reglab/statecodes huggingface dataset:
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 130.000 - Hospital Licensure › Subpart C - SUPPLEMENTARY STANDARDS: IN GENERAL › Section 130.390 - Mammography Facility - Licensure

Current through Register 1525, July 5, 2024
Each hospital operating a mammography facility, as defined in
				  M.G.L. c. 111, § 5Q and
				  105 CMR 127.000:
Licensing of Mammography Facilities
, shall obtain and maintain
				  a license issued pursuant to
				  105 CMR
				  127.000.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 130.000 - Hospital Licensure › Subpart C - SUPPLEMENTARY STANDARDS: IN GENERAL › Section 130.395 - Disposition of Remains Following the Death of a Fetus

Current through Register 1525, July 5, 2024
(A) Hospitals shall have a written policy
				concerning disposition of remains of a fetus following the death of a fetus
				(other than by abortion) irrespective of the duration of the
				pregnancy.
(B) Hospitals shall have
				a written protocol that provides that following the death of a fetus (other
				than by abortion), and irrespective of the duration of the pregnancy, the
				parent is informed:
(1) of the availability of
				counseling, and how to access these services;
(2) of the parent's right to direct either
				burial, entombment, or cremation or disposal of the remains by the
				hospital;
(3) in writing, that
				disposal of the remains by the hospital will be in conformance with state law
				and (105 CMR 480.000:
Minimum Requirements for the Management of Medical or Biological Waste
				(State Sanitary Code Chapter VIII
); and
(4) of the availability of a written
				description of the hospital's policy with respect to the disposition of the
				remains.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 130.000 - Hospital Licensure › Subpart D - SUPPLEMENTARY STANDARDS: PARTICULAR SERVICES › Section 130.510 - Hospital-based Hematopoietic Progenitor/Stem Cell Transplantation Program

Current through Register 1525, July 5, 2024
105 CMR 130.510 through
				  130.580
				  set forth the licensure standards for a hospital-based Hematopoietic
				  Progenitor/Stem Cell Transplantation Program.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 130.000 - Hospital Licensure › Subpart D - SUPPLEMENTARY STANDARDS: PARTICULAR SERVICES › Section 130.527 - Program Requirements

Current through Register 1525, July 5, 2024
(A) The Program
				shall be part of a comprehensive hematopoietic progenitor/stem cell collection,
				processing and transplantation service.
(B) A clinical program that includes
				non-contiguous institutions in the same metropolitan area shall have a single
				Program Director, common protocols, staff training, quality assessment systems,
				review of clinical results and evidence of frequent, regular interaction by all
				members of the multidisciplinary team.
(C) A hospital licensed to provide a
				hematopoietic progenitor/stem cell transplantation program shall provide or
				arrange for collection and processing of hematopoietic progenitor/stem cells
				through collection facilities or services and cell processing laboratories that
				meet (FACT) accreditation standards. Collection facilities and/or processing
				laboratories serving one or more clinical transplantation programs are
				acceptable.
(1) If the collection facility or
				service used by the hospital transplantation program is located outside the
				United States, the collection facility must be affiliated with the National
				Marrow Donor Program (NMDP) or the World Marrow Donor Association
				(WMDA).
(2) The cell processing
				facility shall be:
(a) for facilities located
				within Massachusetts, a licensed, federally certified clinical laboratory, as
				defined under
				42 USC
				263A (the Clinical Laboratory Improvement
				Amendments);
(b) for laboratories
				located outside Massachusetts but within the United States, a federally
				certified clinical laboratory, as defined under
				42 USC
				263A (the Clinical Laboratory Improvement
				Amendments); or
(c) for
				laboratories located outside of the United States, a laboratory that is
				affiliated with the National Marrow Donor Program (NMDP) or the World Marrow
				Donor Association (WMDA).
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 130.000 - Hospital Licensure › Subpart D - SUPPLEMENTARY STANDARDS: PARTICULAR SERVICES › Section 130.535 - Prerequisites for Pediatric Transplantation Program

Current through Register 1525, July 5, 2024
A hospital that provides or intends to provide a
				  hematopoietic progenitor/stem cell transplantation program for pediatric
				  patients shall have a licensed Level III pediatric service.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 130.000 - Hospital Licensure › Subpart D - SUPPLEMENTARY STANDARDS: PARTICULAR SERVICES › Section 130.536 - Prerequisites for Autologous Hematopoietic Progenitor/Stem Cell Transplantation Services Provided in a Freestanding Clinic

