Conclusion kak what has changed. What is a CEC certificate, and what is needed to pass it? groups of navigation bar commands See also section Regulatory and reference information

Even for those who know what KOSGU is in the budget, decoding can be difficult. The classification of general government transactions is part of the classification of the account, which allows you to group the costs of the public sector of the economy depending on the economic content and includes a group, item and subitem.

• expenses for payments to personnel in order to ensure the performance of functions by state (municipal) bodies, state institutions, management bodies of state non-budgetary funds;
• purchase of goods, works and services to meet state (municipal) needs;
• social security and other payments to the population;
• capital investments in objects of state (municipal) property;
• intergovernmental transfers;
• provision of subsidies to budgetary, autonomous institutions and other non-profit organizations;
• service of the state (municipal) debt;
• other appropriations.

Decryption of KOSGU: subarticle 226

• The first group includes income transactions- code 100. It includes sub-articles from 110 to 180, this includes all types of income that the organization has. Subsection 110, for example, includes all income from taxes. Sub-item 120 includes income from property (rent, etc.). 130 includes profit from services rendered. And other sub-articles.
• The second group includes expenditure operations of the organization- code 200. The code has subgroups from 211 to 290. Here are grouped operations on wages, benefits, pensions, paid organizations, rent and much more.
• The third group includes receipts of assets that are not related to financial- code 300. The specified assets can be both production and non-production. The group consists in detail of sub-articles 310-340. This includes income from the increased value of the organization's property, from an increase in the cost of maintaining software and databases, etc.
• The fourth group includes the disposal of assets that are not related to financial is the code 400. This group includes 410-440 sub-entries. If the value of the property of the enterprise has decreased, compensation for damage, etc.
• The fifth group includes the receipt of financial assets– code 500. The group has subgroups 510–550. This includes receipts from shares, promissory notes, an increase in loan balances, and more.
• The sixth group includes the disposal of financial assets- code 600, which consists of 610-650 articles regulating the disposal of assets.
• The seventh group includes an increase in liabilities– code 700, consisting of 710-720 subgroups. Here we are talking about increasing the debts of the organization.
• The eighth group includes a decrease in liabilities- code 800. It consists, in turn, of sub-items 810 and 820, and includes operations to reduce various debt obligations.

In the budgetary accounting of institutions, all transactions in terms of income and expenses are distributed on the basis of the classification according to KOSGU. The specified classifier is necessary in the accounting department when forming the accounting policy of the organization, in order to fully take into account information about the operations performed.

Which CWR and KOSGU to use for public procurement

The detailing of each expenditure operation of an economic entity of the public sector is the basis for planning and budget execution. That is, effective and transparent planning, ensuring the intended use of allocated funds and the reliability of financial statements depend on the correctness of the selected code for the type of expense and the classification of operations of the general government sector.

An expense type code is a special numerical code that allows you to group homogeneous types of expense transactions according to their content in order to manage the budget process in terms of spending funds, as well as control its execution in accordance with the current requirements of budget legislation.

KVR 242 and 244: we reflect the costs in the field of information and communication technologies

Providing clarifications on the attribution of goods, works, services to the field of information and communication technologies is within the competence of the Ministry of Communications of Russia, which, in accordance with Decree of the Government of the Russian Federation dated 02.06.2008 No. 418 "On the Ministry of Communications and Mass Media of the Russian Federation" - legal regulation in the field of information technology.

Analyzing the descriptions of the considered codes of types of expenses, we can conclude that only recipients of federal budget funds, as well as other recipients of budget funds, can apply CWR 242, when the relevant financial authority decides to apply this element of types of expenses. Budgetary and autonomous institutions of CWR 242 cannot apply.

Decoding and special cases of KOSGU 225 and 226 in budgetary institutions in 2019

Separate installation of equipment, if it is not provided for by the contract for the supply, construction, reconstruction, technical re-equipment or additional equipment, refers to article KOSGU 226. Including the installation of security, fire alarms, windows and meters. The main thing to keep in mind is that the contract should be only for the installation or installation of the specified equipment. If you conclude one contract with a contractor for the purchase and installation of equipment, the costs will need to be attributed to article 310 of KOSGU.

The concept of "improvement" in the legislation does not exist. The financial department believes that these are the costs of creating a comfortable, practical and aesthetically equipped space on the territory of the institution. That is, these are various works, services and non-financial assets.

Formation of a working plan of accounts of budgetary and autonomous institutions in 2019

Recall that from 01/01/2019, the account numbers of the working chart of accounts of budgetary and autonomous institutions, depending on their economic content, must also contain in 15-17 digits an analytical code for the type of income - income, other income, including from borrowing (sources of financing deficit of funds of the institution) (hereinafter referred to as receipts) or an analytical code for the type of disposals - expenses, other payments, including for the repayment of borrowings (hereinafter referred to as disposals), corresponding to the code (component of the code) of the budget classification of the Russian Federation (analytical group of the subtype of budget revenues, code of the type of expenses, analytical group of the type of sources of financing of budget deficits). Zeros may be indicated in 5 - 14 digits, unless otherwise established by the Accounting Policy of the accounting entity.

In the elements of the directory "Items of the plan of receipts (disposals)" for articles of the type of KRB, it is enough to indicate the codes of the section and subsection, type of expenses and KOSGU. If necessary, you can specify a code from an arbitrary classifier "KPS Analytical Code", which is used to conduct analytics in accordance with the Accounting Policy of the institution.

