Section 640.40 Standards for Perinatal Care

Section 640

Section 640.40  Standards for

Perinatal Care

a)         Levels of Perinatal Care

Hospital

licensing requirements for all  levels of care are described in Subpart O of

the Hospital Licensing Requirements.  All hospitals shall be designated in

accordance with this Part and have a letter of agreement with a designated APC.

(Section 640.70 describes the minimum components for the letter of agreement.)

1)         Non-Birthing

Center hospitals do not provide perinatal services, but have a functioning

emergency department. All licensed general hospitals that operate an emergency

department shall have a letter of agreement with an APC for referral of perinatal

patients, regardless of whether the hospital provides maternity or newborn

services.  The letter of agreement shall delineate, but is not limited to,

guidelines for transfer/transport of perinatal patients to an appropriate

perinatal care hospital; telephone numbers for consultation and

transfer/transport of perinatal patients;  educational needs assessment for

emergency department staff, and provision of education programs to maintain

necessary perinatal skills.

2)         Level

I hospitals provide care to low-risk pregnant women and newborns, operate

general care nurseries and do not operate an NICU or an SCN;

3)         Level

II hospitals provide care to women and newborns at moderate risk, operate

intermediate care nurseries and do not operate an NICU or an SCN.

4)         Level

II with Extended Neonatal Capabilities hospitals provide care to women and

newborns at moderate risk and do operate an SCN but do not operate an NICU.

5)         Level

III hospitals care for patients requiring increasingly complex care and do

operate an NICU

care to women and newborns at moderate risk, operate

intermediate care nurseries and do not operate an NICU or an SCN.

4)         Level

II with Extended Neonatal Capabilities hospitals provide care to women and

newborns at moderate risk and do operate an SCN but do not operate an NICU.

5)         Level

III hospitals care for patients requiring increasingly complex care and do

operate an NICU.

b)         Perinatal Network

Non-Birthing

Center, Level I, Level II, Level II with Extended Neonatal Capabilities and

Level III hospitals shall function within the framework of a regionally

integrated system of services, under the leadership of an APC, designed to

maximize outcomes and to promote appropriate use of expertise and resources.  Prenatal

consultations, referrals, or transfers and recognition of high risk conditions are

important to improve outcomes. Regional consultant relationships in maternal-fetal

medicine and neonatology referred to in this Part shall be detailed in the

letter of agreement.  The hospital shall ensure that staff physicians and

consultants are familiar with the letter of agreement.

c)         All

hospitals shall inform the Department of any change in or loss of essential

resources required by this Part within 30 days after the change and/or loss.

The hospital shall then replace the required resource within 90 days. Failure

to comply shall result in a review by the Department, with a potential loss of

designation.