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C.C.S.M. c. H120
The Hospitals Act
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HER MAJESTY, by and with the advice and consent of the Legislative Assembly of Manitoba, enacts as follows:
In this Act
"fund" means Manitoba Health Services Insurance Fund; (« Fonds »)
"health region" means a health region established or continued under The Regional Health Authorities Act; (« région sanitaire »)
"hospital" means a hospital as defined in The Health Services Insurance Act; (« hôpital »)
"in-patient" means a person admitted to and assigned to a bed in a hospital on the order of a duly qualified medical practitioner, registered nurse (extended practice) or midwife or, subject to the conditions prescribed in the regulations made under The Health Services Insurance Act, on the order of a licensed dentist; (« malade hospitalisé »)
"in-patient services" has the meaning ascribed to that expression in The Health Services Insurance Act; (« soins en hôpital »)
"insured person" means a person who is an insured person within the meaning of The Health Services Insurance Act; (« assuré »)
"minister" means the Minister of Health; (« ministre »)
"operator" means a person, board of directors, board of management or management committee who or which operates, conducts, or manages a hospital; (« administrateur »)
"out-patient" means a patient who is not an in-patient who is admitted to a hospital for necessary diagnostic or treatment services, but who is not assigned to a bed in the hospital; (« malade en consultation externe »)
"out-patient services" has the meaning ascribed to that expression in The Health Services Insurance Act; (« soins en consultation externe »)
"patient" includes both in-patient and out-patient; (« malade »)
"regional health authority" means a regional health authority established or continued under The Regional Health Authorities Act; (« office régional de la santé »)
"standard ward" means a ward that is classified by the owner of the hospital as a standard ward as provided in section 6, and for the use of which the charge made is not greater than that made for the use of any other ward in the hospital. (« chambre ordinaire »)
S.M. 1992, c. 35, s. 58; S.M. 1993, c. 29, s. 186; S.M. 1996, c. 53, s. 83; S.M. 1996, c. 58, s. 456; S.M. 2001, c. 21, s. 18; S.M. 2004, c. 42, s. 33; S.M. 2005, c. 52, s. 47; S.M. 2013, c. 42, s. 4; S.M. 2014, c. 32, s. 34; S.M. 2015, c. 43, s. 25.
The minister may, in writing, delegate to any person any power, authority, duty or function conferred or imposed upon the minister under this Act or the regulations.
Nothing in this Act applies to a private hospital to which The Private Hospitals Act applies or to the owner, operator, or licensee thereof.
OPERATION OF HOSPITALS
No person shall operate a hospital in Manitoba unless he holds a subsisting licence for that purpose issued to him by the minister.
Subject to subsection (2), every person who operates a hospital in Manitoba shall operate it in accordance with the requirements of this Act and the regulations, and shall provide therein hospital care, treatment, and service in accordance with the standards set out in this Act and the regulations.
Where a hospital is in a health region, the operator of the hospital
(a) shall operate the hospital in accordance with the requirements of The Regional Health Authorities Act and the regulations under that Act, in addition to the requirements of this Act and the regulations;
(b) notwithstanding subsection (1), shall provide only such hospital care, treatment and services as are funded or approved by the regional health authority for the health region which has the responsibility to provide the hospital care, treatment and services; and
(c) in providing hospital care, treatment and services, shall comply with the standards in The Regional Health Authorities Act and the regulations under that Act, in addition to the requirements of this Act and the regulations.
Before the minister issues a licence to the operator of a hospital in respect of the hospital, the operator shall establish by-laws, regulations, or rules
(a) prescribing the method and terms of admission to the hospital;
(b) setting out the duties and authority of the officers and employees engaged in the operation or administration of the hospital;
(c) prescribing the scales of salaries and wages payable to persons to whom clause (b) refers; and
(d) generally for the government and management of the hospital, and making provision for such matters as may be directed by the minister.
Without restricting the generality of subsection (1), the operator of a hospital shall enact and put into force suitable general hospital by-laws and medical staff by-laws, regulations and rules, and all by-laws, regulations and rules under this subsection and subsection (1) shall comply with any model by-laws, regulations and rules, and directions or guidelines, provided or approved by the minister.
Where the operator of a hospital is a corporation, the by-laws, regulations, or rules shall be made by by-law of the board of directors or other such managing board or committee thereof.