Table of codes of KOSGU and compliance with KVR

• Income to the budget account, an indication of the increase in the amount of residual funds of organizations that relate to the budget system.
• The increase in the value of securities, not counting all kinds of shares and other documents reflecting participation in the capital. Carrying out operations related to investing in various securities (not shares).
• Growth in the value of shares and other documents confirming participation in the capital. Expenses on contributions made to acts and other forms of valuable documents, as well as on budget investment.
• Increase in debt on budget loans. Carrying out operations related to the issuance of loans from the budget in favor of other budgets, legal entities or governments of other countries.
• Growth in the value of other financial assets. Investment of budgetary funds in other financial assets.

Thus, when drawing up all kinds of schedules, where KOSGU was previously indicated, now you need to put CWR. At the same time, participants in the procurement process should carefully read the comparative table of these codes, since the classifiers in them are somewhat different, which can lead to an error.

Budget classification

Budget classification represents a grouping of incomes and expenditures of budgets of all levels, as well as sources of financing their deficits. It provides comparability of indicators of all budgets. With its help, the systematization of information on the formation of budget revenues and the implementation of expenditures is achieved.

• functional the classification reflects the allocation of budget funds to the implementation of the main functions of the state (management, defense, etc.). (Section → Subsection → Target items → Types of expenses).
• departmental the classification of budget expenditures is directly related to the management structure, it reflects the grouping of legal entities that receive budgetary funds. (The main managers of budget funds).
• Economic the classification shows the division of state expenditures into current and capital, as well as wages, material costs, and the purchase of goods and services. (Expenditure category → Groups → Subject items → Sub-items)

See also: Budget expenditures

Changes in 2019 for budgetary institutions

It was added that in order to organize management accounting at the request of the founder of the institution, in 1-17 digits of the account number, in which, according to Instruction No. 174n, zeros are put down, indicate analytical codes of receipts and disposals. At the same time, such an opportunity is prescribed in the accounting policy.

The Ministry of Finance has changed the procedure for the financial statements of budgetary and autonomous institutions for 2019 - Instruction No. 33n. New rules by order of the Ministry of Finance of Russia dated November 16, 2019 No. 209n have already entered into force. You can find out about all the news right now from our table.

05 Aug 2018 10422

Conclusion of the KEC. What is meant by KEK help? Composition of the KEC Commission. When you need a medical certificate KEK.

The Ministry of Health is a federal executive body in the Russian Federation. Accordingly, the Ministry should set general guidelines for health protection and various medical issues, while lower-level structures should be involved in clarifying and concretizing these guidelines. Such structures include, for example, regional offices of the Ministry of Health, its departments and services, as well as regional administrations and other institutions.

The issues of the need to form clinical expert commissions on the basis of medical institutions subordinate to the state are regulated by the Orders of the Ministry of Health of Russia only in the most general form. Each subject - region of the Russian Federation establishes its own provisions on the composition, functions and procedure for the work of clinical expert commissions.

Below we will outline those points that an ordinary citizen who acts in medical institutions as a patient should know about such commissions for the general development.

So, in medical institutions (HCI) it is necessary to create, in established cases, a special body of a collegiate nature - a clinical expert commission (CEC). Let us clarify, just in case, that the term "treatment and prevention facility" is equally applicable to hospitals, clinics, trauma centers, etc.

The committee has several goals. However, for HCI patients, the power of the clinical expert commission to make decisions regarding controversial, ambiguous or conflict situations is of the greatest importance. This means that if the diagnosis of a patient causes problems for the attending physician, or the principles of the treatment offered by him, diagnostics, medical certificates issued by him, etc. raise questions or doubts in the patient, then the right to be an "arbitration court" is granted to KEK. In addition, patients should be aware that it is the conclusion of the KEK that has more power than any other medical certificate.

Conclusion can confirm a person's incapacity for work for up to a year. Plus, the clinical expert commission also makes a decision on sending a person for a medical and social labor examination. Such an examination determines whether a person is able to work, or whether he should be assigned a disability group.

Composition of KEC

The CEC consists of the most experienced professionals, who do not have to be practicing doctors. Depending on the considered medical (clinical) case, the members of the clinical expert commission of the health facility may be healthcare workers, representatives of the scientific community, public organizations and government agencies. It turns out that the clinical expert commission can meet in a different qualitative and quantitative composition. Moreover, the commissions in some health facilities are completely temporary and are collected only as the need arises.

In any case, the responsibility for the quality of the work of the clinical expert commissions lies with their chairmen. The chairman of the commission is usually appointed the chief physician of the medical institution in which the CEC is created. At the same time, one or two vice-chairmen of the KEK are appointed. Accordingly, if KEK conclusion is drawn up incorrectly, then the patient has the right to make claims, first of all, to them.

How to use the KEK medical certificate

Incidentally, medical certificates issued by the clinical expert commission to patients can be used in different situations. KEK help may serve as a basis for:

KEK help there is KEK conclusion, issued in an appropriate manner for issuance to the patient. Respectively, KEK certificate is subject to verification by signatures, stamps and seals, like any official document.

Of course, not every person in his life will come across the work of the CEC. However, to know and understand what this commission is not only possible, but also necessary for anyone.

CEC is organized to discuss and make decisions on the most significant clinical and expert issues of diagnosis, treatment, rehabilitation, determination of working capacity, professional suitability and other medical and social issues, as well as to consider claims from patients and interested organizations that arise in the process of providing medical care.

The CEC holds its meetings weekly and is headed by the deputy head of the health facility for CEP.

