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Hospital Insurance Regulations

made under Section 17 of the
Health Services and Insurance Act
R.S.N.S. 1989, c. 197
N.S. Reg. 11/58 (December 1, 1958)
as amended up to and including O.I.C. 90-659 (May 31, 1990), N.S. Reg. 148/90

Interpretation
1 In these regulations

(a) "Act" means the Health Services and Insurance Act;

(b) "agreement" means an agreement between the Government of Canada and the Government of Nova Scotia under the Act;

(c) "board" means board of directors, governors, trustees, commission or other governing body or authority of a hospital;

(d) "Commission" means the Health Services and Insurance Commission;

(e) "federal hospital" means a hospital that is owned or operated by Canada;

(ee) "fiscal year" means the period commencing on April 1 and ending on March 31, with the exception of the period beginning January 1, 1977 and ending on March 31, 1978 which shall be deemed to be a fiscal year;
Clause l(ee) added: O.I.C. 77-1608, N.S. Reg. 176/77.

(eee) "Halifax Metropolitan Hospitals" means Victoria General Hospital, Grace Maternity Hospital, Izaak Walton Killam Hospital for Children, Camp Hill Medical Centre, Dartmouth General Hospital, the Nova Scotia Rehabilitation Centre and Point Pleasant Lodge;
Clause 1(eee) added: O.I.C. 90-659, N.S. Reg. 148/90.

(f) "hospital region" or "region" means an area of the Province as designated from time to time by the Commission;

(g) "in-patient" means a person admitted to and assigned to a bed in a hospital on the application of a duly qualified medical practitioner;

(h) "in-patient services" means any or all of the following services to an in-patient in a hospital:
Clause 1(h) amended: N.S. Reg. 17/64; O.I.C. 79-394, N.S. Reg. 58/79; O.I.C. 83-705, N.S. Reg. 137/83.

(i) accommodation and meals at the standard ward level,

(ii) necessary nursing services,

(iii) laboratory, radiological and other diagnostic procedures, together with the necessary interpretations for the purpose of maintaining health, preventing disease and assisting in the diagnosis and treatment of any injury, illness or disability,

(iv) drugs, biologicals and related preparations as specified in Schedule "A" to these regulations, when administered in a hospital,

(v) use of operating room, case room and anaesthetic facilities including necessary equipment and supplies,

(vi) routine surgical supplies,

(vii) use of radiotherapy facilities where available,

(viii) use of physiotherapy facilities where available,

(ix) services rendered by persons who receive remuneration therefor from the hospital,

(x) the administration in a hospital of blood therapeutic blood fractions;
Subclause l(h)(x) added: N.S. Reg. 12/59.

(i) "out-patient" means a person other than an in-patient, who receives services at a hospital;

(j) "out-patient services" means all of the following services provided to out-patients:

(i) laboratory examinations, from time to time specified by the Commission, together with the necessary interpretations thereof,

(ii) electroencephalographic examinations and the interpretations thereof,

(iii) diagnostic procedures involving the use of radioactive isotopes, and the interpretations thereof,

(iv) use of radiotherapy facilities, where available, for the treatment of malignancy,

(v) use of physiotherapy facilities where available,

(vi) necessary nursing services,

(vii) radiological examinations, from time to time specified by the Commission, together with the necessary interpretations, and

(viii) when used for emergency diagnosis and treatment, within 48 hours after an accident,

(A) all necessary laboratory and radiological diagnostic procedures and electrocardiograms together with the necessary interpretations for the purpose of assisting in the emergency diagnosis and treatment,

(B) use of operating room and anaesthetic facilities including the necessary equipment and supplies,

(C) routine surgical supplies,

(D) drugs, biologicals and related preparations as specified in Schedule "A" to these regulations, when administered in the hospital,

(E) necessary meals at the standard ward level,

(F) necessary nursing services,

(ix) services, other than medical services, provided by the Cancer Treatment and Research Foundation of Nova Scotia,
Subclause l(j)(ix) replaced: O.I.C. 82-980, N.S. Reg. 181/82.

(x) the administration in the hospital of blood or therapeutic blood protein fractions,
Subclause 1(j)(x) added: N.S. Reg. 12/59.

