Implementing Rules and Regulations of Republic Act No. 10677

June 7, 2016

DOH ADMINISTRATIVE ORDER NO. 2016-0016

 

I. Rationale/Background

The Northern Mindanao Medical Center (NMMC) a premiere tertiary, teaching and training hospital in Cagayan de Oro City, came into existence as Misamis Public Hospital in 1918 with a 25 bed capacity. In 1945, it was renamed, Misamis Oriental Provincial Hospital. On June 18, 1966 by virtue of Republic Act No. 4662, the hospital was converted and renamed to the Northern Mindanao Regional Training Hospital (NMRTH) with 200 beds. In 1982, with the prevalence of heart diseases in Northern Mindanao, the NMRTH was designated as a satellite extension of the Philippine Heart Center for Asia. On March 1, 1995, Republic Act No. 7938, renamed NMRTH to Northern Mindanao Medical Center (NMMC) with a 300 bed capacity. On August 26, 2015, Republic Act No. 10677 was approved increasing the bed capacity to 600.

For twenty (20) years, the NMMC has been operating above the authorized bed capacity of 300 (RA 7938, 1995). The basic four (4) major Clinical Departments and the six (6) other medical services are now fully accredited of their individual specialty training programs for physicians. The top leading causes of admissions and discharges are diseases of the heart, lung, kidney and the rising cases of cancer. Aside from being a referral hospital of both private and government hospitals in the Northern Mindanao areas, the NMMC serves patients from the provinces of Misamis Oriental, Misamis Occidental, Bukidnon, Camiguin and Lanao del Norte in Region X as primary catchment population and the neighboring municipalities of Lanao del Sur in the Autonomous Region in Muslim Mindanao (ARMM), Zamboanga del Sur of Region IX, Agusan del Sur, Agusan del Norte and Surigao del Norte of Region XIII.

For the last 3 years (2013-2015), the average bed occupancy rate was 182%. Consequently, this has compromised the delivery of quality health services. As the only level 3 hospital in Northern Mindanao, part of the DOH strategic plan is to modernize the capability of NMMC to address the health problems of the Region. This is the main reason that Republic Act No. 10677 mandating the needed increase in its bed capacity to 600 with appropriate funds for upgrading its infrastructure, equipment and human resources complement was approved. ATICcS

II. Objectives

This Administrative Order sets the Implementing Rules and Regulations of Republic Act No. 10677 "An Act Increasing the Bed Capacity of the Northern Mindanao Medical  Center in Cagayan de Oro City, Amending for the Purpose Republic Act No. 7938, Appropriating Funds Therefor, and for Other Purposes" with the corresponding increase of its health human resource complement for a hospital with 600 bed capacity.

III. Scope

The rules and regulations discussed in this Administrative Order shall only pertain to Republic Act No. 10677.

IV. Definition of Terms/Acronyms

1. Act — refers to the Republic Act 10677, increasing the bed capacity of the Northern Mindanao Medical Center in Cagayan de Oro City, amending for the purpose Republic Act No. 7938, appropriating funds therefor, and for other purposes;

2. AO 2012-0012 — refers to the Rules and Regulations Governing the New Classification of Hospitals and Other Health Facilities in the Philippines dated 18 July 2012;

3. Bed Capacity — refers to the number of beds offered by the hospital for inpatient care;

4. Bed Occupancy Rate (BOR) — is the ratio of actual inpatient service days for a given period to the declared bed capacity of the hospital for the same period;

5. Level 3 Hospital — as classified in Administrative Order 2012-0012-A;

6. Medical Center — refers to a hospital staffed and equipped to care for many patients and a large number of kind of diseases and dysfunctions using modern technology;

7. Referral Hospital — refers to a health care institution capable of accepting referrals from lower level hospitals and render general and specialized health care services.

V. Policies and Guidelines

A. General Policies

The Northern Mindanao Medical Center (NMMC) shall provide a tertiary level of promotive, curative, preventive, rehabilitative health care services, residency training and research. It shall be fully equipped with state of the art technology and modern infrastructure, complemented by competent health care providers appropriate for a licensed and accredited Level 3 health care facility.

Furthermore, the Northern Mindanao Medical Center shall focus on developing and strengthening its existing services and shall aim for the improvement of its service capability. Its current state of the art specialty services on the Heart, Lung, Kidney (HLK), Oncology and Nuclear Medicine sub-specialty services, including the care and management of Acute Stroke classifies NMMC as a health care provider with excellent quality comparable to international health care standards. The increase in bed capacity shall be consistent with the approved Development Plan of the Northern Mindanao Medical Center.

