reglab/statecodes huggingface dataset:
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 141.000 - Licensure of Hospice Programs › Section 141.230 - Operation of Hospice Inpatient Facilities and Residential Hospice Services

Current through Register 1525, July 5, 2024
(A)
Policies and
			 Procedures
. An applicant for the approval of a hospice inpatient
			 facility shall develop, through an interdisciplinary team, and adopt written
			 policies and procedures to ensure the safe and effective operation of the
			 facility to meet the needs of its patients prior to submitting an application
			 for approval. A licensed hospice shall implement, and review and revise through
			 an interdisciplinary team as needed but not less than once a year, its written
			 policies and procedures to operate a hospice inpatient facility or provide
			 residential hospice services in a safe, effective manner that meets the needs
			 of its patients. A hospice shall ensure that all staff, including temporary
			 staff and volunteers, are trained and determined to be competent as needed for
			 their duties on the policies and procedures developed by the
			 facility.
(B)
Environment
. A hospice operating a hospice inpatient
			 facility or providing residential hospice services shall ensure that all
			 patient areas are properly maintained, free from hazards, and meet the needs of
			 its patients; and that temperatures are maintained within a comfortable range
			 for patients. A hospice inpatient facility or a location in which residential
			 hospice services are provided shall comply with all local and state building
			 codes.
(C)
Equipment
. A hospice operating a hospice inpatient
			 facility or providing residential hospice services shall ensure that
			 appropriate and necessary equipment is available at all times, and properly
			 maintained to meet the needs of its patients, including patients with
			 disabilities and pediatric patients.
(D)
Meals and
			 Nourishment
. A hospice operating a hospice inpatient facility or
			 providing residential hospice services shall ensure that meals and nourishments
			 are provided appropriate to the needs of patients; and obtained only from
			 sources approved or considered satisfactory by federal, state or local
			 authorities, and store, prepare, distribute and serve food under sanitary
			 conditions.
(E)
Linen
			 and Laundry
. A hospice operating a hospice inpatient facility or
			 providing residential hospice services shall ensure that sufficient linen is
			 available at all times, and that linen and personal laundry is handled, washed
			 and stored in a sanitary manner.
(F)
Staffing
. A
			 hospice operating a hospice inpatient facility or providing residential hospice
			 services shall ensure that sufficient qualified and trained staff are available
			 at all times to meet the needs of its patients.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 141.000 - Licensure of Hospice Programs › Section 141.300 - Severability

Current through Register 1525, July 5, 2024
The provisions of
				105 CMR 141.000 are
				severable. If any provision herein is declared unconstitutional or invalid by a
				court of competent jurisdiction, the validity of the remaining portions shall
				not be so affected.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 142.000 - Operation And Maintenance Of Birth Centers › Section 142.002 - Authority

Current through Register 1525, July 5, 2024
105 CMR 142.000 is adopted
				under the authority of M.G.L. c. 111, §§ 3 and 51 through
				56.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 142.000 - Operation And Maintenance Of Birth Centers › Section 142.003 - Citation

Current through Register 1525, July 5, 2024
105 CMR 142.000 shall be
				known and may be cited as
				105 CMR 142.000 Operation
				and Maintenance of Birth Centers.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 142.000 - Operation And Maintenance Of Birth Centers › Section 142.004 - Scope

Current through Register 1525, July 5, 2024
105 CMR 142.000 applies to
				every birth center subject to licensing either as a clinic as defined in M.G.L.
				c. 111, § 52 or as a facility operating under a hospital license pursuant
				to M.G.L. c. 111, § 51.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 142.000 - Operation And Maintenance Of Birth Centers › Section 142.200 - Waiver of Requirements Imposed on Birth Centers

Current through Register 1525, July 5, 2024
(A) The Commissioner or his or her designee
			 may waive the applicability to a particular free-standing birth center of one
			 or more of the requirements imposed on free-standing birth centers by
			 105 CMR 142.000 if upon
			 inspection of the birth center the Department finds that:
(1) compliance would cause undue hardship to
			 the birth center;
(2) the birth
			 center is in substantial compliance with the spirit of the requirement;
			 and
(3) the birth center's
			 non-compliance does not jeopardize the health or safety of its clients and does
			 not limit the birth center's capacity to give adequate care.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 142.000 - Operation And Maintenance Of Birth Centers › Subpart A - Licensing and Related Administrative Procedures › Section 142.301 - Licensing of Free-standing Birth Centers

Current through Register 1525, July 5, 2024
Free-standing birth centers are required to obtain clinic
				  licensure pursuant to M.G.L. c. 111, §§ 51 through 56 and to comply
				  with the licensure and administrative requirements set forth in
				  105 CMR
				  140.000: Subpart A (
				  105 CMR
				  140.100 through 140.199 ).
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 142.000 - Operation And Maintenance Of Birth Centers › Subpart A - Licensing and Related Administrative Procedures › Section 142.302 - Licensing of Hospital-affiliated Birth Centers

