R.R.O. 1990, Reg. 937: GENERAL
under Private Hospitals Act, R.S.O. 1990, c. P.24
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Private Hospitals Act
R.R.O. 1990, REGULATION 937
GENERAL
Consolidation Period: From October 29, 1999 to the e-Laws currency date.
Last amendment: 512/99.
Legislative History: 427/91, 16/95, 477/97, 512/99.
This is the English version of a bilingual regulation.
Management
1. No private hospital shall conduct a training school for nurses or issue any diploma for nursing or practical nursing. R.R.O. 1990, Reg. 937, s. 1.
2. No private hospital shall engage in, or permit its name to be used in or in connection with, any undertaking, occupation, scheme or business other than that for which it is licensed. R.R.O. 1990, Reg. 937, s. 2.
3. Unless under the active care of a legally qualified medical practitioner, no patient shall be admitted to or treated in any private hospital. R.R.O. 1990, Reg. 937, s. 3.
4. Every private hospital shall submit to the Minister for his or her approval any publication, writing, advertising or other material, including any letterheads or cards, that is intended or likely to attract the attention of the public, and the Minister may refuse to approve any material that, in his or her opinion, is not in the interest of the public. R.R.O. 1990, Reg. 937, s. 4.
5. No private hospital shall admit any person as a patient who may constitute a danger to other patients. R.R.O. 1990, Reg. 937, s. 5.
6. The superintendent of a private hospital shall not physically restrain any patient or cause or permit any patient to be physically restrained. R.R.O. 1990, Reg. 937, s. 6.
7. Every order for treatment shall be in writing, either on the treatment sheet or in the order book provided for the purpose, and shall be signed by a legally qualified medical practitioner. R.R.O. 1990, Reg. 937, s. 7.
8. Within thirty-six hours of every patient’s admission to hospital, a complete history, including a report of physical examination and provisional diagnosis, of the patient shall be written. R.R.O. 1990, Reg. 937, s. 8.
9. The attending physician is responsible for the preparation of a complete medical record, including identification, complaint, present history, family history, physical examination, special reports including reports of consultations, laboratory examinations, X-ray, provisional diagnosis, medical or surgical treatment, pathological findings, progress notes, reports of operations and anaesthesia, final diagnosis, condition on discharge and follow-up record. R.R.O. 1990, Reg. 937, s. 9.
10. The superintendent of every private hospital shall retain and preserve in a place of safe keeping all records relating to every patient of the hospital. R.R.O. 1990, Reg. 937, s. 10.
Operations
11. (1) Any tissues or sections of tissues removed during an operation or curettage shall be immediately set aside by the surgeon operating and, together with a short history of the case and a statement of the findings during the operation, shall be forwarded by the superintendent to a laboratory approved by the Minister for examination, but any tonsil, appendix, tooth, frenum, hemorrhoid, finger, toe, hand, foot, arm or leg removed or amputated shall not be so forwarded unless the surgeon desires a special examination. R.R.O. 1990, Reg. 937, s. 11 (1).
(2) The pathological report received from the laboratory shall become part of the patient’s case record. R.R.O. 1990, Reg. 937, s. 11 (2).
12. Revoked: O. Reg. 16/95, s. 1.
13. (1) Before any anaesthetic is administered to a patient and before any surgical operation is performed on a patient, a complete history, physical examination and a written preoperative diagnosis shall be furnished by the operating surgeon or any legally qualified medical practitioner authorized by him or her. R.R.O. 1990, Reg. 937, s. 13 (1).
(2) Where the surgeon is of the opinion that the delay that would be caused in obtaining the information required by subsection (1) would be detrimental to the patient, the surgeon shall so state in writing but, in such event, the preoperative diagnosis shall be furnished in writing signed by the operating surgeon. R.R.O. 1990, Reg. 937, s. 13 (2).
14. Every operation performed in a private hospital shall be fully described in writing by the surgeon and the written description shall form part of the patient’s record. R.R.O. 1990, Reg. 937, s. 14.
15. The anaesthetist shall be a legally qualified medical practitioner and shall furnish a record showing the type of anesthetic given, amount used, length of anaesthesia and the condition of the patient after the operation. R.R.O. 1990, Reg. 937, s. 15.
16. Where the death of a patient in a private hospital results either directly or indirectly from pregnancy, the superintendent shall, within twenty-four hours, report the death upon the prescribed form to the Minister. R.R.O. 1990, Reg. 937, s. 16.