By orders of the Ministry of Health of the USSR "On staffing standards for medical, pharmaceutical and other personnel of healthcare facilities" dated 09/26/78 No. 800 and dated 05/31/79 No. 560, the position of deputy for CEP in a healthcare facility is introduced if there are 25 medical posts or more. By Decree of the Ministry of Labor of the Russian Federation of August 27, 1997 No. 43, deputies for CEP were transferred to the group of the administrative and managerial category and must also have a certificate of a specialist in public health and public health.

In accordance with Order No. 363/77 (not registered with the Ministry of Justice), which defines a three-stage system for monitoring the quality of medical care (1st stage - heads of departments; 2nd - deputy for medical work, polyclinic or CEP; 3rd - CEC LPU), deputy for CEP, being at the same time the chairman of the CEC of LPU, is usually responsible for the 3rd stage of quality control of medical care, but there is no strict regulatory framework on this issue. The chief physician has the formal right to put the deputy for CEP responsible for the 2nd stage of the examination of the quality of medical care, and the chief medical officer - for the third. The quantitative composition of CEC is not strictly defined, but should not be less than 3 or too large. To make a decision, at least 50% of the KEC + 1 members must be present.

Accounting for clinical and expert work, including registration of the conclusions of the CEC, is carried out by maintaining the “Journal of accounting for clinical and expert work of healthcare facilities (f. No. 035 / y-02), introduced by order of the Ministry of Health of the Russian Federation dated May 21, 2002 No. 154.

Conclusions (certificates) of KEK can be issued on forms of the established and arbitrary form. Copies of the EEC conclusions, with the exception of the conclusion on the severity of the work injury, are handed over to the patient at his request. In other health facilities or organizations, the KEK conclusions are submitted in accordance with Art. 61 Basics

The government of Moscow
MOSCOW CITY HEALTH DEPARTMENT

ORDER

On the organization of clinical and expert work in the system of the Department of Health of the city of Moscow

Document as amended by:
by order of the Department of Health of the city of Moscow dated January 16, 2015 N 7;
by order of the Department of Health of the city of Moscow dated July 12, 2017 N 498.
____________________________________________________________________

An analysis of the work of the clinical expert commission of the Moscow City Health Department and medical commissions of state healthcare institutions of the city of Moscow shows that the existing organization of departmental control of the provision of medical care and examination of temporary disability of citizens as a whole meets the objectives of further improving the medical provision of the population of Moscow.

At the same time, in connection with the implementation of the activities of the Moscow Healthcare Modernization Program for 2011-2012, the priority national health care project "Health", the implementation of city targeted programs, as well as structural changes in the city health care system, the need to improve the efficiency and quality of medical care, optimization and standardization of the treatment and diagnostic process, further development of clinical and expert work at all levels is required.

In accordance with the order of the Ministry of Health and Social Development of Russia dated September 24, 2008 N 513n "On the organization of the activities of the medical commission of a medical organization", Regulations on the Department of Health of the City of Moscow, approved by the Decree of the Government of Moscow dated December 31, 2002 N 1070-PP "On the reorganization of the Moscow Health Committee", in in order to further improve clinical and expert work in the system of the Moscow Department of Health, strengthen its role in improving the quality of medical care for the population of the city

I order:

1. Approve:

1.1. Regulations on the Clinical Expert Commission of the Department of Health of the City of Moscow (Appendix 1).

1.2. Regulations on the medical expert at the clinical expert commission of the Moscow City Health Department (Appendix 2).

1.3. Regulations on the commission for the study of lethal outcomes (KILI) of the Department of Health of the city of Moscow in the administrative district of the city of Moscow (Appendix 3).

1.4. The order of work of the clinical and anatomical conference (Appendix 4).

1.5. Standard minutes of the meeting of the clinical expert commission of the Moscow City Health Department (Appendix 5).

1.6. Standard act of expert control (Appendix 6).

1.7. The composition of the clinical expert commission of the Department of Health of the city of Moscow (Appendix 7).

2. To the directors of the State public institutions of the Directorates for ensuring the activities of public health institutions of the administrative districts of the city of Moscow:

2.1. Submit to the Moscow City Health Department proposals on the composition of the commissions for the study of lethal outcomes (CLI) of the Moscow City Health Department in the administrative district of Moscow.

2.2. Submit the lists of expert groups of CILI of the Moscow City Health Department in the Moscow City Administrative District according to the profiles headed by the chief freelance specialists of the Moscow City Health Department in the Moscow Administrative District.

Deadline - within two weeks from the date of issuance of this order.

3. Heads of public healthcare institutions of the city of Moscow:

3.1. Create medical commissions in the entrusted state healthcare institutions of the city of Moscow and organize their work in accordance with the requirements of the order of the Ministry of Health and Social Development of Russia dated September 24, 2008 N 513n "On the organization of the activities of the medical commission of a medical organization".

Deadline - within a week from the date of issuance of this order.

3.2. In the activities of medical commissions, to provide for the work of subcommittees for the study of lethal outcomes, medical control subcommittees, subcommittees for the examination of working capacity.

Deadline is permanent.

3.3. To exercise control over the activities of medical commissions in the entrusted state healthcare institutions of the city of Moscow in accordance with the requirements of this order, other legal documents and in compliance with the existing legislation of the Russian Federation.

Deadline is permanent.

4. Clinical expert commission of the Department of Health to provide organizational, methodological and advisory assistance in the work of medical commissions of state health care institutions of the city of Moscow in accordance with the approved regulations; if necessary, make proposals for further improvement of this area of ​​activity.

Deadline is permanent.

5. Consider invalid the order of the Moscow City Health Department dated 13.04.2007 N 155 "On the further improvement of clinical and expert work in the system of the Moscow City Health Department" (as amended by orders of the Moscow City Health Department dated 04.05.2008 N 300 and dated 05.29.2009 N 627).