Current through Register 1525, July 5, 2024
Hospital-affiliated birth centers are required to operate
				  under a hospital license issued pursuant to M.G.L. c. 111, §§ 51
				  through 56 and to comply with the requirements of
				  105 CMR
				  130.000: Hospital Licensure with the exception of
				  those standards governing obstetric and newborn services ( 105 CMR 130.600
				  through 130.699 ).
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 142.000 - Operation And Maintenance Of Birth Centers › Subpart A - Licensing and Related Administrative Procedures › Section 142.303 - Newborn Screening

Current through Register 1525, July 5, 2024
(A) Notwithstanding
				the provisions of
				105 CMR
				142.302, free-standing and
				hospital-affiliated birth centers are subject to the regulations regarding the
				provision of newborn infant hearing screening as described in the hospital
				licensure regulations at
				105 CMR
				130.629: Universal Newborn Hearing Screening
				Programs. Notwithstanding the requirements of those sections, if a birth center
				does not have the equipment or ability to conduct such a screening, the newborn
				infant shall be referred prior to discharge from the birth center to a hospital
				or birth center approved by the Department for such screening.
(1) Prior to discharge, a birth center that
				is not able to conduct a hearing screening shall make an appointment for a
				screening for each newborn infant at a Department approved screening
				site.
(2) Prior to discharge,
				written information shall be provided in the language understood by the parent
				or guardian to the parent or guardian about the importance of the screening,
				coverage of the costs of the screening by third party payers, the time of any
				screening appointment scheduled, and the location and phone number of the
				hearing screening site.
(3) The
				birth center shall within two weeks of the birth of a child perform a follow-up
				call to the parent or guardian of the newborn infant to verify the infant has
				received the hearing screening. Records shall be kept to document the
				conversation about the performance of the screening. As part of the annual
				report submitted to the Department pursuant to
				105 CMR
				130.629(C)(3)(k), the birth
				center shall submit information regarding the follow-up for hearing screening
				of newborn infants.
(4) The birth
				center shall submit a screening protocol for those portions of
				105 CMR
				130.629: Universal Newborn Hearing Screening
				Programs designated by the Department in the Universal Newborn Hearing
				Screening Guidelines.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 142.000 - Operation And Maintenance Of Birth Centers › Subpart B - Physical Environment › Section 142.400 - Compliance with Public Safety Standards

Current through Register 1525, July 5, 2024
Prior to original licensure and licensure renewal each
				  freestanding birth center shall submit a certificate of inspection issued by
				  the head of the local fire department certifying compliance with local
				  ordinances and a certificate of inspection issued by the Department of Public
				  Safety or local body with jurisdiction over the premises.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 142.000 - Operation And Maintenance Of Birth Centers › Subpart B - Physical Environment › Section 142.405 - Space, Equipment and Supplies

Current through Register 1525, July 5, 2024
Each birth center shall provide adequate space, and provide
				  equipment and supplies appropriate and sufficient to render birth center
				  services.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 142.000 - Operation And Maintenance Of Birth Centers › Subpart B - Physical Environment › Physical Plant › Section 142.410 - Hallways and Doors

Current through Register 1525, July 5, 2024
Hallways and doors providing ingress and egress to the
					 birth center and rooms in which births take place shall be of adequate width
					 and conformation to accommodate movement of a standard ambulance stretcher or
					 cot.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 142.000 - Operation And Maintenance Of Birth Centers › Subpart B - Physical Environment › Physical Plant › Section 142.415 - Climate Control

Current through Register 1525, July 5, 2024
Each birth center must provide and maintain a safe and
					 adequate source of heat and air conditioning for stable climate
					 control.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 142.000 - Operation And Maintenance Of Birth Centers › Subpart B - Physical Environment › Physical Plant › Section 142.425 - Rooms in Which Births Take Place

Current through Register 1525, July 5, 2024
(A) Rooms in
				  which births take place shall be located on a grade level to provide unimpeded,
				  rapid access to an exit of the building where emergency transportation vehicles
				  may be accommodated. Such rooms may be located on a level above or below a
				  grade level provided that such levels have access to a grade level via an
				  elevator of adequate size to accommodate a standard ambulance stretcher or
				  cot.
(B) Each room in which births
				  take place shall be spacious enough to accommodate family belongings and the
				  following equipment and supplies:
(1) A
				  double bed or a bed large enough to safely accommodate mother and
				  baby;
(2) Chairs;
(3) Bedside/procedure tables;
(4) A bassinet.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 142.000 - Operation And Maintenance Of Birth Centers › Subpart B - Physical Environment › Physical Plant › Section 142.430 - Toilet and Bath Facilities

