Legal Liability and Statutory Duties of Healthcare Management in Czechia

Managing a healthcare facility involves more than just patient care; it requires a deep understanding of the legal regulations that both protect and bind you under Czech law. This article summarizes the rights and obligations of managers, the risks of non-compliance, and the paths to legal certainty in the Czech Republic. Specialists from our Prague-based law firm, ARROWS, handle these matters daily and can help you avoid errors with multi-million CZK consequences.

Quick Summary

• Legal liability of managers is threefold – civil (damages), administrative (fines from authorities), and in extreme cases, criminal. Authorities and Czech courts are not satisfied with penalizing the provider only as a legal entity; liability can also fall on statutory bodies (directors) and individual physicians.
• Management duties include ensuring the quality and safety of care, proper maintenance of medical records, protection of patients' personal data, handling complaints, and, above all, implementing an internal risk management system.
• Documentation is a vital protection tool – incomplete or incorrectly maintained medical records in legal disputes often lead to a reversal of the burden of proof or a factual presumption against the physician. Without high-quality documentation, it is practically impossible to prove that you acted in accordance with the standard of care (lege artis).
• Inspections and sanctions are real – regional authorities, SÚKL (State Institute for Drug Control), ÚOOÚ (Office for Personal Data Protection), and health insurance companies systematically inspect healthcare facilities in the Czech Republic. Fines for breaches of duty reach hundreds of thousands to millions of Czech korunas. Our Prague-based attorneys at ARROWS law firm regularly represent facilities during these inspections and defend them against sanctions.

Legal framework for the liability of healthcare facility management

A manager of a healthcare facility is not just an entrepreneur managing resources and personnel. They are also the person responsible for setting the processes through which patient care is provided. The Act on Healthcare Services (No. 372/2011 Coll.) and a series of related Czech regulations impose specific duties on you, the violation of which has serious legal consequences.

It is crucial to understand that the liability of a healthcare facility evolves over time. Primarily, the healthcare service provider is liable. However, the statutory body (director) has a duty to act with due managerial care, and if they neglect this care, the facility may seek recovery for the resulting damage from them.

Legal liability arises from three basic sources: breach of contractual or statutory duties toward the patient (civil), breach of regulations toward the state (administrative), and the commission of a criminal offense (criminal). In practice, these levels may overlap, creating cumulative risks.

Civil Liability

When a patient claims they have suffered health damage due to a breach of the duty to provide care with due professional expertise, they pursue a civil lawsuit. This liability leads to the obligation to compensate for both pecuniary and non-pecuniary harm, i.e., pain and suffering and impairment of social utility.

A healthcare facility is obliged to provide care at the "lege artis" level, meaning in accordance with the proper professional standard. If this is not achieved and the patient suffers harm in causal connection with this error, the facility is liable for damages. Civil proceedings in Czech courts can last for years and generate high costs for legal representation.

Administrative Liability

Regional authorities, the Ministry of Health, SÚKL, and other administrative bodies monitor whether you comply with legal obligations under Czech law. If you violate them, you face an administrative fine for a misdemeanor. The Act on Healthcare Services defines a range of offenses for which high sanctions may be imposed.

For example, for a breach of the duty of confidentiality under the Act on Healthcare Services, a fine of up to CZK 1,000,000 may be imposed; however, in the case of a concurrent breach of personal data protection (GDPR), sanctions can reach much higher amounts. The State Institute for Drug Control (SÚKL) can impose fines in the millions of crowns for serious violations of the Act on Pharmaceuticals. Administrative proceedings are a formalized process with a specific financial impact on the facility's economic results.

microFAQ: Administrative Liability and Fines

1. Who can impose a fine for breach of duties in providing healthcare?
The Regional Authority (competent according to the place of authorization), the Ministry of Health, the State Institute for Drug Control (SÚKL), the Office for Personal Data Protection (ÚOOÚ), and other bodies (e.g., labor inspection).

2. How long do administrative proceedings take and when can one defend themselves?
The duration is individual, usually months. Defense is possible by filing objections against the inspection report and subsequently within the administrative proceedings. Our Prague-based attorneys at ARROWS law firm routinely prepare objections and appeals that increase the chances of canceling or reducing the fine.

3. Does the procedure differ when an inspection is conducted by SÚKL versus a regional authority?
Yes, each authority proceeds according to specific Czech laws (Act on Pharmaceuticals vs. Act on Healthcare Services), although the basic procedural framework is similar. It is important to distinguish their competencies and respond in a timely manner.

