Liabilities of Hospitals PDF

LECTURER DR. MB PENIERO OCTOBER 5, 2023 | 3 00 - 5 00 Y1L MEDJUR LIABILITIES OF HOSPITALS TABLE OF CONTENTS I. HOSPITALS II. CLASSIFICATIONS OF HOSPITALS A. As to the Scope of Infirmities Admitted B. Functional Classification C. As to Control and Financial Support D. Based on the Size or Bed Capac...

LECTURER DR. MB PENIERO OCTOBER 5, 2023 | 3 00 - 5 00 Y1L MEDJUR LIABILITIES OF HOSPITALS TABLE OF CONTENTS I. HOSPITALS II. CLASSIFICATIONS OF HOSPITALS A. As to the Scope of Infirmities Admitted B. Functional Classification C. As to Control and Financial Support D. Based on the Size or Bed Capacity E. As to whether it is Training or Not III. A HOSPITAL CANNOT PRACTICE MEDICINE IV. V. VI. VII. VIII. IX. X. XI. XII. XIII. XIV. XV. XVI. XVII. XVIII. XIX. XX. XXI. A. Reasons why a hospital cannot practice medicine B. Duties of the governing board of the hospital REGULATION OF HOSPITALS PRIMARY DUTIES OF A HOSPITAL PERSONS COMING WITHIN THE PREMISES OF THE HOSPITAL LIABILITIES OF HOSPITALS FOR THE WRONGFUL ACTS OF THEIR AGENTS A. Government or Public Hospitals B. Private Charitable, Voluntary or Eleemosynary Hospital 1. Doctrines applied to charitable hospital immunity for the acts of its employees C. Private hospital operating for profit RULES APPLIED IN DETERMINING VICARIOUS LIABILITY A. Principle of administrative/ministerial as against professional/medical duties B. Principle of control C. Contract of service D. Independent Contractor Theory E. Sole Responsibility vs Shared Responsibility LIABILITIES OF HOSPITALS A. Corporate Liabilities B. Vicarious Liabilities for Acts of Hospital Employees ADMISSION ATTENDANCE TO EMERGENCY CASES IN HOSPITALS TRANSFER OF PATIENTS DISCHARGE OF PATIENTS REFUSAL OF PATIENT TO BE HOSPITALIZED REFUSAL OF PATIENT TO LEAVE THE HOSPITAL PREMATURE DISCHARGE DISCHARGED AGAINST ADVICE DETENTION OF PATIENT FOR NON PAYMENT BILL LIABILITY FOR HOSPITAL INFECTION LIABILITIES OF HOSPITAL FOR ITS ANCILLARY SERVICES A. Emergency Room 1. Two aspects of emergency care 2. Malpractice liability in the emergency room 3. Emergency Room Record 4. Emergency Room and the Police 5. Press Reporterʼs Inquiry 6. Compensation for treating an unconscious patient in the emergency room B. Ambulance C. Hospital Pharmacy D. Medical Records 1. Purpose of Maintenance of Medical Records 2. Purpose of Maintenance of Medical Records Hospitals) 3. Violation of the Confidential Nature of Record 4. When may the contents of the record be disclosed 5. Information for which no authorization is needed E. Hospital Security 1. Methods of Arrest without Warrant REVIEW QUESTIONS I. HOSPITALS ● Sec. 2(a), RA 4226, Hospital Licensure Act ○ Hospital means a place devoted primarily to the maintenance and operation of facilities for the diagnosis, treatment, and care of individuals suffering from illness, disease, injury or deformity, or in need of obstetrical or other medical and nursing care. Dr. Peniero: “Take note of the keywords…..the definition talks about the function of the hospital.” ○ The term ‘hospitalʼ shall also be construed as any institution, building or place where there are installed beds, cribs, etc. for twenty-four-hour use or longer by patients in the treatment of diseases…xxx.” Dr. Peniero: “The second definition talks about the structural aspect of the hospital.” II. CLASSIFICATION OF HOSPITALS AS TO THE SCOPE OF INFIRMITIES ADMITTED ● General ○ one concerned with the admission and treatment of a substantial range of diseases and injuries. Dr. Peniero: “Most of the hospitals are general hospitals.” ● Specialized ○ Established to admit specific illness, treatments, organs affected or for a class of people. Dr. Peniero: “example: Orthopedic hospitals” FUNCTIONAL CLASSIFICATION ● Diagnostic hospitals ○ Diagnostics ● Maternity hospitals ○ Expectant mothers ● Rehabilitation hospitals ○ Disability ● Surgical hospitals ○ Operations ● Cosmetic hospitals ○ aesthetics Dr. Peniero: “Examples are Aivee and Belo Clinic….they do facials.” AS TO THE CONTROL AND FINANCIAL SUPPORT ● Public/Government ○ operated and maintained either partially or wholly by the national, provincial, municipal, or city government or other political subdivision, or by any department, division, board or other agency thereof Sec 2b, RA 4226 ● Private ○ privately owned, especially established and operated with funds raised and contributed through donations, or private capital or other means Sec 2c, RA 4226 FOR PURPOSES OF DETERMINING LIABILITY PRIVATE HOSPITALS ● Private charitable or eleemosynary (charitable) ○ established for the public benefit and not conducted for the pecuniary gain of the management, officers or others Dr. Peniero: “Private charitable hospital - non taxable” ● Private pay ○ established for profit and gain. BARBON, CALIZO, DAQUIL, DULANA, LAGAPA, LAYGAN, RODRIGUEZ, SOMBONG, TILOS, TUMACOLE | MG 4 1 of 7 Dr. Peniero: “If it is for charity then it should be non taxable.” BASED