Current through Register 1525, July 5, 2024
Each birth center shall make toilet and bath or shower
					 facilities available to the laboring mother. A separate toilet facility must be
					 available for family and staff use.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 142.000 - Operation And Maintenance Of Birth Centers › Subpart B - Physical Environment › Physical Plant › Section 142.435 - Family Room

Current through Register 1525, July 5, 2024
Each birth center must have a family room which includes a
					 play area for children and a living room setting of tables, chairs and sofa
					 that may be converted into a bed for use by family members.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 142.000 - Operation And Maintenance Of Birth Centers › Subpart B - Physical Environment › Physical Plant › Section 142.440 - Kitchen or Kitchenette

Current through Register 1525, July 5, 2024
Each birth center must have a kitchen which includes
					 refrigerator, stove, sink, cupboard, and counter space for the convenience of
					 families.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 142.000 - Operation And Maintenance Of Birth Centers › Subpart B - Physical Environment › Physical Plant › Section 142.445 - Maintenance of Furnishings and Equipment

Current through Register 1525, July 5, 2024
Birth center furnishings and equipment shall be kept clean
					 and in good repair.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 142.000 - Operation And Maintenance Of Birth Centers › Subpart B - Physical Environment › Physical Plant › Section 142.450 - Reception and Office Areas

Current through Register 1525, July 5, 2024
Each birth center shall provide adequate space and
					 equipment for reception and waiting areas, for administrative and staff offices
					 and for storage of client records.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 142.000 - Operation And Maintenance Of Birth Centers › Subpart B - Physical Environment › Physical Plant › Section 142.455 - Examination and Treatment Areas

Current through Register 1525, July 5, 2024
Exam rooms and treatment areas shall include an examination
					 table, handwashing facilities and shall ensure privacy and
					 confidentiality.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 142.000 - Operation And Maintenance Of Birth Centers › Subpart B - Physical Environment › Equipment and Supplies › Section 142.470 - Storage, Utility Areas and Waste Disposal

Current through Register 1525, July 5, 2024
(A) Each birth center must have adequate
				  utility and storage equipment for washing, sterilizing, storing and other
				  handling of equipment, linens, and medical supplies.
(B) Clean linen and sterile supplies and
				  equipment must be segregated from soiled and/or contaminated linen, equipment
				  and supplies.
(C) Waste products
				  and materials shall be disposed of in a safe and appropriate manner. Tissue
				  shall be disposed of in a manner approved by the Department.
(D) Each birth center must be either equipped
				  to launder linens and other washable goods properly on site at the center, on
				  site at the parent hospital or provide for satisfactory arrangements with a
				  commercial laundry. Water temperature for laundering shall be at least
				  160°F.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 142.000 - Operation And Maintenance Of Birth Centers › Subpart B - Physical Environment › Equipment and Supplies › Section 142.475 - Equipment and Supplies for Infants

Current through Register 1525, July 5, 2024
Each birth center must have a standard neonatal warming
					 device and a transfer incubator which conforms with the standards of
					 Underwriter's Laboratories, Inc.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 142.000 - Operation And Maintenance Of Birth Centers › Subpart B - Physical Environment › Equipment and Supplies › Section 142.480 - Diagnostic Equipment

Current through Register 1525, July 5, 2024
(A) Each birth
				  center shall maintain a microscope for routine office examination of vaginal
				  smears.
(B) A sufficient number of
				  sphygmomanometers and auscultation equipment shall be available.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 142.000 - Operation And Maintenance Of Birth Centers › Subpart B - Physical Environment › Equipment and Supplies › Section 142.485 - Emergency Equipment and Supplies

Current through Register 1525, July 5, 2024
(A) Each
				  birth center shall have available emergency equipment, medication and supplies
				  as outlined in the birth center's policies and procedures and as approved by
				  the Director of Medical Affairs.
(B) Equipment and supplies for administration
				  of intravenous fluids, and full adult and infant resuscitation as required by
				  procedures outlined in the birth center's protocols, shall be
				  maintained.
(C) Each birth center
				  shall have a limited supply of oxygen including portable oxygen available for
				  emergency use. Oxygen shall be properly stored.
(D) Each birth center shall have portable
				  suction available for both the mother and the infant.
(E) Each birth center shall have a source of
				  emergency lighting.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 142.000 - Operation And Maintenance Of Birth Centers › Subpart B - Physical Environment › Fire Protection › Section 142.495 - Evacuation Plan and Drills

