reglab/statecodes huggingface dataset:
Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 3 - Licensing and Certification › Chapter 93 - Hospitals › Subchapter S - Obstetrical and Newborn Services (Optional) › Section I-9517 - Obstetrical Unit Functions

Current through Register Vol. 50, No. 6, June 20, 2024
A. Obstetrical
					 Level I Unit (Basic Care)
1. General
					 Provisions
a. Care and supervision for low
					 risk pregnancies greater or equal to 35 weeks gestation and postpartum patients
					 who are generally healthy and do not have medical, surgical, or obstetrical
					 conditions that present a significant risk of maternal morbidity or mortality,
					 shall be provided.
b. Participation
					 in the state perinatal quality collaborative, which is under the authority of
					 the Louisiana Commission on Perinatal Care and Prevention of Infant Mortality,
					 is required and defined as reporting national perinatal measures determined by
					 the Louisiana Commission on Perinatal Care and Prevention of Infant
					 Mortality.
c. There shall be a
					 triage system present in policies and procedures for identification,
					 stabilization and referral of high risk maternal and fetal conditions beyond
					 the scope of care of a level I unit, including situations where an infant will
					 require a higher level of care than what may be provided by the neonatal level
					 of care of the facility.
d.
					 Postpartum care facilities shall be available onsite.
e. There shall be capability to provide for
					 resuscitation and stabilization of inborn neonates.
f. The hospital shall have a policy for
					 infant security and an organized program to prevent infant
					 abductions.
g. The hospital shall
					 have a program in place to address the needs of the family, including
					 parent-siblingneonate visitation.
h. The hospital shall have a written transfer
					 agreement with another hospital that has an approved appropriate higher level
					 of care.
i. The hospital shall have
					 the capability to screen, provide brief intervention and refer to treatment
					 through consultation with appropriate personnel for behavioral health
					 disorders, including depression, and substance use disorder.
j. Social services, pastoral care and
					 bereavement services shall be provided as appropriate to meet the needs of the
					 patient population served.
Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 3 - Licensing and Certification › Chapter 93 - Hospitals › Subchapter S - Obstetrical and Newborn Services (Optional) › Section I-9519 - Neonatal Intensive Care [Formerly LAC 48:I.9511]

Current through Register Vol. 50, No. 6, June 20, 2024
A. This §9519 is applicable to those
					 hospitals which provide obstetrical and neonatal services.
B. Levels of Care. There are five established
					 neonatal levels of care units:
1. neonatal
					 level I unit;
2. neonatal level II
					 unit;
3. level III NICU
					 unit;
4. level III surgical NICU;
					 and
5. level IV NICU
					 unit.
Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 3 - Licensing and Certification › Chapter 93 - Hospitals › Subchapter S - Obstetrical and Newborn Services (Optional) › Section I-9521 - Neonatal Unit Functions [Formerly LAC 48:I.9513]

Current through Register Vol. 50, No. 6, June 20, 2024
A. Level I Neonatal Unit (Well Newborn
					 Nursery)
1. General Provisions
a. This unit shall have the capability for
					 resuscitation and stabilization of all inborn neonates in accordance with
					 Neonatal Resuscitation Program (NRP) guidelines. The unit shall stabilize
					 unexpectedly small or sick neonates before transfer to the appropriate advanced
					 level of care.
b. The unit shall
					 stabilize and provide care for infants born at 35 weeks or greater gestation
					 and who remain physiologically stable. The requirements for maternal transport
					 at lesser gestations for transfer to a higher level of care shall be determined
					 by the medical staff and approved by the hospital governing body.
c. This unit shall have the capability to
					 stabilize newborns born at less than 35 weeks gestational age for transfer to
					 higher level of care.
d. This unit
					 shall maintain consultation and written transfer agreements with an approved
					 level II or III as appropriate.
e.
					 This unit shall have a defined, secured nursery area with limited public access
					 and/or secured rooming-in facilities with supervision of access.
f. Parent and/or sibling
					 visitation/interaction with the neonate shall be provided.
Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 3 - Licensing and Certification › Chapter 93 - Hospitals › Subchapter S - Obstetrical and Newborn Services (Optional) › Section I-9523 - Additional Support Requirements [Formerly LAC 48:I.9515]