17. No major surgical procedure shall be performed in any private hospital that does not provide sterilization, operating and other equipment to the satisfaction of the inspector. R.R.O. 1990, Reg. 937, s. 17.
18. No surgical procedure shall be attempted within a private hospital without sufficient qualified assistants. R.R.O. 1990, Reg. 937, s. 18.
Classification of Private Hospitals
19. (1) A private hospital shall be classified as,
(a) a medical hospital;
(b) a surgical hospital;
(c) a maternity hospital;
(d) a medical and surgical hospital;
(e) a medical and maternity hospital;
(f) a general hospital;
(g) a hospital for nervous ailments; or
(h) a hospital for alcoholic patients. R.R.O. 1990, Reg. 937, s. 19 (1).
(2) A medical private hospital classification may be qualified by the Minister as,
(a) an active treatment medical hospital;
(b) a medical hospital for convalescent patients; or
(c) a medical hospital for chronically ill patients. R.R.O. 1990, Reg. 937, s. 19 (2).
(3) A surgical private hospital classification may be qualified by the Minister as,
(a) a general surgical hospital,
(i) restricted to minor surgery, or
(ii) restricted to minor and intermediate surgery, or
(iii) not restricted; or
(b) a specialty surgical hospital with the type of surgical specialty indicated to which surgery performed in the hospital shall be restricted. R.R.O. 1990, Reg. 937, s. 19 (3).
(4) When a licence is issued or renewed, the licence shall state the class of hospital for which the licence is issued or renewed. R.R.O. 1990, Reg. 937, s. 19 (4).
(5) No private hospital shall admit, except in the case of an emergency, any patient who is not in medical need of the type of treatment that is usually provided by a hospital of the class stated in the licence for the hospital. R.R.O. 1990, Reg. 937, s. 19 (5).
Hospitals for Alcoholic Patients
20. (1) Any hospital licensed as a hospital for alcoholic patients shall admit only patients who require treatment for alcoholism. R.R.O. 1990, Reg. 937, s. 20 (1).
(2) No person shall be admitted as a patient in the hospital unless a legally qualified medical practitioner certifies that the person requires treatment for alcoholism and is a suitable subject for treatment in the hospital and that the treatment is advisable. R.R.O. 1990, Reg. 937, s. 20 (2).
(3) The register kept by the hospital shall show the name and address of a legally qualified medical practitioner who has charge of the treatment of every patient. R.R.O. 1990, Reg. 937, s. 20 (3).
(4) The medical practitioner in charge of any patient shall see the patient at least twice in each week during the time that the patient is in the hospital, and the medical practitioner shall make in the records of the hospital an entry showing the condition of the patient at the time of each visit. R.R.O. 1990, Reg. 937, s. 20 (4).
Hospitals for Nervous Ailments
21. (1) In this section,
“private hospital for nervous ailments” means a private hospital,
(a) used for the purpose of diagnosing and treating persons suffering from,
(i) neuroses, or
(ii) psychosomatic disorders and alcoholism, and
(b) provided with,
(i) equipment and facilities, and
(ii) the services of a legally qualified medical practitioner who holds a specialist’s certificate in psychiatry issued by the Royal College of Physicians and Surgeons of Canada,
to render the services referred to in clause (a). R.R.O. 1990, Reg. 937, s. 21 (1).
(2) The Minister may issue a licence for a private hospital for nervous ailments. R.R.O. 1990, Reg. 937, s. 21 (2).
(3) Revoked: O. Reg. 512/99, s. 1.
(4) A private hospital for nervous ailments may be used for the purpose of diagnosing the ailments of and treating the persons referred to in clause (1) (a). R.R.O. 1990, Reg. 937, s. 21 (4).
Licences
22. (1) Every licence held under the Act shall be held for a one-year term that begins on April 1 of every year and ends on March 31 of the following year. O. Reg. 477/97, s. 1.
(2) Despite subsection (1), every licence that is renewed under the Act effective as of January 1, 1997 shall expire on March 31, 1998 and be renewed on April 1, 1998 for a term of one year. O. Reg. 477/97, s. 1.
Hospital Employees
23. The hospital staff shall consist of such graduate nurses and employees as are necessary to give adequate nursing care to the number and type of patients for which the licence is granted. R.R.O. 1990, Reg. 937, s. 23.
24. (1) For the purpose of this Regulation, hospital employees are divided into Group 1 and Group 2. R.R.O. 1990, Reg. 937, s. 24 (1).