B. Implementing Mechanisms

In support to the implementation of RA 10677, the following guidelines shall be implemented:

1. Expansion of Services

The Northern Mindanao Medical Center shall operate as a 600-bed Level 3 Teaching and Training hospital with additional services on Mother and Child Health Care service, Thoracic and Cardiovascular Surgery, Renal Transplant, Oncology, Nuclear Medicine and other high-level diagnostic services. Structural reorganization with additional sub-specialty services shall be established based on the Hospital Development Plan.

Furthermore, the expansion of services shall be in compliance to RA 10677, Section 1 which states "the hospital facilities of the Northern Mindanao Medical Center shall be upgraded and increased, consistent with the requirements of modern medical technology and its status as a medical center."

2. Health Human Resource

In case of deployment of staff as a result of the DOH Rationalization Plan, the NMMC shall continue to honor the position, security of tenure, and other rights of its human resource complement. The hospital shall evaluate the existing health human resource complement, re-classify and/or propose upgrading of positions, promote professional development and hire additional staff to comply and conform to the DOH standards, purpose and intent of RA 10677. The NMMC shall implement the staffing standard of a six hundred (600) bed capacity hospital taking into consideration the approval of the proposed amendment to the DBM-DOH Joint Circular No. 2013-01 as reference.

3. Assets and Liabilities

All movable and immovable assets, liabilities and obligations and records of the NMMC as well, shall be properly updated and shall be accounted for in accordance with existing policies and guidelines.

4. Equipment

The NMMC shall make an inventory of the existing hospital equipment to determine the gap and undertake upgrading to conform to DOH minimum standards of a level 3 hospital as provided for under DOH AO No. 2012-0012. Additional equipment and facilities that will complement the expansion of services shall be procured with the support of DOH.

5. Infrastructure

The NMMC shall implement and seek the support of DOH for the construction/repair/renovation of physical infrastructure to conform to all existing laws and licensing standards and current international standards for hospital buildings in line with Hospital Safe from Disasters Program, among others. TIADCc

6. Systems Development

The NMMC shall develop and sustain the standards of hospital operations to provide quality patient care and safety for patients, health workers and clientele of the hospital. It shall develop and implement an effective and comprehensive information system conforming to the standards and basic requirements of the Integrated Hospital Operations and Management Program (IHOMP) and to the state of the art digital system.

7. Quality Management

The NMMC shall continuously implement the Continuing Quality Improvement Program, Patient Safety, DOH Policies and standards prescribed in the manuals issued by DOH-Health Facility Development Bureau (HFDB), Health Facilities and Services Regulatory Bureau (HFSRB), Philippine Health Insurance Corporation (PhilHealth), Food and Drug Administration (FDA) and other DOH policies and standards supportive of international health organization standards.

The NMMC shall pursue the implementation of quality management in conformance with the ISO 9001:2008 certification standards.

VI. Implementing Structure

1. Administrative Control

The Medical Center Chief of NMMC shall be accountable and responsible for the implementation of quality standard hospital operations and management and shall submit developmental plans, financial and statistical reports to the DOH-Central Office through the DOH Regional Office No. X.

The DOH Regional Office No. X shall have oversight jurisdiction and control over the hospital operations of NMMC and shall monitor the implementation of RA 10677 and may recommend further necessary upgrading guided by this Administrative Order.

Further, the Health Facility Development Bureau (HFDB) shall provide the needed technical assistance in line with hospital upgrading, development and capability building.

2. Sourcing and Use of Funds

The amount necessary to carry out the provisions of Republic Act No. 10677 shall be sourced out accordingly:

2.1. Capital Investment for infrastructure and equipment shall be sourced from the DOH General Appropriations Act (GAA), hospital income which includes PhilHealth payments, public-private partnership and other modes of financing scheme subject to the prevailing government rules and regulations.

2.2. The additional Maintenance and Other Operating Expenses (MOOE) resulting from the hospital expansion shall be sourced from the GAA, hospital income, PhilHealth payments, public-private partnership and/or other mode of financing scheme subject to the prevailing government rules and regulations.

2.3. Personnel Services (PS) to carry out the full implementation of the staffing pattern appropriate for a 600 bed hospital shall be appropriated and sourced from GAA.

2.4. Release of funds from the DOH shall be approved by the appropriate authority.

VII. Repealing/Separability Clause

Provisions from previous issuances that are inconsistent or contrary to the provisions of this Order are hereby rescinded and modified accordingly.

If any provisions of this order is declared unauthorized or rendered invalid by any court of law or competent authority, those provisions not affected thereby shall remain valid and effective.

VII. Effectivity

This order shall take effect fifteen days (15) after publication in the official gazette or in a newspaper of general circulation.

(SGD.) JANETTE P. LORETO-GARIN, MD, MBA-HSecretary of Health