Illinois Administrative Code › Title 77 - PUBLIC HEALTH › Part 515 - EMERGENCY MEDICAL SERVICES, TRAUMA CENTER, COMPREHENSIVE STROKE CENTER, PRIMARY STROKE CENTER AND ACUTE STROKE READY HOSPITAL CODE › Subpart K - COMPREHENSIVE STROKE CENTERS, PRIMARY STROKE CENTERS AND ACUTE STROKE-READY HOSPITALS › Appendix A - A Request for Designation (RFD) Trauma Center

Current through Register Vol. 48, No. 28, July 12, 2024
a) Name and address of hospital (typed)
__________________________
__________________________
__________________________
____________________________________________________________________
1) Check the designation level(s) for which your
				  hospital is applying:
________ Level I
________ Level II
________ Level I Pediatric
________ Level II Pediatric
2) The above named facility certifies that each
				  requirement listed in this Request for Designation is met and will be
				  operational by the date of designation.
__________________________________________________________
Typed name CEO/Administrator
__________________________________________________________
Signature
				  CEO/AdministratorDate
__________________________________________________________
Typed name Trauma Director
__________________________________________________________
Signature Trauma
				  DirectorDate
__________________________________________________________
Contact person and phone
b) Level I Designation Criteria
Provide a Trauma Plan that explains how each of
				  the requirements will be met. Options include provision of services in-house,
				  by transfer agreement or by waiver. Requests for waiver must include
the requirement or standards with which it considers compliance to be a
				  hardship
and demonstrate how there
will be no reduction in the
				  standards of medical care.
(Section 3.185 of the Act) The Trauma Plan
				  must be submitted in the order listed in this Appendix A, subsection (b). Each
				  section of the Plan must be referenced by the applicable portion of this Part
				  by subsection number (e.g., the subsections referenced in this subsection
				  (b)).
1) Table of Organization
A) Board of Directors
B) Chief Executive Officer
C) Department of Surgery
D) Trauma Service
E) Department of Medicine
F) Department of Radiology
G) Emergency Medicine
H) Rehabilitation Department, including
				  Occupational Therapy, Speech Therapy, and Physical Therapy
I) Social Services
J) Dietary
K) Department of Psychiatry
2) Review the requirements in Section
				  515.2030(a)
				  and (b) for the Trauma Director. Submit a
				  curriculum vitae for the Trauma Director.
3) Review the criteria in Section
				  515.2030(c)(1)
				   for all general and trauma surgeons.
				  Complete Appendix G.
4) Review requirements in Section
				  515.2030(c)(2)-(6) for resident coverage. If residents are used, submit
				  documentation to substantiate this requirement. Otherwise, submit a statement
				  that residents are not used.
5) Review requirements in Section
				  515.2030(c)(7)
				   for treatment of isolated injuries. Submit
				  documentation to substantiate this requirement.
6) Review requirements in Section
				  515.2030(d)(1)(A)-(C) for physicians to be on call to arrive at the hospital
				  within 30 minutes after notification that their services are needed at the
				  hospital. Submit documentation to substantiate this requirement.
7) Review requirements in Section
				  515.2030(d)(2)(A)-(I) for on-call physicians to arrive at the hospital to treat
				  the patient within 60 minutes. Submit documentation to substantiate this
				  requirement.
8) Review requirements in Section
				  515.2030(d)(3)(A)
				  and (B) for burn care and acute spinal cord
				  injury. Submit documentation to substantiate this requirement.
9) Review criteria for Emergency Physicians in
				  Section
				  515.2030(e)(1)(A)(i)
				  and (ii) and (B). Submit Appendix H.
10) Review criteria in Section
				  515.2030(e)(2)(A)-(C) for Anesthesiology Services. Submit documentation to
				  substantiate this requirement.
11) Review criteria in Section
				  515.2030(e)(3)(A)
				  and (B) for Radiology. Submit documentation
				  to substantiate this requirement.
12) Review criteria in Section
				  515.2030(e)(4)(A)
				  for Intensive Care Unit physician coverage. Submit documentation to
				  substantiate this requirement.
13) Review criteria in Section
				  515.2030(e)(4)(B)
				  for ICU nurse coverage. Submit documentation to substantiate this
				  requirement.