Current through Register Vol. 50, No. 6, June 20, 2024
A. A bioethics committee shall be available
					 for consultation with care providers at all times.
AUTHORITY
						NOTE: Promulgated in accordance with R.S.
						40:2100-2115.
Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 3 - Licensing and Certification › Chapter 93 - Hospitals › Subchapter T - Pediatric Services (Optional) › Section I-9525 - General Provisions

Current through Register Vol. 50, No. 6, June 20, 2024
A.
					 Pediatric services shall be under the medical direction of a qualified
					 physician who is a member of the medical staff with pediatric privileges and
					 appointed by the governing body. Hospitals admitting children shall have proper
					 facilities for their care apart from adult patients and the newborn. Children
					 under 14 years of age shall not be placed in rooms with adult
					 patients.
B. In hospitals with a
					 separate designated pediatric unit in existence prior to March 1, 1995, the
					 maximum number of beds permitted in each pediatric room shall be eight and
					 shall meet the same spatial standards as specified in Subchapter J of these
					 requirements. In hospitals with a separate designated pediatric unit subsequent
					 to March 1, 1995, the maximum number of beds permitted in each pediatric room
					 shall be four and shall meet the same spatial standards as specified in
					 Subchapter J of these requirements. Patient rooms containing cribs shall
					 provide at least 60 square feet minimum clear floor area for each crib, with no
					 more than six cribs in each room. Provisions for hygiene, toilets, sleeping and
					 personal belongings shall be included where the program indicates that parents
					 are allowed to remain with pediatric patients. Equipment and supplies shall be
					 readily available and appropriate for pediatric services.
AUTHORITY NOTE:
						Promulgated in accordance with R.S.
						40:2100-2115.
Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 3 - Licensing and Certification › Chapter 93 - Hospitals › Subchapter T - Pediatric Services (Optional) › Section I-9527 - Personnel

Current through Register Vol. 50, No. 6, June 20, 2024
A. Every registered
					 nurse who works in the pediatric unit shall be trained in an emergency
					 pediatric nursing course that includes training in pediatric trauma and
					 pediatric advanced life support and that has been conducted pursuant to
					 guidelines established by the Louisiana State Board of Nursing.
AUTHORITY NOTE:
						Promulgated in accordance with R.S.
						40:2100-2115.
Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 3 - Licensing and Certification › Chapter 93 - Hospitals › Subchapter T - Pediatric Services (Optional) › Section I-9529 - Pediatric Intensive Care Units

Current through Register Vol. 50, No. 6, June 20, 2024
A. There are two levels of pediatric care
					 units: Level I; and Level II. If pediatric intensive care services are
					 provided, the hospital shall satisfy the Level II PICU requirements.
B. Levels I and II units shall have a PICU
					 Committee established as a standing committee of the hospital. It shall be
					 composed of at least physicians, nurses, respiratory therapists and other
					 disciplines as appropriate to the specific hospital unit. The committee shall
					 participate in the delineation of privileges for all personnel (both MD and
					 non-MD) within the unit. Policies and procedures shall be established by the
					 medical director and the registered nurse manager in collaboration with the
					 committee and with approval of the medical staff and the governing body. These
					 written policies and procedures shall include, but not be limited to, safety
					 procedures infection control, visitation, admission and discharge criteria,
					 patient monitoring and record keeping, equipment preventive maintenance and
					 repair.
AUTHORITY NOTE:
						Promulgated in accordance with R.S.
						40:2100-2115.
Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 3 - Licensing and Certification › Chapter 93 - Hospitals › Subchapter T - Pediatric Services (Optional) › Section I-9531 - Facilities