6. I reserve control over the execution of this order.

Supervisor
Department of Health
Moscow city
L.M. Pechatnikov

Appendix 1. Regulations on the Clinical Expert Commission of the Moscow City Health Department

Appendix 1
to the order of the Department
health care of the city of Moscow
dated November 30, 2011 N 1481

1. General Provisions:

1.1. The Clinical Expert Commission of the Moscow City Health Department (hereinafter referred to as the CEC) is created and its composition is approved by order of the head of the Moscow City Health Department (hereinafter referred to as the Department).

1.2. The tasks of the CEC are: collegial discussion and decision-making on all the most significant clinical and expert issues of the organization and quality of medical care, examination of working capacity and professional suitability, other medical and social issues within its competence, as well as consideration of conflict situations, claims of patients and interested parties. organizations that arise in the process of providing medical care in public healthcare institutions of the city of Moscow.

1.3. KEC is an organizational, methodological and advisory body. The chairman of the EEC is the head of the Moscow Department of Health, the deputy (deputies) - one or more deputy heads of the Department of Health. The CEC includes officials and chief freelance specialists of the Department, if necessary, specialists from medical universities, research institutes, institutions and other organizations can be involved. One or more members of the KEK are appointed by the Secretary(s) of the Commission.

1.4. The Chairman of the CEC, together with the chief freelance specialists of the Department, for expert control, forms a list of medical experts at the CEC from among the most experienced specialists of medical institutions, employees of medical universities, research institutes, scientific centers and other institutions and organizations, which is approved by the chairman of the CEC.

1.5. Medical experts at the CEC are part of the profile groups under the leadership of the chief freelance specialist of the Department, their activities are also coordinated by the members of the CEC.

1.6. The KEC meetings are held as needed. For each case requiring expert control, an administrative document of the Moscow City Health Department is issued, which determines the composition of the commission of medical experts for the main profile of this case, establishes the procedure, terms for preparing materials and the date of the meeting of the EEC.

1.7. At least five members of the CEC must be present at the meeting of the clinical expert commission. All cases received by KEK must be considered within no more than 30 days. If it is impossible to make a decision during this time, the period may be extended in accordance with the established procedure for the time necessary for the final study, but not more than 30 days.

1.8. In special cases, by decision of the chairman of the EEC, an extended meeting of the EEC is held with the involvement of directors of the State public institutions of the Directorate for ensuring the activities of public health institutions of the administrative district of Moscow (hereinafter - GKU DZ AO), heads of public health institutions of the city of Moscow, chief freelance specialists of the Department.

1.9. The secretary (secretaries) of the CEC ensures control over the timely consideration of materials by medical experts, their preparation for the meeting of the CEC, the execution of the minutes of the meeting of the CEC, the maintenance and storage of the established documentation.

1.10. In the absence of the chairman of the KEK, the meeting of the KEK is held by the deputy chairman of the KEK.

1.11. The meeting of the KEC and its decision are documented in the minutes. The decision of the commission comes into force after the approval of the protocol by the head of the Department of Health (Appendix 5 to this order). The minutes of the meeting of the clinical expert commission, as well as the materials of the internal investigation are internal documents, copies of which, certified by the seal of the Moscow Department of Health, are issued at the request of the prosecution and investigation authorities, as well as other institutions in the manner prescribed by law.

1.12. When the commission considers and conducts an expert assessment of the work of specialists or institutions, the presence of the inspected persons and heads of state healthcare institutions in the city of Moscow is mandatory. Representatives of institutions and organizations not under the jurisdiction of the Department of Health, in respect of which an expert assessment was carried out, as well as representatives of insurance companies, the Office of Roszdravnadzor for the city of Moscow and the Moscow Region, etc., may be invited to the meeting of the clinical expert commission.

2. QEC functions:

2.1. Conduct an expert assessment of the quality and effectiveness of the treatment and diagnostic process and the compliance of the medical care provided with approved standards.

2.2. Evaluate the final results of the activities of specialists of structural divisions and institutions.

2.3. Consider the submissions of judicial and law enforcement agencies on the quality of medical care and examination of temporary disability.

2.4. Consider claims and claims of insurance medical organizations and executive bodies of the Social Insurance Fund on the quality of medical care and examination of temporary disability.

2.5. Consider the most complex and conflicting cases in which the medical commissions of state healthcare institutions of the city of Moscow did not make a final decision, or when the applicants disagree with their decisions.

3. KEC has the right:

3.2. Submit, based on the results of the examination, to the Head of the Department conclusions on the compliance of the positions held by the heads of state healthcare institutions of the city of Moscow and medical workers, on the advisability of revising the qualification category, the advisability of disciplinary measures and penalties, transferring cases to the prosecutor's office and investigating authorities.

3.3. Send submissions to institutions, organizations, departments on the provision of medical and social assistance to patients, their employment, career guidance and other issues within the competence of the commission.

4. Responsibility:

KEK is responsible for the validity and objectivity of the results of the examination carried out in accordance with the procedure established by the current legislation of the Russian Federation.

Annex 2. Regulations on the medical expert at the clinical expert commission of the Moscow Health Department

Appendix 2
to the order of the Department
health care of the city of Moscow
dated November 30, 2011 N 1481

1. General Provisions:

1.1. The list of medical experts at the EEC in the main medical specialties is formed from among the chief freelance specialists of the Department, leading specialists and officials of the health authorities and medical institutions of Moscow, which, on the proposal of the chairman of the EEC, is approved by the head of the Health Department. Employees of medical universities, research institutes, research centers and other institutions and organizations may be involved as medical experts.