14) Review the ICU equipment list in Section
				  515.2030(e)(4)(C)(i)
				  -(xii). Submit a statement that the trauma center maintains that ICU
				  equipment.
15) Review the Laboratory requirements in Section
				  515.2030(e)(5)(A)-(G). Submit a statement that the trauma center meets the
				  Laboratory requirements.
16) Review Cardiology requirement in Section
				  515.2030(e)(6).
				  Submit documentation to substantiate this requirement.
17) Review Internal Medicine requirement in
				  Section
				  515.2030(e)(7).
				  Submit documentation to substantiate this requirement.
18) Review requirement for Pediatrics in Section
				  515.2030(e)(9).
				  Submit documentation to substantiate this requirement.
19) Review requirement in Section
				  515.2030(e)(9)
				   for Postanesthetic Recovery. Submit
				  documentation to substantiate this requirement.
20) Review requirement in Section
				  515.2030(e)(10)
				   for Acute Hemodialysis capability in-house
				  24 hours a day. Submit documentation to substantiate this requirement.
21) Review criteria in Section
				  515.2030(e)(11).
				  Submit documentation to substantiate this requirement.
22) Review criteria in Section
				  515.2030(f)(1)
				   for Emergency Department Director. Submit a
				  curriculum vitae.
23) Review criteria in Section
				  515.2030(f)(2)
				   for Trauma Nurse Specialists. Submit
				  documentation to substantiate this requirement.
24) Review criteria in Section
				  515.2030(f)(3)
				   for a full time Trauma Coordinator. Submit
				  documentation to substantiate this requirement.
25) Review criteria in Section
				  515.2030(f)(4)
				   for Operating Room. Submit documentation to
				  substantiate this requirement.
26) Review criteria in Section
				  515.2030(f)(5)
				   for additional facility staff (Occupational
				  Therapy, Speech Therapy, Physical Therapy, Social Service, Dietary, and
				  Psychiatry). Submit documentation to substantiate this requirement for each of
				  these services.
27) Review criteria in Section 515.2030(g)(1)-(5)
				  for a professional staff competency plan. Submit documentation to substantiate
				  this requirement.
28) Review the trauma center equipment list in
				  Section 515.2030(h)(1)-(12). Submit a statement that the trauma center
				  maintains that equipment.
29) Review helicopter landing requirements in
				  Section 515.2030(i)(1)-(4). Submit a statement regarding the helicopter
				  landing.
30) Review requirements in Section
				  515.2030(j)(1)-(4) for trauma center focused outcome analysis. Submit
				  documentation to substantiate this requirement.
31) Review policies in Section
				  515.2030(k)(1)
				   for treating patients. Submit documentation
				  to substantiate this requirement.
32) Review criteria in Section
				  515.2030(k)(2)
				   for clinical protocols. Submit a statement
				  that the trauma center will keep clinical protocols for management of trauma
				  patients on site.
33) Review the transfer criteria in Section
				  515.2030(k)(3).
				  Submit documentation to substantiate this requirement.
34) Review the blood alcohol policy criteria in
				  Section
				  515.2030(k)(4).
				  Submit documentation to substantiate this requirement.
35) Review criteria in Section
				  515.2030(k)(5)
				   regarding Trauma Nurse Specialist
				  suspension.
36) Review criteria in Section
				  515.2030(k)(6)
				   for a professional staff competency plan.
				  Submit documentation to substantiate this requirement.
37) Review criteria in Section
				  515.2030(l)
				   regarding trauma plan approval by the
				  Department. Submit a statement that the trauma center will receive approval on
				  changes to the Trauma Plan before implementing.
38) Review the requirement in Section
				  515.2030(m)
				  for the practices of the Trauma Center to reflect the protocols of the EMS
				  Region and Trauma Center plan. Submit a statement that the practices of the
				  Trauma Center reflect the protocols of the EMS Region and Trauma Center
				  plan.
39) Review the Trauma Flow Sheet criteria in
				  Section
				  515.2030(n).
				  Submit a Trauma Flow Sheet.
40) Review criteria in Section
				  515.2030(o)
				  for the Trauma Center Medical Director job description. Submit a job
				  description.
