Person and profession – medical assistant. Not by bread alone.

• Themes:
• Medical examinations of employees

Key issues: Which employers need a health center? What is needed to organize a health center? Do you need a license to practice medicine? Which employer needs a health center It is unlikely that anyone will argue with the statement that one of the main values ​​of an enterprise is its workforce. And it is necessary to take care not only about staffing levels, but also about the health of workers. One of the ways to demonstrate such care is to organize a health center at the enterprise. From the point of view of labor legislation, the employer needs to establish medical care for employees in accordance with labor protection requirements (Article 212 of the Labor Code of the Russian Federation). For these purposes, the employer equips premises for the provision of medical care (Article 223 of the Labor Code of the Russian Federation).

Health center at the enterprise requirements how many employees

Attention

By Artem Makarov / April 3rd, 2020 / Administrative Law / No Comments To protect their health, medical centers (offices) may also be opened in remote villages. If the organization does not carry out activities that involve the performance of work or the presence of production factors listed in Order N 83, but decides to voluntarily create a first-aid post (health center) for its employees, then, in the opinion of the Ministry of Finance, it should not include the costs associated with its maintenance as expenses for tax purposes. This approach is fraught not only with an understatement of the tax base for income tax (if the accountant did take into account the costs of maintaining a medical center), but also with the possibility of incurring VAT obligations.

The fact is that, according to paragraphs. 2 p. 1 art.

Expenses for remuneration of medical staff and purchase of medicines

The costs of remuneration for employees of medical departments are fully borne by the management of the organization in accordance with the legislation on remuneration for this category of personnel. Paramedics and other personnel are equal to employees of medical organizations and, accordingly, receive all the required allowances when working in accordance with their job description in an office, company, production and other forms of organizations.

Typical medical center on the territory of a small company

As a result, ensuring medical activities at the enterprise is the most important factor in occupational safety and significantly reduces the risk of major injuries during production, and also in many cases preserves and prevents other negative circumstances. The implementation of a medical office in an institution significantly reduces the risk of harm to health and death of personnel during work.

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After all, they are the ones who most strongly influence the health of workers. We are talking, first of all, about enterprises engaged in the extraction of oil, gas and other minerals in the Far North, desert and remote areas.

In addition, there are a number of industries in which the health of the employee affects the quality of the products. For example, food production, provision of catering services, educational and transport services, etc.

Main functions of a health center To understand what main functions a health center can perform at an enterprise, you need to refer to Appendix No. 1 of Order No. 911n of the Ministry of Health of Russia dated November 13, 2012.

First aid station at the enterprise

Orderly 1 per work shift for cleaning premises* * The number of work shifts is determined according to the organization’s work schedule. The standard for equipping a medical health center includes 87 items of equipment. This number includes:

• five first aid kits;
• two emergency medical kits;
• one anti-AIDS first aid kit;
• one portable electrocardiograph, 6-channel;
• three phonendoscopes;
• five medical thermometers;
• three blood pressure monitors;
• two breathalyzers;
• two medical couches;
• ten chairs, including swivel chairs;
• one safe for storing potent medications;
• two refrigerators;
• three hemostatic tourniquets;
• ten individual dressing bags, etc.

Table 1. DYNAMICS OF THE NUMBER OF MEDICAL AND FEDERAL HEALTH CENTERS IN THE USSR.

Medical health center at the enterprise requirements

Important

The composition and area of ​​these points are provided for by the current building codes and regulations and other regulations (clause 3.6.23 POT R M-027-2003, approved by Resolution of the Ministry of Labor of Russia dated May 12, 2003 No. 28). It is also necessary to have health centers at nuclear power plants and railway transport.

Organizations that are recommended to have a health center One of the tasks of a health center is to maintain the health of employees. Therefore, employers who have a large number of harmful factors at work should show interest in its work.

After all, they are the ones who most strongly influence the health of workers. We are talking, first of all, about enterprises engaged in the extraction of oil, gas and other minerals in the Far North, desert and remote areas.