(xi) hospital services in connection with the following minor medical and surgical procedures:

(A) any procedure involving the cutting of tissue, and the insertion and removal of sutures,

(B) the application and removal of casts ("casts" to be restricted to Plaster of Paris or similar hard material),

(C) surgical procedures requiring special aseptic technique,

(D) treatment of haemorrhage,

(E) treatment of dislocations and fractures,

(F) any procedure done under general anaesthesia (except dental extractions on patients 16 years of age or over),

(G) search for or removal of foreign bodies,

(H) taking of cytological smear material for suspected carcinoma,

(I) injections of haemorrhoids,

(J) nerve block,

(K) electroconvulsive therapy,

(L) aspiration or injection of joint cavities, bursae, cysts, thorax, abdomen, hydrocoele or other cavities,

(M) treatment of poisoning,

(N) certain endoscopic procedures (bronchoscopy, esophagoscopy, gastroscopy, cystoscopy, sigmoidoscopy, proctoscopy),

(O) dilatation of strictures,

(P) catheterization,

(Q) transfusions,

(R) spinal punctures,

(S) dental extractions under general anaesthesia, 15 years of age and under,
Subclause 1(j)(xi) added: N.S. Reg. 40/59; paragraphs 1(j)(xi)(A)-(K) replaced: N.S. Reg. 52/62; paragraph 1(j)(xi)(L) repealed, paragraphs 1(j)(xi)(M)-(T) relettered (L)-(S): N.S. Reg. 18/63.

(xii) drugs, biologicals and related preparations as specified in Schedule A to these regulations which are necessarily incidental to the performance of the procedures listed in subclause (xi) of this clause,
Subclause 1(j)(xii) added: N.S. Reg. 18/63.

(xiii) hospital services, where available, including necessary meals, in connection with a day patient care clinic for the necessary training and instruction of diabetics,
Subclause 1(j)(xiii) added: N.S. Reg. 17/64.

(xiv) haemodialysis,
Subclause 1(j)(xiv) added: O.I.C. 68-1004, N.S. Reg. 25/68.

(xv) ultrasonic diagnostic procedures and the interpretation thereof,
Subclause 1(j)(xv) added: O.I.C. 69-53, N.S. Reg. 25/69.

(xvi) the non-medical component (excluding drugs, biologicals and related preparations) of all other general diagnostic and treatment procedures (excluding dental procedures) to the extent that the hospital can provide the same,
Subclause 1(j)(xvi) added: O.I.C. 69-456, N.S. Reg. 90/69.

(xvii) radiotherapy for non-malignant conditions,
Subclause 1(j)(xvii) added: O.I.C. 69-881, N.S. Reg. 91/69.

(xviii) electrocardiograms and the interpretation thereof,
Subclause 1(j)(xviii) added: O.I.C. 69-292.

(xix) subject to the Hospitals Act, psychiatric services which are not medical services,

(xx) services other than medical services provided by and within the Nova Scotia Hearing and Speech Clinic,
Subclauses l(j)(xix) & (xx) added: O.I.C. 79-394, N.S. Reg. 58/79.

(xxi) home parenteral nutrition,
Subclause l(j)(xxi) added: O.I.C. 79-1635, N.S. Reg. 209/79.

(xxii) equipment for the treatment of erythromelalgia and the servicing of such equipment when such equipment and servicing is provided by or through any approved hospital,
Subclause l(j)(xxii) added: O.I.C. 80-642, N.S. Reg. 83/80.

(xxiii) continuous ambulatory peritoneal dialysis,
Subclause l(j)(xxiii) added: O.I.C. 81-305, N.S. Reg. 26/81.

(xxiv) chemotherapy in hospitals which are designated in writing by the Cancer Treatment and Research Foundation of Nova Scotia for the provision of such service;
Subclause l(j)(xxiv) added: O.I.C. 82-980, N.S. Reg. 181/82.

(k) "prescribed form" means form prescribed by the Commission;

(1) "Rate Board" means the board set up by the Commission for the purposes of recommending the basis of payment to hospitals for insured services;

(m) (i) "resident" means a person who is legally entitled to remain in Canada and who makes his home and is ordinarily present in Nova Scotia, but does not include a tourist, a transient, or a visitor to Nova Scotia; for the purposes of the Act and these regulations a person who is a resident of Nova Scotia and who moves from Nova Scotia to acquire residence in another part of Canada, herein called the "new province", shall be deemed to continue to be a resident of Nova Scotia during normal travelling time and any waiting period, not exceeding three months, which may be necessary in order to qualify for benefits under the hospital insurance legislation of the new province if the new province is a participating province, as defined in subsection (2) of Regulation 7, or shall be deemed to continue to be a resident of Nova Scotia for a period of three months from the date of his departure from Nova Scotia if the new province is not a participating province,
Clause l(m) replaced: N.S. Reg. 12/60; relettered subclause l(m)(i): O.I.C. 83-1099, N.S. Reg. 212/83.
Subclause 1(m)(ii) added: O.I.C. 83-1099, N.S. Reg. 212/83; spent: November 1, 1984.