41) Review criteria in Section
				  515.2030(p)
				  for the Trauma Coordinator job description. Submit job description.
42) Review the criteria in Section
				  515.2030(q)
				  for the trauma service to be supported in the facility budget. Submit
				  documentation to substantiate this requirement.
43) Review resource limitation criteria in Section
				  515.2030(r)(1) and (2)(A)-(C). Submit documentation to substantiate this
				  requirement.
44) Review the criteria for public information and
				  education in Section
				  515.2030(s).
				  Submit documentation to substantiate this requirement.
45) Review the criteria in Section
				  515.2050(a)
				  for computer software. Submit documentation to substantiate this
				  requirement.
46) Review reporting schedule data in Section
				  515.2050(d).
				  Submit documentation to substantiate this requirement.
47) Review the criteria for archiving data in
				  Section
				  515.2050(e).
				  Submit documentation to substantiate this requirement.
c) Level I Pediatric Trauma Center Designation Criteria,
				  Section
				  515.2035
Provide a Trauma Plan that explains how each of
				  the requirements will be met. Options include provision of services in-house,
				  by transfer agreement or by waiver. Requests for waiver must include
the requirement or standards with which it considers compliance to be a
				  hardship
and demonstrate how
there will be no reduction in the
				  standards of medical care.
(Section 3.185 of the Act) The Trauma Plan
				  must be submitted in the order listed in this Appendix A, subsection (c). Each
				  section of the Plan must be referenced by the applicable portion of this Part
				  by subsection number (e.g., the subsections referenced in this subsection
				  (c)).
1) Table of Organization
A) Board of Directors
B) Chief Executive Officer
C) Department of Pediatric Surgery
D) Trauma Service
E) Department of Pediatrics
F) Department of Radiology
G) Emergency Medicine
H) Rehabilitation Department, including
				  Occupational Therapy, Speech Therapy, and Physical Therapy.
I) Social Services
J) Dietary
K) Department of Psychiatry
2) Review the criteria in Section
				  515.2035(a) and
				  (b)(1) and (2) for the Pediatric Trauma
				  Director. Submit a curriculum vitae.
3) Review the criteria in Section
				  515.2035(c)
				  for the Pediatric Trauma/General Surgeons. Submit documentation to substantiate
				  this requirement.
4) Review requirements in Section
				  515.2035(c)(1)-(4) for resident coverage. Submit documentation to substantiate
				  this requirement if residents are used. Otherwise, submit a statement that
				  residents are not used.
5) Review criteria in Section
				  515.2035(c)(6)
				   for physician competency. Submit
				  documentation to substantiate this requirement.
6) Review requirements in Section
				  515.2035(c)(7)
				   for treatment of isolated injuries. Submit
				  documentation to substantiate this requirement.
7) Review requirements in Section
				  515.2035(d)(1)(A)
				  and (B) for physicians to be on call to
				  arrive at the hospital within 30 minutes or provide the service by transfer
				  agreement. Submit documentation to substantiate this requirement.
8) Review requirements in Section
				  515.2035(d)(2)(A)-(I) for on-call physicians to arrive at the hospital to treat
				  the patient within 60 minutes. Submit documentation to substantiate this
				  requirement.
9) Review requirements in Section
				  515.2035(d)(3)(A)-(B) for burn care and acute spinal cord injury. Submit
				  documentation to substantiate this requirement.
10) Review the criteria in Section
				  515.2035(e)(1)
				   for Department of Pediatrics. Submit
				  documentation to substantiate this requirement.
11) Review the criteria in Section
				  515.2035(e)(2)
				   for Emergency Physicians. Submit Appendix
				  J.
12) Review criteria in Section
				  515.2035(e)(2)(A)-(C) for Anesthesiology Services. Submit documentation to
				  substantiate this requirement.
13) Review criteria in Section
				  515.2035(e)(4)(A)-(C) for Radiology. Submit documentation to substantiate this
				  requirement.
14) Review criteria in Section
				  515.2035(e)(5)(A)
				  for Intensive Care Unit physician coverage. Submit documentation to
				  substantiate this requirement.
15) Review criteria in Section
				  515.2035(e)(5)(B)
				  for ICU nurse coverage. Submit documentation to substantiate this
				  requirement.