Current through Register 1525, July 5, 2024
If, as part of a hospital-based hematopoietic progenitor/stem
				  cell transplantation program, the hospital intends to provide autologous
				  hematopoietic progenitor/stem cell transplantation services in a separately
				  licensed freestanding clinic, the hospital must have a written, current
				  collaboration agreement with that clinic that describes the responsibilities of
				  each entity. The collaboration agreement shall at a minimum:
(1) Describe the services to be provided at
				the clinic site;
(2) Describe the
				support services available at the hospital site, with particular attention to
				availability for patient care consultation by all members of the
				multidisciplinary team, including but not limited to physicians, nurse
				practitioners, physician's assistants, nurses, nutritionists, social workers,
				physical therapists and psychologists;
(3) Describe the oversight responsibilities
				of the hospital;
(4) Identify a
				physician, nurse practitioner, physician's assistant or nurse coordinator on
				site at the clinic;
(5) Describe
				the quality assessment and assurance programs for transplantation at the clinic
				site, with particular attention to how the assessment data is used to improve
				services and how the data is integrated in the both the clinic's and the
				hospital's quality assurance programs; and
(6) Be signed and dated by the Hospital
				Administrator, Hospital Vice President of Nursing or Clinical Services,
				Hospital Hematopoietic Progenitor/Stem Cell Transplantation Program Director,
				Clinic Medical Director and Clinic Physician or Nurse Coordinator.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 130.000 - Hospital Licensure › Subpart D - SUPPLEMENTARY STANDARDS: PARTICULAR SERVICES › Section 130.560 - Renewal of Hematopoietic Progenitor/Stem Cell Transplantation Program Licensure

Current through Register 1525, July 5, 2024
The hospital shall apply for renewal of its approval to
				  perform allogenic and/or autologous hematopoietic progenitor/stem cell
				  transplantation at the time of renewal of the hospital's
				  license.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 130.000 - Hospital Licensure › Subpart D - SUPPLEMENTARY STANDARDS: PARTICULAR SERVICES › Section 130.570 - Reporting to the Department of Public Health

Current through Register 1525, July 5, 2024
As a condition of maintenance and renewal of licensure of the
				  program, the hospital shall submit information as requested by the Department
				  regarding the transplantation service.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 130.000 - Hospital Licensure › Subpart D - SUPPLEMENTARY STANDARDS: PARTICULAR SERVICES › Section 130.580 - Denial, Revocation or Refusal to Renew Licensure of the Transplantation Program Based on Lack of Accreditation by FACT

Current through Register 1525, July 5, 2024
Loss or denial of accreditation shall be reported in writing
				  to the Department within 48 hours of receipt of such notice to the hospital
				  from FACT. Failure to receive or maintain accreditation by FACT shall result in
				  the denial, revocation or refusal to renew the licensure of the transplantation
				  program without further hearing.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 130.000 - Hospital Licensure › Subpart D - SUPPLEMENTARY STANDARDS: PARTICULAR SERVICES › Section 130.605 - Department Designation of Level of Maternal and Newborn Care in a Hospital

Current through Register 1525, July 5, 2024
(A) Each hospital shall file an application
				as directed by the Department identifying the level of maternal and/or newborn
				services which the hospital requests approval to provide.
(B) The Department shall base approval of
				such applications upon documentation submitted by each hospital demonstrating
				compliance with the requirements of the requested level.
(C) After initial designation, the hospital
				shall re-apply for designation of its maternal and/or newborn services each
				time that it applies for renewal of its hospital license.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 130.000 - Hospital Licensure › Subpart D - SUPPLEMENTARY STANDARDS: PARTICULAR SERVICES › Section 130.610 - Establishment of the Statewide Perinatal Advisory Committee

Current through Register 1525, July 5, 2024
The Department may from time to time convene a state
				  Perinatal Advisory Committee to advise the Department on issues related to
				  105 CMR
				  130.615 through
				  130.628
				  (Maternal and Newborn Services). The Advisory Committee shall serve solelyin an
				  advisory capacity and shall not have authority to make binding decisions. The
				  Committee may include representatives of the following groups: physicians,
				  nurses, including nurse practitioners and nurse midwives, hospital
				  administrators, and consumers.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 130.000 - Hospital Licensure › Subpart D - SUPPLEMENTARY STANDARDS: PARTICULAR SERVICES › Section 130.615 - Patient/Family Services

Current through Register 1525, July 5, 2024
(A) Each hospital
				with a maternal and newborn service shall provide culturally and linguistically
				appropriate prenatal, postnatal and family-planning services either directly or
				through referral to an outside agency.
(B) The hospital shall make health education
				materials and activities available in the major languages identified through
				the acute hospital's language needs assessment pursuant to
				105 CMR
				130.1103(A)  and plain
				language.
(C) The hospital shall
				have visitation policies for all service levels that promote parent-infant
				contact and maintenance of the family unit, while providing safety and privacy.
				These written policies shall be made available to families.
(D) The hospital shall develop policies and
				procedures to provide information and referrals, where appropriate, to parents
				of babies with special health needs about resources such as early intervention,
				self-help groups, and other community contacts as soon as possible after
				delivery.
(E) The hospital shall
				develop and implement policies and procedures regarding providing support and
				referral for the family experiencing the death of a newborn, and providing
				families the opportunity to see, hold and participate in the care of their
				infant during and after the dying process.
(F) The hospital shall provide information
				about the Women, Infants and Children (WIC) program's benefits and services. As
				appropriate, staff shall refer patients to the WIC program closest to their
				residence.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 130.000 - Hospital Licensure › Subpart D - SUPPLEMENTARY STANDARDS: PARTICULAR SERVICES › Section 130.616 - Administration and Staffing