(n) "standard ward" means an area in a hospital designated by the board of the hospital and approved by the Commission as a standard ward;

(o) "superintendent" means the person who has the direct and actual superintendence and charge of a hospital;

(p) "province" includes the Northwest Territories and the Yukon Territory.
Clause 1(p) added: N.S. Reg. 11/60.

Insured services - general
2 (1) Subject to the Health Services and Insurance Act and these regulations,

(a) a resident is entitled to receive in-patient and out-patient services that are medically required by him, without charge as insured services, commencing on the first day of the third month immediately following the month in which he becomes a resident of Nova Scotia;

(b) a new Canadian is entitled to receive in-patient and out-patient services that are medically required by him, without charge as insured services, commencing on the day he becomes a resident of Nova Scotia.

(2) In clause (b) of subsection (1) "new Canadian" means a resident who moves to Nova Scotia from a place outside Canada, and is legally entitled to remain in Canada.
Section 2 replaced: O.I.C. 72-783, N.S. Reg. 89/72.

2A Residents, and their children under the age of 21 years who are dependent on them, and the spouses of such residents, where such residents are employed in the Public Service of the Province including employment by the Crown in the right of the Province and an agency thereof, shall be deemed to be residents for the purpose of the Act during temporary absence from the Province for a period of up to two years where such absence is required by virtue of their employment (and such period of absence may be extended from time to time by the Governor in Council).
Section 2A added: O.I.C. 77-1071, N.S. Reg. 98/77.

3 A resident is entitled to insured in-patient services for the period of time following admission during which such in-patient services are medically required.

4 A person, who claims to be entitled to insured services, shall provide the hospital with proof of his entitlement.

5 The Commission shall not make payment in respect of services rendered to a patient after the effective date of discharge of the patient as ordered by the attending physician, unless the Commission is satisfied that the services were medically required after that date.
Section 5 amended: N.S. Reg. 12/60.

6 (1) If, in the opinion of the Commission, any of the services provided to the patient are or were not medically necessary the patient shall not be entitled to such services as insured services.

(2) When, in the opinion of the Commission, a doubt exists concerning the medical necessity for in-patient or out-patient services in any case, the Commission may appoint and empower a medical review board to report on the case.

Insured services outside Nova Scotia
7 (1) Subject to subsections (2) and (3), where a resident receives insured in-patient services in a hospital, including a federal Hospital, outside Nova Scotia, the Commission shall reimburse him, or the person who on his behalf pays for the services, for the cost of the services, or the Commission shall make payment directly to the hospital for the services, provided that

(a) the services were required because of accident or sudden attack of illness or the receipt of the services is approved by the Commission;

(b) the out-of-province hospital which supplied the treatment is a federal Hospital or is licensed or approved as a hospital by the governmental hospital licensing authority in whose jurisdiction the hospital is situate; or is approved by the Commission if there is no such authority;
Clause 7(1)(c) repealed by subsection 7(5): N.S. Reg. 14/62.

(d) the Commission is satisfied that the person is entitled to receive the services and that they were medically necessary.
Subsection 7(1) amended: N.S. Reg. 12/59.

(2) Where in-patient services were provided in a hospital in a province that provides insured services under an agreement with the Government of Canada under the Hospital Insurance and Diagnostic Services Act (Canada), in this [these] regulation[s] called a "participating province", the amount payable under this [these] regulation[s] shall not exceed an amount calculated on the basis of the per diem rate payable to the hospital by the authority administering the plan for providing insured services in that province.

(3) Subject to subsection (4), where in-patient services relating to accident or sudden attack of illness are provided to a resident of the Province in a hospital outside Canada, the amount payable under this [these] regulation[s] for services rendered on and after the first day of July, 1990 shall not exceed

(a) an amount calculated on the basis of the average per diem rate of Halifax Metropolitan Hospitals at the time the services were provided, such rate to be as calculated by the Department of Health and Wellness; or
[Note: The reference to the Department of Health has been updated in accordance with Order in Council 2011-15 under the Public Service Act, R.S.N.S. 1989, c. 376, effective January 11, 2011.]

