*1
James H. appellants. Justice, Ill, Harrisburg, Knorr,. Dept, of
John G. appellee. J., NIX, EAGEN, O’BRIEN, ROBERTS,
Before C. FLAHERTY, MANDERINO, JJ. LARSEN OF THE COURT OPINION ROBERTS, Justice. Hospital Association
Appellants, Pennsylvania regu- contend that state twenty-one Pennsylvania hospitals, hospitals,” lations 28 Pa.Code governing “general special author- promulgated 101.1 et were without seq., statutory §§ and the ity by appellees, Secretary Department We and the appellees Health. Commonwealth agree challenged basis ample regulations Court IX of the Welfare Accord- by article Public Code.1 provided we affirm. ingly,
I 1972, In determined that the department’s appellees 1966, last “Rules and revised Regulations Hospitals,” In full again compliance publication should be revised. of pro- and notice a set requirements,2 appellees published 1966 rules and posed regulations designed replace 1977, 2 (1972). rules. Pa.Bull. 1129 Between 1972 and extensive on the appellees public opinion proposed evaluated rules, Hospital comment from the Association including into a Pennsylvania, incorporated many suggestions notice, proper revised draft. a Again by appellees published regulations. (1977). revised set of 7 Pa.Bull. 939 rules comment, After further public appellees pro- modified and, December, 1977, rules adopted them as modi- posed (1977). fied. 7 Pa.Bull. 3631 regulatiоns span twenty-six chapters, challenged Manage- from such concerns as “Governance and
ranging 1967, 31, amended, seq., Act of June P.L. et as 62 P.S. 1. 901 §§ seq. (1968 Supp.1979). 901 et §§ Law, 31, 1968, July 2. See Commonwealth Documents Act of P.L. seq., seq. (Supp.1979). 101 et 1101 45 P.S. et §§ §§ chapter Within each Standards.”3 ment” to “Construction example, For specific regulations. series of are a there there Management,” heading “Governance under hospital by-laws, setting objectives appear regulations a performed by functions 103.3, establishing Pa.Code § formation directing id. at body,” “governing 103.4, Also Id. at committees.” “governing body various 103.6. Bill of a “Patient’s establishing regulations included are and administra- managerial id. at Rights,” 103.21-103.24, §§ 103.31-103.39, and standards id. at tive responsibilities, §§ all, appellees In Id. at for fiscаl control. §§ 103.41-103.46. regulations. 500 specific over promulgated regulations, appellants of the the effective date Before Court, in the Commonwealth for review petition filed promul- statutory lacked alleging appellees appellees’ On regulations. rules and challenged gate challenged regulations provides: 3. The Table Contents Chap. Sec. 101. General Information.......................... 101.1 Management.................... 103. Governance and 103.1 Discharge.................... 105. Admission and 105.1 107. Medical Staff............................ 107.1 Nursing 109. Services............................... 109.1 111. Dietetic Services............................ 111.1 113. Pharmacy Services........................ 113.1 115. Medical Record Services .................. 115.1 Emergency 117. Services........................... 117.1 119. Outpatient Services and Short-Term Procedure Units 119.1 121. Social Work Services........................ 121.1 123. Anaesthesia and Services ............ 123.1 Respiratory Services.................. Laboratory 125.1 Radiolоgy Services......................... 127.1 *4 129. Nuclear Medicine Services..................... 129.1 131. Rehabilitation Services.................... 131.1 133. Care Special Units............................ 133.1 Surgical 135. Services........................... 135.1 137. Obstetrical Services........................... 137.1 139. Newborn Services............................. 139.1 141. Dental Services .............................. 141.1 143. Podiatry Services.............................. 143.1 145. Professional Library Services.................... 145.1 147. Environmental Services......................... 147.1 149. Central Services Supply ........................ 149.1 Fire, and Safety, Disaster Services ............... 151.1 153. Construction Standards...................... 153.1 520 Court Commonwealth judgment, summary
motion for relief.4 This denied appellants regulations sustained the followed.5 appeal