Current through Register 1525, July 5, 2024
(A)
Perinatal Committee
. Each maternal and newborn service
				shall establish a multidisciplinary perinatal committee or its equivalent
				responsible for developing a coordinated approach to maternal and newborn care
(2)
Written
				Collaboration and Transfer Agreements
.
(1) Each hospital with a maternal and newborn
				service that is not designated as a Level III service shall develop a written
				collaboration/transfer agreement with at least one primary Level III maternal
				and newborn service. The agreement shall include provisions for consultation;
				guidelines for maternal and newborn transfer, including provision of relevant
				medical information and ongoing patient-centered communications before, during
				and after transport or retro-transfer; provision for professional educational
				offerings; and take into consideration unusual circumstances, such as lack of
				available bed or patient request.
(2) Collaboration/transfer agreements between
				hospitals that regularly transfer patients shall include provisions for
				monitoring the quality of care provided to transfers with a focus on
				outcomes.
(3) A maternal and
				newborn center located close to a level III service in another state may
				develop an agreement with that center, provided the center meets the applicable
				regulations for that state.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 130.000 - Hospital Licensure › Subpart D - SUPPLEMENTARY STANDARDS: PARTICULAR SERVICES › Section 130.619 - Labor-delivery Suite

Current through Register 1525, July 5, 2024
(A)
Labor Room
.
(1) A
				labor room shall meet the Labor Room requirements set forth in administrative
				guidelines of the Department based on the Facility Guidelines Institute's
				Guidelines as referenced in
				105
				CMR 130.107, and additionally must provide
				emergency medications, appropriate clinical equipment to monitor, stabilize and
				resuscitate the mother and newborn(s), and assistive equipment to facilitate
				patient involvement in the delivery process.
(2) Construction of new units or alterations
				or additions to existing maternal and newborn units shall provide a minimum of
				120 square feet per bed in labor rooms.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 130.000 - Hospital Licensure › Subpart D - SUPPLEMENTARY STANDARDS: PARTICULAR SERVICES › Section 130.620 - Birthing Room

Current through Register 1525, July 5, 2024
If the services include birthing room(s), the birthing
				  room(s) shall meet all the requirements of a labor, delivery, recovery room
				  (LDR) in
				  105 CMR
				  130.621.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 130.000 - Hospital Licensure › Subpart D - SUPPLEMENTARY STANDARDS: PARTICULAR SERVICES › Section 130.621 - Labor-delivery - Recovery Room

Current through Register 1525, July 5, 2024
(A) A labor-delivery
				- recovery room shall meet the Labor-delivery - Recovery Room requirements set
				forth in administrative guidelines of the Department based on the Facility
				Guidelines Institute's Guidelines as referenced in
				105
				CMR 130.107, and additionally must provide
				emergency medications, appropriate clinical equipment to monitor, stabilize and
				resuscitate the mother and newborn(s), and assistive equipment to facilitate
				patient involvement in the delivery process.
(B) There shall be written policies and
				procedures for the labor-delivery-recovery room that shall include, at a
				minimum, provisions for the following:
(1)
				Admission criteria.
(2) Criteria
				for transfer to the cesarean/delivery birth room.
(3) Restriction of anesthesia to local or
				regional modes.
(4) Care of the
				normal newborn including the minimum length of time the infant remains in the
				labor-delivery-recovery room.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 130.000 - Hospital Licensure › Subpart D - SUPPLEMENTARY STANDARDS: PARTICULAR SERVICES › Section 130.622 - Labor-delivery - Recovery-postpartum Room (Single Room Maternity Care)

Current through Register 1525, July 5, 2024
(A) A labor-delivery - recovery-postpartum
				room shall meet the Labor-delivery - Recovery-postpartum Room requirements set
				forth in administrative guidelines of the Department based on the Facility
				Guidelines Institute's Guidelines as referenced in
				105
				CMR 130.107, and additionally must provide
				emergency medications, appropriate clinical equipment to monitor, stabilize and
				resuscitate the mother and newborn(s), and assistive equipment to facilitate
				patient involvement in the delivery process.
(B) There shall be written policies and
				procedures for the labor-delivery-recovery- postpartum room that shall include,
				at a minimum, provisions for the following:
(1) Admission criteria.
(2) Criteria for transfer to the
				cesarean/delivery room.
(3)
				Restriction of anesthesia to local or regional modes.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 130.000 - Hospital Licensure › Subpart D - SUPPLEMENTARY STANDARDS: PARTICULAR SERVICES › Section 130.623 - Postpartum Unit