Within two weeks after making any by-law, regulation or rule under subsection (1) or (2), or any amendment or repeal thereof, the operator of the hospital shall,
(a) where the hospital is not in a health region or where the operator of the hospital is a regional health authority, submit the by-law, regulation, rule, amendment or repeal to the minister for approval; and
(b) where the hospital is in a health region and the operator of the hospital is not a regional health authority, submit the by-law, regulation, rule, amendment or repeal to the regional health authority for the health region which has the responsibility to provide the hospital care, treatment and services, for approval.
A regional health authority shall not approve any by-law, regulation or rule, or amendment or repeal thereof, unless it complies with subsection (2).
A by-law, regulation or rule, or any amendment or repeal thereof, has no force or effect unless approved in writing by the minister or the regional health authority as required under subsection (4).
The operator of a hospital shall classify each of the wards therein as
(a) a standard ward;
(b) a semi-private ward; or
(c) a private ward;
as the case may be, and in accordance with the accommodation provided by the hospital and the requirements in respect thereof set out in the regulations.
The rated bed capacity of any hospital established for wards of each of the classes mentioned in subsection (1) in such as may be approved in writing by the minister.
The operator of a hospital shall maintain the number of beds set up in each ward thereof at the number stated in the rated bed capacity established therefor and no more, except in the case of an epidemic or other emergency when the number of beds may be increased; but the maintenance of the increased number shall be discontinued forthwith on the termination of the epidemic or emergency or at any other time if the minister so directs.
The operator of each hospital shall, on or before the date prescribed in the regulations in each year, submit to the minister or, where the hospital is in a health region, to the regional health authority for the health region which has the responsibility to provide the hospital care, treatment and services, a statistical report respecting the operations of the hospital during the last preceding year; and the report shall be in such form and contain such information as may be prescribed in the regulations.
On or before a date prescribed in the regulations in each year, the operator of each hospital shall appoint an auditor to audit the books and accounts of the hospital during the next succeeding year.
No person shall be appointed auditor if, during the year in which the appointment is made or the next preceding year,
(a) he is or was a member of a board of directors or other board or committee responsible for the operation of the hospital; or
(b) he has or has had, directly or indirectly, any share or interest in a contract made by the operator of the hospital; or
(c) is or was employed by the operator in any capacity other than that of auditor.
Where the operator of a hospital is a regional health authority, the appointment of an auditor shall be in accordance with The Regional Health Authorities Act and subsections (1) and (2) do not apply.
On or before a date prescribed in the regulations in each year, the auditor shall prepare, in such form as the minister may approve, an abstract of
(a) the revenue received, and the expenditures made, by the operator in respect of the hospital during such period as may be prescribed in the regulations; and
(b) the assets held by the operator, and the liabilities incurred by him and still outstanding, in respect of the hospital at the end of the period to which clause (a) refers;
and the auditor shall note and make a special report respecting any revenues received or expenditure made by the operator contrary to law.
Forthwith after making the abstract, the auditor shall send, by registered mail, two copies thereof to the minister and one copy thereof to the operator.
Subsections (3) and (4) do not apply where the hospital is in a health region.
The operator of each hospital shall cause it to be insured by an insurer licensed to undertake contracts of insurance in Manitoba against fire and the supplemental perils mentioned in subsection 29(1) of The Insurance Act, to such amount as may be prescribed in the regulations.
The minister shall cause each hospital to be visited, and the hospital premises and the accounts, registers, and other books kept in respect of the hospital to be examined, by an inspector or consultant, as often and at such times as the minister considers necessary, but at least once in each year.
The inspector or consultant shall, on each visit, inquire into the management, maintenance, and operation of the hospital and by means of such inquiries and the examination of the accounts, registers and other books satisfy himself as to the correctness or otherwise of all returns, reports, and information made or furnished by the operator of the hospital; and shall report to the minister respecting his visit and inspection and the information thereby obtained by him.
Subsections (1) and (2) do not apply to a hospital in a health region, which shall be inspected in accordance with the provisions of The Regional Health Authorities Act, and the regulations and any agreements under that Act.
This Part does not apply in respect of
(a) a workman the cost of whose hospital care is payable by The Workers Compensation Board under The Workers Compensation Act; or
(b) a person who is receiving care and treatment in a hospital under an Act of the Parliament of Canada.