II expressly provides Public Welfare Code 902 of the Section number over a “supervision” shall have the department that institu- (8), under subsection facilities, including, “[a]ll Appellants this Commonwealth.”6 for adults within tions hospitals” must, special concede, “general they as however, dispute, They “are for adults.”7 institutions requested petition, appellants Upon filing the Commonwealth their injunction. grant preliminary The Commonwealth them a Court Court granting upon injunction, preliminary later dissolved it granted but summary judgment. appellees stay appeal. appellants pending In view of granted 5. This Court course, stay, disposition, is vacated. this our provides: 6. Section 902 “Supervisory powers supervision department shall have over: The institutions; (1) All State institutions; (2) supervised All All children’s institutions Commonwealth; (3) within this Commonwealth; hospitals (4) maternity within this homes and All penal, correc- (5) Any system on in the of labor carried labor or State; reformatory institutions of tional or by system reparation provided (6) Any the Commonwealth mine-caves, fire, flood, or other relief casualty, conditions caused from welfare; safety public constituting a menace (7) boarding have been licensed homes for children which All State; within this Commonwealth.” All institutions for adults Department Welfare. See “department” of Public refers to the By “Reorganization (definitions). Public Welfare Code Plan No. 2 of Legislature (Supp.1979), 1973,” 755-2 P.L. 71 P.S. “functions, Department of Health the to the transferred regard Department of Public Welfare powers and duties of hospitals, general special licensing as supervision to the Code.’]” Public Welfare 9 and 10 of [‘The set forth Articles Appellants” at “B-33.” Section “Appendix Brief for ‘B’to 7. See “institution for adults” 1967defines an Welfare Code of of the Public as follows: “ unincorpo- any incorporated or means for Adults’ ‘Institution society organization, association includ- public private rated ing municipal- county, county any agency district or institution of a
521 “supervision.” Appellants claim scope appellees’ power which not be prerogatives” they possess “managerial may regulated by appellees. depart
The Public Welfare Code does not define the section 902. Neverthe powers” ment’s under “supervisory must that less, recognize our review of the Code “[substan practice, is a used administrative rule-making widely tive delega its use should be whenever the upheld statutory can be construed to authorize it.” Bernard reasonably tion As Schwartz, (1976). Law 56 at 151 p. Administrative § out, Dean Freedman existence points body “[t]hе deliberations, to self-con encourage greater standards tends sciousness, and in the exercise of administrative consistency likelihood that an thereby agen discretions and reduces the Freedman, will act James 0. Crisis and cy arbitrarily.” The Administrative Process and American Legitimacy: that, (1978). reasonably Government 245 We are satisfied construed, Welfare demonstrates that the the Public Code (A) intended to Legislature permit fully (B) to do so supervise hospitals’ managerial practices through promulgation regulations. rules and
A in article IX of the is “managerial Nowhere Code. reserved. Public Relations prerogative” Compare Employe Act, 23, 1970, 563, 702, Act of P.L. 1101.702 July P.S. (Supp.1979) shall not be (“[p]ublic employers required bargain over mattеrs of inherent managerial policy”). Rather, administration is within the hospital expressly pur food, adults, ity provides which for shelter and some service to or rehabilitation, training, guidance counselling provides which or mentally visually handicapped, physically the blind or or to handicapped, including following: but limited to the homes for the infirm, homes, homes, placement aged nursing convalescent adults, agencies general special hospitals and institutions adults, mentally having ill and defective rehabilitation centers living-in arrangements, workshops for the rehabilita and facilities visually, mentally physically handicapped, all tion of the organizations prevention for the of blindness.” 1973”). (quoting “Reorganization supra
See also notе 6 Plan No. 2 of Sure- regulatory obligations. existing departmental view of uniform proper, seriously disputed it cannot ly *6 of efficiency the promote quality managerial practices to individual consumers care services the of health delivery this which the goal It is precisely health care. requiring to achieve. the Section department Legislature requires expressly to Code, hospitals,8 the 921(c) fully applicable of for the safe and to set “standards department directs the individuals,” making “adequate proper care of adequate humane care.” (x) . provision[] are within of managerial practices hospitals That un competency department the legislatively-defined of anby analogous provision der section 921 is demonstrated contemplates the Code expressly article IX. 911 of Section the managerial practices the review of department’s 911(a)(2), Leg the Under section institutions.” “supervised to relating matter and thing” “all and places every islature of “su “usefulness, administration, and management” the of the inmates institutions,” and “to the welfare pervised obli- ,” mandatory within the department’s thereof . . . Indeed, “super- “inquir[y] gation examin[ation.]”9 hos- definition, includes “all institutions,” expressly vised houses, coun- almshouses, maintained poor by any or pitals, district of this Common- township poor or city, borough, ty, convinced, therefore, the Legislature wealth.” We are Code, 921(b) (“hospitals” expressly enumerat- Public Welfare 8. Sеe