·······························································································151
3) 지적도 ·························································································································152
4) 토지대장 및 등기부등본 ·····························································································153
3. 건축 가능한 대지로 바꾸기∙154
1) 토지의 용도변경? ········································································································154
2) 농지전용 ······················································································································155
3) 개발행위 허가 ·········································································································157
4) 토지의 형질변경 ··········································································································158
5) 토지의 지목변경 ··········································································································159
4. 건축행정절차∙160
1) 건축에 대해서 알아야 하는 이유 ···············································································160
2) 건축행정 과정 ·············································································································162
3) 건축허가와 신고 차이 ·································································································164
4) 착공신고를 해야 공사를 시작할 수 있다 ··································································165
5. 건축사사무소 선정하기∙166
1) 건축사에게 꼭 설계를 맡겨야 하나? ·········································································166
2) 시공사를 찾아가면? ····································································································167
3) 건축가, 건축사, 설계사? ····························································································168
4) 건축사 선정, 신중해야 한다 ······················································································169
5) 건축사사무소 선정방법 ·······························································································170
6. 건축설계∙172
1) 설계의 중요성 ·············································································································172
2) 기획설계 ······················································································································173
3) 계획설계 ······················································································································174
4) 기본설계 ······················································································································174
5) 실시설계 ······················································································································175
6) 설계감리 ······················································································································176
7) 시방서와 내역서 ··········································································································177
8) 설계도면의 종류 ··········································································································178
7. 직영공사와 도급공사∙181
1) 도급공사 기준 ·············································································································181
2) 직영공사의 장단점 ······································································································182

3) 도급공사의 장단점 ······································································································183
4) 건설업 등록업체 ··········································································································183
8. 견적서 및 계약서 작성∙186
1) 견적서를 대하는 태도에서 옥석이 가려진다 ···························································187
2) 원가계산서, 공정표, 공정별 집계표 ·········································································188
3) 건설업 임금(시중노임단가) ·························································································190
4) 견적서에 누락된 사항 확인 ························································································192
5) 공사계약 ······················································································································193
6) 기성금 ·························································································································195
7) 지체상금 ······················································································································195
9. 건물 시공 단계∙196
1) 1단계: 착공신고 ·········································································································196
2) 2단계: 착공준비(현황조사 및 지반조사) ····································································200
3) 3단계: 가설공사 ·········································································································200
4) 4단계: 토공사(터파기 및 지정) ··················································································200
5) 5단계: 기초공사 ·········································································································202
6) 6단계: 골조공사 ·········································································································203
7) 7단계: 단열공사 ·········································································································204
8) 8단계: 지붕공사 ·········································································································205
9) 9단계: 외부 마감공사 ·································································································206
10) 10단계: 창호공사 ·····································································································207
11) 11단계: 급ㆍ배수 설비공사 ·····················································································210
12) 12단계: 난방공사 ·····································································································211
13) 13단계: 전기공사 ·····································································································213
14) 14단계: 내부공사 ···································································································213
15) 15단계: 마무리공사 ·······························································································214
10. 사용승인 및 기타 남은 일∙214
1) 사용승인 신청 전 준비사항 ························································································215
2) 취득세 납부 및 소유권 보존등기 ···············································································216
3) 기타 남은 일 ··············································································································216

CHAPTER 05 장기요양기관 설치신고
1. 사업자등록 및 절차∙220
1) 장기요양기관은 비과세 대상이다 ···············································································220
2) 고유번호증이란? ··········································································································221
3) 소득세와 법인세 납세의무가 없다 ·············································································223
4) 잉여금이란? ·················································································································223
5) 사업자등록 기준 ··········································································································224
6) 사업자등록 절차 ··········································································································225
2. 설치신고서류∙227
1) 설치신고서류 구분 ······································································································227
2) 서류 작성 샘플 ···········································································································228
3) 설치신고서 작성방법 ···································································································231
3. 신고인력과 실제 근로인력은 같아야 하나?∙240
1) 노인복지법 규정을 확인해야 한다 ·············································································240
2) 신고인력 및 실제 근로인력 ························································································242
3) 설립 직후 인력(변경)신고 안 하면 청구할 수 없다 ·················································243
4) 직원확보는 홍보 수단이 될 수 있다 ·········································································243
4. 전기, 소방, 수질검사 확인서∙244
5. 위치도, 평면도, 설비구조내역서∙247
1) 위치도 ·························································································································247
2) 평면도 ·························································································································247
3) 설비구조내역서 ············································································································248
6. 사업계획서∙249
1) 업무 중 사업계획서 작성할 일은 많지 않다 ·····························································249
2) 사업계획서를 제출해야 하는 이유 ·············································································249
3) 사업계획서 작성 요령 ·································································································250
4) 현실적인 방법 ·············································································································251
7. 운영규정∙253
1) 운영규정에 포함되어야 할 사항 ·················································································253
2) 운영규정 자료를 검색해 보자 ····················································································253

3) 현실적인 방법 ·············································································································255
4) 운영규정 샘플 ·············································································································255
8. 이용료 등 수급자 비용부담 관계서류∙261
9. 설치신고 공문 작성∙262
1) 공문 작성 전 준비사항 ·······························································································262
2) 공문 양식 만들기 ········································································································263
10. 시ㆍ군ㆍ구 담당자의 현지실사∙265