1.2. The medical expert (hereinafter referred to as the expert) in his work is guided by the current legislation, legal documents governing legal relations in the system of examination of the quality of medical care, orders and regulations of the Moscow Health Department, orders of the chairman of the CEC, the head of the group of experts, these Regulations. In accordance with the requirements of the Federal Law of December 26, 2008 N 294-FZ "On the protection of legal entities and individual entrepreneurs in the exercise of state control (supervision) and municipal control", a medical expert must have an accreditation certificate:

1.3. The expert carries out the examination in accordance with the instructions received from the head of the group of experts. Timely and in full conducts the analysis of the sent materials with the execution of the act of expert control.

1.4. Examination of the quality of medical care is carried out individually or with other experts (if necessary), on individual cases completed in this institution, on medical documentation (medical record of an inpatient patient, medical record of an outpatient, etc.), based on the results of an internal investigation or in person expertise.

1.5. The main task of the expert is to assess the correctness of the choice of patient management tactics, the volume and quality of medical care, the compliance of its provision with the Moscow City Standards for the provision of medical care, as well as the compliance of the provision of medical care with the final outcome of treatment.

2. The medical expert has the right:

2.1. Use the documents necessary for the evaluation of an expert case.

2.2. Carry out, if necessary, an examination on the spot in accordance with the established procedure.

2.3. Justify additional testing.

2.4. Participate in the preparation of the general conclusion.

2.5. Make proposals for further improvement of the organization and improvement of the quality of medical care to the population.

2.6. Regularly improve your professional level.

3. The medical expert is obliged:

3.1. To give a competent and objective assessment of the quality of medical care based on the study of medical records, and, if necessary, a personal examination of patients.

3.2. If necessary, apply for the involvement of other experts in the examination.

3.3. Discuss with the attending physician and the management of the healthcare institution the preliminary results of the examination.

3.4. Prepare recommendations for improving the level and quality of medical care, improving the work of healthcare professionals and institutions, including the elimination of the causes that caused the provision of medical care to patients of inadequate quality.

3.5. Based on the results of the examination, prepare an appropriate conclusion, draw up the results of the check with an act of expert control. The deadline for submitting an act of expert control of the organization and the quality of medical care should not exceed 7 days from the date of receipt of the necessary documentation.

3.6. Report to the head of the expert group on the results of work with the submission of an expert control act.

4. Responsibility:

The expert in accordance with the established procedure is responsible for the quality and objectivity of the examination.

Appendix 3

Annex 3
to the order of the Department
health care of the city of Moscow
dated November 30, 2011 N 1481

1. KILI of the Moscow City Health Department in the administrative district of Moscow (hereinafter - KILI DZ in JSC) is created and its composition is approved by order of the Moscow City Health Department (hereinafter - the Department).

2. A lethal outcome in the administrative district of the city of Moscow (hereinafter referred to as the AO of the city of Moscow) is any case of a fatal outcome that occurred in the subordinate state healthcare institutions of the city of Moscow on the territory of the administrative district. All deaths are subject to analysis at KILI DZ in the JSC, regardless of whether an autopsy was performed, whether a match or discrepancy in diagnoses was revealed at the autopsy (except for cases of violent death according to information from the Bureau of Forensic Medical Examination).

3. KILI DZ in AO are held at least once a week, and therefore at least 3 co-chairs of clinicians, 3 co-chairs of pathologists and 3 secretaries from among clinicians are required. The timing of the CILI DZ in the AO is on the 2nd month after the death. If necessary, KILI DZ in the joint-stock company is assembled urgently.

4. Lethal outcomes are sorted out on the spot by medical commissions of state healthcare institutions of the city of Moscow. A report on the analysis carried out is sent to the secretary of KILI DZ in the joint-stock company on a monthly basis with a list of final clinical and pathoanatomical (forensic) diagnoses, as well as decisions of medical commissions for each case. Secretaries of KILI DZ in JSC, after consultations with the main freelance specialists of the Moscow City Health Department in the administrative district, select part of the observations for re-analysis at KILI DZ in JSC (at the same time, medical records of the inpatient and outpatient patient of the deceased are requested from the public health institutions of the city of Moscow). When parsing at KILI DZ in the AO of a fatal outcome in a hospital, an outpatient card of the deceased is also required, if necessary - from another AO of Moscow.

5. Materials on fatal outcomes from outpatient clinics are sent monthly to the secretaries of CILI DZ in the JSC with the application of medical records of the outpatient and autopsy diagnoses (pathoanatomical or forensic, if they were performed). All observations about which complaints were received from citizens, regardless of the results of previous reviews, as well as all cases in which shortcomings in the management of patients at the prehospital stage were identified, are selected for the CILI DZ in the AO.

6. Two weeks before the CILI DZ in the JSC, reviewers are sent medical records of deceased patients and copies of pathoanatomical or forensic diagnoses (if an autopsy was performed) by profile. The lists of reviewers by profiles are submitted by the chief freelance specialists of the Moscow City Health Department in the Moscow City Administrative District from the most experienced specialists, the number of reviewers is not limited, and the composition may change from time to time.

7. If necessary, representatives from medical institutions of other Moscow AOs are involved in participation in KILI DZ in JSC.

8. At KILI DZ in the AO, lethal outcomes are selected for clinical and anatomical conferences (AS) of the AO of Moscow and / or the city. On HOW it is expedient to consider several observations similar in terms of problems.