standards). departmental subject ed as “institutions” to 911(a)(2) requires department: the 9. Section year, inspect, all state and once in each visit and at least “To institutions; inquire methods supervised and examine into their care, detention, treatment, instruction, discipline, care or the treatment, management government inmates or those or of their therein, detained, residing thereto, being treated or or committed trustees, managers, inspectors, di- official conduct of their management charged their with other officer or officers rectors or care, custody otherwise, management, having or law or equipment thereof, buildings, grounds, premises, and control therewith, every thing thereof, matter and and all and or cоnnected usefulness, administration, management, relating to their thereof, committed thereto inmates or those welfare of the to the detained, residing being therein.” treated or over expertise experience the tribunal given has similar au- institutions” “supervised managerial practices of hospitals managerial practices thority supervise 921.10 under section standards subject departmental B 902 of Code that section also satisfied We are practices managerial to supervise the department authorizes regula of “rules and promulgation hospitals through confers authori IX expressly No of article provision tions.” and regulations” “rules to establish ty upon de Rather, 921(c), the under section governing hosрitals. Nonetheless, “standards.” to establish required partment these man enforcing means of discussing appropriate contemplates clearly “standards,” Legislature datory *7 affecting hospitals. regulations” “rules and departmental 921(e) provides: Section inves- inspection, shall upon the department
“Whenever in institution any find violation complaint any or tigation department, the or adopted by any regulations of rules or standards establish, or maintain provide failure to it shall department, this act or the by facilities required by thereof, to the officer or notice immediate written give having or way law with or in any officers charged by of control, management exercising government the condition institution, objectionаble the said such to correct depart- within the time specified in the manner and consideration, by appellants, confirms our other overlooked One possess authority appellees under sections 911 and conclusion that appellants hospitals’ managerial practices. to regulate Were to 921 prevail regulations, upon challenged at least in their attack promul- Hospitals” Regulations for portions gated like, appellees’ “Rules governance relating hospital including in those to Legislature, how- to similar criticism. would be vulnerable ever, codifying provisions Welfare Code of in the Public the above regulations. appellees’ It is 1966 to disturb made no effort interpretations, not disturbed established Legislature, administrative that guides legislative intent. 1 appropriate Pa.C.S. are Legislature’s 1921(c)(8). corollary that it a fair We think appellees’ any respect exercise of rule- to disturb failure 1967 in appellees’ legislative recognition making authority in 1966 evinces authority “managerial prerogative.” regulatory over of such officer ment; duty it shall be whereupon, of the department. with the direction comply officers to with such di- comply fail to If such officer or officers rection, may request Department the to en- legal proceedings appropriate Justice to institute therewith, the department may force compliance institution available for such money any withhold State with suсh direction.” comply or officers until such officer added) (emphasis regulations “rules and 921(e) contemplate could
Section if some other only provision the department” adopted by It must authority. the department the Code grants construed, if statute shall be “[ejvery remembered that to all its Pa.C.S. provisions.” effect possible, give department’s super- effect” both to the To 1921(a). “give “rules language under section 902 and power visory it must be concluded 921(e), in section found regulations” its power under empowered, the department “rules and regulations.” formulate “supervision,”
Ill
reasons,
regulations
none of the
the above
For all
affecting gover
those
including
have challenged,
appellants
Rights,”
setting
“Patient’s Bill of
nance, establishing a
admissions,' can realistically
considerations
appropriate
of departmental
the reach
beyond
be viewed as
we hold that the
Accordingly,
conferred under section
*8
its
to
promulgate
has authorized the
Legislature
therefore
We
concerning hospitals.
and regulations
rules
denying
of the Commonwealth Court
affirm the decree
relief.11
injunctive
appellants
own costs.
party pays
Decree affirmed. Each
any particular
regula-
pass upon
of
the reasonableness
11. We do not
authority
statutory
only
appellees possess
to
hold
tion. We
challenged regulations.
District v.
promulgate
Cf. Girard School
(upholding regulations
of
Pittenger,
MANDERINO, J., did not participate decision this case.