ON THE SIZE OR BED CAPACITY ● 25, 50, 100 and 450 bed capacity hospitals. AS TO WHETHER IT IS TRAINING OR NOT ● Utilized for medical and paramedical education. III. A HOSPITAL CANNOT PRACTICE MEDICINE ● The hospital merely agrees to care for the patient by furnishing him with accommodations and attendants including nurses and interns. REASONS WHY A HOSPITAL CANNOT PRACTICE MEDICINE ● The hospital cannot be subjected to government licensure examinations to determine whether or not it is qualified to practice medicine. ● If a hospital will be allowed to practice medicine, then the licensed physician employed by the hospital will be merely receiving orders from the corporate body or officers who are not licensed to practice medicine. ● Dr. Peniero: A hospital is not a person. DUTIES OF THE GOVERNING BOARD OF THE HOSPITAL ● To determine the policies of the hospital in relation to the community needs; ● To see to it that the proper professional standards are maintained in the care of the sick; ● To coordinate the professional interest of the hospital with the administrative, financial, and community needs; ● To direct the administrative personnel in order to carry out the policies; ● To provide adequate financing to secure sufficient income and to assure business-like control of expenditures. IV. REGULATION OF HOSPITALS ● State Regulation ○ The state may impose certain regulations in the establishment or management of a hospital in the interest of public health. ○ E.g. Licenses to operate ● Self-regulation ○ Both public and private hospitals have the right to promulgate rules and regulations in relation to the use of their facilities. V. PRIMARY DUTIES OF A HOSPITAL ● To furnish a safe and well-maintained building and ground. Dr. Peniero: “If somebody is injured because of the hospitalʼs falling debris, then the hospital has a liability to that person.” ● To furnish adequate and safe equipment. ● To exercise reasonable care in the selection of the hospital staff. Dr. Peniero: “Screening qualified staff who can render service in the hospital.” VI. PERSONS COMING WITHIN THE PREMISES OF THE HOSPITAL ● Trespasser ○ One who enters the property of another without being granted the privilege to do so. It is only required of a hospital to refrain from taking positive steps to harm a trespasser ○ Has no business to stay in the hospital ● Licensee ○ One who is neither a customer, servant or a trespasser. He has no contractual relation with the hospital. He is permitted, expressly or impliedly to be within the premises for his own interest or convenience. His presence is merely tolerated. ○ Examples: relatives, guardian/s of the patient ● Invitee ○ One who is essential to the operation of a hospital or for whom the hospital has a purpose. (e.g. attending physician, nurses, patient, blood donors) VII. LIABILITIES OF HOSPITALS FOR THE WRONGFUL ACTS OF THEIR AGENTS GOVERNMENT OR PUBLIC HOSPITALS ● General Rule: A State cannot be sued without its consent. ○ Exceptions to this rule: ■ Has consent of the State ■ If the State has gone down to the personality of a private citizen ■ If the State has entered into business relations (i.e., proprietary/commercial purposes) ● The immunity of the government from the official acts of its officers, agents and employees is based on the legal principle that “there can be no legal right against the authority that makes the law which the right depends.” ● State is for public service so the rationale is that if you sue the State, you are hampering public service ● Rationale: Government funds should be spent for public purposes and not diverted to compensate for private injuries and public service should not be hindered. The government must not be sued because the government derives no profit from its activity unlike a private enterprise. ● Those established to perform government functions are immune from being sued. ● Those performing proprietary functions when it is established for profit. The government goes down to the level of any private hospital. ○ The State is suable in this instance PRIVATE CHARITABLE, VOLUNTARY OR ELEEMOSYNARY HOSPITALS ● A charity hospital is established and maintained from the donations, contributions, philanthropic acts, and pays no dividends. ○ Not taxable ● The determination whether a hospital was established for charity would be the articles of incorporation and the constitution and by-laws of the corporation. ○ Articles of incorporation are submitted to the SEC Securities and Exchange Commission) and the SEC releases the certificate of registration ● A hospital which allows the patient to pay if ever they have the capacity to do so and serve others gratuitously does not change the fundamental nature of the hospital as charity. ○ Purpose of the hospital should be checked: should be actually, directly, and intrinsically used for charity purposes BARBON, CALIZO, DAQUIL, DULANA, LAGAPA, LAYGAN, RODRIGUEZ, SOMBONG, TILOS, TUMACOLE | MG 4 2 of 7