Lower Saxony Hospital Act
| Basic data | |
|---|---|
| Title: | Lower Saxony Hospital Act |
| Abbreviation: | NKHG |
| Type: | State Law |
| Scope: | Lower Saxony |
| Legal matter: | Administrative law |
| References : | No. 1/2012 page 2 |
| Issued on: | January 19, 2012 ( Nds. GVBl. 2012, p. 2) |
| Entry into force on: | predominantly January 1, 2012 |
| Please note the note on the applicable legal version. | |
The Lower Saxony Hospital Act (NKHG) regulates the funding of hospitals in Lower Saxony . It also regulates the establishment of committees and the use of certain instruments to increase patient safety in hospitals. It replaced the Lower Saxony law on the federal law on the economic security of hospitals and on the regulation of hospital care rates (Nds. KHG) of July 12, 1973 (Nds. GVBl. P. 231), which received numerous revisions in the following years up to the end of 2011. As with other state laws, the funding for the promotion of investment costs also relates to Section 9 (1) of the Hospital Funding Act (KHG), see also dual funding .
As an implementation law for the federal hospital financing law, the Lower Saxony Hospital Law initially regulated aspects of hospital planning and investment cost subsidies. Only in 2015 is the patient safety through the murder series in clinics in Delmenhorst and Oldenburg , by the convicted nurses Niels H . Were committed in the middle of 2000, came into focus. Corresponding changes in the law to increase patient safety were unanimously passed by the Lower Saxony state parliament on October 24, 2018.
content
The hospital law in Lower Saxony was introduced by the CDU / FDP state government in 2009 with the heading "Reorganization of the funding of investments in the hospital sector" and was last discussed in 2011 in the social committee. The Lower Saxony state parliament then passed the new law on January 19, 2012. The state law is intended to take account of the changed framework conditions in hospitals. A new regulation on flat-rate funding according to Section 9 (3) Hospital Financing Act (flat-rate funds) became a focus of the law.
In addition to the basic support of the hospitals according to the number of beds provided in the hospital plan , not only should a purely bed-oriented support from the state be paid to the hospitals, but also be dependent on a new, additional performance-related support. The performance-related funding is based on the development of the number of cases and on particularly cost-intensive service areas of a clinic. For the replacement of fixed assets with an average useful life of more than three and up to 15 years (short-term fixed assets) as well as for small structural measures for which the pre-calculated eligible acquisition or production costs for the individual project are based on the ordinance passed on November 15, 2012 do not exceed the value limit set by the lump-sum funding under the Lower Saxony Hospital Act (NKHG-FörderVO) (currently 150,000 euros). The flat-rate subsidy is made up of a basic flat rate (can be increased if the storage costs are particularly high) based on the number of beds and day-care places and a performance flat-rate that takes into account, in particular, the number of people treated as inpatients and the depreciation of fixed assets. Hospitals can also receive an allowance to fund necessary investments for training facilities (e.g. nursing schools) in accordance with Section 2 No. 1 a KHG.
The districts of Lower Saxony and urban districts also have to ensure the hospital care of the population as a task of their own sphere of activity in accordance with the hospital plan and the raising of funding, insofar as hospital care is not guaranteed by other providers.
In addition, the Lower Saxony Hospital Act also presents the framework for setting up alarm and deployment plans and emergency plans .
Planning committee
According to § NKHG, a planning committee is a decisive contributing body at the Lower Saxony Ministry for Social Affairs, Women, Family, Health and Integration . This advises the relevant ministry on questions of hospital planning and the preparation of the investment program.