(b) the standard daily ward rate of the hospital at the time that the services were provided,

whichever is less.
Subsection 7(3) replaced: O.I.C. 90-659, N.S. Reg. 148/90.

(4) Where in-patient services relating to accident or sudden attack of illness are provided in a hospital outside Canada, the amount payable under this [these] regulation[s] for services rendered on and after the first day of July, 1990 in the case of an infant who is less than 15 days old, and who was born to a resident of the Province, shall not exceed

(a) one-third of the amount calculated under Section [clause] 7(3)(a), or,

(b) the standard daily ward rate of the hospital at the time that the services were provided,

whichever is less.
Subsection 7(4) added: N.S. Reg. 14/62; replaced: O.I.C. 90-659, N.S. Reg. 148/90.

(5) Clause (c) of subsection (1) does not apply in respect of services received on or after October 15, 1962.
Subsection 7(5) added: N.S. Reg. 14/62.

(6) If a resident, with the approval of the Minister, receives insured out-patient services at a hospital in Canada but outside Nova Scotia which qualifies under Section [clause] 7(1)(b), while being accommodated at a hostel approved by the Minister for such purpose, the cost of such accommodation shall be deemed to be "insured in-patient services in a hospital" for the purposes of Section 7, and in particular Section [subsection] 7(1) thereof.
Subsection 7(6) added: O.I.C. 82-1406, N.S. Reg. 233/82; amended: O.I.C. 90-659, N.S. Reg. 148/90.

7.1 Where out-patient services are provided to a resident of the Province in a hospital outside Canada on and after the first day of July, 1990, the services shall be deemed to be uninsured services and the Commission shall not be liable to make payment for those services.
Section 7.1 added: O.I.C. 90-659, N.S. Reg. 148/90.

7.2 All claims shall be received by the Commission for payment within six months of the date of discharge from the hospital to be eligible for payment under Section [subsection] 7(3), Section [subsection] 7(4) and Section 8 of these regulations. No claims received after the lapse of six months will be considered
Section 7.2 added: O.I.C. 90-659, N.S. Reg. 148/90.

Referral by specialist for elective services outside Canada
8 (a) Where a resident of the Province

(i) [a resident of the Province] is referred by a physician approved as a specialist by the Provincial Medical Board to a hospital outside Canada for non-emergency or elective treatment not available in Canada, and

(ii) the specialist obtains written approval for the treatment of the resident from the Commission prior to the treatment being rendered,

the Commission may make payment for those services which have been so approved, to such extent and subject to such terms and conditions as the Commission has deemed fit.

(b) For the purpose of subsection (a) above, the Commission shall not make payment for take-home drugs or devices, or for any differential for preferred accommodation. The Commission shall determine what constitutes take-home drugs, devices, and preferred accommodation, and, in doing so, may consult with such persons as it chooses for this purpose.

(c) Where the referring specialist does not obtain the prior written approval of the Commission or the Department under Section [subclause] 8(a)(ii) for non-emergency or elective treatment, the commission shall not be liable to make payment for the treatment rendered.
Original Section 8 repealed: O.I.C. 78-462, N.S. Reg. 102/78; Section 8 added: O.I.C. 90-659, N.S. Reg. 148/90.

Payments to hospitals in the Province other than federal hospitals
9 The board of every hospital shall provide to residents, without charge, those insured services that the hospital is staffed and equipped to provide.

10 The Commission shall pay the cost of insured services as determined by the Commission, provided to residents by each hospital that complies with these regulations.

11 (1) Every hospital board shall submit to the Commission, not later than October 31 of each year, its budget estimates on the forms prescribed for the ensuing fiscal year.
Subsection 11(1) amended: O.I.C. 77-1608, N.S. Reg. 176/77.

(2) The Commission shall appoint a Rate Board of not fewer than 3 nor more than 5 persons, each of whom is a member or employee of the Commission or a consultant to the Commission, which shall review and analyze the annual budget estimates submitted by the hospital boards.
Subsection 11(2) amended: N.S. Reg. 40/59.

(3) The Rate Board shall make recommendations to the Commission for the approval by the Commission of the budget estimates of each hospital either as submitted or with such modifications as the Rate Board considers proper.