Current through Register 1525, July 5, 2024
(A) A postpartum
				unit shall meet the postpartum room requirements set forth in administrative
				guidelines of the Department based on the Facility Guidelines Institute's
				Guidelines as referenced in
				105
				CMR 130.107, and must also provide emergency
				medications, appropriate clinical equipment to monitor, stabilize and
				resuscitate the mother and newborn(s) and assistive equipment to facilitate
				patient involvement.
(B) Provisions
				shall be made to accommodate the mother and infant in the same room 24 hours a
				day as requested by the mother.
(C)
				Equipment for each room in the postpartum unit shall include at least the
				following:
(1) Suction and oxygen
				capabilities.
(2) Staff emergency
				call system.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 130.000 - Hospital Licensure › Subpart D - SUPPLEMENTARY STANDARDS: PARTICULAR SERVICES › Section 130.624 - Nursery

Current through Register 1525, July 5, 2024
(A) A nursery shall meet the Nursery
				requirements set forth in administrative guidelines of the Department based on
				the Facility Guidelines Institute's Guidelines as referenced in
				105
				CMR 130.107, and additionally must provide
				appropriate clinical equipment to monitor, stabilize and resuscitate the mother
				and newborn(s), and assistive equipment to facilitate patient and family
				involvement.
(B) Each service must
				maintain a well-newborn nursery to accommodate its patients in accordance with
				the hospital's established policies and procedures.
(C) All newborns in the nursery shall at all
				times be in direct view of personnel accountable for them.
(D) Well-newborn nurseries shall ensure
				restricted, secure access. Special care nurseries shall be arranged so that
				entrance is gained solely through a well-lighted anteroom with provision for a
				handwashing and gowning area.
(E)
				The following shall be readily available to the nursery:
(1) Separate and secure refrigerator and
				freezer for storage of breast milk.
(2) Electric breast pump and collection
				kits.
(3) Appropriate facilities
				and necessary equipment for circumcision.
(4) Hearing screening equipment.
(5) Washable infant scales.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 130.000 - Hospital Licensure › Subpart D - SUPPLEMENTARY STANDARDS: PARTICULAR SERVICES › Section 130.626 - Infection Control

Current through Register 1525, July 5, 2024
Each maternal and newborn unit shall develop and implement
				  policies incorporating universal precautions as defined in guidelines issued by
				  the Centers for Disease Control and Prevention, and addressing, at a minimum,
				  the ability for mothers and infants to be placed in isolation together and
				  vaccination of health care professionals.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 130.000 - Hospital Licensure › Subpart D - SUPPLEMENTARY STANDARDS: PARTICULAR SERVICES › Section 130.627 - Records

Current through Register 1525, July 5, 2024
(A)
Maternal Record
. The obstetrics service shall establish and maintain a system for obtaining
				prenatal records or summaries of records of patients at 24 weeks of pregnancy
				(with updates as warranted in accordance with hospital policy) and for making
				them available to the staff of the labor and delivery unit when the patient is
				admitted for delivery. Such records shall be maintained as part of the mother's
				permanent record.
In addition to the requirements for all hospital patient
				  records, the mother's record shall include:
(1) Mother's medical and obstetric history
				including prenatal course.
(2)
				Antenatal blood serology, Rh factor, blood type, HBsAg test, rubella antibody
				and Group B streptococcal culture results. In addition, results of maternal HIV
				testing, if applicable.
(3)
				Admission obstetrical examination including the condition of both mother and
				fetus.
(4) Complete description of
				progress of labor and delivery, signed by the attending physician, or certified
				nurse midwife, including reasons for induction and operative
				procedures.
(5) Type of
				medications, analgesia and anesthesia administered to the patient during labor
				and delivery.
(6) Signed report of
				qualified obstetric or other consultant when such service has been
				obtained.
(7) Names and credentials
				of all those present during delivery.
(8) Description of postpartal course,
				including complications and treatments, signed by the attending physician or
				certified nurse midwife.
(9)
				Medications, including contraceptives, prescribed at discharge.
(10) Infant's condition at birth including
				gestational age, weight, Apgar score, blood type, and results of initial
				physical assessment.
(11) Nursing
				assessment, diagnosis, interventions and teaching.
(12) Method of infant feeding and infant
				feeding plan of care and progress and documentation of lactation care and
				services provided.
(13) If neonatal
				death occurs, cause of death, assessment of the family's coping mechanisms and
				plans for follow-up and/or referral of the family.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 130.000 - Hospital Licensure › Subpart D - SUPPLEMENTARY STANDARDS: PARTICULAR SERVICES › Section 130.628 - Data Collection and Reporting Systems

Current through Register 1525, July 5, 2024
(A) Each maternal and newborn service shall
				complywith reporting requirements in accordance with Department
				guidelines.
(B) The hospital shall
				report the death of a pregnant woman during any stage of gestation, labor or
				delivery or the death of a woman within 90 days of delivery or termination of
				pregnancy to the Department in accordance with Department guidelines.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 130.000 - Hospital Licensure › Subpart D - SUPPLEMENTARY STANDARDS: PARTICULAR SERVICES › Section 130.630 - Level I - Community-based Maternal and Newborn Service

