Final answer:
The number of hospital beds a state approves for a facility falls under its healthcare regulatory policies, a precedent with origins in the Hill Burton Act of 1946. While initially a federally-directed goal, the power to regulate such healthcare provisions has increasingly devolved to the states, which ensure compliance with state policies through agencies like the Department of Health and Social Services.
Step-by-step explanation:
The state approves the number of beds a hospital is allowed to have as part of its healthcare regulatory policies. This practice has its roots in historical legislation such as the Hospital Survey and Construction Act of 1946, also known as the Hill Burton Act. This Act was initially responsible for the expansion of hospital facilities and the establishment of a goal for states to reach a quota of 4.5 beds available per 1,000 residents. Although federally initiated, the allocation of funds and the determination of the number of hospital beds were largely left to the states to manage. Over time, this devolution of power from the federal government to the states has also been demonstrated in other areas, such as the regulation of medical practices like abortion and the legalization of medical marijuana, despite the existence of federal laws to the contrary. The decision regarding the number of hospital beds is typically overseen by a governmental agency, such as the state's Department of Health and Social Services, which ensures that the healthcare facilities comply with state-determined health policies and regulations. The Certificate of Need process is a regulatory framework in many healthcare systems, where states require healthcare providers, including hospitals, to obtain approval or a certificate before initiating certain capital projects, such as expanding or adding beds. The goal is to ensure that there is a demonstrated need for additional healthcare services in a particular area, preventing unnecessary duplication of services and promoting cost-effectiveness in the healthcare system.