Organize a health center in the organization

The “Labor Code of the Russian Federation” in relation to sanitary, household and medical and preventive services for workers states: Providing sanitary, household and medical and preventive services for workers in accordance with labor protection requirements is the responsibility of the employer.

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For the purpose of medical and preventive care for employees, the employer is equipped with:

• sanitary facilities,
• eating areas,
• premises for medical care,
• rest rooms during working hours;
• sanitary posts with first aid kits stocked with a set of medicines and first aid preparations, etc.

(Article 223, dated December 30, 2001 N 197-FZ (as amended on November 7, 2011)
Which employer needs a health center

From the point of view of labor legislation, the employer needs to establish medical care for employees in accordance with labor protection requirements (Article 212 of the Labor Code of the Russian Federation). For these purposes, the employer equips premises for the provision of medical care (Article 223 of the Labor Code of the Russian Federation).

Some enterprises are required to have health centers. Requirements for this are contained in industry and intersectoral rules on labor protection, sanitary rules and other regulatory legal acts.

For example, the Intersectoral Rules for Occupational Safety and Health in Road Transport for conducting medical examinations of drivers establish the need to have paramedics or medical health centers in organizations with a payroll of more than 300 people.

The composition and area of ​​these points are provided for by the current building codes and regulations and other regulations (clause 3.6.23 POT R M-027-2003, approved by Resolution of the Ministry of Labor of Russia dated May 12, 2003 No. 28).

Organizations that recommend having a health center:

One of the tasks of the health center is to maintain the health of workers. Therefore, employers who have a large number of harmful factors at work should show interest in its work. We are talking about enterprises engaged in the extraction of oil, gas and other minerals in the Far North, desert and remote areas. In addition, there are a number of industries in which the health of the employee affects the quality of the products. For example, food production, provision of catering services, educational and transport services, etc.

Functions of the health center:

• provision of primary health care before the arrival of an ambulance team;
• examination of temporary disability;
• organizing referrals for medical reasons for employees who seek medical help for consultation with medical specialists;
• issuing certificates confirming the fact of seeking medical help;
• participation in the preparation of lists of contingents and name lists of employees sent to undergo mandatory preliminary and periodic medical examinations;
• participation in monitoring the timely completion of preliminary and periodic medical examinations by employees;
• Carrying out pre-trip, post-trip, pre-shift, post-shift inspections;
• organization and implementation of sanitary, hygienic and anti-epidemic measures on the territory of the organization;
• carrying out measures to prevent and reduce morbidity with temporary disability, injuries, occupational diseases and occupational poisoning, improve the sanitary and hygienic working conditions of the organization’s employees;
• health protection of the organization's employees;
• participation in the development and implementation of a set of preventive and health measures, including monitoring the implementation of recommendations based on the results of preliminary and periodic medical examinations of the organization’s employees;
• maintaining accounting and reporting documentation in established forms, including sending notifications of a preliminary diagnosis of an occupational disease;
• participation in training and exercises simulating emergency situations on the territory of the organization;
• preparation of documents (extracts from patient admission registers, examination reports) upon request;
• advanced training of medical workers at the health center, participation in conferences and seminars;
• study and compliance with labor protection rules;
• providing regular reports on the work carried out and the results obtained.

A medical health center is created as a structural unit of an organization, which, along with the main (statutory) one, is engaged in medical activities.

Premises requirements:

A special room is allocated to accommodate the health center. The requirements for it are established in SP 44.13330.2011 “Administrative and domestic buildings” (approved by order of the Ministry of Regional Development of Russia dated December 27, 2010 No. 782).

The composition and area of ​​the premises of the medical health center are determined in Table 5 of SP 44.13330.2011.

The premises in which medical activities will be carried out must also comply with SanPiN 2.1.3.2630-10 “Sanitary and epidemiological requirements for organizations carrying out medical activities” (approved by Resolution of the Chief State Sanitary Doctor of Russia dated May 18, 2010 No. 58).

