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Community Psychiatric Hospitals Act
R.R.O. 1990, REGULATION 91
GENERAL
Note: This Regulation was revoked on December 15, 2009. See: S.O. 2009, c.33, Sched.18, ss.5(2), 35(1).
Last amendment: S.O. 2009, c.33, Sched.18, s.5(2).
This is the English version of a bilingual regulation.
Definitions
1.In this Regulation,
“attending physician” means the medical practitioner who attends a patient in a hospital; (“médecin traitant”)
“board” means the governing board of an institution, building or other premises or place of which all or any part is approved as a community psychiatric hospital; (“conseil”)
“inspector” means a person appointed by the Minister for the purposes of making inspections under this Regulation; (“inspecteur”)
“medical practitioner” means a legally qualified medical practitioner; (“médecin”)
“Ministry” means the Ministry of Health; (“ministère”)
“out-patient” means a person who is not a patient and who attends an out-patient department for the purpose of receiving examination, diagnosis or treatment for a psychiatric disorder; (“malade externe”)
“out-patient department” means that part of a hospital that is established and maintained for the purpose of examining, diagnosing and treating out-patients; (“service de consultations externes”)
“physical treatment” includes electro shock therapy and insulin shock therapy; (“traitement physique”)
“superintendent” means the person who has the direct and actual superintendence of a hospital. (“directeur général”) R.R.O. 1990, Reg. 91, s.1.
Application
2.This Regulation applies to any institution, building or other premises or place, or to any part or parts thereof, approved by the Lieutenant Governor in Council under section 3 of the Act as a community psychiatric hospital. R.R.O. 1990, Reg. 91, s.2.
Management and Operation
3.The board is responsible for the enforcement of the Act, this Regulation and the by-laws of the hospital. R.R.O. 1990, Reg. 91, s.3.
4.The superintendent is responsible to the board for the due observance and enforcement of the Act, this Regulation and the by-laws of the hospital. R.R.O. 1990, Reg. 91, s.4.
5.The superintendent is the officer representing the hospital with whom the Minister, an inspector and other officers of the Ministry shall deal with respect to hospital matters. R.R.O. 1990, Reg. 91, s.5.
Staff
6.(1)The board shall provide for,
(a)the appointment and functioning of a superintendent, a medical staff, a nursing staff and an auditor; and
(b)the establishment of an administrative and accounting system.
(2)An auditor shall not be appointed for a hospital unless the auditor is licensed under the Public Accountancy Act. R.R.O. 1990, Reg. 91, s.6.
7.A hospital shall have on duty at all times sufficient nursing staff to give such nursing care to every patient in the hospital as is required for the patients’ care and treatment. R.R.O. 1990, Reg. 91, s.7.
8.Where the Ministry furnishes medical staff or nursing, technical or other assistants to a hospital, the medical staff and nursing, technical and other assistants are responsible to the board and subject to its directions in the performance of their duties. R.R.O. 1990, Reg. 91, s.8.
Fiscal Year
9.The fiscal year of a hospital shall be from the 1st day of April to the 31st day of March next following. R.R.O. 1990, Reg. 91, s.9.
Meetings
10.An annual meeting of the hospital shall be held between the 1st day of January and the 31st day of May in each year on a day fixed by the board. R.R.O. 1990, Reg. 91, s.10.
11.The board shall hold at least six meetings a year upon such days and times as are fixed by the chair and superintendent. R.R.O. 1990, Reg. 91, s.11.
Inspections
12.An inspector may,
(a)inspect the premises, management and operation of a hospital;
(b)require the superintendent, a member of the medical staff or a hospital employee,
(i)to furnish any information in his or her possession or under his or her control, and
(ii)to make returns, reports or statements in writing,
relating to the management and operation of the hospital;
(c)examine and audit all the hospital books, accounts and records; and
(d)investigate any hospital matter and require information from any person in respect of any hospital matter. R.R.O. 1990, Reg. 91, s.12.
Patients
13.A hospital shall keep a register of patients. R.R.O. 1990, Reg. 91, s.13.
14.When a patient is admitted to a hospital, the patient shall be issued a register number. R.R.O. 1990, Reg. 91, s.14.
15.(1)Any person who is believed to be suffering from a psychiatric disorder and to be in need of the observation, care and treatment provided in a hospital may be admitted thereto on his or her own application or on the application of a medical practitioner on his or her behalf.
