While a license may be expired, it is still Lawful to operate because the users are still in compliance with the Spirit of the law. Don't get your panties in a bunch just yet, read on.
It is going to be tough for many of you to wrap your head around this, but even though transmitting with an expired license is technically illegal, it is still a Lawful operation. Are they in violation of FCC rules? Yes, they clearly are. BUT, without getting into all the technical lawyer-ese jargon, they are still (technically) in "compliance" because of the Spirit of the law aspect, and are in fact operating Lawfully.
Now, I know a bunch of arm-chair self appointed Attorney wanna-bees are going to chime in and give examples of how if they let their license expire and keep transmitting, they will be fined and banned from the airwaves because it has happened before.
Yes it certainly has happened, because in all probability they did not fight it, or did not do well enough to fight it. Who is going to fine a hospital and take away their communications? Nobody. They would not even think about ever doing so. But a single individual? Yes!
There is the difference - it's not the offense, but the circumstances and details surrounding a simple violation. You can expect an individual to be responsible for their own personal license and would know if they are in compliance or not, but a company with many users is much more difficult to self-police. It is assumed the private individual operator with an expired license is willfully operating outside the spirit of their rules because it is 1 person and 1 license.
The hospital did have a valid license, so it's not like they just started using a frequency they liked, but they had gone the route to be in compliance from the beginning, but things do get lost and forgotten in big offices. The private individual is an entirely different matter, where the expiration is hardly likely to go unnoticed. Please don't bring up the exceptions to that statement because we all know it is a general rule of thumb. There are exceptions to everything, which only further proves the rule.
If you look up "Spirit of the Law -vs- Letter of the Law", and the difference between "Lawful and Legal", you will get a sense of what I am saying here. And PLEASE don't use Wikipedia for obvious reasons.
If an expired license at a hospital is so bothersome, then give them a call and explain that you noticed an oversight and would like to call their attention to it. Most likely the hospital Administrator will be so thankful he will buy you lunch at the Patient Cafeteria.