9. The Chief Pathologist of the Moscow City Health Department in the Moscow JSC ensures the participation of experienced pathologists from public health institutions of the administrative district of Moscow as co-chairs of the KILI or personally participates in the KILI (in the status of a co-chairman of the KILI), as well as for reviews on morphological issues . If an autopsy was not performed or a forensic autopsy was performed, the heads of KILI DZ in the AO can also involve pathologists to participate in the review and meeting.

10. If a forensic autopsy was performed to participate in CILI DZ, a forensic expert appointed by the Bureau of Forensic Medical Examination is involved in the JSC. Lists of forensic medical experts for participation in CILI are transferred to the JSC of Moscow from the Bureau of Forensic Medical Examination. Cases of violent death at KILI are not analyzed, their lists are transferred to the secretaries of KILI DZ in the AO from the Bureau of Forensic Medical Examination on a monthly basis.

11. KILI DZ in JSC is responsible for the validity and objectivity of the results of the examination in the manner prescribed by the current legislation of the Russian Federation.

Annex 4. The order of work of the clinical and anatomical conference

Appendix 4
to the order of the Department
health care of the city of Moscow
dated November 30, 2011 N 1481

1. The format of the clinical and anatomical conference (hereinafter - HOW) - a group of departments in multidisciplinary public health institutions of the city of Moscow, a public health institution of the city of Moscow, an administrative district, a city.

2. Tasks HOW - improving the skills of doctors and the quality of medical care based on a joint analysis, as well as discussion of clinical and morphological data on materials of lethal outcomes.

3. On HOW are discussed:

3.1. Fatal cases of scientific and practical interest for a wide range of clinicians, regardless of how correctly the disease was diagnosed during life.

3.2. Generalized data on sectional observations in technosological forms, the issues of morbidity, treatment and causes of death in which are relevant (thematic conferences).

3.3. Cases of discrepancies in the final clinical and pathoanatomical (forensic) diagnoses with systematically repeating defects in diagnosis and treatment.

3.4. Clinical cases that are difficult to fully analyze at PILS meetings, controversial or insufficiently clear observations of lethal outcomes.

3.5. Rare or understudied diseases, diseases with atypical course, iatrogenies, cases of drug disease and drug pathomorphosis of diseases.

3.6. Analysis of the activities of the pathoanatomical department (services of the GKU DZ AO, city) for the previous year (conducted annually).

4. HOW they are carried out during working hours according to the annual plan in public health institutions of the city of Moscow - once a month, in the GKU DZ AO - once every two months. Participation in AS is the functional responsibility of the management and doctors of those public health institutions who took part in the examination and treatment of the patient at the outpatient and inpatient stages. In large multidisciplinary hospitals, in addition to the general hospital, AS should be carried out AS by groups of the relevant specialized departments.

5. HOW also analyzes the results of a study of surgically removed organs and biopsies, confirming the correctness of medical thinking when making an intravital diagnosis, the completeness of the examination of the patient before the biopsy, the expediency of the surgical intervention and other methods of treatment.

6. Responsibility for the organization and quality of the HOW is, depending on the format, HOW the chief physician of the state healthcare institution of the city of Moscow, director of the GKU DZ AO,.

7. Preparation, organization and conduct of HOW are carried out by the deputies of the chief physician of public health institutions of the city of Moscow, the director of the GKU DZ JSC for medical work, the deputy heads of the Department of Health of the city of Moscow together with the chief freelance pathologist of the Department of Health of the city of Moscow in the administrative district or city. Employees of departments of medical universities and departments of research institutes can be involved in the preparation, organization and conduct of HOW.

8. The direct management of the meeting of the HOW is carried out by the chairman - the chief physician (director of the GKU DZ AO), and in his absence - the deputy for medical work.

8.1. By order of the chief physician (director of the GKU DZ JSC), two permanent secretaries of the AS from among clinical physicians are appointed, whose duty is to register in a special journal the dates of the conferences and their agenda, the personal composition of the participants, the names and positions of the co-chairs, the main provisions of all speeches, as well as the final summary adopted by the conference.

8.2. The deputy chief physician (director of the GKU DZ JSC) for medical work, together with the head of the pathoanatomical department (in the district and the city - the chief pathologists of the districts and the city) determine the agenda and date of the next HOW, which is brought to the attention of the medical staff no later than 7 days (in the district and city 2 weeks) before the day of the conference.

9. The cases to be analyzed are reported by the attending physicians, pathologist or forensic expert who performed the autopsy of the deceased, by the official opponent (reviewer) who analyzed the data of medical records (outpatient and / or inpatient) and presents his judgment on the course of diseases, timeliness, completeness and the adequacy of treatment, as well as the quality of medical records.

10. Reviewers (at least two) are appointed (invited) from among the most experienced clinicians of this or other state healthcare institutions of the city of Moscow, departments of medical universities or research institutes no later than 2 weeks before the AS.

11. Messages from doctors (clinicians and a pathologist or a forensic expert, as well as reviewers) should be accompanied by a demonstration of all materials that allow to highlight the clinic, the pathogenesis of the disease and thanatogenesis (X-rays, tomograms, electrocardiograms, laboratory data in dynamics, images of macro- and microscopic morphological changes, etc.), as well as a review of modern literature on the analyzed problem. Their duration should not exceed 20 minutes, after which the cases to be analyzed are discussed by the conference participants, including doctors of other specialties who took part in the diagnosis of the disease.

12. HOW should end with summarizing speeches of the co-chairs (or one of them), in which the results of the discussion are summed up, proposals are made aimed at improving the quality of the diagnostic and treatment process.

