(NAR) VOL. 15 NOS. 1-2 / APRIL - JUNE 2004
7.1 Government or Private7.1.1 Government - operated and maintained partially or wholly by the national, provincial, city or municipal government, or other political unit; or by any department, division, board or agency thereof.
7.1.2 Private - privately owned, established and operated with funds through donation, principal, investment, or other means, by any individual, corporation, association, or organization.
7.2 General or Special7.2.1. General - provides services for all types of deformity, disease, illness or injury.
7.2.2. Special - primarily engaged in the provision of specific clinical care and management.
7.3 Service Capability7.3.1 Primary Care -
7.3.1.1 Non-departmentalized hospital that provides clinical care and management on the prevalent diseases in the locality.
7.3.1.2 Clinical services include general medicine, pediatrics, obstetrics and gynecology, surgery and anesthesia.
7.3.1.3 Provides appropriate administrative and ancillary services (clinical laboratory, radiology, pharmacy)
7.3.1.4 Provides nursing care for patients who require intermediate, moderate and partial category of supervised care for 24 hours or longer
7.3.2 Secondary Care -7.3.2.1 Departmentalized hospital that provides clinical care and management on the prevalent diseases in the locality, as well as particular forms of treatment, surgical procedure and intensive care
7.3.2.2 Clinical services provided in Primary Care, as well as specialty clinical care
7.3.2.3 Provides appropriate administrative and ancillary services (clinical laboratory, radiology, pharmacy)
7.3.2.4 Nursing care provided in Primary Care, as well as total and intensive skilled care
7.3.3 Tertiary Care -7.3.3.1 Teaching and training hospital that provides clinical care and management on the prevalent diseases in the locality, as well as specialized and sub-specialized forms of treatment, surgical procedure and intensive care.
7.3.3.2 Clinical services provided in Secondary Care, as well as sub-specialty clinical care
7.3.3.3 Provides appropriate administrative and ancillary services (clinical laboratory, radiology, pharmacy)
7.3.3.4 Nursing care provided in Secondary Care, as well as continuous and highly specialized critical care
7.3.4 Infirmary - a health facility that provides emergency treatment and care to the sick and injured, as well as clinical care and management to mothers and newborn babies.
7.3.5 Birthing Home - a health facility that provides maternity service on pre-natal and post-natal care, normal spontaneous delivery, and care of newborn babies.
7.3.6 Acute-Chronic Psychiatric Care Facility - a health facility that provides medical service, nursing care, pharmacological treatment and psychosocial intervention for mentally ill patients.
7.3.7 Custodial Psychiatric Care Facility - a health facility that provides long-term care, including basic human services such as food and shelter, to chronic mentally ill patients.
9.1 The planning and design of a hospital and other health facilities shall comply with the prescribed guidelines that shall be formulated by the Department of Health, through the Bureau of Health Facilities and Services, in consultation with, and through public hearings involving, various affected organizations, associations, and/or stakeholders.
9.2 The management of the service capability, personnel, equipment and physical plant of a hospital and other health facilities shall conform to the prescribed guidelines that shall be formulated by the Department of Health, through the Bureau of Health Facilities and Services, in consultation with, and through public hearings involving, various affected organizations, associations, and/or stakeholders.
9.3 The construction of a new hospital or other health facilities, and Alteration, expansion or renovation of an existing hospital or other health facility shall be implemented in accordance with:9.3.1 Floor plans prepared by a duly licensed Architect and/or Civil Engineer and approved by the Bureau of Health Facilities and Services;
9.3.2 Architectural and engineering drawings (based on approved floor plans by the Bureau of Health Facilities and Services), specifications, building permit and fire safety permit prepared by a duly licensed Architect and/or Civil Engineer and approved by the Office of the Building Official and the Bureau of Fire Protection in the locality; and
9.3.3 Prescribed guidelines that shall be formulated by the Department of Health, through the Bureau of Health Facilities and Services, in consultation with, and through public hearings involving, various affected organizations associations, and/or stakeholders.
9.4 The Bureau of Health Facilities and Services, or the Center for Health Development, as the case may be, shall evaluate compliance with the licensing requirements for all hospitals and other health facilities, in accordance with the following criteria:9.4.1 Service Capability - administrative, clinical, ancillary and other services rendered.
9.4.2 Personnel - staffing of qualified and trained health and health-related professionals and non-professionals.
9.4.3 Equipment/Instrument - tools to perform the required services.
9.4.4. Physical Plant - well ventilated, lighted, clean, safe and functional structure sufficient to accommodate its activities.
