Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 130.000 - Hospital Licensure › Subpart D - SUPPLEMENTARY STANDARDS: PARTICULAR SERVICES › Section 130.601 - Definitions Applicable to 105 CMR 130.601 through 130.650

Current through Register 1525, July 5, 2024
The following definitions apply in
				  105 CMR
				  130.000 when used with regard to maternal and newborn
				  services:
Antepartum Patient
. Any pregnant
				  woman who is characterized as having a high-risk obstetric complication or a
				  pregnant patient with a medical or surgical condition.
Audiologist
. An audiologist licensed
				  by the Commonwealth of Massachusetts pursuant to the Board of Registration of
				  Speech-language Pathology and Audiology regulations at
				  260 CMR 1.00:
Standards, Complaint and Grievance Procedure
, who meets such
				  requirements for additional experience as defined by the Department in the
				  Universal Newborn Hearing Screening Guidelines.
Birth Hospital
. For the purposes of
				  105 CMR
				  130.000 and
				  142.000:
Operation
				  and Maintenance of Birth Centers
, a hospital with a maternal and
				  newborn service, as designated by the Department pursuant to
				  105 CMR
				  130.000, or a hospital without a maternal and newborn
				  service but with a pediatric service, as designated by the Department pursuant
				  to
				  105 CMR
				  130.700, from which an infant may be
				  initially discharged to home.
Birthing Room
. A room designed to
				  provide family-centered care in a "homelike" environment for low-risk mothers
				  throughout the labor, delivery and immediate recovery periods.
Certified Nurse Midwife
. An
				  individual authorized by the Board of Registration in Nursing under M.G.L. c.
				  112, § 80C and authorized to practice as a nurse-midwife pursuant to
				  244 CMR 4.00:
Advanced
				  Practice Registered Nursing
.
Cesarean/Delivery Room
. A room
				  staffed and equipped to handle low-risk to high-risk deliveries, including
				  cesarean births, and have capabilities of administering all forms of
				  anesthesia, including inhalation agents.
Clinical Nurse Specialist
. A
				  registered nurse with a current license from the Massachusetts Board of
				  Registration in Nursing. For the purpose of 105 CMR 130.601 through
				  130.650,
				  the clinical nurse specialist must be master's prepared with clinical expertise
				  in advance nursing practice in the specialty area of maternal or neonatal
				  health.
Continuing Care Nursery
. A nursery
				  that is specially equipped and staffed to offer a variety of specialized
				  services as specified in
				  105 CMR
				  130.630(E)  to mild or
				  moderately ill infants born at the level IB hospital or to retrotransferred
				  stable - growing or recovery infants who do not require intensive or special
				  care.
Critical Care Obstetrics Team
. A
				  team including representatives from the following available 24 hours a day,
				  seven days a week: Maternal-fetal medicine consultant; in-house obstetrician;
				  in-house nursing staff with demonstrated competency in critical care; in-house
				  anesthesia; inhouse neonatologist and other medical specialties available, as
				  needed, including at a minimum infectious disease, pulmonary, surgery, and
				  cardiology.
Critical Congenital Heart Disease
. A
				  group of defects that cause severe and life-threatening symptoms and require
				  intervention within the first days or first year of life.
Designated Service Levels
. Levels of
				  care based on services provided by the hospital as approved by the Department
				  of Public Health.
Family-centered Care
. A method of
				  providing services that fosters the establishment and maintenance of
				  parent-newborn-family relationships. The family may consist of the parent(s)
				  and child and may include other identified support persons (biologically or
				  nonbiologically related) for the mother and infant.
Family Practitioner
. A physician
				  licensed by the Massachusetts Board of Registration in Medicine who has
				  completed a residency in family medicine, which includes training in internal
				  medicine, pediatrics and obstetrics and is certified or board eligible for
				  certification by the American Board of Family Practice.
Freestanding Pediatric Hospital with Neonatal
				  Subspecialty Services
. A service that has the capabilities to
				  provide care to moderately to severely ill newborns who require neonatal
				  intensive care services and to newborns with medical problems.
Hearing Screening
. A test to detect
				  hearing thresholds of 30 decibels or greater in either ear in the speech
				  frequency range. The methodology shall be one defined as acceptable by the
				  American Academy of Pediatrics and the American Speech and Hearing Association
				  for the purposes of newborn infant hearing screening. The hospital's or birth
				  center's screening outcomes shall meet referral rates established by the
				  Department in the
Universal Newborn Hearing Screening
				  Guidelines
.
Labor Room
. An area in which the
				  mother experiences the first stage of labor.
Labor-delivery Suite
. That part of a
				  maternal and newborn service used to care for patients during labor, delivery
				  and recovery. It shall include physically contiguous labor room(s),
				  cesarean/delivery room(s) and ancillary facilities.
Labor-delivery-recovery-postpartum Room (LDRP or
				  Single-Room Maternity Care)
. A room designed, staffed and equipped
				  to care for mothers, newborns and their families throughout the labor,
				  delivery, recovery and postpartum periods.
Labor-delivery-recovery Room (LDR)
.
				  A room designed, staffed and equipped to care for mothers, newborns and their
				  families throughout the labor, delivery and recovery periods.
Lactation Consultant
. An individual
				  certified as an International Board Certified Lactation Consultant (IBCLC) or
				  an individual with equivalent training and experience.