Current through Register Vol. 50, No. 6, June 20, 2024
A. The Levels I and
					 II shall be distinct, separate units within the hospital. There shall be clean
					 and soiled utility rooms, isolation room capabilities, medication and a
					 conference area available on the units.
B. Level I units shall be located in the
					 Category 1 facility as defined by the American Academy of Pediatrics.
C. The Emergency Department (ED) shall have a
					 separate covered entrance. Two or more areas within the ED shall have the
					 capacity and equipment to resuscitate any pediatric patient with any medical,
					 surgical or traumatic illness within facilities with Level I units. Hospitals
					 with Level II units only need one such area. The emergency room shall be
					 staffed 24 hours a day in facilities with either Level I of II units.
D. There shall be an operating suite with one
					 room available within 30 minutes and a second room within 45 minutes, 24 hours
					 a day. Hospitals with Level I units must have the capability of providing
					 cardiopulmonary bypass, pediatric bronchoscopy and radiography.
E. Clinical Laboratories
1. Clinical laboratories shall have
					 microspecimen capability and the capability to perform clotting studies with
					 one-hour turn around. There must also be the capability to perform:
a. complete blood cell count;
b. differential count;
c. platelet count;
d. urinalysis;
e. electrolytes;
f. blood urea nitrogen;
g. creatinine;
h. glucose calcium;
i. prothrombin time;
j. partial thromboplastin time; and
k. cerebrospinal fluid cell counts.
Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 3 - Licensing and Certification › Chapter 93 - Hospitals › Subchapter T - Pediatric Services (Optional) › Section I-9533 - Patient Rooms

Current through Register Vol. 50, No. 6, June 20, 2024
A. The head of each
					 bed and/or crib shall be rapidly accessible for emergency airway
					 management.
B. Electrical power,
					 oxygen, medical compressed air and vacuum outlets shall be available at each
					 bed/crib.
C. There shall be walls
					 or curtains available at each bedside to provide for full visual
					 privacy.
AUTHORITY NOTE:
						Promulgated in accordance with R.S.
						40:2100-2115.
Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 3 - Licensing and Certification › Chapter 93 - Hospitals › Subchapter T - Pediatric Services (Optional) › Section I-9535 - Medical Staff

Current through Register Vol. 50, No. 6, June 20, 2024
A. The medical
					 director in Level I units shall be:
1. board
					 certified in pediatrics and board certified or in the process of board
					 certification in pediatric critical care medicine (certification must be
					 completed within five years);
2.
					 board certified in anesthesiology with practice limited to infants and children
					 with special qualifications (as defined by the American Board of
					 Anesthesiology) in critical care medicine; or
3. board certified in pediatric care medicine
					 (as defined by the American Board of Surgery). A Level II medical director
					 shall meet the same criteria of Level I except the board certification in
					 Pediatric Critical Medicine is not required. The medical director shall name a
					 qualified alternate to serve in his or her absence.
Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 3 - Licensing and Certification › Chapter 93 - Hospitals › Subchapter T - Pediatric Services (Optional) › Section I-9537 - Staffing

Current through Register Vol. 50, No. 6, June 20, 2024
A. Levels I and II
					 shall have a unit manager dedicated to the unit who is a registered nurse with
					 specific training and experience in pediatric critical care. The Level I
					 manager shall be certified in critical-care nursing. The registered nurse
					 manager shall name a qualified alternate to act in his/her absence.
1. The staff to patient ratio shall vary with
					 the acuity of the patients; however, the minimum shall be 1:3.
2. There shall be an organized written
					 orientation program as well as an ongoing in-service/continuing education
					 program.
Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 3 - Licensing and Certification › Chapter 93 - Hospitals › Subchapter T - Pediatric Services (Optional) › Section I-9539 - Supplies and Equipment