(2) Group 1 is composed of,
(a) graduate nurses;
(b) interns;
(c) graduate physiotherapists;
(d) graduate occupational therapists;
(e) nursing assistants, nurses’ assistants, ward maids and ward orderlies;
(f) laboratory technicians; and
(g) X-ray technicians. R.R.O. 1990, Reg. 937, s. 24 (2).
(3) Group 2 is composed of all hospital employees not listed in subsection (2). R.R.O. 1990, Reg. 937, s. 24 (3).
25. (1) Every Group 1 employee shall receive a tuberculin test and an X-ray film of the lungs within thirty days of employment. R.R.O. 1990, Reg. 937, s. 25 (1).
(2) Every Group 1 employee who has a negative tuberculin reaction shall receive an additional tuberculin test within six months of the date of the first test and shall receive an additional test within six months after the date of each test, where the result of the test is negative. R.R.O. 1990, Reg. 937, s. 25 (2).
(3) Employees referred to in subsection (2) shall receive an X-ray film of the lungs annually. R.R.O. 1990, Reg. 937, s. 25 (3).
(4) Every Group 1 employee who is found to have a positive tuberculin reaction shall not be required to take another tuberculin test but shall receive an X-ray film of the lungs forthwith and every six months thereafter. R.R.O. 1990, Reg. 937, s. 25 (4).
(5) Every Group 1 employee whose X-ray film shows evidence of abnormal shadowing shall forthwith receive further examination to determine the nature of the disease. R.R.O. 1990, Reg. 937, s. 25 (5).
(6) No tests other than the intradermal (Mantoux) test, using one-twentieth of a milligram of Old Tuberculin, or the patch test shall be used in the test given under this section. R.R.O. 1990, Reg. 937, s. 25 (6).
(7) Where an employee has received a tuberculin test and an X-ray film of the lungs within four months before the date of employment, the record of the result of the test and film may be accepted in lieu of the test and film required by subsection (1). R.R.O. 1990, Reg. 937, s. 25 (7).
26. (1) Every Group 2 employee shall receive an X-ray film of the lungs within thirty days of employment and annually thereafter. R.R.O. 1990, Reg. 937, s. 26 (1).
(2) Where an employee has received a tuberculin test and an X-ray film of the lungs within four months before the date of employment, the record of the result of the test and film may be accepted in lieu of the X-ray film required by subsection (1). R.R.O. 1990, Reg. 937, s. 26 (2).
(3) Every Group 2 employee whose X-ray film shows evidence of abnormal shadowing shall receive forthwith further examination to determine the nature of the disease. R.R.O. 1990, Reg. 937, s. 26 (3).
27. No employee found to be suffering from active tuberculosis shall be permitted to work in the hospital, and the superintendent shall report the case within twenty-four hours to the medical officer of health of the municipality in which the employee resides. R.R.O. 1990, Reg. 937, s. 27.
28. Where any legally qualified medical practitioner believes or suspects that any person admitted to the hospital is suffering from tuberculosis, he or she shall notify the superintendent forthwith. R.R.O. 1990, Reg. 937, s. 28.
29. No employee shall be detailed to care for a patient believed or suspected to be suffering from tuberculosis until the employee has received instruction as to the necessary technique to protect himself or herself and others against infection and, where possible, the employee so detailed shall be a reactor to tuberculin. R.R.O. 1990, Reg. 937, s. 29.
30. Upon ceasing to be employed, every employee who has been employed for four months or more shall receive an X-ray film of the lungs. R.R.O. 1990, Reg. 937, s. 30.
31. (1) The superintendent shall keep a permanent record of all examinations and tests of every employee of the hospital and if requested shall send a copy of every record, including the X-ray films, to the Workers’ Compensation Board or to the Minister. R.R.O. 1990, Reg. 937, s. 31 (1).
(2) Any officer authorized by the Minister or by the Chair of the Workers’ Compensation Board may inspect the medical records of employees at any time. R.R.O. 1990, Reg. 937, s. 31 (2).
32. The hospital is responsible for the examination of the employees and any expenses thereby incurred. R.R.O. 1990, Reg. 937, s. 32.
33. Where an employee shows evidence of tuberculosis, the superintendent shall give written notice thereof and a complete report of the medical findings within seven days after the time of diagnosis to the Workers’ Compensation Board. R.R.O. 1990, Reg. 937, s. 33.
34. Nothing contained in sections 24 and 33 prevents an employee from being employed in a hospital when his or her disease is inactive. R.R.O. 1990, Reg. 937, s. 34.
Form 1 Revoked: O. Reg. 512/99, s. 2.