Most of the patients who died at the hospital in Janseong county, south of the capital Seoul, were in their seventies and eighties, Yonhap news agency said, citing police and fire officials.
Thirty bedridden patients were trapped by "choking fumes" on the second floor of an annex building, while 10 patients on the first floor managed to escape, the report said.
One nurse was on duty at the time and was among the dead.
The fire was extinguished in around 30 minutes, Yonhap cited fire official Kim Kyong-Man as saying, adding that officials said the toxic fumes were to blame for the heavy death toll.
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