13. The management of state healthcare institutions of the city of Moscow (GKU DZ AO, the Department of Health of the city of Moscow), based on the materials, conclusions and proposals of HOW, develops and implements a set of measures to prevent and prevent identified shortcomings in the organization of medical care.

Appendix 5. Standard minutes of the meeting of the clinical expert commission of the Moscow Health Department

Annex 5
to the order of the Department
health care of the city of Moscow
dated November 30, 2011 N 1481

	APPROVE
	(head of institution)

MODEL PROTOCOL MEETINGS OF THE CLINICAL-EXPERT COMMISSION OF THE DEPARTMENT OF HEALTH OF THE CITY OF MOSCOW

AGENDA:

1. Commission consisting of:

Chairman

(Chairman of the CEC or his deputy)

(KEC members, coordinators of expert groups)

Invited

(specialists presenting materials at KEK, leaders of expert groups, experts)

KEC Secretary

In the presence:

Checked persons

Leaders

2. Considered:

Submissions

(medical documents, protocols, explanatory notes, results of official investigations, inspection reports, orders, etc.)

3. Found out

(statement of the essence of the issue under consideration)

4. Noted

(identified shortcomings and violations)

5. Conclusion:

KEK Chairman

KEK members

KEC Secretary

Annex 6. Model act of expert control

Appendix 6
to the order of the Department
health care of the city of Moscow
dated November 30, 2011 N 1481

STANDARD ACT
EXPERT CONTROL
dated _______ N _______

By me, a medical expert at the Clinical Expert Commission
									(institution)
based
since							examination of the case
1. During the examination, the following materials were studied:
2. Statement of the essence of the issue under consideration:
3. Identified shortcomings and violations
4. Conclusion
medical expert
Agreed: Team leader medical experts profile __________

Appendix 7. Composition of the Clinical Expert Commission of the Moscow City Health Department

Annex 7
to the order of the Department
health care of the city of Moscow
dated November 30, 2011 N 1481
(As amended by
by order of the Department
health care of the city of Moscow
dated July 12, 2017 N 498. -
See previous edition)

The composition of the clinical expert commission of the Department of Health of the city of Moscow