Current through Register 1525, July 5, 2024
The Level I capabilities include the management of
				  uncomplicated pregnancies and the management of pregnancy complications not
				  requiring the facilities and resources of Level IB, IIA, IIB or Level III
				  services. The Level 1 service provides for the care and management of well
				  newborns, stable infants born at 35 weeks gestation, including stable
				  retro-transferred infants not needing Level IB, IIA, IIB or III
				  services.
The Level I Service shall meet all of the General
				  Requirements for Maternal and Newborn Services contained in
				  105 CMR
				  130.601 through
				  130.628
				  and, in addition, the following:
(A)
Administration and Staffing
.
(1) An obstetrician certified by the American
				Board of Obstetrics and Gynecology shall be designated as medical director of
				the maternal service. The medical director or his or her designee shall be
				available on-call 24 hours a day.
(2) A physician certified by the American
				Board of Pediatrics and experienced in the care of newborns shall be designated
				as medical director of the newborn service. The medical director or his or her
				designee shall be available on-call 24 hours a day.
(3) The medical directors of the maternal
				service and the newborn service shall collaborate in the overall medical
				management of the maternal and newborn service.
(4) An obstetrician with full privileges
				shall be available on-call 24 hours a day.
(5) A pediatrician, family practitioner or a
				neonatal nurse practitioner with full privileges shall be available on-call 24
				hours a day.
(6) A registered nurse
				designated by the hospital shall be accountable for the 24 hour nursing
				management of the Level I service. At a minimum, this nurse shall be
				baccalaureate prepared (master's preferred) and have at least two years
				experience in the care of stable newborns.
(7) A registered nurse educator, prepared at
				the baccalaureate level, shall have dedicated responsibility for coordinating
				and providing educational and training activities to enhance staff knowledge of
				relevant procedures and technological advances for staff of the maternal and
				newborn service.
(8)
				Anesthesiologists shall be available in-house or on-call such that emergency
				cesarean deliveries can be started within 30 minutes of the recognition of the
				need for the procedure.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 130.000 - Hospital Licensure › Subpart D - SUPPLEMENTARY STANDARDS: PARTICULAR SERVICES › Section 130.640 - Level IIA and IIIB: Community-based Maternal and Newborn Service with a Special Care Nursery

Current through Register 1525, July 5, 2024
(A)
Level IIA Service
. Level IIA capabilities include the
				management of pregnancies of 34 weeks gestation or greater, and the management
				of pregnancy complications not requiring the facilities and resources of Level
				IIB or Level III services. Level IIA capabilities include the care and
				management of the stable to moderately ill newborn, well newborns, premature
				infants and infants who require special care services (including
				retro-transferred infants).
A service shall be eligible to apply for designation as a
				  Level IIA service with a special care nursery if one of the following
				  conditions is met:
(1) the service has
				a minimum of 1,500 births per year in any one of the past three years prior to
				the initiation of the service designation request; or
(2) the service has satisfactorily
				demonstrated to the Department that a minimum volume of 1,500 births per year
				will be reached in the next three years; or
(3) the service has satisfactorily
				demonstrated to the Department that the hospital meets Level IIA quality and
				competency requirements and therefore the designation is warranted. Following
				the designation, a Level IIA service shall maintain a minimum volume of 1,500
				births.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 130.000 - Hospital Licensure › Subpart D - SUPPLEMENTARY STANDARDS: PARTICULAR SERVICES › Section 130.650 - Level III Maternal and Newborn Service or a Freestanding Pediatric Hospital with Neonatal Subspecialty Services

Current through Register 1525, July 5, 2024
(A)
Level III Service
. The Level III maternal and newborn
				service has the capabilities to provide care for stable to severely ill
				newborns, well newborns, premature infants, and infants who require neonatal
				intensive care services. The maternal service has the capability to manage
				complex maternal conditions with the expertise of a Critical Care Obstetrics
				Team.
(B) A service shall be
				eligible for designation as a Level III service with a neonatal intensive care
				nursery if one of the following conditions is met:
(1) the service has a minimum of 2,000 births
				per year in any one of the past three years; or
(2) the service has satisfactorily
				demonstrated to the Department that a minimum volume of 2,000 births per year
				will be reached in the next three years; or
(3) the service has satisfactorily
				demonstrated that the percent of low birth weight infants (< 2,500 grams)
				delivered is no less than 10% of the annual births.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 130.000 - Hospital Licensure › Subpart D - SUPPLEMENTARY STANDARDS: PARTICULAR SERVICES › Section 130.660 - Minimum Lengths of Stay

Current through Register 1525, July 5, 2024
The minimum length of inpatient stay for mothers and infants
				  shall be 48 hours following a vaginal delivery and 96 hours following a
				  cesarean section. These time periods begin at the time of the infant's birth.
				  Inpatient stays of less than these time frames shall constitute early
				  discharge. No discharge shall occur between the hours of 8:00 P.M. and 8:00
				  A.M. without the mother's agreement. Any decision to shorten these minimum
				  stays shall be made by the attending practitioners for both mother and infant
				  in consultation with and upon agreement by the mother. For the purposes of 105
				  CMR 130.660, attending practitioner shall include obstetrician, pediatrician,
				  family physician, or otherwise qualified attending physician, certified nurse
				  midwife, or nurse practitioner.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 130.000 - Hospital Licensure › Subpart D - SUPPLEMENTARY STANDARDS: PARTICULAR SERVICES › Section 130.661 - Early Discharge Protocols