| Members of the planning committee at the ministry (according to § 3 NKHG as direct participants according to § 7 para. 1 sentence 2 KHG and additionally through state law) |
|---|
| Working group of the central municipal associations of Lower Saxony ( Lower Saxony Association of Cities and Towns (NSGB), Lower Saxony District Association (NLT), Lower Saxony Association of Cities (NST)) |
| Lower Saxony Hospital Society (NKG), regional association of the German Hospital Society (DKG) |
| Associations of statutory health insurance companies in Lower Saxony AOK Lower Saxony , Innungskrankenkasse (IKK), company health insurance fund (BKK) National Association Center, Miners , Agricultural health insurance company (LKK) Lower Saxony-Bremen and Association of private plans (vdek) |
| German Statutory Accident Insurance (DGUV) - Regional Association Northwest - |
| State Committee of the Association of Private Health Insurance (PKV) |
| Christian Trade Union Confederation of Germany (CGB) Landesverband Niedersachsen |
| DBB Beamtenbund and Tarifunion Landesbund Lower Saxony |
| German Trade Union Federation (DGB) Lower Saxony - Bremen - Saxony-Anhalt district |
|
State Working Group of Free Welfare Care in Lower Saxony ( Arbeiterwohlfahrt (AWO), German Caritas Association , German Parity Welfare Association , German Red Cross (DRK), Diakonie Deutschland - Evangelical Federal Association , Central Welfare Office of Jews in Germany (ZWST)) |
| Lower Saxony Chamber of Psychotherapists |
|
Lower Saxony employers' associations (UVN) (including the member associations Bauindustrieverband Niedersachsen-Bremen eV and the Association of Liberal Professions in Lower Saxony eV) |
| Marburger Bund - Association of employed and civil servant doctors in Germany V. |
| Advisory members in the planning committee at the ministry |
|---|
| Lower Saxony Ministry for Science and Culture (MWK) as the responsible ministry for universities |
| Medical Association of Lower Saxony |
| Association of Statutory Health Insurance Physicians (KV) Lower Saxony |
structure
- § 1 - Construction and maintenance of hospitals
- § 2 - Raising the funding
- § 3 - Participation of those involved
- § 4 - Hospital plan
- § 5 - Investment Program
- § 6 - Individual funding
- § 7 - Flat rate funding
- § 8 - Compensation payments for departing hospital operators
- § 9 - Earmarking of funding, ancillary provisions
- § 10 - Monitoring the use of funds
- § 11 - Revocation of funding notices
- § 12 - Change of carrier
- § 13 - Emergency Care
- § 14 - Alarm and deployment plan, emergency plan
- § 15 - Falling short of minimum quantities (valid since January 27, 2012)
- § 16 - Entry into force
criticism
Helmut Fricke, director of the Lower Saxony Hospital Society (NKG), criticized the new hospital law in the Ärztezeitung on February 2, 2012. "The funding should be measured according to DRG valuation ratios. But these are constantly changing and are only available after two years". From his point of view, it would have been better "to use fixed ratios according to subject areas."
Hospital investment program 2012
The Lower Saxony investment program 2012 according to § 6 KHG:
| hospital | Location | Investment measure | Sum in euros |
|---|---|---|---|
| Schaumburg Clinic | Obernkirchen | New construction of a central hospital from the existing district hospitals in Rinteln and Stadthagen and the Bethel hospital in Bückeburg , 2nd FA | 19,800,000 |
| HELIOS Albert Schweitzer Clinic Northeim | Northeim | Replacement building 3rd FA | 10,000,000 |
| Alexianer St. Ansgar Clinic Bassum | Bassum | New building psychiatry-psychosomatics 2nd construction phase 3rd FA | 7,000,000 |
| Elbe Kliniken Stade-Buxtehude ( Elbe-Heide Hospital Association ) | Buxtehude | New construction and renovation of the functional wing, central emergency room, intensive care unit, operating theater 1. Construction phase 2. FA | 6,500,000 |
| Osnabrück Clinic | Osnabrück - Westerberg | Unity, merging geriatrics and early rehabilitation (FZS) 3rd FA | 6,500,000 |
| Niels-Stensen-Kliniken Franziskus-Hospital Harderberg | Georgsmarienhütte | Restructuring of care, intermediate care, interdisciplinary admission 3rd FA | 6,000,000 |