Chairman of the Commission:
Alexey Ivanovich	Minister of the Government of Moscow, Head of the Department of Health of the City of Moscow
Deputy Chairmen of the Commission:
Alexey Vladimirovich	Deputy Head of the Moscow City Health Department
Starshinin Andrey Viktorovich	Deputy Head of the Moscow City Health Department
Elena Yurievna	Deputy Head of the Moscow City Health Department
Secretaries of the Commission:
Steshenko Maxim Leonidovich	Chief Specialist of the Office for the Organization of Inpatient Medical Care of the Moscow City Health Department
Valentin Yurievich	Chief Specialist of the Department of Organization of Primary Health Care of the Moscow City Health Department
Members of the Commission:
Belostotsky Andrey Viktorovich	Director of the State Treasury Institution of the City of Moscow "Directorate for Coordinating the Activities of Medical Organizations of the Department of Health of the City of Moscow"
Vladimir Borisovich	Director of the State Treasury Institution of the City of Moscow "Directorate for ensuring the activities of state healthcare institutions of the Troitsky and Novomoskovsky administrative districts of the city of Moscow"
Znachkova Elena Alexandrovna	Deputy Head of the Department of Organization of Primary Health Care
Maksimenko Elena Vadimovna	Head of the Department of Organization of Primary Health Care
Mikryukov Anton Vladimirovich	Head of the Department of Organization of Inpatient Medical Care
Evgeny Leonidovich	Head of the Department of Affairs and Coordination of Activities
Alexey Stanislavovich	Deputy Head of the Department of Organization of Inpatient Medical Care
Commission experts:
Arutyunov Grigory Pavlovich	Chief External Therapist
Antsiferov Mikhail Borisovich	Chief Freelance Endocrinologist
Ampleeva Tatyana Viktorovna	Chief Freelance Nursing Management Specialist
Elmira Ibragimovna	Chief Freelance Pediatric Gastroenterologist
Belevsky Andrey Stanislavovich	Chief Freelance Pulmonologist
Dmitry Stanislavovich	Chief Freelance Gastroenterologist
Burmistrova Tatyana Borisovna	Chief Freelance Occupational Pathologist
Bogorodskaya Elena Mikhailovna	Chief Freelance TB Specialist
Evgeny Alekseevich	Chief freelance psychiatrist-narcologist
Batysheva Tatyana Timofeevna	Chief Freelance Pediatric Neurologist
Belchenko Viktor Alekseevich	Chief freelance specialist in maxillofacial surgery
Andrey Yulievich	Chief Freelance Transfusiologist
Yuri Pavlovich	Chief Freelance Psychotherapist
Brezhnev Tatyana Yuryevna	Chief Freelance Pediatric Nutritionist
Vasiliev Elena Yurievna	Chief Freelance Cardiologist
Vrublevsky Sergey Granitovich	Chief freelance pediatric specialist - urologist-andrologist
Valiullina Svetlana Albertovna	Chief freelance specialist children's specialist in medical rehabilitation and spa treatment
Vybornov Dmitry Yurievich	Chief freelance pediatric specialist - traumatologist-orthopedist
Andrey Anatolievich	Chief Freelance Neurosurgeon
Devyatkin Andrey Viktorovich	Chief Freelance Infectious Diseases Specialist
Vadim Erikovich	Chief freelance specialist - traumatologist-orthopedist
Demikova Natalya Sergeevna	Chief Freelance Specialist in Medical Genetics
Victoria Pavlovna	Chief freelance specialist in instrumental diagnostics
Evgeny Valerievich	Chief External Rheumatologist
Zhuravleva Marina Vladimirovna	Chief Freelance Specialist - Clinical Pharmacologist
Zholobov Elena Spartakovna	Chief Freelance Pediatric Rheumatologist
Islim Nidal	Chief Freelance Radiotherapy Specialist
Alexey Yurievich	Chief Freelance Pediatric Otorhinolaryngologist
Kartavtsev Larisa Ruslanovna	Chief Freelance Specialist for Primary Health Care for Children
Oleg Nikolaevich	Chief Freelance Nephrologist
Andrey Ivanovich	Chief freelance specialist-otorhinolaryngologist
Georgy Petrovich	Chief Freelance Psychiatrist
Kildushov Evgeny Mikhailovich	Chief Freelance Forensic Specialist
Konoplyannikov Alexander Georgievich	Chief Freelance Specialist in Obstetrics and Gynecology
Kondratchik Konstantin Leonidovich	Chief Freelance Pediatric Hematologist
Karaseva Olga Vitalievna	Chief Freelance Pediatric Specialist - Abdominal Surgeon
Ilya Mikhailovich	Chief Freelance Pediatric Ophthalmologist
Koltunov Igor Efimovich	Chief Freelance Pediatric Specialist
Kashkarov Yuri Mikhailovich	Chief freelance specialist for the implementation of modern information systems in healthcare
Lebedev Anastasia Yurievna	Deputy Chief Freelance Cardiologist
Alexander Borisovich	Chief Freelance Pediatric Pulmonologist
Moshetov Larisa Konstantinovna	Chief Freelance Ophthalmologist
Manturova Natalya Evgenievna	Chief Freelance Specialist - Plastic Surgeon
Mitronin Alexander Valentinovich	Chief Freelance Dentist
Sergei Pavlovich	Chief Freelance Radiologist
Mazankova Lyudmila Nikolaevna	Chief Freelance Pediatric Infectious Disease Specialist
Alexey Izral'evich	Chief Freelance Specialist in Diagnostics and Treatment of HIV Infection
nostrils Igor Vasilievich	Chief Freelance Epidemiologist
Nevzorova Diana Vladimirovna	Chief Freelance Palliative Care Specialist
Ostapenko Yuri Nikolaevich	Chief Freelance Toxicologist
Oleg Olegovich	Chief Freelance Specialist in Pathological Anatomy
Ostreikov Ivan Fedorovich	Chief freelance pediatric specialist - anesthesiologist-resuscitator
Ismail Magomedtagirovich	Chief Freelance Pediatric Nephrologist
Alexander Nikolaevich	Chief Freelance Specialist - Allergist-Immunologist
Vadim Vadimovich	Chief Freelance Hematologist
Pogosov Nana Vachikovna	Chief Freelance Specialist in Medical Prevention
Potekaev Nikolai Nikolaevich	Chief Freelance Specialist in Dermatovenereology and Cosmetology
Dmitry Yurievich	Chief freelance urologist
Protsenko Denis Nikolaevich	Chief specialist in anesthesiology and resuscitation
Plavunov Nikolai Filippovich	Chief Freelance Specialist for Emergency, Emergency Medicine and Disaster Medicine
Pogonchenkova Irena Vladimirovna	Chief Freelance Specialist in Medical Rehabilitation and Spa Treatment
Petryaykina Elena Efimovna	Chief Freelance Pediatric Endocrinologist
Portnova Anna Anatolyevna	Chief Freelance Child Psychiatrist
Dmitry Dmitrievich	Chief Freelance Child and Adolescent Hygienist
Razumovsky Alexander Yurievich	Chief Freelance Pediatric Surgeon
Skrypnik Dmitry Vladimirovich	Deputy Chief Freelance Specialist - Cardiologist for Endovascular Diagnosis and Treatment
Anatoly Boleslovovich	Chief Freelance Osteopathic Specialist
Viktor Viktorovich	Chief Freelance Specialist - Cardiovascular Surgeon
Starodubova Antonina Vladimirovna	Chief Freelance Nutritionist
Semenov Zhanna Borisovna	Chief Freelance Pediatric Neurosurgeon
Siberian Elena Viktorovna	Chief Freelance Pediatric and Adolescent Gynecologist
Tyazhelnikov Andrey Alexandrovich	Chief Freelance Specialist for Adult Primary Health Care
Olga Nikolaevna	Chief Freelance Geriatric Specialist
tarabrine Evgeny Alexandrovich	Chief Freelance Specialist - Thoracic Surgeon
Tumanova Elena Leonidovna	Chief External Pathologist (Children's Network)
Tiganova Olga Alexandrovna	Chief Freelance Pediatric Oncologist
Sergey Alekseevich	Deputy chief freelance specialist for emergency, emergency medical care and disaster medicine
Igor Evgenievich	Chief Freelance Oncologist
Mogeli Shalvovich	Chief Freelance Transplant Specialist
Alexander Nikolaevich	Chief Freelance Specialist for Clinical Laboratory Diagnostics
Chubarova Antonina Igorevna	Chief Freelance Neonatologist
Nikolai Anatolievich	Chief Freelance Neurologist
Alexey Vasilyevich	Chief Freelance Surgeon
Yuri Anatolievich	Chief Freelance Coloproctologist
Shkolnikova Maria Alexandrovna	Chief Freelance Pediatric Cardiologist

Revision of the document, taking into account
changes and additions prepared
JSC "Kodeks"

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