Current through Register 1525, July 5, 2024
Each hospital operating a maternal and newborn service shall
				  develop protocols governing early discharge for mothers and infants. Protocols
				  shall be developed in collaboration with obstetric, pediatric and nursing
				  practitioners, and shall be consistent with guidelines and early discharge
				  criteria set forth by the American College of Obstetricians and Gynecologists
				  (ACOG) and the American Academy of Pediatrics (AAP) and at a minimum shall
				  provide that early discharge may be considered only when the simultaneous
				  discharge of the mother and infant is feasible and only after environmental and
				  other risk factors affecting the well-being of the mother and infant have been
				  assessed. Nothing in 105 CMR 130.661 shall affect the right of a mother to
				  voluntarily choose an early discharge.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 130.000 - Hospital Licensure › Subpart D - SUPPLEMENTARY STANDARDS: PARTICULAR SERVICES › Section 130.662 - Notices

Current through Register 1525, July 5, 2024
Mothers shall be informed in writing, at the time of
				  admission and with any pre registration materials, in language understandable
				  to the mother and in their own language, by the hospital, payers or insurers
				  subject to the provisions of St. 1995, c. 218, of their rights under
				  105 CMR
				  130.660 through
				  130.669. The
				  notice shall include, but not be limited to, information about the minimum
				  lengths of inpatient stay of 48 hours following a vaginal delivery and 96 hours
				  following a cesarean section; the right to home visits as provided for in
				  105 CMR 130.665
				  following early discharge; and the process and telephone number for filing
				  appeals, if they feel their rights have been violated.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 130.000 - Hospital Licensure › Subpart D - SUPPLEMENTARY STANDARDS: PARTICULAR SERVICES › Section 130.663 - Discharge Plans

Current through Register 1525, July 5, 2024
The hospital shall develop a comprehensive written discharge
				  plan for each mother and newborn for whom an early discharge is contemplated.
				  Said discharge plan, at a minimum, shall identify the mother's and newborn's
				  primary health care providers and specify and arrange for existing, appropriate
				  home care services consistent with ACOG and AAP early discharge
				  guidelines.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 130.000 - Hospital Licensure › Subpart D - SUPPLEMENTARY STANDARDS: PARTICULAR SERVICES › Section 130.664 - Transfer of Clinical Information

Current through Register 1525, July 5, 2024
Each hospital operating a maternal and newborn service shall
				  develop protocols for the transfer of pertinent clinical information concerning
				  the mother and infant to the professional or agency providing the home care
				  services. A minimum standard for content should include specific information on
				  the timing and necessity of performing newborn screening as well as information
				  regarding relevant prenatal, birth and hospital postpartum course of
				  care.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 130.000 - Hospital Licensure › Subpart D - SUPPLEMENTARY STANDARDS: PARTICULAR SERVICES › Section 130.665 - Home Visits

Current through Register 1525, July 5, 2024
Eligible mothers and infants who participate in early
				  discharge shall be provided, upon agreement by the mother, a minimum of one
				  home visit. The first home visit shall occur within 48 hours following
				  discharge of the mother and infant and shall be conducted by a registered
				  nurse, physician, or certified nurse midwife trained in maternal and infant
				  care. Any subsequent visits determined to be clinically necessary shall be
				  provided by a licensed health care professional or appropriately trained
				  individual under the supervision of a licensed health care professional.
				  Subsequent home visits for the mother and infant shall be based on need as
				  determined by the attending practitioners in consultation with the mother.
				  Minimum content of the first home visit includes review of relevant health
				  history, physical examination of the mother and infant, performance of newborn
				  screening tests, assessment/teaching of maternal self-care, infant care,
				  breast/bottle feeding, and the need for social support communication with
				  primary obstetric and pediatric health providers and referral to appropriate
				  follow-up resources. Refusal of any services as specified in 105 CMR 130.665
				  shall be documented.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 130.000 - Hospital Licensure › Subpart D - SUPPLEMENTARY STANDARDS: PARTICULAR SERVICES › Section 130.666 - Appeals

Current through Register 1525, July 5, 2024
Denial of benefits under St. 1995, c. 218 may be appealed to
				  the Department of Public Health. Appeals may be filed by contacting the
				  Department by telephone. The Department shall establish a toll-free telephone
				  number to receive such appeals.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 130.000 - Hospital Licensure › Subpart D - SUPPLEMENTARY STANDARDS: PARTICULAR SERVICES › Section 130.667 - Notification and Request for Information