Current through Register Vol. 50, No. 6, June 20, 2024
A. There
					 shall be lifesaving, therapeutic and monitoring equipment present in Level I
					 and II units. There shall be a complete "code" or "crash" cart available on
					 both Level I and II units. The cart contents available on Level I and II units
					 should include, but not be limited to, approved medications, a
					 defibrillator/cardioverter, automated blood pressure apparatus devices. All
					 equipment shall be of proper size for infants and children. Oxygen tanks are
					 needed for transport and backup for both Levels I and II units.
B. There shall be additional equipment
					 available to meet the needs of the patient population.
C. Level I units shall have the capability of
					 ventilator support.
D. There shall
					 be bedside monitoring in Level I and II PICUs with the capability for
					 continuously monitoring heart rate and rhythm, respiratory rate, temperature
					 and one hemodynamic pressure. Level I units shall also have the ability to
					 monitor systemic arterial, central venous, pulmonary arterial and intracranial
					 pressures. The monitors must have alarms with both high and low settings and
					 they must also have both audible and visible capability. There shall be a
					 maintenance and calibration schedule maintained for all monitoring
					 devices.
AUTHORITY NOTE:
						Promulgated in accordance with R.S.
						40:2100-2115.
Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 3 - Licensing and Certification › Chapter 93 - Hospitals › Subchapter T - Pediatric Services (Optional) › Section I-9541 - Miscellaneous

Current through Register Vol. 50, No. 6, June 20, 2024
A. PICUs shall be
					 integrated with the regional EMS system as available. Rapid access to a poison
					 control center is essential. Each PICU shall have or be affiliated with a
					 transport system and team to assist other hospitals in arranging safe patient
					 transport.
B. Each Level I PICU
					 shall offer pediatric critical care education for EMS providers, emergency
					 department and transport personnel as well as for the general public. The staff
					 nurses and respiratory therapists must also have basic life support
					 certification.
C. Level I PICUs
					 offering a fellowship program in pediatric critical care will possess
					 sufficient patient volume, teaching expertise, and research capability to
					 support such a fellowship. Programs providing sub-specialty training in
					 critical care must possess approval by the residency review committee of the
					 Accreditation Council on Graduate Medical Education. Research is essential for
					 improving our understanding of the pathophysiology affecting vital organ
					 systems. Such knowledge is vital to improve patient care techniques and
					 therapies and thereby decrease morbidity and mortality.
AUTHORITY NOTE:
						Promulgated in accordance with R.S.
						40:2100-2115.
Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 3 - Licensing and Certification › Chapter 93 - Hospitals › Subchapter U - Alternative Birthing Units › Section I-9551 - General Provisions

Current through Register Vol. 50, No. 6, June 20, 2024
A. An
					 alternative birthing unit (ABU) is a unit that is housed within a licensed
					 hospital that provides both obstetrical and neonatal intensive care unit (NICU)
					 level one status at that location. The ABU shall be its own designated unit,
					 separate and apart from any other unit within the hospital.
B. An ABU shall be in compliance with the:
1. American Midwifery Certification
					 Board;
2. American Academy of
					 Pediatrics; and
3. American College
					 of Obstetrics and Gynecology guidelines.
Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 3 - Licensing and Certification › Chapter 93 - Hospitals › Subchapter U - Alternative Birthing Units › Section I-9555 - Program Requirements

Current through Register Vol. 50, No. 6, June 20, 2024
A. An ABU
					 shall have policies/procedures and written criteria for the evaluation of risk
					 status, admission, transfer, discharge, and complications requiring medical or
					 surgical intervention. The policies/procedures and written criteria shall be
					 developed, implemented, enforced, monitored, and reviewed annually by the
					 clinical staff and approved by the governing body.
1. In order for a pregnant woman to be
					 admitted to an ABU, the following admission requirements must be met.
a. The pregnancy shall be deemed low-risk by
					 the licensed practitioner with the expectation of a singleton, vertex, and
					 spontaneous vaginal birth at term without complication.
b. The pregnant woman shall have had
					 consistent prenatal care which began no later than 28 weeks gestation with
					 consistent prenatal screening.
c. A
					 maternal/fetal assessment performed by the CNM shall be completed and
					 documented within one hour of admission to the ABU.
Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 3 - Licensing and Certification › Chapter 93 - Hospitals › Subchapter U - Alternative Birthing Units › Section I-9557 - Policies and Procedures

