LAW
Writer®
Ohio Laws and Rules
(A) Designation as a level III newborn care service requires that the provider of the newborn care service provide care for normal newborns, moderately ill newborns, and extremely ill newborns. Newborn care services shall provide services for all neonatal conditions except for very specialized services such as cardiac surgery, organ transplants and treatment of rare inborn metabolic errors, fetuses needing intrauterine transfusion or surgery, and extracorporeal membrane oxygenation (ECMO).
(B) Each level III newborn care service shall have a neonatal intensive care unit staffed and equipped to provide care for critically ill newborns and an intermediate care unit for convalescing and moderately ill newborns. The availability of highly technical expertise and specialized physicians at another newborn care service shall be considered by a level III newborn care service for purposes of decisions concerning the need for consultation and possible transfer.
(C) Each level III newborn care service shall meet the requirements of paragraph (B) of rule 3701-84-50, paragraph (B) of rule 3701-84-54 and paragraphs (B)(1) to (B)(10) of rule 3701-84-55 of the Administrative Code, except that level III newborn care services do not have to meet the requirements of paragraphs (B)(1) to (B)(5) of rule 3701-84-46 of the Administrative Code. Each level III newborn care service shall:
(1) Provide multi-disciplinary planning relating to management and therapy for newborn care;
(2) Coordinate and facilitate newborn transports from referring services consistent with the current American college of obstetricians and gynecologists guidelines for newborn care;
(3) Accept newborn referrals on a twenty-four hour basis; and
(4) Conduct ongoing continuing education.
(D) Each level III newborn care service shall meet the requirements of paragraphs (D) of rule 3701-84-51 and paragraph (D) of rule 3701-84-54 of the Administrative Code, except that a level III newborn care service does not have to meet the requirements of paragraph (E) of rule 3701-84-51 of the Administrative Code and each level III newborn care service shall provide:
(1) All specialized diagnostic services or referral to another newborn service;
(2) Anesthesia services with staff assigned to the newborn service available in the building in which the service is located on a twenty-four hour basis. Staff with credentials to administer neonatal/pediatric anesthesia shall be available as needed;
(3) Blood, blood products, and substitutes available on a twenty-four hour basis.
(E) In addition to the requirements of paragraphs (E)(1) to (E)(6) of rule 3701-84-54 of the Administrative Code, each level III neonatal service shall have qualified staff as appropriate for the services provided including:
(1) A director of newborn care service who is a board certified neonatologist and who is responsible for coordinating and integrating the following:
(a) A system for consultation;
(b) In-service education programs;
(c) Close coordination and communication with referring hospitals and other obstetrics centers;
(d) Defining and establishing, in collaboration with other members of the obstetrics team, appropriate procedures for obstetrics patients; and
(e) Treatment of patients in the neonatal intensive care unit who are not under the care of other physicians;
(2) A complement of pediatric, medical and surgical specialists that are readily available for on-site consultation;
(3) Pediatric subspecialists including:
(a) Cardiology, neurology, surgery, ophthalmology, and genetics available for care;
(b) Nephrology, hematology, metabolism, endocrinology, gastroenterology, nutrition, infectious diseases, pulmonology, immunology and pharmacology available for on-site consultation; and
(c) Pediatric surgical subspecialists such as cardiovascular surgeons, neurosurgeons, and orthopedic, urologic and otolaryngologic surgeons available for on-site consultation and care;
(4) A licensed dietitian with knowledge of newborn parenteral/enteral nutritional management of at-risk newborns;
(5) An American college of medical genetics (ACMG) certified or eligible genetics counselor to identify families at risk for genetic abnormalities, obtain family genetic history, provide genetic counseling in complicated cases and if necessary refer complicated cases to a medical geneticist on staff or the newborn care service shall have the ability to obtain the services of an individual meeting the requirements of this paragraph;
(6) A biomedical engineer;
(7) An RN with a master’s degree in nursing and an area of specialization in newborn health to provide clinical nursing expertise commensurate with the patient acuity and services provided;
(8) A licensed social worker to provide psychosocial assessments, family support services, and medical social work; and
(9) A certified lactation consultant available for support and education as needed.
(F) Newborn care service staff requirements that are identical to obstetric care service staff requirement set forth in paragraph (E) of rule 3701-84-55 of the Administrative Code do not need to be duplicated.
Effective: 05/15/2008
R.C. 119.032 review dates: 02/29/2008 and 03/01/2013
Promulgated Under: 119.03
Statutory Authority: 3702.11, 3702.13
Rule Amplifies: 3702.11, 3702.12, 3702.13, 3702.14, 3702.141, 3702.15, 3702.16, 3702.18, 3702.19, 3702.20
Prior Effective Dates: 3/1/1997, 3/24/03