1.2.23 House rules

Purpose and goal

Rules for behavior in the hospital and on the hospital grounds must be drawn up. the house rules should be comprehensible and well-founded. They should ensure that everything runs smoothly. It should be possible to issue warnings for disruptive behavior by patients. Regulation of the behavior of patients and visitors in the hospital.

Area of application

Entire hospital

Description

Leaving the ward/hospital grounds Patients cannot be denied the wish to leave the ward or hospital grounds. Only in the latter case (3) is there a leave of absence within the meaning of SGB V § 112, which neither the patient nor the hospital can decide on their own. Procedures are given here for situations (1) and (2).

Please note the following:

1. The patient only leaves the ward temporarily, but not the hospital grounds

If there are no medical or nursing concerns, the patient may leave the ward for a short time. However, the patient should pay attention to the needs of the ward, i.e. in particular, he/she should (re)enter the ward for ward rounds, medication administration and the like. This must be discussed with the patient. A certificate is not generally required. However, each ward is free to use the certificate (variant "Temporary removal from ward only") for its own security.

1. The patient also leaves the hospital grounds for a short time

If a patient wishes to leave not only the ward but also the hospital grounds, the instructions given under (1) apply. However, the patient must also be informed that he/she must not exceed the limit for leave of absence in the strict sense, i.e. the patient must remain involved* in the operation of the ward. The rule of thumb here is that the patient must participate in all hospital services. For liability reasons, the certificate attached in Appendix 1 (variant "Distance from the premises") must always be completed and signed by the patient.

1. The patient leaves the hospital so that he or she is no longer available for the regular course of hospital treatment.

The patient must be informed that it is not justifiable from a medical or nursing point of view for the patient to leave the ward (or even the grounds). If the patient nevertheless insists on doing so and cannot be prevented from doing so by possible and reasonable means, efforts must be made to ensure that he or she signs the certificate in Appendix 1 ("Leaving the hospital" option must be ticked) or that the doctor makes a note of it. In any case, the process must be documented in the medical file.

1. The patient is on leave for personal or therapeutic reasons.

Leave of absence is only possible in a few exceptional cases and requires the doctor's written consent. A sample for this can be found in Appendix 1 ("Leave of absence" option to be ticked). Formalities must also be observed, such as informing the health insurance fund at the latest when the invoice is submitted (para. 1 sentence 2).

Documentation

The house rules should be displayed in a pleasant, graphic design.

Responsibilities

• in-house counsel
• Operations department

Notes and comments

Applicable documents

Literature, regulations

§ 8 of the General Terms and Conditions of Hospital Treatment (§ 112 I SGB V to § 112 II No. 1 SGB V) dated December 19, 2002 ("Hospital Contract"), which reads:

During hospital treatment, patients may only be granted leave of absence for compelling personal or therapeutic reasons and only with the written consent of the head department physician or his/her deputy, or the attending physician. The health insurance fund must be informed of the duration and reason for the leave of absence before/at the latest when the invoice is submitted.

There may be compelling reasons if the leave of absence during inpatient treatment is unavoidable for family or other important personal reasons, which must be documented in the medical file. Leave of absence for therapeutic reasons can only take place to promote the success of treatment.

As a rule, a leave of absence is not compatible with a somatic illness.

A patient can be granted leave of absence under strict conditions. Patients with statutory health insurance are provided with medicines, remedies and aids by the hospital for the duration of the leave of absence, which they require in accordance with the ongoing therapy. The costs for this are covered by the nursing rate (§ 10 BPflV) or the fee (§ 7 KHEntG).

The first day of the leave of absence and all further days before the day of return to the hospital are not charged. The day of return to the hospital will be charged at the nursing rate, unless a flat rate per case is charged. The co-payment obligation according to § 39 IV SGB V remains unaffected.

Terms

Short-term removal

The wording "leave of absence" in Section 8 of the hospital contract suggests that this is a permission to be absent for a limited period of time. This is confirmed by the billing regulation in para. 5, according to which a leave of absence is an absence whose duration is to be measured in days. This allows the conclusion to be drawn that an absence of only a short duration is not to be regarded as leave of absence within the meaning of the standard. The line must be drawn where the removal of the patient means that the patient is no longer involved in ward operations, i.e. is away from the premises overnight or from morning to evening. The situation is different for short walks or errands undertaken by a patient who is continuously involved in ward operations.

Attachments