16) Review the ICU equipment list in Section
				  515.2035(e)(5)(C)(i)-(xi). Submit a statement that the trauma center maintains
				  that ICU equipment.
17) Review the Laboratory requirements in Section
				  515.2035(e)(6)(A)-(G). Submit a statement that the trauma center meets the
				  laboratory requirements.
18) Review requirement in Section
				  515.2035(e)(7)
				   for board certified pediatrician to be
				  available in 60 minutes. Submit documentation to substantiate this
				  requirement.
19) Review Pediatric Cardiology requirement in
				  Section
				  515.2035(e)(8).
				  Submit documentation to substantiate this requirement.
20) Review requirement in Section
				  515.2035(e)(9)
				   for Postanesthetic Recovery, which may be
				  fulfilled by ICU. Submit documentation to substantiate this requirement.
21) Review requirement in Section
				  515.2035(e)(10)
				   for Acute Hemodialysis capability 24 hours a
				  day. Submit documentation to substantiate this requirement.
22) Review requirement in Section
				  515.2035(e)(11)
				   for Open Heart capability. Submit
				  documentation to substantiate this requirement.
23) Review criteria in Section
				  515.2035(f)(1)
				   for Emergency Department Director. Submit a
				  curriculum vitae.
24) Review criteria in Section
				  515.2035(f)(2)
				   for Trauma Nurse Specialists. Submit
				  documentation to substantiate this requirement.
25) Review criteria in Section
				  515.2035(f)(3)
				   for a full-time Trauma Coordinator. Submit
				  documentation to substantiate this requirement.
26) Review criteria in Section
				  515.2035(f)(4)
				   for Operating Room. Submit documentation to
				  substantiate this requirement.
27) Review criteria in Section
				  515.2035(f)(5)
				   for additional facility staff (Occupational
				  Therapy, Speech Therapy, Physical Therapy, Social Service, Child Protective
				  Services, Nutrition and Pediatric Psychiatry). Submit documentation to
				  substantiate this requirement for each of these services.
28) Review criteria in Section 515.2035(g)(1)-(5)
				  for a professional staff competency plan. Submit documentation to substantiate
				  this requirement.
29) Review the trauma center equipment list in
				  Section 515.2035(h)(1)-(13). Submit a statement that the trauma center
				  maintains that equipment.
30) Review budget requirements in Section
				  515.2035(i).
				  Submit documentation to substantiate this requirement.
31) Review requirements for Level I, Section
				  515.2030(i)-(s). Submit policies for each.
d) Level II Designation Criteria, Section
				  515.2040
Provide a Trauma Plan that explains how each of
				  the requirements will be met. Options include provision of services in-house,
				  by transfer agreement, or by waiver. Requests for waiver must include the
				  requirement or standards with which it considers compliance to be a hardship
				  and demonstrate how there will be no reduction in the standards of medical
				  care. (Section 3.185 of the Act) The Trauma Plan must be submitted in the order
				  listed in this Appendix A, subsection (d). Each section of the Plan must be
				  referenced by the applicable portion of this Part by subsection number (e.g.,
				  the subsections referenced in this subsection (c)).
1) Table of Organization
A) Board of Directors
B) Chief Executive Officer
C) Department of Surgery
D) Trauma Service
E) Department of Medicine
F) Department of Radiology
G) Emergency Medicine
H) Rehabilitation Department, including
				  Occupational Therapy, Speech Therapy, and Physical Therapy
I) Social Services
J) Dietary
K) Department of Psychiatry
2) Review the requirements in Section
				  515.2040(a)
				  and (b) for the Trauma Director. Submit a
				  curriculum vitae.
3) Review the criteria in Section
				  515.2040(c)(1)
				   for all General and Trauma Surgeons.
				  Complete Appendix G.
4) Review requirements in Section
				  515.2040(c)(2)-(5) for resident coverage. Submit documentation to substantiate
				  this requirement if residents are used. Otherwise, submit a statement that
				  residents are not used.
5) Review the requirement in Section
				  515.2040(c)(6)
				   for a physician competency plan. Submit
				  documentation to support this requirement.
6) Review the requirement in Section
				  515.2040(c)(8)
				   for a call schedule. Submit documentation to
				  substantiate this requirement.