Criminal Liability

In extreme cases, management and the healthcare facility may face criminal liability. Under the Act on Criminal Liability of Legal Entities (TOPO), the healthcare facility itself can be prosecuted.

Personal criminal liability of management is a risk if a manager violates an important duty arising from their employment, position, or function.

In criminal proceedings, the principle of subsidiarity applies – criminal repression is the last resort. Nevertheless, the Czech police often investigate deaths or serious injuries in healthcare facilities to rule out culpability.

Main statutory duties of healthcare facility management

Managers must fulfill a range of legal requirements affecting operations, documentation, and personnel. Below is an overview of the key areas you must focus on when managing a facility in the Czech Republic.

Ensuring Quality and Safety of Care

The Act on Healthcare Services imposes a duty to implement an internal system for evaluating the quality and safety of the healthcare services provided. For inpatient care providers, Decree No. 102/2012 Coll. specifies minimum requirements. However, even outpatient specialists must act in a way that prevents damage.

In practice, this means an obligation to have processes in place for monitoring and reporting adverse events and taking corrective actions based on findings.

Reporting adverse events is mandatory in certain cases even externally (e.g., serious adverse drug reactions to the State Institute for Drug Control - SÚKL). However, internal record-keeping is crucial for your legal defense. If you do not have a risk management system in place, it is difficult to prove in the event of a dispute that you did everything possible for patient safety under Czech law.

Our attorneys in Prague from the ARROWS law firm can assist you with embedding a risk management system into internal directives and processes, which subsequently protects management from liability even if an incident occurs.

microFAQ: Quality and Safety of Care

1. What must an internal quality assessment system include?
Standard operating procedures, defined responsibilities, monitoring of quality indicators (e.g., patient satisfaction, occurrence of complications), and a mechanism for resolving adverse events.

2. What are the sanctions for failing to implement the system?
The Regional Authority may impose a fine in the range of tens to hundreds of thousands of Czech korunas for failing to implement a quality system where required by Czech legislation.

3. Will a high-quality system help me in litigation?
Absolutely. Documented processes and corrective measures demonstrate an effort to follow "lege artis" procedures and the duty of professional care (due diligence) under the Czech Civil Code.

Medical Documentation

Many managers do not realize how vital the role of medical documentation is. In Czech legal practice, the rule is: if it is not in the documentation, it did not happen. If the documentation is incomplete or retroactively modified, a Czech court may conclude that the provider failed to meet the burden of proof regarding the correctness of the procedure.

Medical documentation in the eHealth era: Many managers do not realize that in 2026, medical documentation is no longer just an internal record of the facility, but part of a national ecosystem. In legal practice, it holds: what is not in the documentation (or what is not recorded in accordance with technical standards) effectively does not exist.

The maintenance of documentation is now primarily governed by the Act on Health Services and the Act on the Digitalization of Healthcare (No. 325/2021 Coll.). The key requirement is no longer just legibility, but:

• Interoperability: The obligation to maintain records so that they can be transferred via a secure shared interface in a defined standard when necessary.
• Non-repudiation: Every entry must be uniquely authorized by a specific healthcare professional through electronic identification means (e.g., the Czech eGovernment mobile key).
• Availability and Integrity: Documentation must be protected against unauthorized interference in accordance with current cybersecurity standards (NIS2).

Errors in digitalization (e.g., missing access logs or the use of uncertified cloud storage) are currently the most frequent source of sanctions from the Office for Personal Data Protection (ÚOOÚ) and the Ministry of Health's supervisory bodies.

Our Czech legal team at ARROWS prepares model informed consents for clients, reviews documentation processes, and provides staff training.

microFAQ: Medical Documentation

1. What are the most common errors in documentation?
Missing informed consents, retroactive entries without marking the date of correction, insufficient description of the procedure, and illegibility in paper form.

2. How should informed consent be correctly documented?
Ideally in writing with the patient's signature for more serious procedures. It must contain specific instructions regarding the risks of the given intervention, not just general phrases. The patient should have the opportunity to ask questions.

3. Do I face a fine if a patient is unable to assess their decision?
If a patient is unable to grant consent, you must proceed according to Czech law (consent of a representative, urgent care). If you perform a non-urgent procedure without the consent of the authorized person, you face legal prosecution.

Liability of Management and Individual Physicians

It is essential to distinguish between the liability of an employee and the liability of a statutory body (e.g., a managing director) or a shareholder. For an error by an employee-physician, the employer (the healthcare facility) is primarily liable to the patient under Czech commercial law.

However, if the physician is also the managing director of the s.r.o. (LLC) and causes damage through poor management of the company, they are liable to the company for breach of due diligence with their entire personal assets.