9.4.5 Other such analogous factors and circumstances that may be formulated and approved by the Department of Health.
10.1 Permit to Construct - required for construction of a new hospital or other health facility; substantial alteration, expansion or renovation of an existing hospital or other health facility; change in classification; or increase in bed capacity. It is a prerequisite for a license to operate. However, existing health facilities providing maternity service on pre-natal and post-natal care, normal spontaneous delivery, and care of newborn are exempted from securing the Permit to Construct.10.1.1 The following are the required documents to be accomplished and/or submitted before a Permit to Construct can be issued:
10.1.1.1. Letter of Application to the Director of the Center for Health Development
10.1.1.2 Letter of Endorsement to the Director of the Bureau of Health Facilities and Services
10.1.1.3 Form No. 1-01: Notarized Application for Permit to Construct
10.1.1.4 Four (4) Sets of Site Development Plans and Floor Plans signed and sealed by an Architect and/or Engineer
10.1.1.5 Environmental Compliance Certificate from the DENR Environmental Management Bureau-Regional Office (for hospitals only)
10.1.1.6 Waste Management Plan
10.1.1.7 Such other documents that may be required by the Bureau of Health Facilities and Services
For construction of a new hospital or other health facility; or change in classification, include:10.1.1.8 Feasibility Study
10.1.1.9 Zoning Certificate or Location Clearance from the City/Municipal Planning and Development Office
10.1.1.10 DTI/SEC Registration (for private hospital or other health facility)
10.1.1.11 Enabling Act (for national government hospital or other health facility)
10.1.1.12 Approved Sanggunian Resolution (for local government hospital or other health facility)
10.1.1.13 Building Permit from the Office of the Building Official in the locality
10.1.1.14 Fire Safety Permit from the Bureau of Fire Protection in the locality
10.1.1.15 Such other documents that may be required by the Bureau of Health Facilities and Services
10.1.2 The following are the procedures for application for Permit to Construct;
10.1.2.1 Applicant requests relevant information and prescribed form either from the Bureau of Health Facilities and Services or the Center for Health Development, either in person, or through mail, email or Internet.
10.1.2.2 Applicant then accomplishes required documents and submits them to the Center for Health Development for endorsement to the Bureau of Health Facilities and Services.
10.1.2.3 The Bureau of Health Facilities and Services reviews the documents and approves or disapproves the issuance of permit to construct.
10.1.2.4 If disapproved, the Bureau of Health Facilities and Services returns the documents, together with their findings and recommendations, to the applicant. The applicant makes necessary revisions on the documents. The applicant submits the revised documents to the Bureau of Health Facilities and Services for another review .
10.1.2.5. If approved, the Bureau of Health Facilities and Services issues a permit to construct to the applicant. The applicant pays the corresponding fee for permit to construct to the Cashier of the Department of Health in person, or through postal money order.
10.2 License to Operate - required for operation of a hospital or other health facility. It is secured after construction and completion of a hospital or other health facility.
10.2.1. The following are the required documents to be accomplished before an initial License to Operate can be issued:10.2.1.1 Letter of Application and Request for Inspection to the Director of the Center for Health Development
10.2.1.2 Letter of Endorsement to the Bureau of Health Facilities and Services
10.2.1.3 Form No. 2-01: Notarized Application for Registration and Issuance of License to Operate
10.2.1.4 Notarized List of Personnel
10.2.1.5 List of Equipment/Instrument
10.2.1.6 Photo Album of the Exterior and Interior of the Hospital or Other Health Facility
10.2.1.7 Certificate of Occupancy from the Office of the Building Official in the locality
10.2.1.8 Fire Safety Inspection Certificate from the Bureau of Fire Protection in the locality
10.2.1.9 Sanitary Certificate from the Local Health Office
10.2.1.10 Such other documents that may be required by the Bureau of Health Facilities and Services
10.2.2 The following are the procedures for application for initial License to Operate:10.2.2.1 Applicant requests relevant information and prescribed form either from the Bureau of Health Facilities and Services or the Center for Health Development, either in person, or through mail, email or internet.
10.2.2.2 Applicant accomplishes required documents and submits them to the Center for Health Development for endorsement to the Bureau of Health Facilities and Services. Upon filing of application, the applicant pays the corresponding fees for registration and license with the Cashier of the Center for Health Development, either in person, or through postal money order.
10.2.2.3 The Bureau of Health Facilities and Services conducts ocular inspection in accordance with licensing requirements.