CHAPTER 06 설립인가 직후 처리사항
1. 공인인증서 및 시설코드 등록∙270
1) 확인을 위해서 사업주도 업무를 익혀야 한다 ···························································270
2) 공인인증서 ··················································································································270
3) 개인용 공인인증서 ······································································································271
4) 공인인증서 컴퓨터 저장 ·····························································································274
5) 기존 공인인증서도 사용 가능하다 ·············································································274
6) 기관용 공인인증서 ······································································································274
7) 시설코드 ······················································································································277
2. 장기요양기관 정보 게시∙279
3. 업무용 통장 만드는 것도 요령 있게∙282
1) 공단 청구용 통장 ········································································································283
2) 통장 예금주는 기관명으로 한다 ·················································································284
3) 체크카드, 인터넷뱅킹도 놓치지 말자 ········································································285
4. 인력(변경)신고는 수입과 직결된다∙286
1) 요양시설 종사자 보고 ·································································································288
2) 요양시설 인력변경공문 ·······························································································292
3) 인력(변경)신고를 깜박하고 하지 못했을 때 ······························································293
4) 재가기관용 사회복지시설정보시스템 ··········································································294

5. 전문직업인 배상책임보험∙295
1) 방문요양, 방문목욕, 방문간호 ····················································································295
2) 요양시설(공생 포함), 주야간보호, 단기보호기관 ·······················································297
6. 이동서비스를 위한 차량등록 ···········································································300
1) 시ㆍ군ㆍ구에 등록된 차량만 사용해야 한다 ·····························································301
2) 차량이 더 필요하면? ··································································································302
3) 직원 차량 임대계약 체결하기 ····················································································303
4) 송영 시 동승자 ···········································································································303

CHAPTER 07 직원 채용 전 숙지사항
1. 직원배치 기준부터 알고 직원 채용하자∙308
2. 어떤 경로로 직원 채용하면 좋을까?∙311
1) 지역신문 ······················································································································311
2) 주변 사람들에게 부탁하기 ··························································································312
3) 고용노동부 워크넷 ······································································································312
4) 전문 직종 협회 이용하기 ···························································································313
5) 현수막 ·························································································································314
6) 실습생을 직원으로 채용하기 ······················································································314
3. 일자리 정책을 알면 인건비를 줄일 수 있다∙315
1) 일자리 안정자금 ··········································································································315
2) 청년추가고용 장려금제도 ····························································································317
3) 새일여성 인턴제 ··········································································································318
4. 직원 월급은 얼마나 줘야 하나?∙319
1) 사업주도 월급을 많이 주고 싶다 ···············································································319
2) 지역 평균임금을 고려하자 ··························································································320
3) 인건비 지출비율에 맞춰야 하는가? ···········································································322
4) 최저임금은 반드시 지켜야 한다 ·················································································326
5) 최저임금 산정 기준은 기본급이다 ·············································································327

5. 애매모호한 근로시간∙328
1) 법정근로시간 ···············································································································329
2) 소정근로시간 ···············································································································329
3) 요양시설은 연장, 야간, 휴일근로가 불가피하다 ·······················································330
4) 야간 수면시간은 휴게시간인가, 근로시간인가? ·························································333
5) 주휴일 및 주휴수당 ····································································································335
6) 공식적인 휴일은 대체 언제인가? ···············································································337
6. 퇴직금과 퇴직연금∙338
1) 퇴직금제도는 사라졌나? ·····························································································338
2) 퇴직금 계산(계속근로 및 휴직기간) ···········································································339
3) 퇴직금 중간정산 ··········································································································341
4) 퇴직금 지급 ················································································································342
5) 퇴직연금 ······················································································································343
6) 퇴직연금의 종류 및 차이 ···························································································344
7. 4대 사회보험∙347
1) 사회보험 관련 공부가 필요하다 ·················································································347
2) 4대보험 사업장 성립, 변경, 탈퇴신고 ······································································348
3) 사업장가입자 자격취득, 변경, 상실신고 ····································································351
4) 신고서식 ······················································································································353
5) 단시간 근로자 처리 ····································································································354
6) 입사일에 따른 보험료 부과 ························································································355
7) 둘 이상의 사업장 근로인 경우 ··················································································355
8) 보험료 부과 기준 ········································································································355
9) 보험료 상한액과 하한액 ·····························································································358
10) 국민연금보험료, 고용보험료 국가지원제도 ······························································359
11) 사업장관리번호 ·········································································································360
12) EDI(전자문서교환) ····································································································360
13) 보수총액신고 ·············································································································362
8. 근로계약서 작성 유의사항∙366
1) 근로계약서 양식 ··········································································································367
2) 근로계약서 작성 시 유의사항 ····················································································368
3) 손해배상 책임을 넣었다가 근로기준법 위반이 될 수 있다 ······································369
9. 직원 외 활용할 수 있는 인력이 있다?∙370
1) 자원봉사자 ··················································································································370
2) 자원봉사자의 발굴 ······································································································371

3) 자원봉사자의 상해보험 ·······························································································372
4) 자원봉사 인정과 보상 ·································································································373
5) 사회복지자원봉사 인증관리 ························································································374
6) 사회복지사 실습생 ······································································································376
7) 요양보호사 실습생 ······································································································377
8) 사회복무요원 ···············································································································378
9) 지자체 또는 지역 단위 공공단체의 강사지원 프로그램 ···········································379
참고문헌∙381
찾아보기∙384