Current through Register 1525, July 5, 2024
Written copies of a plan for evacuation in event of fire
					 shall be available to all personnel. All personnel shall be instructed and kept
					 informed of their responsibilities under the plan and supervised drills shall
					 be conducted at regular intervals.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 142.000 - Operation And Maintenance Of Birth Centers › Subpart C - Governing Body and Administration › Section 142.500 - Birth Center Governing Body

Current through Register 1525, July 5, 2024
(A) Each
				free-standing birth center, whether organized as proprietary or not for profit
				health services, under sole ownership, partnership or corporate group, shall
				identify a governing body with full authority and responsibility for overall
				policy and fiscal management of the facility and the services.
(B) The governing body of a free-standing
				birth center shall develop and maintain a written organizational
				plan.
(C) The governing body of the
				parent hospital of a hospital-affiliated birth center assumes full authority
				and responsibility for the overall policy, fiscal management and services
				provided by the birth center.
(D)
				The governing body is responsible for the appointment of the clinical birth
				center staff and the delineation of all clinical privileges.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 142.000 - Operation And Maintenance Of Birth Centers › Subpart C - Governing Body and Administration › Section 142.501 - Director of the Birth Center

Current through Register 1525, July 5, 2024
(A) Each
				free-standing birth center shall have a director who shall be responsible to
				the governing body for the operation and maintenance of the center.
(B) The director of a free-standing birth
				center must be a certified nurse-midwife, or an obstetrician or family
				practitioner with obstetrical privileges in a nearby hospital licensed in
				Massachusetts or operated by the Commonwealth.
(C) Each hospital-affiliated birth center
				shall have a director who shall be administratively responsible to the
				administrator of the hospital for the operation and maintenance of the birth
				center.
(D) The director of a
				hospital-affiliated birth center must be a certified nurse-midwife, or an
				obstetrician or family practitioner with obstetrical privileges in the parent
				hospital. If the parent hospital does not provide obstetrics and newborn
				services, the Director must meet the requirements set forth in 105 CMR
				142.501(B).
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 142.000 - Operation And Maintenance Of Birth Centers › Subpart C - Governing Body and Administration › Section 142.502 - Director of Medical Affairs

Current through Register 1525, July 5, 2024
(A) Each
				free-standing birth center shall designate a Director of Medical Affairs who
				shall be a board certified or board eligible obstetrician/gynecologist with
				full obstetrical privileges at a nearby hospital.
(B) Each hospital operating a
				hospital-affiliated birth center shall appoint a Director of Medical Affairs
				for the birth center who shall be a board certified or board eligible
				obstetrician/gynecologist with full obstetrical privileges at the parent
				hospital.
If the parent hospital does not provide obstetrics and
				  newborn services, the Director of Medical Affairs must meet the requirements
				  set forth in 105 CMR 142.502(A).
(C) The Director of Medical Affairs shall be
				responsible for advising and consulting with the primary care staff of the
				birth center on all matters related to medical management of pregnancy, birth,
				post-partum, newborn and gynecologic health care including policies, procedures
				and protocols for midwifery management of care.
(D) The Director of Medical Affairs shall
				develop policies and procedures governing administration of controlled
				substances by nurse midwives under standing orders. These policies and
				procedures are subject to approval by the Commissioner.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 142.000 - Operation And Maintenance Of Birth Centers › Subpart C - Governing Body and Administration › Section 142.503 - Administrative Records

Current through Register 1525, July 5, 2024
(A) Each birth
				center shall maintain current, complete, and accurate administrative records in
				a safe location. The birth center shall make all administrative records
				available promptly to any agent of the Department seeking to determine
				compliance with
				105 CMR 142.000.
(B) Administrative records in a free-standing
				birth center shall include:
(1) Updated
				articles of organization and by-laws or partnership agreement, as appropriate.
				The documents shall specify the organizational structure of the governing body
				and the method of selection of members.
(2) Updated lists of the names, addresses,
				and professions of the members; and of the names and addresses of directors and
				officers.
(3) Minutes of meetings
				of the governing body and of the members.
(4) An organizational chart for the entire
				organization.
(5) Personnel records
				for each employee, including any license or registration number; documentation
				of any specialty certificate, education and job experience.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 142.000 - Operation And Maintenance Of Birth Centers › Subpart C - Governing Body and Administration › Section 142.504 - Client Records