From and out of the Consolidated Fund, with moneys authorized by an Act of the Legislature to be so paid and applied, the Minister of Finance, on order of the Lieutenant Governor in Council, may pay grants to the operators of hospitals in such amounts, in such manner, and at such times, as prescribed in the regulations or as may be stated in the order, for the purpose of
(a) hospital construction;
(b) education and training of hospital and related health personnel;
(c) the care and treatment of out-patients who are indigents.
The Lieutenant Governor in Council may, by order in council, direct that, after a date fixed in the order, no payment or grant for which provision is made in this or any other Act shall be made to, on behalf of, in respect of, or for the benefit of, an operator of a hospital that is named in the order and to which, before the date fixed in the order, such payments or grants might be made; and thereupon while the order remains unrevoked no such grants or payments shall be made.
On the revocation of an order made under subsection 12(2) payments and grants may be made to the operator of the hospital as provided herein, including payments and grants in respect of the period during which the order revoked was in force.
The Minister of Finance, on order of the Lieutenant Governor in Council, may pay from the Consolidated Fund the fees of architects incurred in respect of the preparation of plans for the construction of any hospital in Manitoba; but any amount so paid is a debt due from the operator of the hospital to the government and the whole or any part thereof may be recovered by the government, represented therein by the minister, from the operator of the hospital by action taken in any court of competent jurisdiction.
Sections 12, 13 and 14 do not apply to a hospital, or the operator of a hospital, which is in a health region.
Where a standard ward patient dies in a hospital, the municipality of which the patient was a resident, unless it takes charge of the body, is liable to the operator for the burial expenses thereof, not exceeding such amount as may be fixed in the regulations, together with the cost of a burial plot, and that amount is due to the operator.
Where an incorporated hospital has borrowed moneys for its purposes on the security of an issue of bonds or debentures, and the moneys or any part thereof are not immediately required for those purposes, the operator may, notwithstanding any provision of the Act or letters patent incorporating the hospital, cause the moneys not so required to be invested in any of the following securities or forms of investment and no others; namely:
(a) Treasury bills issued by the Government of Manitoba.
(b) Treasury bills issued by the Government of Canada.
(c) Bank deposit receipts issued by a bank.
(d) Such other securities or forms of investment as may be prescribed in the regulations.
The minister may issue to the operator of a hospital a licence authorizing the operation of the hospital in such form, and on payment of such fee, as may be prescribed in the regulations.
A licence is subject to the terms and conditions therein set out and also to the terms and conditions with respect thereto set out in the regulations.
A licence shall, as provided in the regulations, either expire at such time as prescribed in the regulations, or continue in force until suspended or revoked.
The minister may, at any time and in the minister's absolute discretion, suspend a subsisting licence for a period not exceeding three months.
At least one month before
(a) recommending the revocation of a licence as herein provided, or
(b) the expiration of a licence the renewal of which for a further period it is considering refusing,
the minister shall notify the licensee and give him an opportunity to be heard; and, after the hearing, if the minister considers it advisable to do so, the minister may recommend to the Lieutenant Governor in Council that the licence be revoked or not renewed, and shall accompany his or her recommendation by a summary of the evidence given at the hearing.
On receipt of a recommendation under section 21 the Lieutenant Governor in Council, after considering the recommendation and the summary and obtaining such other information as he may deem desirable, may
(a) approve the recommendation and direct that the licence be revoked or not renewed;
(b) direct that the licence be not revoked or be renewed and that any suspension thereof be terminated; or
(c) that a suspension be continued for a further period stated in the order, before the end of which the minister shall hold a further hearing and make a further recommendation which shall be dealt with as provided in this subsection in respect of the first recommendation.
Neglect or refusal by the operator of a hospital to observe, in the opinion of the Lieutenant Governor in Council, sound business and accounting practices and procedures in respect of the operation and management of the hospital is a sufficient reason for revocation, suspension, or refusal to renew a licence issued in respect of the hospital.
Where the minister deems it desirable that a standards committee be established in respect of any hospital in or area of the province he may, in writing, request The College of Physicians and Surgeons of Manitoba to appoint members to such a committee, and thereupon the council of The College of Physicians and Surgeons of Manitoba shall appoint the members to such a committee, and from time to time appoint persons to fill vacancies in the committee.
The College of Physicians and Surgeons shall report to the minister the names of all persons appointed to a standards committee under section 24.
The minister may prescribe the duties, functions, and powers of standards committees appointed under section 24.
