B-120940, NOVEMBER 4, 1954, 34 COMP. GEN. 215

B-120940: Nov 4, 1954

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HOSPITALS - PRIVATE NONPROFIT - FEDERAL AID FACILITIES IN A PRIVATE NONPROFIT HOSPITAL WHICH ARE INTENDED FOR PUBLIC HEALTH SERVICES DO NOT CONSTITUTE "RELATED FACILITIES" TO THE HOSPITAL WITHIN THE MEANING OF THE HOSPITAL SURVEY AND CONSTRUCTION ACT. 1954: REFERENCE IS MADE TO YOUR LETTER OF JULY 29. IT WOULD APPEAR FROM THE EXAMPLES FURNISHED THAT FACILITY IS ONE THAT IS FUNCTIONALLY RELATED TO AND ADMINISTRATIVELY A PART OF THE HOSPITAL. THAT IS. THE FACILITY FUNCTIONS AND IS ADMINISTERED AS A SUBORDINATE BUT INTEGRAL PART OF THE HOSPITAL AND THE SERVICES FURNISHED BY IT FORM A PART OF THE TOTAL SERVICE FURNISHED BY THE HOSPITAL. SUCH STATEMENTS APPEAR TO HAVE BEEN MADE SOLELY BY PERSONS GIVING TESTIMONY IN FAVOR OF THE BILL.

B-120940, NOVEMBER 4, 1954, 34 COMP. GEN. 215

HOSPITALS - PRIVATE NONPROFIT - FEDERAL AID FACILITIES IN A PRIVATE NONPROFIT HOSPITAL WHICH ARE INTENDED FOR PUBLIC HEALTH SERVICES DO NOT CONSTITUTE "RELATED FACILITIES" TO THE HOSPITAL WITHIN THE MEANING OF THE HOSPITAL SURVEY AND CONSTRUCTION ACT, AND, THEREFORE, THE COSTS OF SUCH FACILITIES MAY NOT BE INCLUDED IN THE COMPUTATION OF FEDERAL GRANTS FOR HOSPITAL CONSTRUCTION UNDER THE ACT.

ACTING COMPTROLLER GENERAL MORROW TO THE SECRETARY OF HEALTH, EDUCATION AND WELFARE, NOVEMBER 4, 1954:

REFERENCE IS MADE TO YOUR LETTER OF JULY 29, 1954, REQUESTING ADVICE AS TO WHETHER THE GENERAL ACCOUNTING OFFICE WOULD BE REQUIRED TO OBJECT TO GRANTS TO PRIVATE NONPROFIT HOSPITALS UNDER THE HOSPITAL SURVEY AND CONSTRUCTION ACT, PUBLIC LAW 725, 79TH CONGRESS, 60 STAT. 1040, AS AMENDED, 42 U.S.C. 291, ET SEQ., BASED UPON THE VIEW THAT FACILITIES IN SUCH HOSPITALS FOR THE PROVISION OF PUBLIC HEALTH SERVICES BY LOCAL PUBLIC HEALTH DEPARTMENTS CONSTITUTE "RELATED FACILITIES" TO SUCH HOSPITALS WITHIN THE MEANING OF SAID ACT.

SUBSECTIONS (E) AND (F) OF SECTION 631 OF THE ACT, 60 STAT. 1047, 42 U.S.C. 291I (E) AND (F), DEFINE "HOSPITAL" AND "PUBLIC HEALTH CENTER," RESPECTIVELY, AS FOLLOWS:

(E)THE TERM "HOSPITAL" (EXCEPT AS USED IN SECTION 622 (A) AND (B) ( INCLUDES PUBLIC HEATH CENTERS AND GENERAL, TUBERCULOSIS, METAL, CHRONIC DISEASE, AND OTHER TYPES OF HOSPITALS, AND RELATED FACILITIES, SUCH AS LABORATORIES, OUT-PATIENT DEPARTMENTS, NURSES' HOME AND TRAINING FACILITIES, AND CENTRAL SERVICE FACILITIES OPERATED IN CONNECTION WITH HOSPITALS, BUT DOES NOT INCLUDE ANY HOSPITAL FURNISHING PRIMARILY DOMICILIARY CARE;