Current through Register 1525, July 5, 2024
(A) Each birth
				center shall keep in one centralized location records indicating all the
				services rendered to birth center clients.
(B) Client records in hospital-affiliated
				birth centers shall be part of the hospital's record system and shall be
				maintained in conformance with hospital birth center record standards
				established in written policies and procedures.
(C) Each client shall have a single
				integrated record. Each entry into each client record shall be dated and signed
				by the staff member making the entry, indicating name and title. Each page of
				each client's record shall have two unique forms of identification. The record
				with respect to each client shall be accurate and complete and include the
				following:
(1) Client's name, date of birth,
				home address and telephone number, and spouse or other person to contact in an
				emergency.
(2) Date of each client
				visit with birth center staff, at the birth center or elsewhere.
(3) Obstetrical and medical
				history.
(4) Diagnostic
				observations, evaluations, and therapeutic plans.
(5) Orders for any medication, test, or
				treatment.
(6) Records of any
				administration of medications, treatment, or therapy.
(7) Laboratory, radiology, and other
				diagnostic reports.
(8) Progress
				notes.
(9) Reports of any
				consultations, special examinations, or procedures.
(10) Referrals to other agencies.
(11) Discharge summary where
				appropriate.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 142.000 - Operation And Maintenance Of Birth Centers › Subpart C - Governing Body and Administration › Section 142.505 - Off-hour Coverage

Current through Register 1525, July 5, 2024
Each birth center shall make arrangements for the provision
				  of services 24 hours a day. These requirements can be met through on call
				  coverage by a certified nurse-midwife or physician on the staff of the birth
				  center during the hours when it is not open. These arrangements shall be
				  reflected in a written policy that is made available to all the birth center's
				  clients.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 142.000 - Operation And Maintenance Of Birth Centers › Subpart C - Governing Body and Administration › Section 142.506 - System for Referral

Current through Register 1525, July 5, 2024
(A) The
				free-standing birth center shall have a written agreement with a
				board-certified or eligible obstetrician/gynecologist, and a pediatrician or
				neonatologist for the provision of 24 hour consultation, referral and transfer
				to appropriate hospital facilities for obstetric/newborn care.
(B) Each hospital-affiliated birth center
				shall develop written agreements or policies for the provision of 24 hour
				consultation with a board-certified or eligible obstetrician/gynecologist and a
				pediatrician or neonatologist with clinical privileges at the parent hospital.
				If the parent hospital does not provide obstetrics and newborn services, the
				birth center must meet the requirements set forth in 105 CMR
				142.506(A).
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 142.000 - Operation And Maintenance Of Birth Centers › Subpart C - Governing Body and Administration › Section 142.507 - Emergency Transfer Agreements

Current through Register 1525, July 5, 2024
(A) Each birth
				center shall have a written agreement with a nearby or the parent hospital
				providing obstetrical and newborn services for the transfer of their clients
				for emergency treatment beyond that provided by the birth center.
(B) Each birth center shall have a written
				agreement with a board certified or eligible obstetrician with full obstetrical
				privileges at a nearby or the parent hospital, and a written agreement with a
				board certified or eligible pediatrician with full pediatric privileges at a
				nearby or the parent hospital for the care and transfer of clients for
				emergency treatment beyond that provided by the birth center.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 142.000 - Operation And Maintenance Of Birth Centers › Subpart C - Governing Body and Administration › Section 142.508 - Transfer of a Client or Newborn

Current through Register 1525, July 5, 2024
(A) Each birth
				center shall develop written procedures for the prompt and safe transfer of the
				obstetrical client and of the newborn for emergency treatment beyond that
				provided in the birth center.
(B)
				Whenever a birth center refers a client to the parent facility or to another
				facility, agency or health care provider, it shall send a copy of relevant
				portions of the birth center's records on the client to such facility, agency,
				or provider.
(C) A birth attendant
				as described in
				105 CMR 142.510(A)
				 shall accompany the client and newborn upon
				transfer to the parent or nearby hospital.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 142.000 - Operation And Maintenance Of Birth Centers › Subpart C - Governing Body and Administration › Section 142.509 - Evaluation of Quality

Current through Register 1525, July 5, 2024
(A) Each birth
				center shall have an on-going program for the review and evaluation of the
				quality and appropriateness of services provided by the birth center.
(B) Each birth center shall document all such
				reviews conducted and their findings and shall make such documentation
				available to the Department upon request.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 142.000 - Operation And Maintenance Of Birth Centers › Subpart C - Governing Body and Administration › Staff › Section 142.510 - Birth Attendants

Current through Register 1525, July 5, 2024
A certified nurse-midwife, or an obstetrician or family
					 practitioner with obstetrical privileges in the parent or nearby hospital shall
					 attend each woman in labor from the time of admission; during labor; during the
					 birth; and through the immediate postpartum period. Such attendance may be
					 delegated only to another certified nurse midwife or
					 physician.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 142.000 - Operation And Maintenance Of Birth Centers › Subpart C - Governing Body and Administration › Staff › Section 142.515 - Birth Assistant