(4) The Commission shall review and may approve and accept the recommendations of the Rate Board, or may vary them of its own motion or on the request of the hospital board to the Commission.

(5) On approval by the Commission of the budget estimates of a hospital either as submitted or as modified, the estimates shall be the approved budget of the hospital for the ensuing fiscal year and shall constitute the basis on which payments shall be made by the Commission to the hospital for that year.
Subsection 11(5) amended: O.I.C. 77-1608, N.S. Reg. 176/77.

(6) Notwithstanding any other provision of these regulations, the Commission, at any time after the first of September in any year on its own motion or at the written request of a board made to the Commission between the first of September and the thirty-first day of January in any year, may review and revise the budget of a hospital and the budget so revised shall be, for the remainder of that year, the approved budget of the hospital.
Subsection 11(6) replaced: N.S. Reg. 11/60; amended: O.I.C. 77-1608, N.S. Reg. 176/77.

(7) Pending the approval of the budget estimates of a hospital for any fiscal year, the Commission may establish an interim approved budget for the hospital for a fiscal year and may make payments to the hospital on the basis of the interim approved budget.
Subsection 11(7) amended: O.I.C. 77-1608, N.S. Reg. 176/77.

(8) The Commission shall pay in approximately equal instalments, at intervals that are not less frequent than semi-monthly, the portion of the approved budget of a hospital related to the costs of insured services that does not represent the cost of providing out-patient services and depreciation on furniture and equipment, as those portions are determined by the Commission.
Subsection 11(8) replaced: N.S. Reg. 17/63.

(9) The portion of the approved budget of a hospital representing depreciation on furniture and equipment that is included in the cost of providing insured services, shall be paid by instalments to the hospital not less frequently than every 6 months, and shall be funded by the board and used only for the purchase of furniture and equipment approved by the Commission.
Subsection 11(9) replaced: N.S. Reg. 17/63.

(9A) Notwithstanding the provisions of subsections (8) and (9), payments may be made to a hospital of sums not exceeding the total cost of furniture and equipment that is included in the cost of providing insured services.
Subsection 11(9A) added: O.I.C. 78-620, N.S. Reg. 122/78.

(10) The Commission, at intervals determined by it, shall pay to each hospital for insured out-patient services provided by the hospital at the rates determined by the Commission under subsection (11).
Subsection 11(10) replaced: N.S. Reg. 17/63.

(11) The Commission shall calculate the costs to the hospitals of providing out-patient services and shall determine the rates at which it will make payments to hospitals in respect of the cost to them of providing insured out-patient services.
Subsection 11(11) replaced: N.S. Reg. 17/63.
Subsections 11(12), (13) and (14) repealed: N.S. Reg. 17/63.

11A In computing the number of patient days of hospital services provided to a patient, the day of admission shall be counted as one day, and the day of discharge or death shall not be counted, regardless of the hour of admission or death, providing that if the patient is discharged or dies on the day of admission, that day shall be counted as one day.
Section 11A added: N.S. Reg. 17/63.

12 (1) Each month, not later than a date to be fixed by the Commission, the Superintendent of every hospital shall submit to the Commission a report, in the prescribed form, of actual revenues and expenditures of the hospital in the preceding month.

(2) Not later than the thirty-first day of May of each year, every hospital board shall submit to the Commission financial statements for the preceding fiscal year, audited by an accountant licensed under the Public Accountants Act or in the case of a Provincial or federal hospital, by an auditor appointed by the body controlling the hospital.
Subsection 12(2) amended: O.I.C. 77-1608, N.S. Reg. 176/77.

13 (1) Subject to the other provisions of these regulations, if the audited financial statement of a hospital for the fiscal year shows that the hospital has had actual expenditures for insured services greater or less than the amount received from the Commission in respect of the fiscal year, the Commission may determine that it will pay the hospital part or all of the difference between the amount received from the Commission and actual expenditures for insured services, or where the amount that the hospital received was over and above what was expended by it for insured services, according to the audited financial statement of the hospital for the fiscal year, the Commission may require some or all of the amount to be returned to it by the hospital.
Subsection 13(1) replaced: O.I.C. 86-1005, N.S. Reg. 228/86.