Table 1. Composition and area of ​​premises of a medical health center

The structure of the health center and its staffing levels are established by the head of the organization. Recommended staffing standards and the standard of equipment for the health center are established by Order of the Ministry of Health of Russia dated November 13, 2012 No. 911n. However, they can be adjusted by decision of the head of the organization depending on the type of activity

Recommended staffing standards for a medical health center

Medical center equipment:

• five first aid kits;
• two emergency medical kits;
• one anti-AIDS first aid kit;
• one portable electrocardiograph, 6-channel;
• three phonendoscopes;
• five medical thermometers;
• three blood pressure monitors;
• two breathalyzers;
• two medical couches;
• ten chairs, including swivel chairs;
• one safe for storing potent medications;
• two refrigerators;
• three hemostatic tourniquets;
• ten individual dressing bags, etc. (Appendix No. 3 to the order of the Ministry of Health of Russia dated November 13, 2012 No. 911n).

Licensing of medical activities of a health center:

To conduct any medical activity, you must have the appropriate license. The health center is no exception. Without a license, only first aid can be provided at a health center. The list of works and services that make up medical activities and the procedure for licensing them is determined by Decree of the Government of the Russian Federation of April 16, 2012 No. 291.

Obtaining a license for medical activities for most organizations is a very troublesome and expensive matter; as a rule, this path is taken by enterprises with a large number of employees (over 300 people) engaged in hazardous working conditions, or by large transport companies.

However, recently, many organizations are choosing to outsource medical services to a licensed medical organization - under a contract.

Indeed, obtaining a license, and especially conducting medical activities, is a troublesome matter and requires special knowledge, is associated with checks, risks, and a shortage of qualified medical personnel. That is why more and more medical institutions are appearing on the market, offering services for organizing the work of a first-aid post or health center on the territory of an enterprise.

IMPORTANT:

1. Health centers are required to organize not all enterprises, but only those for which this requirement is established by industry or intersectoral regulatory legal acts.
2. The health center performs a wide range of functions, including providing primary health care before the arrival of an emergency medical team, participating in monitoring the timely completion of preliminary and periodic medical examinations by employees, and others.
3. The size of the health center premises depends on their type. It does not have to contain all the premises recommended by the order of the Ministry of Health.
4. If a license for medical activities has not been obtained, only first aid can be provided at a health center. Or you need to enter into an agreement with a medical organization that will provide medical care to your employees.

Our company provides licensed medical services:

• duty of an emergency medical team (for organizations that have not been licensed for medical activities, for high-risk facilities).
• departure of a commercial ambulance to an organization
• duty of medical personnel: doctor, paramedic, nurse in the office of a first-aid post or health center of an organization
• Carrying out pre-trip and post-trip examinations of drivers on the territory of our clinic or on the territory of the customer
• visit of a specialist for medical care of employees at the customer’s premises
• medical support for events, groups of employees

• medical evacuation of victims, followed by hospitalization in municipal and commercial hospitals
• consultation and hospitalization services in specialized institutions in Moscow

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Duty at events

Minimum duty time 5 hours To calculate the cost, call us at tel. 8(800) 30-112-03
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Company services

• Transportation of patients
• Intensive care with hospitalization
• Resuscitation transport from hospital to hospital
• Calling a paramedic team
• Ambulance transport
• Hospitalization of patients
• Ambulance on set
• Ambulance duty at construction sites and high-risk sites
• Planned hospitalization
• Emergency hospitalization

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How to organize a first aid station at an enterprise

All processing of sick leave, health insurance policies and related documents can be entrusted to the health center staff.

• Tax benefits. The costs of organizing and maintaining a health center will reduce the tax base if this is a legal obligation for the entrepreneur, and also if the owner turned to a third-party organization for this service. An independent initiative does not provide for such a tax bonus (clause 7, clause 1, article 264 of the Tax Code of the Russian Federation). From the point of view of tax legislation, these expenses relate to “other expenses associated with production and sales.”
• FOR YOUR INFORMATION! The Civil Code of the Russian Federation authorizes the conclusion of contracts with medical institutions, but not the transfer of premises in exchange for free medical services. This is not prohibited, but it will be much more expensive from a tax point of view.