Current through Register 1525, July 5, 2024
(A) A second staff
				  person shall also be present at each birth. The second staff person must be
				  either a nurse-midwife, or a licensed nurse.
(B) Licensed nurses must have labor and
				  delivery experience within one year of employment in a licensed obstetrical
				  service which includes training in:
(1) full
				  adult and infant resuscitation;
(2)
				  assessing the phases and stages of labor;
(3) psychology and physiology of labor and
				  delivery; and
(4) equipment and
				  supplies used for labor and delivery.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 142.000 - Operation And Maintenance Of Birth Centers › Subpart C - Governing Body and Administration › Staff › Section 142.520 - Other Staff Requirements

Current through Register 1525, July 5, 2024
(A) There shall be
				  sufficient professional staff to provide services for safe operation and
				  maintenance of the birth center.
(B) Qualified professional staff shall be on
				  duty at all times when clients are present.
(C) Professional staff shall be responsible
				  for training and supervision of all non-professional staff, unlicensed staff
				  and volunteers.
(D) All staff must
				  have an pre-employment physical exam including tuberculin testing.
(E) Prior to employment by the birth center
				  each individual shall demonstrate evidence of immunization to rubella or shall
				  receive a rubella vaccination prior to employment.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 142.000 - Operation And Maintenance Of Birth Centers › Subpart D - Required Services › Section 142.600 - Selection of Clients

Current through Register 1525, July 5, 2024
(A) Standards
				governing medical risk factors which exclude women from care at the birth
				center are established separately as Department guidelines.
(B) The Director of Medical Affairs shall
				develop and review annually a list of medical and social risk factors for the
				birth center in consultation with the birth center's primary care staff which:
(1) includes but is not limited to the risk
				factors set forth in the Department guidelines; and
(2) is approved by the
				Commissioner.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 142.000 - Operation And Maintenance Of Birth Centers › Subpart D - Required Services › Section 142.610 - Orientation

Current through Register 1525, July 5, 2024
Each birth center shall provide an orientation program for
				  clients and childbearing families. Such program shall include:
(A) the philosophy and goals of the birth
				center;
(B) the services that are
				available in the center and the services to which clients will have access by
				referral, consultation or contract including but not limited to education,
				nutrition counselling, and family guidance;
(C) all charges for care; and
(D) a tour of the facility.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 142.000 - Operation And Maintenance Of Birth Centers › Subpart D - Required Services › Section 142.620 - Program of Care

Current through Register 1525, July 5, 2024
The birth center shall provide a program of care to include
				  at least the following:
(A) a personal
				and family history;
(B) a physical
				examination and appropriate laboratory tests;
(C) continuous assessment of risk to mother
				and baby;
(D) a program of prenatal
				care that shall include components of self-help, self-care, and fetal
				assessment;
(E) a program of
				prenatal education that shall include the importance of nutrition, preparation
				for birth and breast feeding, and information on adverse effects of smoking,
				alcohol and other drugs;
(F)
				intrapartum and postpartum services that foster parental control and
				responsibility for the birth experience and infant parental bonding;
(G) labor support for the woman and her
				family;
(H) professional attendance
				at the birth;
(I) immediate
				postpartum care and newborn assessment;
(J) required eye prophylaxis;
(K) postpartum laboratory examination and
				program for prevention of Rh immunization;
(L) newborn metabolic screening and other
				such tests as may be required;
(M)
				a plan for follow-up;
(N) a
				postpartum examination and family planning; and
(O) a plan for well woman routine gynecologic
				health care.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 142.000 - Operation And Maintenance Of Birth Centers › Subpart D - Required Services › Section 142.630 - Other Services

Current through Register 1525, July 5, 2024
(A) The birth
				center shall have access to diagnostic services including clinical laboratory,
				sonography, radiology, electronic monitoring.
(B) All services used by the birth center
				shall meet applicable standards of the Department.
(C) Other services not provided by the birth
				center shall be made available to clients through referral as
				needed.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 142.000 - Operation And Maintenance Of Birth Centers › Subpart D - Required Services › Section 142.640 - Surgical Procedures

Current through Register 1525, July 5, 2024
(A) Surgical
				procedures shall be limited to those normally accomplished during uncomplicated
				childbirth, such as episiotomy and repair.
(B) Surgical procedures such as forceps
				delivery, tubal ligation, abortion, or Cesarean section shall not be performed
				in birth centers.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 142.000 - Operation And Maintenance Of Birth Centers › Subpart D - Required Services › Section 142.650 - Use of Medications

