Law Summary
Purpose
- To protect and promote public health by ensuring quality health services appropriate to the level of care.
- Achieved through regulation of hospitals and other health facilities.
Scope
- Applies to all government and private hospitals and other health facilities in the Philippines.
Regulatory Agency
- The Department of Health (DOH), specifically through the Bureau of Health Facilities and Services (BHFS) in the Office for Health Regulation, is responsible for regulatory functions.
Definitions
- Hospital: A health facility for diagnosis, treatment, and care of individuals with deformity, disease, illness, injury, or requiring surgical, obstetrical, medical, or nursing care.
- Must have bassinets or beds for 24-hour patient use.
Classification of Hospitals and Health Facilities
- By Ownership:
- Government: Operated wholly or partially by national/local government or their agencies.
- Private: Privately owned and funded through donations, investments, or corporative means.
- By Type:
- General: Provides services for all deformities, diseases, illnesses, or injuries.
- Special: Focused on specific clinical care and management; referral hospitals may offer special services.
- By Service Capability:
- First Level Referral Hospital: Non-departmentalized, provides basic clinical care for prevalent diseases, general medical services, and nursing care.
- Second Level Referral Hospital: Departmentalized, offers specialized treatment and intensive care in addition to first level services.
- Third Level Referral Hospital: Teaching and training hospital with specialized and sub-specialized treatment.
- Infirmary: Provides emergency care and clinical services for mothers and newborns.
- Birthing Home: Offers maternity services including normal deliveries.
- Acute-chronic Psychiatric Care Facility: Provides medical and psychosocial treatment for mentally ill patients.
- Custodial Psychiatric Care Facility: Provides long-term care with basic services for chronic mentally ill.
License
- Formal authorization from DOH to operate hospitals or health facilities.
- Mandatory prerequisite for accreditation by recognized bodies.
Licensing Requirements
- Compliance with planning and design guidelines.
- Management of service capability, personnel, equipment, and physical plant must conform to prescribed standards.
- Construction, alteration, or expansion requires floor plans approved by licensed professionals and permits.
Procedures for Permit and License Application
Permit to Construct:
- Required prior to new construction, alterations, change of classification, or bed capacity increase.
- Application includes letters of application and endorsement, notarized forms, architectural plans, feasibility study, zoning clearance, and relevant registrations.
- Process involves submission to Center for Health Development (CHD), endorsement to BHFS, review, and issuance or disapproval.
License to Operate:
- Required post-construction prior to commencing operations.
- Requires submission of application letters, notarized forms, personnel and equipment lists, and photo documentation.
- BHFS conducts inspection, approves or disapproves license issuance.
Review and licensing are conducted by specialized committees and teams composed of qualified professionals in architecture, engineering, medicine, nursing, pharmacy, and allied disciplines.
License Renewal
- Licenses must be renewed annually; inspections may be biennial.
- Renewal application submitted 90 days before expiry including required documentation.
- Similar procedural steps for inspection and approval.
Inspection and Monitoring
- Regular inspections by BHFS or CHD.
- Hospitals must allow reasonable access and provide records for review.
- Unlicensed facilities or violations reported to BHFS.
Technical Assistance
- BHFS shall enhance CHD capabilities for enforcement.
- Provides advisory support to CHD, Local Government Units, and private institutions.
Fees
- Non-refundable fees imposed for permit, registration, license issuance, and renewal.
- Fees paid to the DOH or CHD cashier according to prescribed schedules.
Terms and Conditions for Licenses
- Construction permits must be obtained before construction or modifications.
- Permits lapse if construction does not commence within 365 days.
- Licenses granted based on meeting specific conditions identified during inspections.
- Licenses unrenewed for two years are cancelled; new application required for operation.
- Licenses are non-transferable without written DOH consent.
- Changes in management, ownership, or location must be promptly reported and may require new permits and licenses.
- Licenses must be publicly displayed with rules accessible.
Violations
- Conducts considered violations include unauthorized alterations, false statements, unreported changes, denial of inspections, refusal to admit or discharge properly, and failure to correct deficiencies.
Investigation and Hearing
- BHFS investigates complaints against hospitals or personnel.
- Upon finding violations, licenses may be suspended or revoked pending possible criminal proceedings.
Revocation of License
- Issued by BHFS Director upon violation findings.
- Notification sent by registered mail specifying reasons.
Closure of Facilities
- BHFS shall close unlicensed hospitals immediately and may enforce closure with government agency support.
Penalties
- Establishing or operating without necessary permits or licenses subjects offenders to fines: P500 for first offense, P1,000 for subsequent offenses per day.
Appeal Process
- Aggrieved entities may appeal BHFS decisions within 30 days to the Office of the Secretary of Health.
- The Secretary's decision is final and executory.
Publication
- Periodic publication of licensed hospitals and health facilities classified accordingly.
Repealing Clause and Effectivity
- Rules repeal inconsistent prior administrative orders.
- Take effect upon approval and publication.
Moratorium
- Two-year preparation period for effective renewal enforcement.
- BHFS assists CHD in renewing licenses of second and third level referral hospitals.
Guidelines in Planning and Design
- Hospitals must meet architectural, safety, sanitation, accessibility, electrical, and plumbing codes.
- Environment must be accessible and free from hazards.
- Facilities must be safe, secure, allow free patient movement, provide sufficient light and ventilation.
- Privacy, water supply, waste disposal, sanitation, housekeeping, maintenance, fire protection, signage, parking, zoning, and functional layout standards specified.
- Space requirements for various hospital services detailed.
Guidelines in Management of Service Capability, Personnel, Equipment, and Physical Plant
- Hospitals to render quality health services suitable to level of care.
- Administratively organized for personnel, finance, records, housekeeping, security, and support functions.
- Clinical services include key medical specialties.
- Nursing services categorized by care intensity and responsibility.
- Ancillary services cover laboratory, radiology, and pharmacy.
- Staffing must be qualified and continuously educated.
- Maintenance of equipment and facilities must ensure safety and efficiency.
- Quality assurance through ongoing assessment, monitoring, evaluation, and feedback systems required.