7) Review the requirements in Section
				  515.2040(c)(9)
				   for treatment of isolated injuries. Submit
				  documentation to substantiate this requirement.
8) Review requirements in Section
				  515.2040(d)(1)-(4) for physicians to be on call to arrive at the hospital
				  within 60 minutes after notification that their services are needed at the
				  hospital. Submit documentation to substantiate this requirement.
9) Review requirements in Section
				  515.2040(e)(1)-(9) for on-call physicians to arrive at the hospital to treat
				  the patient within 60 minutes or provide the service by transfer agreement.
				  Submit documentation to substantiate this requirement.
10) Review criteria in Section
				  515.2040(f)(1)(A)(i)
				  and (ii) and (B) for Emergency Physicians.
				  Submit Appendix H.
11) Review criteria in Section
				  515.2040(f)(2)(A)
				  and (B) for Anesthesiology Services. Submit
				  documentation to substantiate this requirement.
12) Review the Laboratory requirements in Section
				  515.2040(f)(3)(A)-(G). Submit a statement that the trauma center meets the
				  Laboratory requirements.
13) Review criteria in Section
				  515.2040(f)(4)(A)
				  and (B) for Radiology. Submit a
				  policy.
14) Review criteria in Section
				  515.2040(f)(5)
				   for Cardiology. Submit documentation to
				  substantiate this requirement.
15) Review criteria in Section
				  515.2040(f)(6)
				   for Internal Medicine. Submit documentation
				  to substantiate this requirement.
16) Review criteria in Section
				  515.2040(f)(7)
				   for Postanesthetic Recovery. Submit
				  documentation to substantiate this requirement.
17) Review criteria in Section
				  515.2040(f)(8)(A)
				  for Intensive Care Unit physician coverage. Submit documentation to
				  substantiate this requirement.
18) Review criteria in Section
				  515.2040(f)(8)(B)
				  for ICU nurse coverage. Submit documentation to substantiate this
				  requirement.
19) Review the ICU equipment list in Section
				  515.2040(f)(8)(C)(i)-(ix). Submit a statement that the Trauma Center maintains
				  that ICU equipment.
20) Review requirement for Pediatrics in Section
				  515.2040(f)(9).
				  Submit documentation to substantiate this requirement.
21) Review requirement in Section
				  515.2040(f)(10)
				   for Acute Hemodialysis capability in-house
				  24 hours a day. Submit documentation to substantiate this requirement.
22) Review criteria in Section
				  515.2040(g)(1)
				   for Emergency Department Director. Submit a
				  curriculum vitae.
23) Review criteria in Section
				  515.2040(g)(2)
				   for Trauma Nurse Specialists. Submit
				  documentation to substantiate this requirement.
24) Review criteria in Section
				  515.2040(g)(3)
				   for a full time Trauma Coordinator. Submit a
				  job description.
25) Review criteria in Section
				  515.2040(g)(4)
				   for Operating Room. Submit documentation to
				  substantiate this requirement.
26) Review criteria in Section
				  515.2040(g)(5)
				   for additional facility staff (Occupational
				  Therapy, Speech Therapy, Physical Therapy, Social Service, Dietary, and
				  Psychiatry). Submit a policy for each of these services.
27) Review the trauma center equipment list in
				  Section 515.2040(h)(1)-(12). Submit a statement that the trauma center
				  maintains that equipment.
28) Review helicopter landing requirements in
				  Section 515.2040(j)(1)-(3). Submit a statement regarding the helicopter
				  landing.
29) Review requirements in Section
				  515.2040(k)(1)-(4) for Trauma Center focused outcome analysis. Submit
				  documentation to substantiate this requirement.
30) Review policies in Section
				  515.2040(l)(1)
				   for policies for treating patients. Submit
				  documentation to substantiate this requirement.
31) Review criteria in Section
				  515.2040(l)(2)
				   for clinical protocols. Submit a statement
				  that the trauma center will keep clinical protocols for management of trauma
				  patients on site.
32) Review the transfer criteria in Section
				  515.2040(l)(3).
				  Submit documentation to substantiate this requirement.
33) Review the blood alcohol policy criteria in
				  Section
				  515.2040(l)(4).