(2) The Commission shall not pay part or all of the said difference to a hospital unless the board of the hospital submits to the Commission with its financial statement a claim for the payment, in the form prescribed, together with material that satisfies the Commission that

(a) the additional expenditure could not reasonably have been foreseen and provided for;

(b) these expenditures were reasonable and proper;

(c) these expenditures, if foreseen and included in original budget estimates, would have been approved by the Commission.

Payments to federal hospitals in the Province
14 The Commission shall make payments to federal hospitals in Nova Scotia, in respect to insured services provided in federal hospitals to residents as provided in the agreement.

Standard control
15 The superintendent of a hospital, if required by the Commission, shall forward to the Commission, within forty-eight hours after each patient is admitted, a notification of admission of the patient in the form prescribed.

16 The superintendent of every hospital shall forward to the Commission within four days after each patient is discharged from hospital, a notification of discharge or death, in the form prescribed.

17 When a person, entitled to insured services, has been an in-patient in a hospital for thirty or more consecutive days, the superintendent of the hospital shall forward to the Commission a Long Stay Report, in the prescribed form, respecting the patient, within four days after the expiry of the first and every subsequent thirty-day period during which the patient remains in hospital.

18 The superintendent of every hospital shall forward to the Commission every month, not later than a date to be fixed by the Commission, a report, in the prescribed form, with respect to out-patient services in the preceding month.

19 To provide for the effective utilization of in-patient and out-patient services in hospitals, there shall be set up the following Standards Committees:

(a) Hospital Standards Committee

(i) In every hospital that is not a facility, there shall be set up by the Board, a Hospital Standards Committee of not fewer than three persons, including the superintendent, with representation from the board and the medical staff; the function of this Committee shall be to assist and advise the hospital board in developing and maintaining high standards of service and reasonable and proper utilization of services.

(ii) The members of a Hospital Standards Committee who are members of the medical staff, together with such other members of the medical staff as are appointed by that staff, shall constitute a subcommittee whose function shall be to study matters primarily of a medical nature, and to report to and advise the Committee on such matters.

(iii) The Committee shall review semi-monthly, admissions, length of patient stay, drug usage, diagnostic services, nursing services and all other matters having to do with the standard of services and the utilization of services in the hospital.

(iv) The Committee shall advise forthwith the hospital board if, in the opinion of the Committee, the standard of any service is unsatisfactory or the utilization of any service provided by the hospital is not reasonable and proper.

(b) Regional Standards Committee

(i) In a Hospital Region, there may be set up by the Commission a Regional Standards Committee, on which there shall be representation from each hospital in the region.
Subclause 19(b)(i) amended: N.S. Reg. 52/62.

(ii) It shall be the function of this Committee to conduct studies relative to standards of care and utilization, and to strive to effect a high standard of care and proper utilization of services in the Region by means of such studies and by dissemination of information to the hospital boards and staffs in the Region.

(iii) The Committee shall meet not less frequently than every six months.

(c) Provincial Standards Committee

(i) The Commission in whole or in part shall act as a Provincial Standards Committee to ensure insofar as is possible the development and maintenance of a high standard of hospital services and reasonable and proper utilization of hospital services in all hospitals of the Province.
Subclause 19(c)(i) replaced: N.S. Reg. 12/59.

(ii) To assist the Provincial Standards Committee in carrying out its function, the Commission may appoint a Professional Technical Advisory Committee.

20 If the board or superintendent of a hospital fails to comply with the requirements of the Act or these regulations, the Commission may withhold payments to the hospital until the hospital has complied substantially with the requirements of the Act or these regulations.

21 The Commission may, from time to time, prescribe such forms as it considers necessary or advisable for the proper administration of the Act and these regulations.

22 (1) In this regulation [Section]

(a) "Board" means the Board of Management of the Hospital;

(b) "fiscal year" means a year ending on the 31st day of March;

(c) "Hospital" means the Nova Scotia Hospital at Woodside, in the County of Halifax.

(2) This regulation [Section] applies only to the Hospital.

(3) (a) The Board shall submit to the Commission, not later than October 31 of each year, its annual budget estimates on the forms prescribed for the ensuing year.

(b) On approval by the Commission of the budget estimates of the Hospital either as submitted or as modified, the estimates shall be the approved budget of the Hospital and shall constitute the basis on which payments shall be made by the Commission to the Hospital for that year.

(c) Pending the approval of the budget estimates of the Hospital for any year, the Commission may establish an interim budget for the Hospital for that year and may make payments to the Hospital on the basis of the interim approved budget.

