Arkansas Administrative Code › Agency 007 - ARKANSAS DEPARTMENT OF HEALTH › Division 05 - Health Facility Services › Rule 007.05.20-007 - Rules for Free-Standing Birthing Centers in Arkansas

Current through Register Vol. 49, No. 6, June, 2024
SECTION 1:
PREFACE.
These rules have been prepared for the purpose of establishing
				criteria for minimum standards for licensure, operation and maintenance of
				Free-Standing Birthing Centers. By necessity they are of a regulatory nature
				but are considered to be practical minimum design and operational standards for
				their facility type. These standards are not static and are subject to periodic
				revisions. It is expected Free-Standing Birthing Centers will exceed these
				minimum requirements and will not be dependent upon future revisions as a
				necessary prerequisite for improved services.
SECTION 2:
AUTHORITY.
These rules for Free-Standing Birthing Centers in Arkansas are
				duly adopted and promulgated by the Arkansas State Board of Health pursuant to
				the authority expressly conferred by the laws of the State of Arkansas in Ark.
				Code Ann. §
									20-9-401
				et seq.
SECTION 3:
DEFINITIONS.
Free-Standing Birthing Centers - any facility which is
				organized to provide family-centered maternity care in which births are planned
				to occur in a home-like atmosphere away from the mother's usual residence
				following a low risk pregnancy. The facility shall not provide operative
				obstetrics, including use of forceps, vacuum extractions, Caesarean sections,
				or tubal ligations. The Free-Standing Birthing Center must be located within
				thirty (30) minutes of a hospital (via ambulance) which offers obstetric and
				nursery services and which maintains an on-call team to provide emergency
				C-sections and stabilization of infants.
Administrator
- an individual designated to
				provide daily supervision and administration of the Free-Standing Birthing
				Center.
Certified Nurse Midwife
- a trained and licensed
				advanced practice nurse with an arrangement with a physician in accordance with
				the Arkansas Nurse Practice Act, Arkansas Code Annotated
				17-87-101
				et seq.
Complications
- any condition according to written
				risk criteria of the Free-Standing Birthing Center that contraindicates
				continued care in the Free-Standing Birthing Center.
Large Free-Standing Birthing Center
- a birthing
				center comprised of four (4) or more birthing rooms with an exam room.
Low Risk Pregnancy
- a normal uncomplicated
				pregnancy as determined by a generally accepted course of prenatal care and the
				expectation of a normal uncomplicated birth as defined by a reasonable and
				generally accepted criteria of maternal and fetal health.
Medical Director
- a person licensed to practice
				medicine in the state of Arkansas.
Preterm
- before the end of the thirty-seventh
				(37th) week of gestation.
Professional Review Committee
- shall be composed
				of at least three (3) members. The members shall include a Physician with
				advanced training in Obstetrics, one (1) Certified Nurse Midwife and/or one (1)
				Registered Nurse (required for large Free- Standing Birthing Centers).
Qualified Physician
- a person licensed to
				practice medicine in the State of Arkansas, who has obstetrical privileges at
				the licensed hospital.
Small Free-Standing Birthing Center
- a birthing
				center comprised of three (3) or fewer birthing rooms and occupied by fewer
				than four (4) patients, not including newborns, at any time.
Term
- at thirty-seven (37) weeks gestation, or
				greater.
SECTION 4:
LICENSING.
A. Application for License.
			 Application for a license or renewal of a license for a Free Standing Birthing
			 Center shall be made to the Arkansas Department of Health on forms provided by
			 the Division of Health Facility Services. The application shall set forth the
			 complete name and address of the Free-Standing Birthing Center for which the
			 license is sought and any additional information as required by the Arkansas
			 Department of Health.
B. The
			 Free-Standing Birthing Center shall have a written agreement with a local
			 hospital which has twenty-four (24) hour obstetric services. The Free-Standing
			 Birthing Center shall be within thirty (30) minutes of the hospital. If the
			 hospital ceases to provide obstetric services, the Birthing Center shall obtain
			 a written agreement with another hospital that provides obstetric services and
			 is within thirty (30) minutes of the Birthing Center. If another written
			 agreement cannot be obtained, the Birthing Center must cease providing
			 services, notify the Division of Health Facility Services in the Arkansas
			 Department of Health, and surrender the license to the Division. The Birthing
			 Center may reapply for licensure once a new written agreement is
			 obtained.
C. Fee. In accordance
			 with Section 5 of Act 891 of 1997, each application for initial licensure of a
			 Free-Standing Birthing Center shall be accompanied by a fee of one thousand
			 dollars ($1000). The fee shall be payable to the Arkansas Department of
			 Health.
D. Renewal of License. A
			 license, unless revoked, shall be renewable annually upon payment of a fee of
			 one thousand dollars ($1000) to the Arkansas Department of Health accompanied
			 by an application for re-licensure. The application for annual license renewal
			 along with the fee shall be postmarked no later than January 2 of the year for
			 which the license is issued.
E.
			 Issuance of License. A license shall be issued only for the premises and person
			 or persons reflected in the application and shall be posted in a conspicuous
			 place in the Free-Standing Birthing Center. The license shall be effective on a
			 calendar year basis and shall expire on December 31 of each calendar year. The
			 license shall not be transferrable and shall expire if a change of ownership
			 occurs.
F. Change of Ownership. It
			 shall be the responsibility of the Free-Standing Birthing Center to notify the
			 Division of Health Facility Services in writing at least thirty (30) days prior
			 to the effective date of a change of ownership. The following information shall
			 be submitted for review and approval:
1.
			 License application
2. One thousand
			 dollars ($1000) change of ownership fee; and
3. Legal documents, ownership agreements, and
			 other information to support re-licensure requirements.
G. Management Contract. It shall be the
			 responsibility of the Free-Standing Birthing Center to notify the Division of
			 Health Facility Services in writing at least thirty (30) days prior to entering
			 into a management contract or agreement with an organization or firm. A copy of
			 the contract or agreement shall be submitted for review to assure the
			 arrangement does not affect the license status.
H. Closure. Once a Free-Standing Birthing
			 Center closes, it shall no longer be considered licensed. The license issued to
			 the Free-Standing Birthing Center shall be returned to the Division of Health
			 Facility Services. To be eligible for re-licensure, the Free-Standing Birthing
			 Center shall meet requirements for new construction and all the current life
			 safety and health regulations.
I.
			 Inspection. Any authorized representative of the Arkansas Department of Health
			 shall have the right to enter upon or into the premises of any Free-Standing
			 Birthing Center at any time in order to make whatever inspection it deems
			 necessary in order to assure minimum standards and regulations are
			 met.