FLAHERTY, Justice, dissenting.
I cannot sit while the idly by majority my colleagues an give unwarranted license to a governmental agency enact social legislation in the form of regulation without a semblance of to be found in the enabling legisla- tion. A governmental regulation to valid gain must its life from a defined clearly delegation of statutory origin. The obvious reason for this principle has its foundation in the nature of our concept government. The law which of our people governed are society them, emanates from through their representatives elected in the legislative branch of government. executive branch cannot mаke law, while the has judiciary to determine duty whether any restrictions on human valid, freedom are and that includes the duty determine whether regulations promul- gated an agency executive branch of government fall within the limits of authority delegated that agency by legislation. When regulations go beyond purpose of statute, enabling or bear no rational to the relationship purpose that legislation, are of no they force and effect and must be set aside.
The Public Code,1 Welfare 921(c) provides:
The department shall establish standards for the safe
and adequate
individuals,
care of
not inconsistent with the
laws of this Commonwealth and the rules and regulations
of the various departments of the Commonwealth, for all
such institutions
Commonwealth,
within this
which stan-
dards shall make adequate and proper provisions
(i)
fire protection, (ii) water
supply
sewage disposal, (iii)
sanitation, (iv)
lighting
heating, (v) ventilation, (vi)
safety, (vii) equipment, (viii) bed space, (ix)
keeping
13, 1967,
seq.,
amended,
1. Act of June
P.L.
901 et
as
§§
62 P.S.
seq. (1968
Supp.1979).
§§
et
*9
of identification of residents in the institution and
records
kin,
care
and all
provided
perti-
next of
of medical
their
data,
(x) humane care.
discharge
nent admission and
the
of this
meaning
It
is not difficult
to
clear
glean
“The
shall
standards
for
establish
language.
department
care of
.
.
. which
adequate
the safe and
individuals
shall make
for
adequate
proper provisions
standards
con-
plain
provides
.” The
for no other
language
.
in
a
for
standards
the
requirement
struction than
minimum
the
is a provision
enumerated areas.
In
902 of
Code there
§
adults,
921(c)
for
for the
over institutions
supervision
§
that
subjects
supervision.
majority
sets forth the
for
in an
911(a)(2)
draws
902 and
of the Code
opinion
upon §§
hospital
to
meth-
justify regulation
management
attempt
have been
the
the
must
theory
ods on
abili-
legislature
apply
management
intended
to
its
institutions”,
ties,
“supervised
pre-
acquired
examining
management
and control
under
hospital
generally
empt
a
921(c).2
far-reaching
grant
construction strains
Such
§
“supervised institution” as follows:
901 defines
‘
any
“Supervised
means
charitable institution within
institution”
from
which receives financial assistance
Commonwealth
Commonwealth,
directly
indirectly,
or
which
either
and to
any
inspectors,
appoint
does not
member of
board of
Governor
directors;
managers,
places
trustees
all
within
or
houses or
detained,
any person
of unsound mind is
Commonwealth which
house,
person
occupant
having
owner of the
or
whenever
or
mind,
person
any compensa-
charge of such
of unsound
receives
attendance,
custody,
for
an
tion
control or
other than as
attendant
nurse;
institutions, houses,
places, in which
or
and also all
or
more
detained,
compensation
person
than one such
or without
attendance;
custody
paid for
all children’s institutions and
or
Commonwealth;
maternity
hospitals
homes
within the
all
hospitals
crippled
homes or
wealth,
children within the Common-
Children;
hospi-
except
Hospital
Crippled
all
State
almshouses,
tals,
any сounty, city,
poor-houses,
or
maintained
Commonwealth;
borough, township
poor
of this
district
all
or
institutions,
and societies within this Commonwealth
associations
delinquent,
neglected
custody
dependent or
into whose care the
committed,
may
places
all
children
by
be
houses and
maintained
institutions,
or
such
such
associations
societies in which
chil-
21,
13, P.L.-,
may
kept
No.
dren
June
art.
detained.
added)
(emphasis
901.’
impliedly delegated
not
power
expressly
this
agency
*10
v.
Joe
In
Human Relations Commission St.
it.