| Elbe Kliniken Stade-Buxtehude ( Elbe-Heide Hospital Association ) | Stade | New construction and reconstruction of the functional wing, central emergency room, intensive care unit, intermediate care, operating theater 1. Construction phase 2. FA | 5,000,000 |
| KRH Klinikum Nordstadt ( Klinikum Region Hannover ) | Hanover - Nordstadt | 4. NT new building surgery 1. Construction phase 2. FA | 5,000,000 |
| Wahrendorff Clinic | Celle | New building psychiatry and psychosomatic medicine at the General Hospital Celle (AKH) | 4,000,000 |
| Oldenburg Clinic | Oldenburg | Restructuring and refurbishment of the central operating room 3rd FA | 4,000,000 |
| St. Marienhospital Vechta (Catholic Clinics Oldenburger Münsterland) | Vechta | Complete renovation of the hospital 4th construction phase 3rd FA | 4,000,000 |
| Gifhorn Clinic ( Rhön Clinic ) | Gifhorn | Completion of the restructuring | 3,600,000 |
| BDH Clinic Hessisch Oldendorf (Neurological Clinic) | Hessian Oldendorf | Extension of intensive care 2nd FA | 3,600,000 |
| Braunschweig Municipal Clinic | Braunschweig | Merging of operations 3 to 2 locations 2nd construction phase 1st FA | 3,400,000 |
| Sophien Clinic Hanover | Hanover - center | Redesign of the Sophien-Klinik 1. FA | 3,000,000 |
| Winsen Hospital ( Elbe-Heide Hospital Association ) | Winsen (Luhe) | Cooperation in the Harburg district - construction of a new functional wing 1. FA | 3,000,000 |
| Osnabrück Children's Hospital | Osnabrück - Nahne | Expansion of child and adolescent psychiatry 1. FA | 3,000,000 |
| Inselkrankenhaus Borkum (Klinikum Leer) | Borkum | New health center | 2,800,000 |
| St. Bonifatius Hospital (St. Bonifatius Hospital Society) | Lingen (Ems) | Renovation of the functional area and new construction of the care area 2nd construction phase 3rd FA | 2,500,000 |
| St. Marien Stift (Corantis Clinics) | Friesoythe | New construction of a ward building 2. FA | 2,500,000 |
| General Hospital Celle (AKH group) | Celle | Centralization of the surgical department and nursing 1. FA | 2,000,000 |
| Northwest Hospital Sanderbusch (Friesland Clinics) | Sande (Friesland) | Emergency room and central functional diagnostics , stroke unit 3rd FA | 2,000,000 |
| Vincent Hospital Hanover | Hanover - Kirchrode | Renovation of the functional wing, 3rd construction phase, 1st TA, 3rd FA | 1,800,000 |
| Hümmling Hospital Sögel (St. Bonifatius Hospital Society) | Sögel | Restructuring of the operating theater area 2. BA 1. FA | 1,500,000 |
| Evangelical Hospital Göttingen-Weende | Göttingen - turnaround | New construction of two care stations and functional area, implementation of the one-house structure 1. FA | 1,400,000 |
| KRH Klinikum Lehrte ( Klinikum Region Hannover ) | Taught | Example of restructuring the operating theater / recovery room / intensive care 2. FA | 1,300,000 |
| Burghof Clinic Rinteln | Stadthagen | Establishment of a day clinic in Stadthagen | 1,250,000 |
| Agaplesion Diakonieklinikum Rotenburg | Rotenburg (Wümme) | Establishment of a palliative care unit and expansion of psychosomatic medicine 1. FA | 1,200,000 |
| Children's hospital on the Bult (Foundation Hannoversche Kinderheilanstalt) | Hanover - Südstadt-Bult | Renovation of the nursing wards 1. FA | 1,000,000 |
| Leer Clinic | Leer (East Frisia) | Expansion of the children's clinic 3rd FA | 1,000,000 |
| Clinic Dr. Hancken | Stade | Construction of the nuclear medicine decay facility 2nd FA | 750,000 |
| Several clinics | Flat-rate approach for emergency measures, small construction measures, initial acquisition of large medical-technical devices and additional costs for the investment program in previous years | 7,600,000 | |
| total | 128,000,000 |
Individual evidence
- ^ Draft of a law amending the Lower Saxony Hospital Act and other regulations. Lower Saxony State Parliament - 18th electoral period, May 16, 2018, accessed on October 30, 2018 .
- ^ NDR: Högel case: State parliament tightened hospital law . ( ndr.de [accessed October 30, 2018]).
- ↑ http://www.aerztezeitung.de/praxis_wirtschaft/klinikmanagement/article/803914/niedersachsen-neues-krankenhausgesetz-kritisiert.html
