13 October 2004 GST/HST Interpretation 54857 - Application for Designation of XXXXX as a Hospital Authority

Please note that the following document, although correct at the time of issue, may not represent the current position of the Agency. / Veuillez prendre note que ce document, bien qu'exact au moment émis, peut ne pas représenter la position actuelle de l'Agence.

Dear XXXXX:

Thank you for your letter received in this office XXXXX requesting that

XXXXX be designated as a hospital authority for purposes of the Goods and Services Tax/Harmonized Sales Tax (HST).

"Hospital authority" is defined in subsection 123(1) of the Excise Tax Act (ETA) as an organization that operates a public hospital and that is designated by the Minister of National Revenue to be a hospital authority for purposes of the ETA.

If an organization wishes to be designated as a hospital authority, it must operate a public hospital that meets the following criteria.

i) it is recognized as a public hospital by the government of the province in which it is located;

ii) it is established and operated otherwise than for profit;

iii) it is operated for the medical or surgical treatment of the sick or injured; and

iv) it provides and maintains inpatient beds and services.

XXXXX.

XXXXX.

XXXXX.

XXXXX.

XXXXX:

•   XXXXX

•   XXXXX

•   XXXXX

•   XXXXX

•   XXXXX.

Additional information and documentation concerning the following points will help us understand the day-to-day operations of the institutions operated by XXXXX in order to determine if XXXXX meets the administrative criteria for designation as a hospital authority.

Are any of the institutions operated by XXXXX recognized as a public hospital by the province XXXXX? If so, please explain and provide evidence of this status. XXXXX

Do these institutions admit patients? What are the admission criteria? What proportion of each facility is reserved for inpatient beds? What is the average length of stay for patients in these facilities?

Please explain the roles and responsibilities of medical practitioners in these institutions. Are medical practitioners on site to provide medical care to patients in these facilities on a 24-hour a day basis? Alternatively, are medical practitioners only on-call in case of emergency or to consult on particular cases to determine whether individuals have needs that must be addressed in other health care facilities?

The ETA defines a "medical practitioner" as a person who is entitled under the laws of a province to practice the profession of medicine or dentistry.

Do these institutions have policies and procedures in place for the care of patients and supervision of staff? Are Medical Staff Rules and Guidelines and/or Medical Staff Bylaws in place? Is so, please provide copies.

Are medical or surgical procedures and treatments provided by medical practitioners to patients in these institutions? Please provide details.

We would explain that criterion (c) listed above means that the facility in question must be operated for the purpose of providing medical or surgical services by medical practitioners that are either employed by the facility or who are actively practicing medicine at the facility. An "active" medical practitioner is one who has admitting privileges at the facility or who works regularly at the facility. Medical or surgical treatment refers to treatment provided by a medical practitioner and does not refer to care given by other health care providers, such as nurses, physiotherapists, etc.

Do these institutions have the following: clinical laboratories and technicians, radiological facilities and services, dietary services, pharmacy services, medical libraries and records, etc.

Do the institutions provide inpatient care and services? Please indicate what support services are provided to inpatients. Do inpatients receive meals, laundry services, etc.? Are nursing services provided on a 24-hour a day basis?

If you have any questions about the points discussed above, please do not hesitate to contact me at (613) 952-9590.

Yours truly,

Elaine Bonnah
Municipalities and Health Care Services Unit
Public Service Bodies and Governments Division
Excise and GST/HST Rulings Directorate

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