Pennsylvania
302, 310,
731,
A.2d
735-736
Minerals
476 Pa.
382
Corporation,
a
(1978),
longstanding principle:
this court repeated
agency’s
In
the
of an administrative
delimiting
scope
slate,
write on blank
and the control-
we do not
a
power,
are
established:
ling principles
firmly
is this: The power
“The
to decision
principle guiding
commis-
and
to be exercised
administrative
by
clear and
language
conferred by legislative
sions must be
A doubtful
does not exist.
power
unmistakable.
Such
the
should act within
extrajudicial. They
tribunals are
v. Milk
strict and exact limits defined.” Green
Control
3,
Comm’n,
(1940).
340
The of set of of standards care statutory purpose supervision forth in rather a manifesto for a 921(c), represent but of complete by government management preroga- take over tives in of Put another a hospitals. way, the operation hospitals! socialization of private is the regulate We have never held that to power se; to to the In Nоrth power manage, per quite contrary. Commission, v. Public Pennsylvania Company Utility Power 265, 267-268, (1939), 333 Pa. 5 A.2d 134-135 where this “supervised department’s power over institu- defines the ‘§ tions” as follows: inspection 911 Visitation and (a) duty power, The shall have and its shall be: visitation, (1) regulations To make and enforce rules and supervised inspection institutions. examination and of all year, inspect, to and in each all State and visit at least once institutions; supervised inquire and examine into their methods to treatment, care, instruction, detention, discipline, or care treatment, management government those or of their inmates or therein, detained, treated, thereto, residing being or committed or trustees, inspectors, managers, di- the official conduсt of their charged management rectors or officer or officers with their other otherwise, care, custody management, having or law or thereof, equipment buildings, grounds, premises, and control thereof, therewith, every thing matter and or connected and all and administration, management, usefulness, relating to their thereof, or those committed thereto the welfare the inmates added) detained, being residing (emphasis therein.’ treated or a certain prevent lacked power that the P.U.C. held Court we said: merger, utility board of super not a is Public Commission Utility of the State
directors
utility companies
for the public
is
power
Its sole
management
no
of them.
right
it has
facilities,
rates,
service
in the matter of
to see that
thrоugh
fair. Speaking
public
their treatment
“It was not intended
Justice, we said:
Chief
the present
should be a board
the Legislature
the commission
control the affairs
of public
conduct and
managers
that, where certain
it was meant
but
companies;
service
relation to
had intimate
obligations
powers
of their
accommodation, or conve-
fairness,
through.
public
inquisitorial
have an
nience,
commission should
*11
in
the utility
and control
regulate
authority
corrective
jur-
the commission’s
within
brought-
the field specifically
* * *
affairs
its own
manages
The company
isdiction.
extent consistent
protection
with the
to the fullest
com-
matters
is the
interest,
to such
as
only
public’s
and.
only
for the
intervene,
and then
mission authorized
Cement
Coplаy
mentioned
in the act.”
special purposes
649,
Comm., 271 Pa.
58, 61, 114 A.
Co. v. Public Ser.
Mfg.
that, while
be forgotten
“It must never
North Pennsylvania Commission, 449 Pa. Utility Public v. Pennsylvania specific had the P.U.C. holding a (1972) by A.2d 825 North However, mergers. to review statutory manage- in noninterference Power view of Pennsylvania clear au- statutory Thus, unless ment was not disturbed. mat- management to control agency for an is found thority ters, implied. it not be should been has “regulations” five A web of more than hundred on rules which include controls by appellees’ promulgated administrators, dealings organization, patients’ hospital controls, social serv- standards, medical and fiscal admissions to be used methods management ices to be provided, assuring supervi- simply Far from meeting care standards. care, the obvi- of health sion of minimum standards quality in a the rules put ous legislative purpose, of a social- and manager as creator self-appointed position an enact- and constitute ized health care integrated system, of an guise legislation” ment or “social sweeping usurping bypassing executive regulation, completely branch The executive Assembly. functions of the General suсh schemes adopt must not government permitted action, such are to be systems without clear as legislative through legisla- will of the adopted people, expressed reason, For this regulators. tors—not executive through important obliga- is an department’s power of the scrutiny tion of this Court. hazard created great