(4) Not later than May 31st of each year the Board shall submit to the Commission financial statements for the preceding fiscal year audited by the Auditor General of Nova Scotia.

(5) (a) Subject to the other provisions of these regulations, the Commission may approve payment to the Hospital of part or all of the difference between the amount received from the Commission and the actual expenditures as shown on the audited financial statements; or the Commission shall determine the amount to be recovered over and above the amount the Commission determined should have been expended.

(b) The Commission shall not approve payment of part or all of the said difference to the Hospital unless the Board submits to the Commission a claim for the payment, in the form prescribed, together with material that satisfies the Commission that these expenditures were reasonable and proper.

(6) The Hospital shall forthwith transmit to the Commission a copy of every direction and report required under the Nova Scotia Hospital Act, R.S.N.S. 1967, c. 210, S. 24(2).
[Note: R.S.N.S. 1989, c. 313; S. 24(2) repealed by 1977, c. 45, S. 11.]
Subsection 22(6) replaced: O.I.C. 70-638, N.S. Reg. 26/70.

(7) In computing the number of patient days of hospital services provided to a patient, the day of admission shall be counted as one day, and the day of discharge or death shall not be counted, regardless of the hour of admission or death, providing that if the patient is discharged or dies on the day of admission that day shall be counted as one day.

(8) Each month, not later than a date to be fixed by the Commission, the Hospital shall submit to the Commission a report, in the prescribed form, of actual revenues and expenditures of the Hospital in the preceding month.

(9) The Hospital, if required by the Commission, shall forward to the Commission, within forty-eight hours after each patient is admitted, a notification of admission of the patient in the form prescribed.

(10) The Hospital shall forward to the Commission within four days after each patient is discharged from the Hospital or dies in the Hospital, a notification of discharge or death, in the form prescribed.

(11) The Hospital shall forward to the Commission every month, not later than a date to be fixed by the Commission, a report, in the prescribed form, with respect to outpatient services in the preceding month.

(12) (a) To provide for the effective utilization of in-patient and out-patient services in the Hospital, there shall be set up by the Board a Hospital Standards Committee of not fewer than three persons, including the administrator, with representation from the Board and the medical staff; the function of this Committee shall be to assist and advise the Board in developing and maintaining high standards of service and reasonable and proper utilization of services.

(b) The members of the Hospital Standards Committee who are members of the Medical Staff, together with such other members of the Medical Staff as are appointed by that staff, shall constitute a subcommittee whose function shall be to study matters primarily of a medical nature, and to report to and advise the Committee on such matters.

(c) The Committee shall review semi-monthly, admission, length of patient stay, drug usage, diagnostic services, nursing services and all other matters having to do with the standard of services and the utilization of services in the Hospital.

(d) The Committee shall advise forthwith the Board if, in the opinion of the Committee, the standard of any service is unsatisfactory or the utilization of any service provided by the Hospital is not reasonable and proper.

(13) If the Hospital fails to comply with the requirements of this regulation [Section], the Commission may withhold payments to the Hospital until the Hospital has complied substantially with the requirements of this regulation [Section].

(14) The Commission may, from time to time, prescribe such forms as it considers necessary or advisable for the proper administration of this regulation [Section].
Section 22 added: O.I.C. 67-761, N.S. Reg. 25/67.

23 (1) In this regulation [Section], "facility" means any institution approved as a hospital for the purposes of this Act only, but not approved as a hospital for the purposes of the Hospitals Act.
Subsection 23(1) added: O.I.C. 70-550, N.S. Reg. 25/70; replaced: O.I.C. 83-705, N.S. Reg. 137/83.

(2) Every facility shall be governed by a Board established in a manner satisfactory to the Minister.

(3) The Board of every facility shall make, amend, repeal and revise such by-laws as required by the Minister.

(4) No by-law made by the Board of any facility shall have any effect until it is approved by the Minister.

(5) No facility shall establish or extend any service without the approval of the Minister.
Subsections 23(2)-(5) added: O.I.C. 70-550, N.S. Reg. 27/70; amended: O.I.C. 83-705, N.S. Reg. 137/83.


Schedule "A" - Drugs, Biologicals and Related Preparations

1 Drugs, biologicals and related preparations which, in the judgment of the physician, are required by an insured patient, in accordance with accepted practice and sound teaching, and administered in a hospital including a federal Hospital.

2 Excluded are preparations sold under the Proprietary or Patent Medicine Act.