(A) As used in this rule "service" means obstetrical and neonatal care services as may be found in a hospital maternity unit, including antepartum, intrapartum and postpartum care, or neonatal care services as may be found in a children's hospital. Obstetrical and newborn care services do not include services performed in a maternity home, a freestanding birthing center licensed or a freestanding birthing center exempted from licensure under Chapter 3702. of the Revised Code and Chapter 3701-83 of the Administrative Code, or services performed in an individual's home.
(B) Each service provider shall:
(1) Designate in writing to the director the level classification it provides or intends to provide;
(2) Designate in writing to the director the scope of services provided within the level classification;
(3) Meet the requirements of this chapter for the service level designated;
(4) Not hold itself out to any person or government entity by means of signage, advertising, or other promotional efforts as having a specific level classification unless the provider meets the requirements for that level classification;
(5) Provide direct care staff to accommodate the acuity level of the patient population and the volume of patients served; and have a system in place to adjust staffing levels based on changes in patient acuity levels and volumes;
(6) Establish minimum competency requirements for staff in accordance with recognized national standards and ensure that all staff are competent to perform services based on education, experience and demonstrated ability. Services that allow for the use of advanced practice nurses, anesthesiologist assistants, or physician assistants, shall develop and follow written policies and procedures;
(7) Develop and follow policies and procedures that address the following:
(b) Laundering or disposal of newborn linens, including diapers;
(c) Integration of non-infectious gynecologic patients to the service; and
(8) Notify the director when planning to change the level classification sixty days prior to implementing the level classification.
(C) Each provider of an obstetrics care service shall provide neonatal care services commensurate with the level of obstetric care services provided and in accordance with the "Guidelines for perinatal care." Except as provided for in rule 3701-7-12 of the Administrative Code, no neonatal care service shall operate without acommensurate level of obstetrical care service.
(D) Each maternity unit shall provide newborn nursery facilities appropriate to the number of newborns that do not remain with their mothers during the postpartum stay, the average daily delivery volume, and the level designation of the newborn service.
(E) Staffing requirements for each service may be met by individuals with equal or greater qualifications, if the replacement's scope of practice encompasses the duties of the required staff.
(F) In accordance with the obstetric service admission and infection control policies and procedures and consistent with current infection control guidelines issued by the United States centers for disease control and prevention, provided the patient to be admitted does not pose a risk to the health or safety of other patients in the unit, a maternity unit obstetric service may only admit the following:
(1) Women at any stage of the maternity cycle for the treatment of any health condition whether related to the maternity condition or not;
(2) Non-infectious gynecologic patients; and
(3) Non-infectious female surgical patients in accordance with policies and procedures approved by the service's director.
(G) Maternity units and newborn care nurseries shall develop and follow policies and procedures that address:
(2) Infection control, consistent with current infection control guidelines issued by the United States centers for disease control and prevention; and
(3) Individual patient care plans.
(H) Each maternity home shall:
(1) Have the ancillary and support staff necessary for the provision of the maternity home's services; and
(2) Ensure all staff members provide services in accordance with applicable, current and accepted standards of practice and the clinical capabilities of the maternity home.
(I) Each maternity home shall develop and follow infection control policies and procedures consistent with current infection control guidelines issued by the United States centers for disease control and prevention.
(J) Prior to admission, the maternity home shall provide the following in writing to the prospective resident or the prospective resident's representative:
(1) An itemized list of fees for all services provided by the home;
(2) A list of the services provided at the maternity home, to include at least the following:
(a) Medical services;
(b) Nursing services; and
(c) Social services.
(3) A list of services available to the resident within the home or outside of the home within a reasonable proximity, along with instructions on how to obtain such services.
(K) The maternity home shall designate a person as administrator to be responsible for day to day operations of the home, ensuring that resident needs are met at all times and for assuring compliance with Chapter 3711. of the Revised Code and Chapter 3701-7 of the Administrative Code.
(L) The maternity home shall retain the services of a medical director. The medical director shall be a physician licensed to practice in Ohio and qualified in obstetrical care. The medical director shall be responsible for the initiation and maintenance of policies and procedures for the prenatal and, where applicable, postpartum care of maternity home residents in the home.
(M) If the maternity home operates a nursery, a physician qualified in pediatrics shall be retained to direct the care of the infants including the initiation and maintenance of policies and procedures necessary for this care.
(N) The maternity home shall retain the services of a registered nurse to direct the nursing activities, including the initiation and maintenance of policies and procedures dealing with nursing care.
(O) A nurse shall be on duty at all times when the nursery is occupied in a maternity home that operates a nursery.
Replaces: 3701-7-03, 3701-7-09, 3701-84-42
R.C. 119.032 review dates: 01/01/2017
Promulgated Under: 119.03
Statutory Authority: 3711.12
Rule Amplifies: 3711.05 , 3711.12
Prior Effective Dates: 7/15/1976, 3/1/97, 3/24/03, 4/30/03, 5/15/08, 8/1/08