Section 640.44 Administrative Perinatal Center

Section 640

Section 640.44  Administrative

Perinatal Center

To be designated as an APC, a hospital shall submit an

application to the Department for a grant to provide financial support to

assist the Department in the implementation and oversight of the Regionalized

Perinatal Health Care Program;and shall comply with all of the conditions

described for intensive (Level III) perinatal care in Section 640.43; and shall

comply with all of the conditions described in Subpart O of the Hospital

Licensing Requirements.  The APC shall comply with the following:

a)         Administrative Perinatal Center − General Provisions

1)         An APC shall be a university or university-affiliated hospital,

having Level III hospital designation.  An APC may be composed of one or more

institutions.  The APC shall be responsible for the administration and

implementation of the Department's regionalized perinatal health care program,

including but not limited to:

A)        Continuing education for health care professionals;

B)        Leadership

and implementation of CQI projects, including morbidity and mortality reviews

at regional network hospitals;

C)        Maternal and neonatal

transport services;

D)        Consultation services

for high-risk perinatal patients;

E)        Follow-up developmental

assessment programs; and

F)         Laboratory

facilities and services available to regional network hospitals.

2)         An APC shall be capable of providing the highest level of care

within a regional network appropriate to maternal and neonatal high-risk

patients.  The following services shall be available:

A)        Consultants in the various medical-pediatric-surgical

subspecialties including, but not limited to, cardiac, neurosurgery, genetics,

and other support services;

B)        Follow-up developmental assessment program;

C)        Maternal and neonatal transport services; and

D)        Laboratory facilities available to the hospitals within the

regional perinatal network

shall be available:

A)        Consultants in the various medical-pediatric-surgical

subspecialties including, but not limited to, cardiac, neurosurgery, genetics,

and other support services;

B)        Follow-up developmental assessment program;

C)        Maternal and neonatal transport services; and

D)        Laboratory facilities available to the hospitals within the

regional perinatal network.

b)         The Department will designate an A

PC

within each regional perinatal network to be responsible

for the administration and implementation of the Department's Regionalized

Perinatal Health Care Program.

c)         The APC will be responsible for providing leadership in the

design and implementation of the Department's CQI Program, including the

establishment and regularly scheduled meetings of a regional quality

improvement structure (Regional Quality Council).

d)         The APC

shall establish a Joint Mortality and Morbidity Review Committee with the

affiliated regional network hospitals. The Committee shall review all perinatal

deaths and selected morbidity, including, but not limited to, transports of

neonates born with handicapping conditions, or developmental disabilities, or

unique medical conditions. This review shall also include a periodic comparison

of total perinatal mortality and the numbers attributable to categories of

complications. Membership on the Committee shall include, but not be limited

to, pediatricians, obstetricians, family practice physicians, nurses, quality

assurance, pathology, and hospital administration staff and representatives

from the hospital's APC. The network administrator shall prepare a yearly

synopsis of the Regional Perinatal Network's perinatal deaths. This synopsis

shall include statistical information, as well as an identification of the

factors contributing to deaths that are identified as potentially avoidable.

The synopsis shall be shared with the Regional Quality Council

on staff and representatives

from the hospital's APC. The network administrator shall prepare a yearly

synopsis of the Regional Perinatal Network's perinatal deaths. This synopsis

shall include statistical information, as well as an identification of the

factors contributing to deaths that are identified as potentially avoidable.

The synopsis shall be shared with the Regional Quality Council. The Council

shall develop, for the Network, an action plan to address issues of

preventability. The Council's action plan shall be forwarded to the Department.

The membership of the Council shall include representatives from all levels and

disciplines of perinatal health care providers.

e)         Perinatal Program Oversight

1)         The Department shall work in conjunction with the APCs to

conduct site visits at network hospitals to assure compliance with this Part on

a periodic basis not to exceed three years.

2)         The requirements of this Part do not apply to infants who,

after having completed initial therapy, are transferred back to the referring

hospital for continuing care.  The capability of the hospital to provide

necessary services for these infants shall be determined by mutual consent with

the APC and addressed in the letter of agreement.

3)         APCs shall provide information to the Department no less

frequently than quarterly. These reports shall include,  but not be limited to,

network education activities; network meetings; overview of CQI activities;

schedule of mortality and morbidity review meetings; and schedule of proposed

and completed network hospital site visits.