(F) THE TERM "PUBLIC HEALTH CENTER" MEANS A PUBLICLY OWNED FACILITY FOR THE PROVISION OF PUBLIC HEALTH SERVICES, INCLUDING RELATED FACILITIES SUCH AS LABORATORIES, CLINICS, AND ADMINISTRATIVE OFFICES OPERATED IN CONNECTION WITH PUBLIC HEALTH CENTERS;

WHILE NEITHER THE ACT ITSELF NOR THE LEGISLATIVE HISTORY THEREOF FURNISHES A CLEAR AND COMPREHENSIVE DEFINITION OF WHAT WOULD CONSTITUTE "RELATED FACILITIES" TO A HOSPITAL OR A PUBLIC HEALTH CENTER, THE ACT DOES NOT GIVE EXAMPLES OF SUCH FACILITIES AS INDICATED IN THE ABOVE QUOTED DEFINITIONS. IT WOULD APPEAR FROM THE EXAMPLES FURNISHED THAT FACILITY IS ONE THAT IS FUNCTIONALLY RELATED TO AND ADMINISTRATIVELY A PART OF THE HOSPITAL. THAT IS, THE FACILITY FUNCTIONS AND IS ADMINISTERED AS A SUBORDINATE BUT INTEGRAL PART OF THE HOSPITAL AND THE SERVICES FURNISHED BY IT FORM A PART OF THE TOTAL SERVICE FURNISHED BY THE HOSPITAL. IT DOES NOT APPEAR THAT AN INDEPENDENT FACILITY OPERATING UNDER THE JURISDICTION OF A DIFFERENT ADMINISTRATIVE OR GOVERNING BODY THAN THE HOSPITAL ITSELF AND IN NO MANNER UNDER THE JURISDICTION OR CONTROL OF THE HOSPITAL COULD BE CONSIDERED AS A "RELATED FACILITY" TO THE HOSPITAL WITHIN THE MEANING OF THE ACT. MOREOVER, THE ACT SPECIFICALLY DESIGNATES A PUBLIC HEALTH CENTER AS A HOSPITAL AND IT SEEMS CLEAR THAT ONE HOSPITAL COULD NOT BE CONSIDERED AS A "RELATED FACILITY" TO ANOTHER HOSPITAL.

ALSO, WHILE YOUR LETTER QUOTES NUMEROUS STATEMENTS RELATIVE TO THE DESIRABILITY OF COMBINING IN ONE UNIT BOTH A GENERAL HOSPITAL AND A PUBLIC HEALTH CENTER, SUCH STATEMENTS APPEAR TO HAVE BEEN MADE SOLELY BY PERSONS GIVING TESTIMONY IN FAVOR OF THE BILL. THERE IS NOTHING IN THE LEGISLATIVE HISTORY TO INDICATE THAT THE CONGRESS SUBSCRIBED TO SUCH VIEWS AND INDEED THE DEFINITIONS CONTAINED IN THE ACT AND QUOTED HEREINABOVE WOULD INDICATE TO THE CONTRARY.

ACCORDINGLY, IT IS THE OPINION OF THIS OFFICE THAT FACILITIES IN A PRIVATE NONPROFIT HOSPITAL WHICH ARE INTENDED FOR THE PROVISION OF PUBLIC HEALTH SERVICES DO NOT CONSTITUTE "RELATED FACILITIES" TO SUCH HOSPITAL WITHIN THE MEANING OF THE HOSPITAL SURVEY AND CONSTRUCTION ACT AND, HENCE, THIS OFFICE WOULD BE REQUIRED TO OBJECT TO GRANTS MADE ON SUCH A BASIS.