10.2.2.4 The Bureau of Health Facilities and Services approves or disapproves the issuance of the initial License to Operate.
10.2.2.5 If disapproved, the Bureau of Health Facilities and Services sends the findings and recommendations to the applicant. The applicant may move for a reconsideration of such disapproval. In case such motion is denied, the applicant may appeal such disapproval to the Office of the Secretary in accordance with the provisions of Section 22 hereof.
10.2.2.6 If approved, the Bureau of Health Facilities and Services registers the hospitals or other health facility and issues an initial License to Operate to the applicant.
10.3 The Bureau of Health Facilities and Services shall create a Health Facility Establishment Review Committee for the effective, judicious, prompt and swift action on the application for Permit to Construct a hospital or other non-exempt health facility.10.3.1 The Committee shall review all applications with respect to compliance with the licensing requirements and the prescribed guidelines in the planning and design of a hospital or other non-exempt health facility.
10.3.2 The Committee shall meet once a week or when necessary. It shall be composed of, but not limited to, the following staff from the Bureau of Health Facilities and Services:10.3.2.1 Chairman - Assistant Director (Bureau of Health Facilities and Services)
10.3.2.2 Vice Chairman - Head (Standards Development Division)
10.3.2.3 Members - Architect, Engineer, Health Physicist, Licensing Officer III, Nurse, Pathologist or Medical Technologist, Pharmacist, Physician
10.4 The Bureau of Health Facilities and Services shall create a Health Facility Licensing Team(s) for the effective, judicious, prompt and swift action on the application for initial License to Operate a hospital or other health facility.10.4.1 The licensing team(s) shall inspect all hospitals and other health facilities with respect to compliance with the licensing requirements, the prescribed guidelines in the planning and design of a hospital and other health facilities and in the management of service capability, personnel, equipment and physical plant.
10.4.2 The licensing team(s) shall be composed of, but not limited to, the following staff from the Bureau of Health Facilities and Services:10.4.2.1 Team Leader - Physician
10.4.2.2 Members - Architect or Engineer, Health Physicist, Licensing Officer III, Nurse, Pathologist or Medical Technologist, Pharmacist
10.4.3 The Bureau of Health Facilities and Services, pursuant to an appropriate Memorandum of Agreement with the biggest (in terms of membership) non-stock, non-profit hospital association in the Philippines, shall allow the latter's duly authorized representative to be a third party observer and accompany the licensing team in the inspection of hospitals.
11.1 License to Operate a hospital or other health facility shall be automatically renewed every year upon the submission of: (a) Application for Renewal of License to Operate, which must be filed ninety (90) days before the expiry date to the Center for Health Development under whose territorial jurisdiction the hospital or other health facility is located; and (b) upon the payment of the renewal fee.
11.2 The following are the required documents to be accomplished before a license to operate can be renewed:11.2.1.1 Letter of Application to the Director of the Center for Health Development
11.2.1.2 Form No. 2-01: Application for Renewal of License to Operate
11.2.1.3 Sworn Statement that the hospital or health facility has complied with all the requirements of applicable laws, rules and regulations and that the submitted documents are true and correct insofar as applicant is concerned or knowledgeable of.
11.3 The following are the procedures for application for Renewal of License to Operate:11.3.1 Applicant requests relevant information and prescribed form from the Center for Health Development under whose jurisdiction the proposed hospital or other health facility is located in person, or through mail, email or Internet.
11.3.2 Applicant accomplishes required documents and submits them to the Center for Health Development. Upon filing of application, the applicant pays the corresponding fees for renewal of License to Operate to the Cashier of the Center for Health Development in person, or through postal money order.
11.3.3 Upon presentation of proof of payment, the Center for Health Development issues a Renewal of License to Operate to the applicant.
11.4 The Center for Health Development shall submit a quarterly report of all applications for Renewal of License to Operate to the Bureau of Health Facilities and Services. The report shall include the name of hospital or other health facility, location, type of application, and scope of work.
11.5 During the transition period provided in Section 26 of this Order, the Center for Health Development under whose territorial jurisdiction the hospital/health facility is located shall be responsible for processing and renewal of the respective License to Operate, Birthing Home, Acute-Chronic Psychiatric Care Facility, Custodial Psychiatric Care Facility, Infirmary, or Primary Care Hospital. Meanwhile, the Bureau of Health Facilities and Services shall be responsible for the processing and renewal of the respective License to Operate Secondary Care Hospital or Tertiary Care Hospital.