				  Submit documentation to substantiate this requirement.
34) Review criteria regarding Trauma Nurse
				  Specialist suspension in Section
				  515.2040(l)(5).
				  Submit documentation to substantiate this requirement.
35) Review criteria in Section
				  515.2040(h)
				   regarding professional staff competency
				  plan. Submit documentation to substantiate this requirement.
36) Review criteria in Section
				  515.2040(m)
				   regarding Trauma Plan approval by the
				  Department. Submit a statement that the Trauma Center will receive approval on
				  changes to the Trauma Plan before implementing.
37) Review the requirement in Section
				  515.2040(n)
				  for the practices of the Trauma Center to reflect the protocols of the EMS
				  Region and Trauma Center plan. Submit a statement that the practices of the
				  Trauma Center reflect the protocols of the EMS Region and Trauma Center
				  plan.
38) Review the Trauma Flow Sheet criteria in
				  Section
				  515.2040(o).
				  Submit a Trauma Flow Sheet.
39) Review criteria in Section
				  515.2040(p)
				  for the Trauma Center Medical Director job description. Submit a job
				  description.
40) Review criteria in Section
				  515.2040(q)
				  for the Trauma Coordinator job description. Submit job description.
41) Review the criteria in Section
				  515.2040(r)
				  for the Trauma Service to be supported in the facility budget. Submit
				  documentation to substantiate this requirement.
42) Review resource limitation criteria in Section
				  515.2040(s).
				  Submit documentation to substantiate this requirement.
43) Review the criteria for public information and
				  education in Section
				  515.2040(t).
				  Submit documentation to substantiate this requirement.
44) Review the criteria in Section
				  515.2050(a)
				  for computer software. Submit documentation to substantiate this
				  requirement.
45) Review reporting data schedule in Section
				  515.2050(d).
				  Submit documentation to substantiate this requirement.
46) Review the criteria for archiving data in
				  Section
				  515.2050(e).
				  Submit documentation to substantiate this requirement.
e) Level II Pediatric Trauma Center Designation Criteria,
				  Section
				  515.2045
Provide a Trauma Plan that explains how each of
				  the requirements will be met. Options include provision of services in-house,
				  by transfer agreement or by waiver. Requests for waiver must include the
				  requirement or standards with which it considers compliance to be a hardship
				  and demonstrate how there will be no reduction in the standards of medical
				  care. (Section 3.185 of the Act) The Trauma Plan must be submitted in the order
				  listed in this Appendix A, subsection (e). Each section of the Plan must be
				  referenced by the applicable portion of this Part by subsection number (e.g.,
				  the subsections referenced in this subsection (e)).
1) Table of Organization
A) Board of Directors
B) Chief Executive Officer
C) Department of Pediatric Surgery
D) Trauma Service
E) Department of Pediatric Medicine
F) Department of Radiology
G) Emergency Medicine
H) Rehabilitation Department, including
				  Occupational Therapy, Speech Therapy, and Physical Therapy.
I) Social Services
J) Dietary
K) Department of Psychiatry
2) Review the criteria in Section
				  515.2045(a) and
				  (b)(1) and (2)(A) and (B) for the Pediatric
				  Trauma Director. Submit a curriculum vitae.
3) Review the criteria in Section
				  515.2045(c)
				  for the Pediatric Trauma/General Surgeons. Submit documentation to substantiate
				  this requirement.
4) Review requirements in Section
				  515.2045(c)(1)-(4) for resident coverage. Submit documentation to substantiate
				  this requirement if residents are used. Otherwise, submit a statement that
				  residents are not used.
5) Review requirements in Section
				  515.2045(c)(7)
				   for primary and back-up call
				  schedule.
6) Review requirements in Section
				  515.2045(c)(8)
				   for treatment of isolated injuries. Submit
				  documentation to substantiate this requirement.
7) Review requirements in Section
				  515.2045(d)(1)-(4) for physicians to be on call to arrive at the hospital
				  within 60 minutes. Submit documentation to substantiate this
				  requirement.
8) Review requirements in Section
				  515.2045(e)(1)-(8) for on-call physicians to arrive at the hospital to treat
				  the patient within 60 minutes or provide the service by transfer agreement.
				  Submit documentation to substantiate this requirement.