The management of a healthcare facility in the Czech Republic is responsible for errors in selection and errors in supervision. Therefore, you must ensure that personnel have the appropriate qualifications and are properly managed and controlled.

Who can you contact?

Obligations Regarding Personnel and Working Conditions

The manager of a healthcare facility is also an employer subject to obligations in the field of Occupational Health and Safety (OSH/BOZP). You must ensure a safe environment and evaluate risks.

Non-compliance with breaks and overtime limits, which are subject to strict limits under the Czech Labour Code, is a frequent target of inspections by the Labour Inspectorate.

If you cooperate with doctors as independent contractors (OSVČ), a mere formal contract setup is not enough; the actual performance of work must not show signs of "dependent work" (especially direct subordination and integration into the operational structure), otherwise there is a risk of sanctions for illegal employment (the so-called "Švarcsystém"). A doctor operating under a trade license (IČO) is liable for damages with their entire assets unless agreed otherwise.

Our Prague-based attorneys regularly review contractual relationships with external contractors to ensure your rights are protected.

microFAQ: Employer Obligations

1. Who has legal responsibility for OSH (BOZP)?
The statutory body (managing director, CEO). A professionally qualified person in risk prevention ("safety officer") is an advisory body, but ultimate responsibility lies with the employer.

2. What are the risks in the event of a workplace injury?
If OSH rules were not followed, there is a risk of high fines from the Labour Inspectorate, the obligation to compensate the employee for damages (beyond statutory insurance), and potentially criminal prosecution for negligent injury.

Patient Data Protection and GDPR

Health data are a "special category of personal data" under GDPR and are subject to the strictest protection regime. Processing is mostly based on legal obligation rather than patient consent.

You must have technical and organizational measures in place, such as access rights management for the hospital information system, encryption, or backups.

The Office for Personal Data Protection (ÚOOÚ) can impose high fines, with sanctions in the millions of korunas for serious data breaches. Any security incident posing a risk to individual rights must be reported to the ÚOOÚ within 72 hours.

Our attorneys in Prague conduct GDPR audits, prepare internal directives, and train staff to minimize the risk of sanctions.

Handling Complaints and Patient Communication

A patient has the right to file a complaint regarding the provider's procedure, and the Act on Health Services (§ 93) imposes an obligation on you to resolve the complaint. The deadline is set at 30 days, with the possibility of a justified extension.

If you ignore a complaint or handle it in a formally insufficient manner, the patient may turn to the Regional Authority, which will investigate the complaint.

We recommend having a directive for handling complaints, maintaining a record of them, and approaching each complaint objectively. If you discover an error, it is better to act proactively than to deny the matter and face litigation in Czech courts.

Risks and Sanctions	How ARROWS Assists (office@arws.cz)
Failure to maintain or improper maintenance of medical records: Reversal of the burden of proof in court; fines from regional authorities (hundreds of thousands of CZK); lost damages disputes under Czech law.	Preparation and review of internal directives: Our Czech legal team at ARROWS prepares documentation procedures in full compliance with Czech legislation.
GDPR violations and data leaks: Fines from the Office for Personal Data Protection (millions of CZK); compensation for non-material harm to patients; reputational risk.	GDPR audits and implementation of measures: We conduct audits, identify vulnerabilities, and set up contractual documentation with IT providers according to Czech data protection standards.
Improper handling of patient complaints: Escalation to the regional authority; fines; motivating the patient to file a lawsuit in the Czech Republic.	Representation in complaint resolution: Our Prague-based attorneys help formulate responses to complaints, participate in negotiations, and ensure a legally correct procedure.
Criminal liability of legal entities: Fines for the facility, ban on activities; management liability for lack of oversight under the Czech Act on Criminal Liability of Corporations.	Compliance programs: We help implement a criminal liability prevention system (Compliance), which can exonerate the facility in the event of employee misconduct.
Personnel disputes and "Švarcsystém" (illegal subcontracting): Fines from the Labor Inspection; back-payments of taxes and social security contributions.	Contractual agenda: We prepare employment contracts and cooperation agreements with doctors (as independent contractors) to minimize the risks of disguised employment under the Czech Labor Code.

Obligations regarding telemedicine and electronic care in the Czech Republic

Telemedicine is becoming a standard part of care. If you provide remote consultations, you must meet the conditions where care is provided only if the health status allows it, and proper documentation must be maintained under Czech regulations.

Software tools used, if intended for diagnosis or therapy, may fall under the Medical Device Regulation (MDR) and require certification.