Current through Register 1525, July 5, 2024
(A) Controlled
				substances may be administered by a nurse-midwife only in a medical emergency
				and only in accordance with client specific standing orders written by a
				physician.
(B) Local anesthesia for
				the infiltration of the perineum for episiotomy repair may be administered in
				accordance with client specific standing orders written by the
				physician.
(C) The following
				practices are prohibited:
(1) use of any
				analgesics subject to regulation under M.G.L. c. 94C for pain control during
				labor;
(2) inhibition, stimulation
				or augmentation of the first or second stage of labor with controlled
				substances;
(3) use of general or
				regional anesthesia except as permitted in 105 CMR 142.650(B);
(4) maintenance of controlled substances or
				provision of controlled substances for self-administration outside of the birth
				center.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 142.000 - Operation And Maintenance Of Birth Centers › Subpart D - Required Services › Section 142.660 - Discharge Follow-up

Current through Register 1525, July 5, 2024
(A) Mothers and
				infants shall be discharged or transferred within 24 hours after
				birth.
(B) There shall be 24 hour
				telephone service to a professional birth attendant.
(C) Maternal and newborn examinations shall
				be performed by the birth center professional staff, or a physician or
				certified nurse-midwife of the family's choice within 72 hours of birth. Such
				examinations shall include required laboratory tests for health
				screening.
(D) A plan for pediatric
				care, contraception services and assessment of breast feeding and mother-infant
				bonding shall be developed for each mother and infant after birth.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 142.000 - Operation And Maintenance Of Birth Centers › Subpart D - Required Services › Section 142.670 - Reporting Requirements

Current through Register 1525, July 5, 2024
(A) Birth centers
				shall report all births to Registrars and City Clerks within ten days of the
				event and forward the confidential section of the birth record to the
				Department.
(B) Birth centers shall
				report any child with low birth weight, congenital abnormalities, and other
				high risk infants as defined by the Department.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 142.000 - Operation And Maintenance Of Birth Centers › Subpart E - Clinical Laboratory Services › Section 142.700 - Definition: "Clinical Laboratory Services"

Current through Register 1525, July 5, 2024
Biological, serological, chemical, immunohematological,
				  cytological, pathological, or other examinations of materials derived from a
				  human body shall be described in 105 CMR 142.700 through
				  142.730
				  as "clinical laboratory services".
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 142.000 - Operation And Maintenance Of Birth Centers › Subpart E - Clinical Laboratory Services › Section 142.710 - Approval of In-house Clinical Laboratory Services

Current through Register 1525, July 5, 2024
In-house clinical laboratory services offered by a birth
				  center are subject to clinical laboratory approval as set forth in
				  105 CMR 180.000: Operation,
				  Approval and Licensing of Clinical Laboratories.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 142.000 - Operation And Maintenance Of Birth Centers › Subpart E - Clinical Laboratory Services › Section 142.720 - Contracting for Outside Clinical Laboratory Services

Current through Register 1525, July 5, 2024
A birth center may enter into a written contract for the
				  provision of all or part of its clinical laboratory services with a laboratory
				  independent of the birth center which is licensed, approved or certified by the
				  appropriate federal or state agencies. The birth center must have detailed
				  written statements of policy on procedures for the collection, transport, and
				  handling of specimens referred to such an outside laboratory, which are
				  available for review by the Commissioner.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 142.000 - Operation And Maintenance Of Birth Centers › Subpart E - Clinical Laboratory Services › Section 142.730 - Affidavits Concerning Clinical Laboratory Services

Current through Register 1525, July 5, 2024
Each birth center shall submit an annual affidavit to the
				  Commissioner specifying the nature of all its testing services, the individuals
				  performing the tests, the individuals responsible for the accuracy of the
				  tests, the methods of testing employed, the quality control practice employed
				  and any other information required by the Department.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 143.000 - Standards Governing Cardiac Rehabilitation Treatment › Section 143.001 - Purpose and Scope

Current through Register 1525, July 5, 2024
St. 1985, c. 628 requires certain health insurance plans to
				provide benefits for the expense of cardiac rehabilitation treatment. St. 1985,
				c. 628 also provides that, in order to be included in such mandatory coverage,
				cardiac rehabilitation treatment must meet standards promulgated by the
				Commissioner of Public Health. The purpose of105 CMR 143.000 is to set
				forth the standards which cardiac rehabilitation treatment must meet under St.
				1985, c. 628. The standards are intended to prescribe the basic
				programcomponents for cardiac rehabilitation, including the baseline
				characteristics of candidates for cardiac rehabilitation. They do not prescribe
				a set course of treatment to individual patients nor do they define the medical
				necessity of the treatment for individual patients. Those aspects of cardiac
				rehabilitation are properly in the realm of the patient's physician and the
				program's professional staff, as well as any additional standards which third
				party payors may set.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 143.000 - Standards Governing Cardiac Rehabilitation Treatment › Section 143.003 - Citation

Current through Register 1525, July 5, 2024
105 CMR 143.000 shall be
				known and may be cited as
				105 CMR 143.000:
Standards Governing Cardiac Rehabilitation
				Treatment
.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 143.000 - Standards Governing Cardiac Rehabilitation Treatment › Section 143.004 - Definitions