Current through Register 1525, July 5, 2024
Upon receipt of the appeal, the Department shall immediately
				  contact the hospital, post hospital provider, payers or insurers subject to the
				  provisions of St. 1995, c. 218 as appropriate, and may require that portions of
				  the patient's record be immediately furnished to the
				  Department.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 130.000 - Hospital Licensure › Subpart D - SUPPLEMENTARY STANDARDS: PARTICULAR SERVICES › Section 130.668 - Appeal Decision

Current through Register 1525, July 5, 2024
Upon review of all relevant information, the Department shall
				  make a determination regarding whether the mother or infant has been denied
				  benefits pursuant to
				  105 CMR
				  130.660 through
				  130.669. Such
				  decision shall be communicated to the patient and to the hospital, post
				  hospital provider, payers or insurers subject to the provisions of St. 1995, c.
				  218, by telephone immediately following the receipt of all requested
				  information. The Department shall send written confirmation of its decision
				  within a reasonable period of time.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 130.000 - Hospital Licensure › Subpart D - SUPPLEMENTARY STANDARDS: PARTICULAR SERVICES › Section 130.669 - Stay Pending Appeal

Current through Register 1525, July 5, 2024
The filing of an appeal shall stay any proposed early
				  discharge of the mother and the infant during the pendency of the
				  appeal.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 130.000 - Hospital Licensure › Subpart D - SUPPLEMENTARY STANDARDS: PARTICULAR SERVICES › Section 130.700 - Definitions Applicable to 105 CMR 130.720 Through 130.761

Current through Register 1525, July 5, 2024
Terms used in
				  105 CMR
				  130.720 through
				  130.761
				  shall be interpreted as set forth in 105 CMR 130.700.
General Pediatric Service (Level
				  II)
. A service that provides care for pediatric patients with
				  medical and surgical problems who do not require the specialized pediatric
				  intensive care and/or comprehensive specialized services found on a tertiary
				  pediatric service (Level III). A Level II service must have a pediatric unit
				  with suitable personnel and access to subspecialty consultation, supportive
				  laboratory facilities, and ancillary services necessary to provide for the
				  level of care offered.
Pediatric Patient
. Any inpatient
				  from birth through 21 years of age, other than an infant in a newborn nursery,
				  an intermediate or special care nursery, or a neonatal intensive care unit.
				  Pediatric patients younger than 15 years old must be admitted to a pediatric
				  service. Pediatric patients 15 years of age or older may, at the option of the
				  admitting physician, be cared for on a service other than the pediatric
				  service.
Pediatric Specialty Service
. A
				  hospital or a unit of a hospital that limits the pediatric care it provides to
				  a class of diseases or a subdivision of a department of medicine or
				  surgery.
Pediatric Service
. The combination
				  of personnel, programs, and space needed to provide care for the diagnosis,
				  treatment, and support of pediatric patients.
Pediatric Unit
. The discrete area
				  and equipment designated for the use of pediatric patients.
Tertiary Pediatric Services (Level
				  III)
. A service that includes Level II pediatric care, pediatric
				  intensive care, and comprehensive specialized services. A Level III service
				  must have a wide range of pediatric specialists and subspecialists, 24-hour
				  in-hospital medical coverage by physicians at a minimum in a pediatric
				  residency program, appropriate pediatric laboratory facilities, and a medical
				  school affiliation.
Uncomplicated Pediatric Service (Level
				  I)
. A service that provides care and/or stabilization for
				  pediatric patients with uncomplicated medical and surgical problems who do not
				  require the specialized pediatric intensive care and/or comprehensive
				  specialized services found on a tertiary pediatric service (Level III). A Level
				  I service may perform emergency and selected elective pediatric surgical
				  procedures requiring general or spinal anesthesia in accordance with guidelines
				  developed by the Department. A Level I service need not have a pediatric unit
				  but it must admit all pediatric patients younger than 15 years old to a room or
				  rooms designated primarily for the use of pediatric patients.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 130.000 - Hospital Licensure › Subpart D - SUPPLEMENTARY STANDARDS: PARTICULAR SERVICES › Section 130.720 - Requirements for all Pediatric Services (Levels I-III)

Current through Register 1525, July 5, 2024
Pediatric services (Levels I-III) shall comply with the
				  following requirements:
(A) Hospitals
				providing inpatient care to children younger than 15 years old must admit these
				patients to a level I pediatric area as described in
				105 CMR
				130.730(C)  or a level II
				pediatric unit or sub-unit, or a level III pediatric unit, with the exception
				of those patients who require specialized care that cannot be provided in such
				a pediatric area, unit or sub-unit, such as obstetrics or other care designated
				by the Department.
(B)
(1) Any patient 21 years of age or older may
				be admitted to a pediatric service when in the opinion of the Chiefs of
				Pediatrics, and the Director of Nursing or their designees, he or she has a
				condition most appropriately treated on a pediatric service.
(2) When a temporary medical emergency fills
				the medical/surgical service, and the admission to a pediatric unit or sub-unit
				of certain medical/surgical patients 21 years of age or older poses no danger
				to pediatric patients, such a medical/surgical patient may be admitted to a
				pediatric unit or sub-unit with the approval of the Chief of Pediatrics and the
				Director of Nursing or their designees, provided:
(a) No such patient occupies a bed in the
				same room as a pediatric patient, and
(b) The hospital keeps a log of each such
				admission, which is available for the Department's inspection.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 130.000 - Hospital Licensure › Subpart D - SUPPLEMENTARY STANDARDS: PARTICULAR SERVICES › Section 130.730 - Requirements for Uncomplicated Pediatric Services (Level I)