An of the understanding when considering becomes evident holding majority are Hospitals and detail of these scope regulations. to structure their as institutions deprived right private which describe their own rules govern organizations by boards,4 (including require- contents ownership,3 bylaws who Bill of duties of those Rights),5 ment of a Patient’s *12 Principle. 3. 103.1. § person body designated organized governing an or There shall be legal authоrity ownership shall assume the full and vested with who hospital. responsibility of the for the conduct Single 4. and autonomous boards. 103.2. § educational, subsidiary Any part hospital organized of an aas governed by religious, parent organization a shall be or commercial organization. hospital governing body designated by parent A the body may govern hospital. more one than Governing body bylaws. 103.3. adopt bylaws governing body all in accordance with The shall subpart requirements and in accordance with the in this contained minimum, bylaws hospital. community responsibility of As a the the following: shall do the the govern institution a (including duty devote resources to emotional and care for the spiritual patients),6 manner in (1) (2) general goals specific hospital. State the and of the annually, necessary, Be reviewed be revised as and be dated to
indicate when last reviewed or revised. (6) Require bylaws approval any auxiliary organiza- the by hospital. tions established the (9) procedure implementing, disseminating, Establish a and enforcing Rights compliance a Patient’s Bill 103.21- §§ (relating Rights). 103.24 title of this to Patient’s Bill of (10) Require governing body procedures the to institute to ensure: (i) newly-elected specific orientation of board members to board procedures; functions and (ii) periodic relationship reexamination of the board to the hospital community; total (iii) opportunity general public meetings some for the attend occasion; governing body meetings of the publicized on these shall be well meeting in advance of the date and shall be a held at by general public; time convenient for attendance (iv) taking governing body of minutes of all and executive minutes, meetings committee and dissemination of those or sum- thereof, regular governing maries body. on a basis to all members of the 103.4. Functions. governing body, with technical assistance and advice from the hospital, following: shall do the (2) long-range plans development Formulate for the short- hospital. (6) granting defining Utilize the advice of the medical staff scope privileges governing of clinical individuals. When body regarding does not concur in the staff medical recommendation individual, privileges the clinical of an there should be a review of the joint recommendation governing body committee of the medical staff and governing before a final decision is reached body. (7) Require applicants disposition be informed of the of their application membership privileges, for medical staff clinical both, period application within a reasonable of time after their has been submitted. (9) Delegate to the medical staff the to evaluate the professional competence privileges applicants of staff members and for staff responsible recommending hold medical staff appointments, assignments reappointments, initial staff or cur- privileges. tailments of (10) Require that resources be made available to addrеss the emo- spiritual patients. tional and needs of hospital report Ensure that the annual includes the names of members, officers, governing body hospital’s the and a financial the names of the report report that the annual available to the public for review. *13 finan- which shall be requirements committees run,7 far-reaching cial disclosure to the These governing body.8 in business de- conducting restrictions on freedom private serve close scrutiny statutory authority — which is here totally lacking.
In addition, the rules educational require job descriptions,9 and writ- rate insurance programs,10 programs,12 schedules,11 ten purchasing policies.13 Governing body 103.6. committees. § committee, equivalent, (c) planning or its be a There shall long-range develop governing body written short- and established hospital plans plans hospital. shall coordinate for the These and related commu- care facilities with those of other health services committee, Representatives who need not be nity governing body of this resources. members, appointed as liaison to to serve shall be planning agencies. regional local or health procedures. 7. 103.7. Committee § body governing (a) procedures established shall be Basic activity. include clear These shall of committee ensure effectiveness written statements body specifying governing from or directives the of the purpose, goals committee. Committee authority, procedures include: shоuld also meetings, and methods of (1) requirements, notice Attendance recording minutes. minutes, agendas, previous issue (2) Timely prior distribution option papers, relevant documents. and other will assure effi- which of number of members Restrictions any prejudicial relationships exclusion working without cient members. organizations. requirements for related 8. 103.10. Disclosure § lease, sale, use governing body prohibit or exclusive the receiving shall or certificate any hospital buildings a license or facilities of of provides any entity subpart or which compliance with this in accordance hospital’s patients, to the medical or other health services sale, and, full, except complete, case of a there is a unless рeriodic entity’s body governing financial of that to the disclosure assets, earnings distribution. liabilities and descriptions. 9. 103.35. Job type job description in the job for each There shall be a written depart- hospital, including and heads of chief executive officer ments. programs. 