Current through Register Vol. 50, No. 6, June 20, 2024
A. An ABU
					 shall develop, implement, enforce, monitor, and review annually the policies
					 and procedures specific to the care and services of the mother and newborn. The
					 policies and procedures shall be jointly developed by the medical director and
					 professional staff and adopted by the governing body. These policies and
					 procedures shall include, but are not limited to:
1. staffing;
2. admission criteria;
3. educational services;
4. consent for medical treatment and
					 care;
5. initial and continuing
					 risk assessment by the CNM;
6.
					 criteria for consultation with collaborative physicians;
7. water birth;
8. external fetal monitoring (EFM);
9. nursing assessments;
10. medication administration;
11. laboratory and diagnostic
					 services;
12. dietary
					 services;
13. obstetric and
					 pediatric consultation services;
14. newborn care, including:
a. pulse oximetry heart disease screening;
					 and
b. circumcision of a male
					 newborn by a licensed OB/GYN or other qualified physician as determined by the
					 governing body;
15.
					 emergency procedures for the mother and/or newborn, including:
a. maternal emergent care policy;
b. newborn emergent care policy;
c. maternal transfer to an acute care unit
					 within the hospital or transfer to another hospital;
d. newborn transfer to an acute care unit
					 within the hospital or transfer to another hospital;
e. precipitous delivery; and
f. newborn abduction;
16. family support and participation,
					 including:
a. criteria for labor and delivery
					 attendance; and
b. doula;
17. unique identification for
					 mother and newborn;
18. delivery
					 log;
19. mother/baby couplet
					 aftercare, including:
a. lactation support
					 services;
b. social services;
					 and
c. home health care services,
					 if applicable;
20.
					 maternal and newborn discharge, including:
a.
					 length of stay; and
b. child
					 passenger restraint system;
21. follow-up postpartum and newborn care;
					 and
22. hospital staff on call
					 policy and procedure.
Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 3 - Licensing and Certification › Chapter 93 - Hospitals › Subchapter U - Alternative Birthing Units › Section I-9559 - Physical Environment

Current through Register Vol. 50, No. 6, June 20, 2024
A. An ABU
					 shall submit, meet, and obtain approval for facility plan review from the
					 Office of State Fire Marshall prior to construction.
1. An ABU shall:
a. consist of a minimum of two birthing rooms
					 and one examination room;
b. be
					 located to ensure privacy;
c. be
					 located out of the path of unrelated traffic; and
d. be under the direct supervision of the
					 unit staff.
Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 3 - Licensing and Certification › Chapter 93 - Hospitals › Subchapter U - Alternative Birthing Units › Section I-9561 - Equipment

Current through Register Vol. 50, No. 6, June 20, 2024
A. The governing
					 body and medical staff shall specify the types of equipment that is required
					 for an ABU. This shall include at a minimum:
1. emergency equipment including:
a. an adult emergent care cart labeled and
					 stocked accordingly; and
b. a
					 neonatal emergent care cart labeled and stocked accordingly;
Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 3 - Licensing and Certification › Chapter 93 - Hospitals › Subchapter U - Alternative Birthing Units › Section I-9563 - Services

Current through Register Vol. 50, No. 6, June 20, 2024
A. The ABU shall
					 have patient care services policies that delineate the organization of the
					 unit, qualifications of the staff and requirements for staff to patient
					 ratio.
B. Unit Organization
1. Care in an ABU shall be under the
					 direction of a CNM.
a. A CNM and a registered
					 nurse shall be available per hospital on call policy to ensure 24-hour coverage
					 for patient care.
b. Qualified
					 professional clinical staff shall monitor the patient's progress in labor with
					 ongoing assessments of maternal/fetal reactions to the process of labor, within
					 accepted professional standards.
Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 3 - Licensing and Certification › Chapter 93 - Hospitals › Subchapter U - Alternative Birthing Units › Section I-9565 - Medical Records Requirements