Current through Register 1525, July 5, 2024
Uncomplicated pediatric services (Level I) must meet the
				  following requirements in addition to those listed in
				  105 CMR
				  130.720:
(A) A physician with pediatric experience
				shall be designated as the Chief of Pediatrics. The Chief of Pediatrics or the
				Chief's designee shall be on call at all times for the care of pediatric
				patients.
(B) A registered nurse
				with clinical pediatric experience must be on duty 24 hours a day for the
				direct supervision of pediatric nursing care.
(C) There must be specific beds within an
				adult care unit designated for pediatric patients. These beds and other
				equipment must be adaptable for pediatric patients younger than 15 years old.
				The area must be equipped with bathroom facilities for the exclusive use of
				pediatric patients.
(D) Social
				services for pediatric patients shall be available in-hospital or through
				consultant arrangements and families of pediatric patients must be made aware
				of social services offered.
(E) At
				a minimum, consultant arrangements shall be made for the provision of physical
				and occupational therapy for pediatric patients.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 130.000 - Hospital Licensure › Subpart D - SUPPLEMENTARY STANDARDS: PARTICULAR SERVICES › Section 130.740 - Requirements for General Pediatric Services (Level II)

Current through Register 1525, July 5, 2024
General pediatric services (Level II) must meet the following
				  requirements in addition to those listed in
				  105 CMR
				  130.720:
(A)
Environment
. The
				hospital must have either:
(1) a discrete unit
				designated for pediatric patients; or
(2) a discrete sub-unit within an adult care
				unit containing beds permanently designated as pediatric beds, provided this
				sub-unit meets the following requirements:
(a)
				Such pediatric beds are located in a specific room, or contiguous specific
				rooms, and such beds and other support equipment are appropriate for pediatric
				patients younger than 15 years old.
(b) The nursing station or sub-station
				serving pediatric patients is adjacent to the room(s) containing beds
				designated for pediatric patients. Observation of these rooms is possible from
				the nursing station or sub-station.
(c) The pediatric service has written
				policies specifying the ages and types of diagnoses of patients who may be
				admitted to the sub-unit for elective and emergency purposes, and the types of
				procedures that may be performed on them.
(d) The pediatric sub-unit is situated in
				such a way that the flow of adult patients through it is discouraged.
(3) The service must have an area
				or areas that are used primarily for recreation or play, and equipped with
				items appropriate for the pediatric patients of the age using the
				areas.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 130.000 - Hospital Licensure › Subpart D - SUPPLEMENTARY STANDARDS: PARTICULAR SERVICES › Section 130.760 - Requirements for Pediatric Specialty Services

Current through Register 1525, July 5, 2024
Pediatric specialty services must apply to the Department, as
				  set forth in guidance by the Department, for designation of the level of their
				  pediatric service as so defined in
				  105 CMR
				  130.700. Absent a waiver from the Department,
				  each such service shall comply with all the requirements for the level of care
				  at which it is designated.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 130.000 - Hospital Licensure › Subpart D - SUPPLEMENTARY STANDARDS: PARTICULAR SERVICES › Section 130.761 - Emergency Service - Pediatric Patients

Current through Register 1525, July 5, 2024
(A)
				All hospitals providing emergency care for pediatric patients, as defined by
				105 CMR
				130.700, shall meet the following
				requirements:
(1) At least one physician with
				training in pediatric resuscitation shall be on duty in the emergency room at
				all times.
(2) A pediatrician or a
				general or family practitioner who regularly sees pediatric patients of all
				ages shall be on call 24 hours a day and available for consultation in the
				emergency room within 30 minutes.
(3) The hospital shall develop and implement
				a policy providing for consultation and/or referral from the emergency room to
				an appropriate pediatric inpatient service.
(4) Equipment and medication necessary for
				pediatric emergency resuscitation shall be readily available in the emergency
				room.
(5) Radiology and laboratory
				services, including appropriately board-certified physicians and technicians,
				shall be available on call 24 hours a day.
(6) The emergency service shall develop and
				implement written policies and procedures for the management of pediatric
				problems.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 130.000 - Hospital Licensure › Subpart D - SUPPLEMENTARY STANDARDS: PARTICULAR SERVICES › Section 130.800 - Hospice Services

Current through Register 1525, July 5, 2024
A hospital that provides a hospice service must be licensed
				  pursuant to
				  105 CMR 141.000:
The Licensure of Hospice Programs
.