103.38. Education provided in training programs should and in-service Orientation may and learn of hospital personnel their skills maintain order that developments new care. health p. *14 hospital’s controls a regulations of set disturbing most A for care admitted shall be persons which to determine ability admission.14 refusing reasons limiting by force choice, regulations right restricting By liabilities potential and responsibilities assume hospitals Certainly, them. accorded traditionally those beyond far executive statute, by but not by change, a novel allow such is to of clear authority, bounds exceed which regulation precedent. dangerous most set a staffs,15 to medical admission govern also regulations The duties,16 conduct and memberships committee medical staff 103.42. Rates. 11. § hospital charges for all written schedule of rates and A current upon request to and made available services shall be maintained use those services. those who Insurance. 12. 103.43. § provides program for the which There should be an insurance hospital. physical protection financial resources of the of the and coverage buildings equipment appropriate and There of the should be equivalent adеquate comprehensive liability insurance or an and body covering governing plan and members of the self-insurance personnel. appropriate medical and administrative inventory. Purchasing 13. 103.44. § inventories, governing policies be written the control of There shall evaluation, including purchasing procedures, product selection and supply from distribution. Records shall be maintained annual compliance survey survey documenting with these estab- to annual policies. lished 14. 105.1Í. Access. § hospital (a) person seeking necessary medical care from the No not on sound medical shall be denied such care for reasons based person particularly practice hospital’s no such charter and race, creed, color, religion, shall be denied such care on account of sex, preference, provisions with the of the or sexual accordance 951-963). (43 Pennsylvania P.S. §§ Human Relations Act 105.12. Admission criteria. § conjunction governing body, of or in with the The with the advice staff, criteria for admissions to ensure medical shall establish medical necessity appropriateness. provision of care based on medical privileges. Requirements membership and 15. 107.3. § (c) privileges applicant staff on the No shall be denied medical sex, race, creed, origin or basis of or national on the basis of color justification, any cluding lacking professional in- or ethical other criterion prepaid group practice. association with a Bylaws, Regulations. Rules and 107.12. Content p. 16. See note 16 on re- education continuing meetings,17 staff medical of not only of utilization is required Review
quirements.18 services.19 out-of-hospital even but facilities hospital by-laws. (o) Acceptance medical staff whereby that each is evidence provided there shall be Mechanisms bylaws and and understands has read staff member medical agrees regulations bylaws and rules by staff medical the current to abide having bylaws. read hospital As evidence medical staff should bylaws, each member and understood bylaws are and as the medical staff sign, amended, application to the on bylaws staff current medical agreement to abide an hospital bylaws. regulations and and rules and committees. 107.26. Additional mandatory: (b) following are additional committees committee, *15 appropriate, shall which (1) where A nominations bylaws required of the in the as shall be conduct such elections rules, make not committee shall The nominations medical staff. inconsistent with elections. bylaws, govern medical staff the medical staff bylaws A committee. membership. 107.27. Committee § (b) committees, than the exec- Membership other medical staff on committees, by the executive shall be selected and nominations utive bylaws. The mem- staff be elected with medical or in accordance committee by the entire shall nominations committee bers of the staff. medical Meetings attendance. 107.32. § frequency departmentalized, Where the medical staff meetings the medical staff and general be determined shall staff regulations. bylaws clearly rules and medical staff stated in the monthly. the medical Departmental meetings When should be held meetings be con- departmentalized, shall medical staff staff is not monthly annually, There shall at intervals. at least ten ducted times meeting officers staff at which of the medical be at least an annual may reports be desirable and make such as and committee chairmen ensuing year. officers are elected for at which 107.33. Minutes. § meeting on file for at and retained at each Minutes shall be taken year. records of attendance minutes shall include one These lеast conclusions, transactions, and recom- adequately reflect the and shall mendations of the beyond meetings. minutes one Retention hospital. policy of the year with the shall be accordance Continuing 18. 107.41. education. profession- continuing program require a The medical staff shall members, require its members to staff al education medical participation program. give a such evidence 107.53. Utilization review. un- go must not be allowed agencies Governmental rules create continually tendency natural checked in their more and more invading while authority, which stretch their action. freedom of for private traditionally proper areas the view that adopts appear, it would The mаjority, those There are run our hospitals. can best government enactment, event, legislative In disagree. any who would there is a where necessary should be a “regulation”, not managerial prerogatives. private of heretofore usurpation I, dissent. therefore
LARSEN, J., in the dissent. joins