GUIDELINES ON DOWNGRADING, CLOSURE/CEASE AND DESIST OPERATION OF INSTITUTIONAL HEALTH CARE PROVIDERS

National Administrative Register [ PHIC PHILHEALTH CIRCULAR NO. 22, S. 2009, May 18, 2009 ]



In order to facilitate the accreditation of institutional health care
providers and to make the processing of applications for accreditation
more efficient, the following are hereby issued:

A. DOWNGRADING OF IHCPs:

1. A Level 2, Level 3 or Level 4 (L2, L3 or L4) hospital that was
given provisional accreditation due to non-compliance to the requirements or standards of accreditation but failed to comply within the
compliance period as prescribed by the Corporation may be downgraded to a
level/category it is compliant with. This however, shall be done only
after submission of a letter of intent (LOI) within the compliance
period stating therein that they are amenable to such downgrading.
Failure to submit the said document shall result to termination of its
provisional accreditation effective on the date of deliberation of
Accreditation Committee.

2. An IHCP applying for accreditation but upon evaluation
and/or pre-accreditation inspection was noted to be incapable of
delivering the service required of the level/ category it is applying
for, shall follow the guidelines stated hereunder:

a. The IHCP shall be informed by the concerned PHRO within five
(5) days after receipt of application of its evaluation results or by
the surveyors during the pre-accreditation inspection exit conference on
their findings as to deficiencies. Thereafter, IHCP shall comply within
the prescribed compliance period (PC 24 s. 2008).

b. If the IHCP cannot comply with the deficiencies, they may opt
to be downgraded to a level/category it is compliant with by submitting a
Letter of Intent (LOI) within the reglamentary period of compliance,
stating therein that they are amenable to such downgrading. Otherwise,
the said application shall be denied by the Corporation.

B. CLOSURE/CEASE AND DESIST OPERATION OF AN IHCP

1. Any accredited IHCP which plans to close its facility or with a
Cease and Desist Operation Order from DOH shall have its accreditation
validity terminated on the same day it shall close/cease and desist to
operate. The IHCP shall inform the Corporation five (5) days prior to
the planned closure/cease operation. The concerned PhRO shall validate
the same within three (3) days after receipt of such information and
shall immediately inform the Accreditation Department, Central Office to
effect necessary changes in the database.

2. For any IHCP with active accreditation which, upon monitoring,
was noted to have closed/ceased opera t ion but failed to give
information to the Corporation, the concerned PhRO/SO personnel shall
exhaust all efforts to validate within the same day the actual date of
closure/cease operation. Immediately, thereafter, it shall provide the
Accreditation Department Central Office the same information to effect
the necessary changes in the databases.

3. Claims paid for admissions during the closure/cease operations,
if any, due to failure of the hospital to inform the Corporation as
specified, shall be charged to its unpaid claims. If there are no unpaid
claims, the same amount shall be collected from the hospital by the
Corporation as re-payment without prejudice for any legal action the
Corporation may take in the future.

4. Any IHCP may apply for re-accreditation with the Corporation once it has resumed its operations.

All previous policies and guidelines and other administrative
issuances with provisions inconsistent herewith are hereby
repealed/amended accordingly.

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

Adopted: 18 May 2009

(SGD.) DR. REY B. AQUINO
President and CEO