Who is required by law to organize a first aid station?

A number of entrepreneurs consider themselves responsible for the health of their employees; some believe that this issue should be of concern to the employees themselves. Meanwhile, the legislation of the Russian Federation mandatory declares this form of health protection in certain organizations:

1. The Labor Code of the Russian Federation guarantees that the employer provides employed citizens with:
2. absence of danger in working conditions (Part 1 of Article 212 of the Labor Code of the Russian Federation);
3. service for employees in accordance with the adopted regulations for sanitary, preventive and health measures (Part 2 of Article 212 of the Labor Code of the Russian Federation).
4. Federal Law No. 323-FZ of November 21, 2011 “On the fundamentals of protecting the health of citizens in the Russian Federation” states that such a clause should be an integral part of the health protection system for employees of medium-sized and large companies.
5. SNiP 2.09.04-87 “Administrative and domestic buildings” in paragraph 5.27 specifies at which enterprises it is mandatory to place such a point:
6. with an average number of staff from 50 to 300 - a first-aid post;
7. with more than 300 employees - a paramedic (medical) station.

NOTE! A number of organizations, even those that do not reach the declared number, are required to organize permanent access for employees to medical services due to their industry specifics. For example, transport workers receive a medical clearance before going on a trip and are examined after the end of their shift (Federal Law of December 10, 1995 No. 196-FZ “On Road Safety”).

The law prescribes the organization of their own medical (paramedic-medical) points for enterprises in the following industries :

• oil and gas production in the Far North and equivalent territories, as well as during offshore drilling;
• security services (militarized);
• food production;
• catering services (stationary and in transport);
• transport enterprises;
• a number of services (educational, some household services, etc.).

Can other entrepreneurs organize a medical center?

The law stipulates the absolute need for health centers for large and medium-sized companies. Other entrepreneurs can take care of the health of their employees on their own initiative by hiring medical workers and organizing a workplace for them. It should be remembered that this is impossible without obtaining two important permits:

• licenses for medical activities;
• sanitary and epidemiological conclusion.

IMPORTANT! If you open a medical center without a license, which is discovered during an inspection, the managers will receive a serious fine, and if something serious happens, then a criminal charge.

Is a medical office required in a manufacturing enterprise?

Cheat sheetpublic health and healthcare Health centers and first-aid posts, as a rule, serve employees free of charge (at the expense of the employer), and do not serve third parties at all. Thus, these subdivisions are not included in the list of industrial enterprises.

Info

Their activities are related to ensuring normal, safe working conditions for workers, and therefore all costs of their maintenance can be included in expenses in the general manner. This, in particular, is stated in the Resolution of the Federal Antimonopoly Service of the North-Western District dated June 30, 2005 N A42-9476/04.

A few important nuances If first aid stations are located in rotational camps Enterprises often organize rotational camps for the accommodation of workers employed, for example, in oil and gas production.

Health center at the enterprise

The list of works and services that make up medical activities and the procedure for licensing them is determined by Decree of the Government of the Russian Federation of April 16, 2012 No. 291. Obtaining a license for medical activities for most organizations is a very troublesome and costly matter; as a rule, enterprises follow this path having a large number of workers engaged in hazardous working conditions, or large transport companies. However, most enterprises prefer outsourcing of medical services - transferring the health center available at the enterprise under an agreement for the professional management of a medical organization licensed for the relevant types of medical activities. This area is now actively developing, and more and more medical institutions are appearing on the market, offering services for organizing the work of a first-aid post or health center on the territory of an enterprise.

