Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 130.000 - Hospital Licensure › Subpart D - SUPPLEMENTARY STANDARDS: PARTICULAR SERVICES › Section 130.750 - Requirements for Tertiary Pediatric Services (Level III)

Current through Register 1525, July 5, 2024
Tertiary pediatric services (Level III) must meet the
				  requirements listed in
				  105 CMR
				  130.720 and
				  130.740.
				  In addition, Level III services must meet the following requirements (in case
				  of conflict between these requirements and those listed in
				  105 CMR
				  130.740, Level III services must meet the
				  requirements listed in 105 CMR 130.750) :
(A) At least one social worker with an M.S.W.
				and experience working with pediatric patients and their families must be
				assigned to the pediatric service.
(B) Occupational therapy services must be
				available in-hospital and provided or supervised by an occupational therapist
				with documented experience as a pediatric occupational therapist.
(C) Physical therapy services must be
				available in-hospital and provided or supervised by a physical therapist with
				documented experience as a pediatric physical therapist.
(D) There must be a board certified or board
				eligible radiologist or a radiology resident inhospital at all times.
(E) At least one radiologist and one
				radiology technician in the hospital at all times must have training and
				experience in pediatric radiologyand radiologic technologyrespectively beyond
				that required for board certification in radiology and certification in
				radiologic technology.
(F) There
				must be a pediatric patient recreation program supervised by at least one
				trained activity therapist, whose education and experience is in one or more of
				the following fields: child development, early childhood education, or early
				childhood counseling.
(G) Each
				Level III service must have a pediatric intensive care unit (PICU), discrete
				from the adult ICU, that is designed and staffed to provide for critically ill
				or potentially critically ill pediatric patients who need highly specialized
				intervention and advanced life-support technology. The PICU shall meet the
				following requirements:
(1) The PICU shall be
				directed by a board-certified pediatrician, or a pediatric anesthesiologist
				board-certified in anesthesiology, who has documented special training and
				experience in the care and management of critically-ill pediatric
				patients.
(2) The PICU Director
				shall be assisted by at least one Associate Director who is a board-certified
				pediatrician or anesthesiologist with special training and experience in the
				care and management of critically ill pediatric patients.
(3) A physician who is responsible for the
				PICU patients shall be in-hospital 24 hours a day.
(4) A person capable of intubating and
				resuscitating pediatric patients shall be available within or immediately
				adjacent to the PICU 24 hours a day.
(5) Consultant board-certified physicians
				with training and experience in the following: pediatric surgery,
				cardio-thoracic surgery, neurosurgery, and neurology shall be available to the
				PICU 24 hours a day. Consultants from other subspecialties shall be available
				as necessary.
(6) The hospital
				shall designate a registered nurse who has responsibility and accountability
				for the 24 hour nursing management of the PICU service. She or he shall have at
				least five years of nursing experience, of which at least two years is
				pediatric nursing experience, be bachelor's prepared and meet the
				qualifications for the management position as defined by hospital
				policy.
(7) Registered nurses in
				the PICU shall have had documented experience in either clinical pediatric
				nursing or adult medical/surgical nursing and shall have received specialized
				orientation in the care and management of critically-ill pediatric patients
				prior to assuming PICU staff nurse positions.
(8) The registered nurse/patient ratio in the
				PICU shall be between 1:1 and 1:2, depending upon the number of nursing care
				hours required by each patient in accordance with M.G.L. c. 111, § 231 and
				958 CMR 8.00:
Patient
				Assignment Limits for Registered Nurses in Intensive Care Units in Acute
				Hospitals
.
(9) Support
				personnel Respiratory therapy services necessary to operate, maintain,
				regulate, or repair monitoring and ventilatory equipment shall be available to
				the PICU 24 hours a day.