Request By:
Mr. Francis J. Mellen, Jr.
Attorney at Law
Twenty-Eighth Floor - Citizens Plaza
Louisville, Kentucky 40202
Opinion
Opinion By: Robert F. Stephens, Attorney General; By: Charles W. Runyan, Assistant Deputy Attorney General
Hardin County Memorial Hospital is a county hospital established by the Hardin County Fiscal Court pursuant to KRS 216.010. The medical staff of the hospital is attempting to promulgate new by-laws for that staff which would purportedly grant all responsibility and control for medical staff affairs to the medical staff, leaving the hospital board and hospital administrator with no control or supervision over the activities of the medical staff. For example, the new by-laws would provide that the granting or withdrawal of medical staff privileges, all policies relating to peer review, and related matters, would be determined solely by the medical staff.
The proposed by-laws raise the question whether the medical staff can assume such control over medical staff affairs in light of KRS 216.040, which provides in part that:
"The county hospital shall be under the control of the proper county authorities."
Since the governing body of the county is fiscal court, it has the primary responsibility for the operation and control of the county hospital. See also KRS 67.080(8), 216.010, and
Abernathy v. City of Irvine, Ky., 355 S.W.2d 159 (1962). The Abernathy case stresses that if the hospital is to be a county hospital, the statutes require that it be controlled and managed by public officials. Here the public officials are members of fiscal court, considered as a body. Of course administrative discretions may be conferred by fiscal court upon the hospital board. Thus a board of directors of a county hospital may properly operate within the scope of administrative and ministerial implementation of the decisions, policies and directives of fiscal court in the operation and management of the county hospital.
Spahn v. Stewart, 268 Ky. 97, 103 S.W.2d 651 (1937).
It is our opinion that the attending physician appointed to the medical staff should have full authority in the professional care of patients in the hospital, subject to the policies stated by the hospital board. However, in connection with the overall control and management of the county hospital, the medical staff has no authority to usurp such overall control; and the fiscal court has no authority to surrender or part with its overall control and management of the county hospital. See