The budget must include the cost of paying medical staff: usually a doctor (paramedic) and a nurse. Action plan for registering a medical center If everything necessary is available and the entrepreneur does not want to entrust the organization of a medical center to a third-party organization, he will have to take a number of steps:

1. Collect a package of constituent documents of the organization.
2. Contact Rospotrebnadzor for permission to open a medical center.
3. Obtain a license to practice medicine or enter into an agreement with an existing medical organization to provide specialized services.
4. To register in the accounting policy of the organization the Regulations on the medical (paramedic, medical, health) point at the enterprise.

• maintaining accounting and reporting documentation in established forms, including sending notifications of a preliminary diagnosis of an occupational disease;
• participation in training and exercises simulating emergency situations on the territory of the organization;
• preparation of documents (extracts from patient admission registers, examination reports) upon request;
• advanced training of medical workers at the health center, participation in conferences and seminars;
• study and compliance with labor protection rules;
• providing regular reports on the work carried out and the results obtained.

What is needed to organize a health center To organize a health center, you must be guided by the Rules for organizing the activities of a medical health center (Order of the Ministry of Health of Russia dated November 13, 2012 No. 911n).

Main functions of the health center

To understand what the main functions

can operate a health center at an enterprise, you must refer to Appendix No. 1 of Order No. 911n of the Ministry of Health of Russia dated November 13, 2012. Here are the main ones:

• provision of primary health care before the arrival of an ambulance team;
• examination of temporary disability;
• organizing referrals for medical reasons for employees who seek medical help for consultation with medical specialists;
• issuing certificates confirming the fact of seeking medical help;
• participation in the preparation of lists of contingents and name lists of employees sent to undergo mandatory preliminary and periodic medical examinations;
• participation in monitoring the timely completion of preliminary and periodic medical examinations by employees;
• Carrying out pre-trip, post-trip, pre-shift, post-shift inspections;
• organization and implementation of sanitary, hygienic and anti-epidemic measures on the territory of the organization;
• carrying out measures to prevent and reduce morbidity with temporary disability, injuries, occupational diseases and occupational poisoning, improve the sanitary and hygienic working conditions of the organization’s employees;
• health protection of the organization's employees;
• participation in the development and implementation of a set of preventive and health measures, including monitoring the implementation of recommendations based on the results of preliminary and periodic medical examinations of the organization’s employees;
• maintaining accounting and reporting documentation in established forms, including sending notifications of a preliminary diagnosis of an occupational disease;
• participation in training and exercises simulating emergency situations on the territory of the organization;
• preparation of documents (extracts from patient admission registers, examination reports) upon request;
• advanced training of medical workers at the health center, participation in conferences and seminars;
• study and compliance with labor protection rules;
• providing regular reports on the work carried out and the results obtained.

Health center at the enterprise requirements how many employees

• Themes:
• HR records management

Question Is a medical office required at a manufacturing enterprise? Answer Answer to the question: Labor legislation imposes a number of responsibilities on the employer to ensure safe conditions and labor protection, sanitary, medical and preventive services for workers. In accordance with “SP 44.13330.2011. Set of rules. Administrative and domestic buildings. Updated version of SNiP 2.09.04-87" (approved by Order of the Ministry of Regional Development of the Russian Federation dated December 27, 2010 N 782) https://vip.1kadry.ru/#/document/97/21907/bssPhr7/?step=30 clause 5.27 for payroll with a workforce of 50 to 300, it is necessary to provide a medical center. The area of ​​the medical station should be taken as follows: 12 m2 - with a payroll number of 50 to 150 workers, 18 m2 - from 151 to 300.

Is it necessary to license a medical center at an enterprise?

Licensing the activities of medical personnel and the medical office at the enterprise as a whole is the direct and immediate responsibility of the enterprise management. This procedure is carried out by state medical centers. After passing it, the medical center has the right to carry out certain medical actions in accordance with the specifics of the license received.

Note! Based on the results of certification, the licensing authority makes a decision on the compliance of the standards and organization of the medical center at the enterprise with the requirements and quality parameters with state standards. After these activities are completed, the functional center can carry out its activities.