Any person who
(a) refuses to make a statutory declaration that he is required to make under this Act or the regulations; or
(b) knowingly makes or submits
(i) a false statement, oral or written, as to his property or means, or as to his residence; or
(ii) a false return;
that he is required to make or submit under this Act or the regulations;
is guilty of an offence and is liable, on summary conviction, to a fine not exceeding $500.
Any person who contravenes or refuses or fails to observe any provision of this Act or of the regulations for which a penalty is not otherwise provided herein is guilty of an offence and is liable, on summary conviction, to a fine not exceeding $200.
For the purpose of carrying out the provisions of this Act according to their intent, the Lieutenant Governor in Council may make such regulations and orders as are ancillary thereto and are not inconsistent therewith; and every regulation or order made under, and in accordance with the authority granted by, this section has the force of law; and, without restricting the generality of the foregoing, the Lieutenant Governor in Council may make regulations and orders,
(a) respecting the manner in which, and the conditions and requirements under and in accordance with which, hospitals must be operated, conducted, and managed;
(b) setting forth the requirements for the equipment of, and accommodation provided in, wards of various classes in hospitals;
(c) prescribing the form in which reports and returns are to be made as required herein by the operator of a hospital and the information to be set out therein;
(d) subject to subsection (2), prescribing the percentage of the value of hospitals that must be insured as provided in section 9;
(e) fixing the amounts of grants that may be made to the operators of hospitals for the several purposes mentioned in subsection 12(1);
(f) prescribing the form in which licences shall be issued by the minister, and the fee payable therefor by the licensee;
(g) prescribing terms and conditions to which a licence is subject and that must be observed by the licensee;
(h) prescribing the time, if any, at which a licence expires;
(i) prescribing the reports of returns additional to those hereinbefore required that must be made by the operators of hospitals;
(j) respecting the locations in which hospitals may, or shall not be, erected, the acquisition or use of land as site for hospitals, and the size, type, kind of construction, and equipment of hospitals;
(k) respecting the manner, method, and conditions in or under which hospitals may, or shall not be, repaired or altered;
(l) setting forth the classification and grades of hospitals and standards to be observed in the operation of hospitals of the several classes or grades;
(m) providing for the regular inspection of hospitals or categories of hospitals;
(n) respecting the duties charged on, and the powers and authority vested in, officers, servants, and employees of operators of hospitals, including both professional and non-professional personnel;
(o) establishing the method of appointing and terms of appointment of members of the medical staff of the hospital, their duties and privileges, and the various divisions or grades into which persons so appointed shall be divided;
(p) prescribing the methods to be observed in the admission, care, treatment, discipline, and discharge of patients, and rules of conduct to be observed by patients;
(q) setting out the various classes of patients who may be admitted to hospitals of various kinds;
(r) prescribing the books, registers, records, and accounts to be kept by operators of hospitals;
(s) providing, in particular, for the recording of births and deaths occurring in hospitals;
(t) prescribing the manner in which tissues removed from human bodies shall be dealt with and disposed of;
(u) prescribing the methods to be observed in the care of the dead;
(v) prescribing the minimum equipment that must be provided in laboratories, x-ray rooms, operating rooms, emergency rooms and the manner in which they must be maintained and operated;
(w) providing for the establishment, operation, and supervision of places for the training of hospital personnel;
(x) [repealed] S.M. 1996, c. 53, s. 83;
(y) prescribing the conditions under which registered dentists may make orders admitting patients to hospitals;
(z) prescribing the maximum amount for which a municipality is liable to an operator in respect of the burial expenses of a standard ward patient who dies in a hospital;
(aa) prescribing the date on or before which the operator of each hospital shall submit its annual statistical report to the minister or a regional health authority;
(bb) prescribing the date on or before which each hospital shall appoint an auditor to audit its books during the next succeeding year;
(cc) prescribing the date on or before which the auditor of the hospital shall prepare an abstract regarding the revenue and expenditures of the hospital and the assets held by the operator of the hospital and the liabilities incurred by him;
(dd) prescribing the time period to be covered by the auditor's abstract of the revenue and expenditures of a hospital; and
(ee) respecting the borrowing and investment powers of operators of hospitals, including but not limited to prescribing restrictions on borrowing and prescribing securities or forms of investment for the purposes of clause 16(d).
A regulation made under clause (1)(d) may prescribe for different hospitals differing percentages of the values required to be insured, based on the materials of which the hospital is built, the type of construction, its location and age, and any other considerations affecting the risk.
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