12.1 All hospitals and other health facilities shall be inspected regularly and records shall be made available to determine compliance with these rules and regulations.
12.2 The Bureau of Health Facilities and Services or the Center for Health Development shall be allowed to inspect the hospitals and other health facilities at any given time and without prior notice.
12.3 All hospitals and other health facilities shall make their records available for inspection and examination to the Bureau of Health Facilities and Services or the Center for Health Development.
12.4 The Director of the Center for Health Development, and the Chief of the Provincial, City or Municipal Health Office are required to report the existence of all unlicensed hospitals and other health facilities and all violations of these rules and regulations to the Bureau of Health Facilities and Services.
13.1 All hospitals and other health facilities shall be monitored regularly and records shall be made available to determine compliance with these rules and regulations.
13.2 The Bureau of Health Facilities and Services shall be allowed to monitor the hospital and other health facilities at any given time and without prior notice.
13.3 All hospitals and other health facilities shall make their records available for inspection and examination to the Bureau of Health Facilities and Services.
14.1 The Bureau of Health Facilities and Services shall develop the capability of the Center for Health Department on enforcement of these rules and regulations.
14.2 The Bureau of Health Facilities and Services shall provide technical assistance and advisory services to the Center for Health Development, Local Government Unit, and Private Institution regarding compliance with the licensing requirements for all hospitals and other health facilities.
15.1 A non-refundable fee shall be charged for Application for Permit to Construct; Application for Registration and Issuance of License to Operate; or Application for Renewal of License to Operate.
15.2 All fees shall be paid to the Cashier of either the Bureau of Health Facilities and Services or the Center for Health Development, as the case may be.
15.3 All fees shall follow the current prescribed schedule of fees of the Department of Health.
16.1 No License to Operate shall be issued to applicable hospitals and other non-exempt health facilities without the appropriate Permit to Construct secured prior to the construction, alteration, expansion, renovation, increase in bed capacity, or issuance of license for the operation of clinical laboratory, radiology and pharmacy.
16.2 A Permit to Construct shall be considered lapsed and the fee paid shall be forfeited when the work authorized by the permit does not commence within three hundred sixty-five (365) days from date of issuance, or is abandoned during the period specified.
16.3 An initial License to Operate shall be granted in accordance with prescribed licensing requirements and on the basis of specific conditions and limitations established during inspection.
16.4 A License to Operate that is not renewed for a period of two (2) consecutive years shall be considered lapsed and registration shall be cancelled. A new Application for Registration and Issuance of License to Operate shall be required before hospitals and other health facilities can be allowed to operate.
16.5 The License to Operate as herein granted as well as any right under the license cannot be assigned or otherwise transferred directly or indirectly to any party without the written consent of the Director of the Bureau of Health Facilities and Services.
16.6 The Bureau of Health Facilities and Services shall be notified of any change in management, name or ownership without disruption in hospital/health facility operation (service capability, personnel, equipment/instrument and physical plant). In case of any change in management, name or ownership with disruption in hospital/health facility operation, or in case of transfer of location, a new application for permit to construct, registration and issuance of License to Operate shall be required.
16.7 Failure to report in writing within fifteen (15) days of any substantial change in the condition of the License to Operate may be a basis for the suspension or revocation thereof.
16.8 A separate License to Operate shall be required for all hospitals and other health facilities or branches maintained in separate premises but operated under the same management. However, a separate License to Operate shall not be required for separate buildings in the same premises.
16.9 The License to Operate shall be placed in an area readily seen by the public. A copy of the rules and regulations shall be readily available for guidance of all personnel of the hospitals and other health facilities.
16.10 The License to Operate shall automatically expire on the date of anniversary of its issuance.
17.1 Making substantial alteration or renovation of a hospital and other non-exempt health facilities without securing a Permit to Construct;
17.2 Any material false statement in the application;
17.3 Any fraudulent, unscrupulous, or false claims or misrepresentations in the Sworn Statement (for Renewal of License to Operate);
17.4 Change of location, management, name or ownership without the written consent of the Bureau of Health Facilities and Services in writing;
17.5 Refusal to allow inspection of a hospital or other health facility by the Bureau of Health Facilities and Services or the Center for Health Development;
17.6 Refusal to allow monitoring of a hospital or other health facility by the Bureau of Health Facilities and Services; or
17.7 Failure to make necessary corrections of deficiencies or adjustments required by the Bureau of Health Facilities and Services or the Center for Health Development after due notice.