(2)An application for admission by a medical practitioner may be made orally or in writing to the superintendent, and the person for whom the application is made shall not be taken to the hospital for admission or admitted thereto until the admission has been awarded.
(3)Where an application for admission is made by a person who is not a medical practitioner, the superintendent may admit the person as a patient if,
(a)the person requires treatment; and
(b)the person’s mental condition, in the opinion of the superintendent, is such as to render him or her competent to apply for admission. R.R.O. 1990, Reg. 91, s.15.
16.Where a medical practitioner sends any person to a hospital for admission and he or she knows or suspects that the person is or may become dangerous for any reason to himself or herself or to other patients, the medical practitioner shall notify the superintendent of the danger. R.R.O. 1990, Reg. 91, s.16.
17.(1)When a patient is no longer in need of treatment in a hospital, the attending physician shall write an order that the patient is discharged.
(2)A patient shall be deemed to be discharged when the attending physician writes the order under subsection (1) and communicates it to the patient.
(3)A patient who is discharged shall leave the hospital but the patient may, at his or her option and with the approval of the superintendent, remain in the hospital for a further period not exceeding twenty-four hours.
(4)When a patient under the age of sixteen years is discharged, the person liable for his or her maintenance shall remove the patient from the hospital but, at the request of the person so liable and with the approval of the superintendent, the patient may be permitted to remain in the hospital for a further period not exceeding twenty-four hours. R.R.O. 1990, Reg. 91, s.17.
18.(1)A person who is admitted to a hospital shall give the name and address of a relative or friend to be notified under subsection (3).
(2)The attending physician shall notify the superintendent when he or she believes that the relative or friend should be present at the hospital with a patient.
(3)The superintendent shall so notify the relative or friend. R.R.O. 1990, Reg. 91, s.18.
Orders for Treatment
19.(1)All orders for treatment shall be in writing on a paper attached to the medical record of the patient.
(2)Orders for treatment shall be dated and signed by an attending physician or a medical practitioner authorized by him or her, but an attending physician or a medical practitioner authorized by him or her may dictate by telephone orders for treatment to a person designated by the superintendent to take the orders.
(3)The person to whom the order has been dictated shall transcribe and sign the order and endorse thereon the name of the medical practitioner and the date and time of receiving the order.
(4)When a medical practitioner has dictated an order by telephone, he or she shall sign the order on his or her first visit to the hospital thereafter. R.R.O. 1990, Reg. 91, s.19.
Case Records
20.Within seventy-two hours after the admission of a patient, the board shall cause a medical practitioner to,
(a)write a medical history;
(b)make a physical examination and record his or her findings; and
(c)make and record a provisional diagnosis. R.R.O. 1990, Reg. 91, s.20.
21.The board shall cause to be compiled for each patient a medical record including,
(a)identification;
(b)history of present illness;
(c)history of previous illnesses;
(d)family history;
(e)provisional diagnosis;
(f)orders for treatment;
(g)progress notes;
(h)reports of,
(i)condition on discharge,
(ii)consultations,
(iii)follow-up care,
(iv)laboratory examinations,
(v)medical, surgical and physical treatment,
(vi)physical examinations,
(vii)radiological examinations,
(viii)cause of death,
(ix)post mortem examination, if any, and
(x)final diagnosis. R.R.O. 1990, Reg. 91, s.21.
22.(1)A person who makes any part of a record under sections 20 and 21 shall deliver the part to the superintendent.
(2)The superintendent is responsible for the safe-keeping of all records relating to a patient. R.R.O. 1990, Reg. 91, s.22.
23.(1)When a patient dies, the attending physician shall report the cause of death in writing to the superintendent for the medical record of the patient.
(2)Where the attending physician completes the medical certificate required by subsection 21(3) of the Vital Statistics Act and delivers a copy to the superintendent, subsection (1) does not apply. R.R.O. 1990, Reg. 91, s.23.
24.When a medical practitioner performs a post mortem examination on the body of a patient, he or she shall make and sign a report of the examination and deliver it to the superintendent for the medical record of the patient. R.R.O. 1990, Reg. 91, s.24.
Out-Patient Department
25.Where an out-patient department is maintained in a hospital, the superintendent shall provide therein,
(a)medical staff and nursing, technical and other assistants in regular attendance;
(b)adequate equipment;
(c)facilities and clerical staff for keeping records; and
(d)facilities for the examination, diagnosis and treatment for psychiatric disorders of out-patients. R.R.O. 1990, Reg. 91, s.25.
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