Liability insurance needs to be reviewed – ensure that your policy also covers damages caused during telemedicine. Our Prague-based attorneys at ARROWS prepare terms and conditions for providing telemedicine and check compliance with Czech legislation.

Obligations in patient safety and risk prevention

Patient safety is a priority. While methodological guidelines from the Czech Ministry of Health are not laws in the strict sense, they define the standard of due professional care, and Czech courts take them into account.

If a patient falls from a bed and is injured, the court will examine whether you performed a fall risk screening and took preventive measures. If a record is missing, you bear the liability.

Corporate ethics and practical management of a healthcare facility

Management obligations also have an ethical dimension. The tone set by management determines the organizational culture; if management signals that safety and regulations are merely administrative burdens, staff will make mistakes.

A manager must actively address quality of care issues regarding specific doctors. Passivity can be evaluated as a breach of duties in the management of third-party property (fiduciary duty) if the facility suffers a loss under the Czech Civil Code.

How to protect yourself: practical steps

If you are interested in how to reduce legal risks, follow these recommendations. The first step is securing a legal audit, where our attorneys will review your template documents, contracts, and internal regulations.

An attendance sheet from staff training on documentation and GDPR serves as evidence in a Czech court that you, as an employer, have not neglected your duties.

Furthermore, implement an internal control system. It is sufficient to clearly define responsibilities and conduct random documentation checks, while identified deficiencies must be addressed immediately.

Check the indemnity limits of your insurance, as compensation amounts in the Czech Republic are rising and old policies for 1–2 million CZK may no longer be sufficient.

Finally, we recommend building a relationship with experts. Our attorneys in Prague provide long-term support, understand the specifics of the Czech healthcare sector, and can respond quickly to crisis situations.

Conclusion

Managing a healthcare facility is a highly responsible role with extensive legal obligations. Modern Czech law and case law emphasize not only the liability of the facility as a whole but also the specific liability of statutory bodies for proper operation.

Errors in these processes can be fatal not only for the patient but also for the economic stability of your facility.

The Czech legal team at ARROWS deals with these issues daily. Investing in prevention – audits, contracts, and processes – is a fraction of the costs you would have to spend on resolving a single lost dispute. If you want peace of mind, contact us at office@arws.cz and we will help you ensure legal certainty.

FAQ – Most frequent legal questions regarding the liability of healthcare facility managers in the Czech Republic

1. Can I be personally liable as a manager for a doctor's error?
Generally, the healthcare facility (provider) is liable directly to the patient. However, you as a manager (statutory body) are liable to the company for ensuring proper supervision and a quality system. If you breached this duty and the company suffered a loss (e.g., had to pay damages), the company can claim this loss from you. In cases of gross negligence, criminal liability may also arise under Czech law.

2. What is the difference between civil and administrative liability?
Civil liability deals with compensation for damages to the patient (indemnity, pain and suffering). Administrative liability involves fines from the state (Regional Authority, State Institute for Drug Control - SÚKL) for violations of the law, regardless of whether anyone suffered harm. Often, both occur simultaneously.

3. Do I need to have an internal system for reporting adverse events?
Yes, the Czech Act on Health Services and the relevant decree on requirements for minimum personnel and technical equipment presuppose the implementation of a quality and safety system. Without it, you risk fines and a weaker position in potential litigation.

4. What happens if we do not maintain medical records correctly?
In the event of a dispute, you risk failing to meet the burden of proof. A Czech court will proceed on the assumption that if a procedure is not recorded, it was not performed, or was not performed correctly. Furthermore, there is a risk of an administrative fine for violating the Czech Act on Health Services.

5. Which regulations govern medical documentation in the Czech Republic?
The primary framework consists of the Act on Health Services (No. 372/2011 Coll.) and the Decree on Medical Documentation (No. 444/2024 Coll.), including fully effective Czech legislation on the digitalization of healthcare (the eHealth Act). This legislation imposes specific obligations on providers regarding the use of shared services and secure identification. It is essential to monitor amendments that further refine the rules for electronic record-keeping and data sharing under Czech law.

6. Can I choose which obligations to fulfill?
No. The obligations established by Czech law are mandatory (peremptory). Ignorance of the law is no excuse. If you are unsure about the scope of your obligations, please contact our Prague-based attorneys at ARROWS law firm at office@arws.cz. 

Disclaimer: The information contained in this article is for general informational purposes only and serves as a basic guide to the subject matter. While we strive for maximum accuracy, Czech legal regulations and their interpretation evolve over time. To verify the current wording of regulations and their application to your specific situation, it is necessary to contact our Prague-based law firm, ARROWS, directly at office@arws.cz.