9) Review the criteria in Section
				  515.2045(f)(1)
				   for Emergency Physicians. Submit Appendix
				  J.
10) Review criteria in Section
				  515.2045(f)(2)(A)
				  and (B) for Anesthesiology Services. Submit
				  documentation to substantiate this requirement.
11) Review the Laboratory requirements in Section
				  515.2045(f)(3)(A)-(G). Submit documentation to substantiate this
				  requirement.
12) Review criteria in Section
				  515.2045(f)(4)
				   for a Department of Pediatrics. Submit
				  documentation to substantiate this requirement.
13) Review criteria in Section
				  515.2045(f)(5)(A)-(C) for Radiology. Submit documentation to substantiate this
				  requirement.
14) Review criteria in Section
				  515.2045(f)(6)
				   for Pediatric Cardiology. Submit
				  documentation to substantiate this requirement.
15) Review requirement in Section
				  515.2045(f)(7)
				   for Postanesthetic Recovery. Submit
				  documentation to substantiate this requirement.
16) Review criteria in Section
				  515.2045(f)(8)(A)
				  for Intensive Care Unit physician coverage. Submit documentation to
				  substantiate this requirement.
17) Review criteria in Section
				  515.2045(f)(8)(B)
				  for ICU nurse coverage. Submit documentation to substantiate this
				  requirement.
18) Review the ICU equipment list in Section
				  515.2045(f)(8)(C)(i)
				  -(viii). Submit a statement that the trauma center maintains that ICU
				  equipment.
19) Review requirement in Section
				  515.2045(f)(9)
				   for Acute Hemodialysis capability 24 hours a
				  day. Submit documentation to substantiate this requirement.
20) Review criteria in Section
				  515.2045(g)(1)
				   for Emergency Department Director. Submit a
				  curriculum vitae.
21) Review criteria in Section
				  515.2045(g)(2)
				   for Trauma Nurse Specialists. Submit
				  documentation to substantiate this requirement.
22) Review criteria in Section
				  515.2045(g)(3)
				   for a full-time Trauma Coordinator. Submit a
				  job description.
23) Review criteria in Section
				  515.2045(g)(4)
				   for Operating Room. Submit documentation to
				  substantiate this requirement.
24) Review criteria in Section
				  515.2045(g)(5)
				   for additional facility staff (Occupational
				  Therapy, Speech Therapy, Social Service, Child Protective Services and
				  Pediatric Psychiatry). Submit documentation to substantiate this requirement
				  for each of these services.
25) Review the trauma center equipment list in
				  Section 515.2045(i)(1)-(13). Submit a statement that the trauma center
				  maintains that equipment.
26) Review the criteria in Section
				  515.2045(j)
				  for trauma service to be identified in the facility's budget. Submit
				  documentation to substantiate this requirement.
27) Review helicopter landing requirements in
				  Section 515.2040(j)(1)-(3). Submit a statement regarding the helicopter
				  landing.
28) Review requirements in Section
				  515.2040(k)(1)-(4) for a focused outcome analysis. Submit documentation to
				  substantiate this requirement.
29) Review criteria in Section
				  515.2040(l)(2)
				   for clinical protocols. Submit a statement
				  that the trauma center will keep protocols for management of trauma patients on
				  site.
30) Review the criteria in Section
				  515.2040(m)
				   regarding trauma plan approval by the
				  Department. Submit a statement that the trauma center will receive approval on
				  changes to the trauma plan before implementing.
31) Review the Trauma Flow Sheet criteria in
				  Section
				  515.2040(o).
				  Submit a Trauma Flow Sheet.
32) Review criteria in Section
				  515.2040(p)
				  for the Trauma Center Medical Director job description. Submit a job
				  description.
33) Review criteria in Section
				  515.2040(q)
				  for the Trauma Coordinator job description. Submit job description.
34) Review criteria in Section
				  515.2040(r)
				  for the trauma service to be supported in the facility budget. Submit
				  documentation to substantiate this requirement.
35) Review resource limitation criteria in Section
				  515.2040(s).
				  Submit documentation to substantiate this requirement.
36) Review criteria for public information and
				  education in Section
				  515.2040(t).
				  Submit documentation to substantiate this requirement.