Level I - Community-based Maternal and Newborn
				  Service
. A community-based maternal and newborn service including
				  Level IA and Level IB services that meets the requirements in
				  105 CMR
				  130.630.
Level IA Service
. A community-based
				  maternal and newborn service with a well newborn nursery that provides for the
				  care and management of maternal conditions consistent with American College of
				  Obstetricians and Gynecologists (ACOG) guidelines, including management of
				  pregnancies judged unlikely to deliver before 35 weeks gestation.
Level IB Service
. A Level I
				  community-based maternal and newborn service with a continuing care nursery
				  that provides for the care and management of maternal conditions consistent
				  with ACOG guidelines, including management of pregnancies judged unlikely to
				  deliver before 35 weeks gestation.
Level II Service
. A community-based
				  maternal and newborn service with a Special Care Nursery including Level IIA
				  and Level IIB services that meets the requirements in
				  105
				  CMR 130.640.
Level IIA Service
. A community-based
				  Level II maternal and newborn service with a Special Care Nursery that provides
				  for the care and management of maternal conditions consistent with ACOG
				  guidelines, including management of pregnancies judged unlikely to deliver
				  before 34 weeks gestation.
Level IIB Service
. A community-based
				  maternal and newborn service with a Special Care Nursery that provides for the
				  care and management of maternal conditions consistent with ACOG guidelines,
				  including management of pregnancies judged unlikely to deliver before 32 weeks
				  gestation.
Level III Maternal and Newborn
				  Service
. A maternal and newborn service that provides for the care
				  and management of maternal conditions consistent with ACOG guidelines,
				  including pregnancies at all gestational ages and that meets the requirements
				  in
				  105
				  CMR 130.650.
Maternal and Newborn Service
. That
				  part of the hospital in which care is routinely delivered to mothers and
				  newborns.
Maternal-fetal Medicine Specialist
.
				  An obstetrician/gynecologist who is licensed by the Massachusetts Board of
				  Registration in Medicine and is certified or board eligible for certification
				  in the subspecialty of maternal-fetal medicine by the American Board of
				  Obstetrics and Gynecology.
Neonatal Fellow
. A physician
				  licensed by the Massachusetts Board of Registration in Medicine who is enrolled
				  in a fellowship in neonatology.
Neonatal Intensive Care Unit
. A unit
				  located either in a hospital with a Level III maternal and newborn service or a
				  freestanding pediatric hospital with neonatology specialty services that
				  provides a comprehensive range of specialty and subspecialty services to
				  severely ill infants.
Neonatal Nurse Practitioner
. An
				  individual authorized by the Massachusetts Board of Registration in Nursing
				  under M.G.L. c. 112, § 80B and authorized to practice as a nurse
				  practitioner pursuant to
				  244 CMR 4.00:
Advanced
				  Practice Registered Nursing
who holds certification as a neonatal
				  nurse practitioner from a nationally recognized accrediting body acceptable to
				  the Board.
Neonatal Resuscitation Program
				  (NRP)
. The American Academy of Pediatrics' course designed to
				  teach resuscitation of the newborn.
Neonatologist
. A physician licensed
				  by the Massachusetts Board of Registration in Medicine who is either certified
				  or board eligible for certification in neonatology by the American Board of
				  Pediatrics.
Newborn Infant
. For the purposes of
				  105 CMR
				  130.000 and
				  142.000:
Operation
				  and Maintenance of Birth Centers
, an infant younger than three months
				  old.
Obstetrician
. A physician licensed
				  by the Massachusetts Board of Registration in Medicine and who is certified or
				  board eligible for certification by the American Board of Obstetrics and
				  Gynecology.
Pediatrician
. A physician licensed
				  by the Massachusetts Board of Registration in Medicine who is certified or
				  board eligible for certification in pediatrics by the American Board of
				  Pediatrics.
Postpartum Unit
. That part of a
				  maternal and newborn service that is used exclusively for postpartum care.
				  Postpartum beds include beds located in labor-delivery-recovery- postpartum
				  rooms.
Recovery Area
. A specifically
				  designated area within the labor-delivery suite used to care for patients
				  recovering immediately after delivery.
Retro-transfer
or
Retrotransferred Infant
. An infant who required
				  transfer to a more acute level facility for diagnosis or treatment not
				  available in the birth hospital, who no longer requires these services, and is
				  transferred back to the birth hospital or to another hospital with the level of
				  service meeting his or her needs.
Risk Assessment of the Infant
. The
				  process of evaluating the newborn to determine whether he or she has special
				  risks or combination of risks for adjustment to extrauterine life, health or
				  survival in order to determine the need for specialized services, which
				  includes a review of social, economic, genetic, and medical history findings
				  prior to delivery or within the newborn period.
Risk Assessment of the Maternal
				  Patient
. The process of medically evaluating the mother to
				  determine whether she has special risks or combination of risks to her own
				  health and well-being or to that of the fetus in order to determine the need
				  for specialized services and which includes a review of social, economic,
				  genetic and/or medical conditions during the antepartal, intrapartal and/or
				  postpartal periods.
Special Care Nursery
. A nursery that
				  is specially equipped and staffed to offer a variety of specialized services to
				  moderately ill infants who do not require intensive care.
Transfer Infant
. Any infant who is
				  transferred from the birth hospital because he or she requires acute services
				  for diagnosis and treatment not available at the birth hospital.
Well Newborn Nursery
. A room housing
				  newborns who do not need continuing care, special care of intensive care
				  newborn services.