Current through Register 1525, July 5, 2024
Physician
shall mean a doctor of
				medicine or doctor of osteopathy who is registered to practice medicine in
				Massachusetts pursuant to M.G.L. c. 112, § 2.
Registered Nurse
shall mean an
				individual registered under M.G.L. c. 112, § 74.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 143.000 - Standards Governing Cardiac Rehabilitation Treatment › Section 143.005 - General Requirements for Cardiac Rehabilitation Programs

Current through Register 1525, July 5, 2024
For the purposes of St. 1985, c. 628, cardiac rehabilitation
				treatment must be provided by a "cardiac rehabilitation program"which meets the
				requirements set forth hereafter in
				105 CMR 143.000.
A "cardiac rehabilitation program" or "CRP" shall mean the
				Phase II and Phase III program components of a multiphasic program of medically
				necessary treatment that is designed to restore and maintain the individual
				with documented cardiovascular disease to optimal physiological and
				psychosocial health. Cardiac rehabilitation treatment shall be initiated within
				26 weeks after the diagnosis of or an event related to cardiovascular disease.
				For the purposes of this section, event related to cardiovascular disease shall
				at a minimum include angioplasty, cardiovascular surgery and myocardial
				infarction.
Phase II
shall mean the outpatient
				convalescent phase of a multiphasic cardiac rehabilitation program that begins
				subsequent to hospital discharge and usually extends for three to 12
				weeks.
Phase III
shall mean the outpatient
				phase of a multiphasic cardiac rehabilitation program that addresses multiple
				risk reduction, adjustment to illness and therapeutic exercise, follows the
				convalescent phase and usually extends for a period of 12 to 26 weeks.
For the purposes of105 CMR 143.000, "cardiac
				rehabilitation program" does not include Phase I (the in-patient phase of a
				multiphasic cardiac rehabilitation program beginning at the time of the cardiac
				event and continuing until the time of hospital discharge) and Phase IV, (that
				phase of a multiphasic cardiac rehabilitation program that begins
				followingcompletionofPhase III and is designed to maintain the patients'
				rehabilitated cardiovascular health).
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 143.000 - Standards Governing Cardiac Rehabilitation Treatment › Section 143.006 - Candidates for Cardiac Rehabilitation Programs

Current through Register 1525, July 5, 2024
(A) All individuals shall enter the cardiac
			 rehabilitation program through a referral from a physician responsible for the
			 individual's care.
(B) Participants
			 in the cardiac rehabilitation program shall be post-operative cardiovascular
			 surgery patients, or shall have documented coronary artery disease verified by
			 a positive exercise tolerance test, thallium scan or coronary angiography, or
			 shall have a documented myocardial infarction.
(C) Each CRP shall develop written admission
			 policies that clearly state admission criteria. Such policies shall
			 specifically define contraindications to admission and shall be approved by the
			 Medical Director.
(D) Each CRP
			 shalldevelopwritten policies that clearly specify the conditions which exclude
			 a patient from engaging in the therapeutic exercise. Such policies shall be
			 approved by the Medical Director.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 143.000 - Standards Governing Cardiac Rehabilitation Treatment › Section 143.007 - Administrative Records

Current through Register 1525, July 5, 2024
(A) Each program
			 shall maintain and have available current, complete, and accurate
			 administrative records in a safe location.
(B) Administrative records shall include:
(1) Updated articles of organization and
			 by-laws, partnership agreement or trust instrument. as appropriate. The
			 documents shall specify the organizational structure of the governing body and
			 the methods of the selection of its members.
(2) Minutes of meetings of the governing body
			 and of the members.
(3) An
			 organizational chart for the entire organization.
(4) Written policies and procedures designed
			 to safeguard the health and safety of patients and staff. These policies and
			 procedures shall be reviewed and updated annually. At a minimum the policies
			 shall address:
(a) Selection of personnel and
			 the qualifications for each position. A job description for each position must
			 be included in the administrative records.
(b) Employee health policies that assure
			 employees are free of communicable disease.
(c) Release of information to another
			 facility, agency, or health care provider.
(d) Obtaining informed consent.
(e) Services which the program
			 provides.
(f) Smoking on the
			 premises. Such policies shall assure the comfort of all patients including
			 patients in waiting areas. In the case of a program operated by a health care
			 facility licensed by the Department, said program shall comply with any
			 regulations concerning smoking that are applicable to such facility.
(g) Informing patients of the admission
			 criteria, services available. and third party coverage and personal
			 charges.
(5) Personnel
			 records for each employee, including evidence of any required license or
			 registration number; documentation of any specialty certification, education
			 and job experience.