WHAT IS THE GOVERNANCE STRUCTURE OF STRUCTURE OF A HOSPITAL?
1. Governing Board
An acute care hospital is “a health facility having a duly constituted governing body with overall administrative and professional responsibility and an organized medical staff that provides 24-hour inpatient care...” (Health & Safety Code, § 1250, emphasis added)
Duties of the Governing Board
1. Insure Competency & Evaluate Quality of Medical Treatment
A “Hospital owes generally a duty to insure the competency of its medical staff and to evaluate the quality of medical treatment rendered on its premises...”. Elam v. College Park Hospital (1982) 132 Cal.App.3d 332, 347
2. Be Accountable to State & Federal Regulators
“It is a hospital's governing body, not its medical staff, that is accountable to federal and state regulators, not to mention to patients themselves and their families.” (Elam v. College Park Hospital (1982) 132 Cal.App.3d 332, 335
3. Power to Render Final Decisions
“A hospital's governing body must be permitted to align its authority with its responsibility and to render the final decision in the hospital administrative context.” (Hongsathavij v. Queen of Angels/Hollywood Presbyterian Med. Ctr. (1998) 62 Cal.App.4th 1123, 1143.)
See also: Alexander v. Superior Court (1993) 5 Cal.4th 1218, 1224 [“an administrative governing body (often comprised of persons other than health care professionals) takes ultimate responsibility for the quality and performance of the hospital”], disapproved on other grounds, Hassan v. Mercy Am. River Hosp. (2003) 31 Cal.4th 709.)
See also: Weinberg v. Cedars-Sinai Medical Center (2004) 119 Cal.App.4th 1098, 1109 [“we further conclude that the Board's authority encompasses final responsibility for the quality of its medical staff and care...”]
2. Executive Leadership
22 CCR 70701 lists the requirements of a hospital’s governing body. It must “Appoint an administrator whose qualifications, authority and duties shall be defined in a written statement adopted by the governing body.” (22 CCR 70701(2)) This is the hospital CEO and top management.
3. Organized Medical Staff
Every acute care hospital must have “an organized medical staff responsible to the governing body for the adequacy and quality of the medical care rendered to patients in the hospital.” (22 CCR § 70703(a).)
A medical staff is required to adopt written bylaws. The medical staff also must provide a means for enforcing its bylaws. (22 CCR § 70703(b).)
Medical Staff is subservient to the Governing Board as 22 CCR 482.12(5) states that the Governing Board must “(5) Ensure that the medical staff is accountable to the governing body for the quality of care provided to patients”.