Current through Register Vol. 50, No. 6, June 20, 2024
A. The
					 medical record of the mother and newborn shall include, but not be limited to,
					 the following documentation:
1. informed
					 consent signed by the patient and the CNM;
2. demographic and patient
					 information;
3. family, medical,
					 social, reproductive, nutrition and behavioral history;
4. initial maternal assessment and
					 examination;
5. evaluation of
					 maternal/fetal risk factors;
6.
					 written orders for maternal/fetal and newborn care;
7. laboratory and/or diagnostic test
					 results;
8. documentation of
					 maternal/fetal and newborn monitoring;
9. postpartum assessments;
10. physical assessment of newborn, e.g.,
					 Apgar score, weights, measurements;
11. labor and discharge summaries;
					 and
12. educational instructions
					 for postpartum and newborn home care, follow ups, and referrals.
Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 3 - Licensing and Certification › Chapter 93 - Hospitals › Subchapter U - Alternative Birthing Units › Section I-9567 - Pharmaceutical Services

Current through Register Vol. 50, No. 6, June 20, 2024
A. The ABU
					 shall follow hospital policies and procedures for pharmaceutical services
					 regarding the procurement, storage, distribution and control of all
					 medications. The ABU shall be in compliance with all local, state, and federal
					 regulations.
AUTHORITY NOTE:
						Promulgated in accordance with R.S.
						40:2100-2115.
Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 3 - Licensing and Certification › Chapter 93 - Hospitals › Subchapter V - Newborn Safety Devices › Section I-9573 - General Provisions

Current through Register Vol. 50, No. 6, June 20, 2024
A. In
					 accordance with the Louisiana Children's Code (La. Ch. Code 1149 et seq.), a
					 parent may leave an infant in a newborn safety device (NSD) that is physically
					 located inside a facility which is licensed as a hospital in accordance with
					 R.S.
					 40:2100 et seq., and has an emergency
					 department that is staffed 24 hours per day.
B. Each NSD shall meet all of the following
					 specifications:
1. voluntarily installed in
					 the designated hospital;
2.
					 installed in a location that ensures the anonymity of the relinquishing
					 parent;
3. installed in a
					 climate-controlled environment consistent with the internal temperature of the
					 hospital;
4. installed by a
					 licensed contractor in accordance with manufacturer's
					 recommendations;
5. have an access
					 door that locks automatically upon closure when an infant is in the
					 device;
6. have a supporting frame
					 that is anchored so as to align the bed portion of the NSD directly beneath the
					 access door and prevent movement of the unit as a whole; and
7. feature a safe sleep environment which
					 includes a firm, flat bassinet mattress and a sheet that fits snugly on and
					 overlaps the mattress, and is free of pillows, bumpers, blankets and other
					 bedding.
Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 3 - Licensing and Certification › Chapter 96 - Hospitals-Crisis Receiving Centers › Subchapter A - General Provisions › Section I-9601 - Introduction

Current through Register Vol. 50, No. 6, June 20, 2024
A. A hospital
					 crisis receiving center is a specialty unit of a hospital that provides health
					 care services to individuals who are experiencing a behavioral health
					 crisis.
B. Crisis receiving centers
					 shall receive, examine, triage, refer or treat individuals that present to the
					 unit and are in need of assistance with a behavioral health crisis.
AUTHORITY NOTE:
						Promulgated in accordance with R.S.
						40:2100-2115.
Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 3 - Licensing and Certification › Chapter 96 - Hospitals-Crisis Receiving Centers › Subchapter A - General Provisions › Section I-9603 - Licensure Requirements

Current through Register Vol. 50, No. 6, June 20, 2024
A. All
					 crisis receiving center specialty units shall be licensed by the department and
					 shall comply with the provisions of
					 §9333 of these
					 hospital licensing standards.
B. A
					 crisis receiving center specialty unit (CRC-SU) shall have approval from the
					 Office of Behavioral Health (OBH) and/or the appropriate human service district
					 or authority before applying to become licensed as part of the
					 hospital.
C. Prior to securing
					 licensure and operating the CRC-SU, the hospital shall submit architectural
					 plans of the CRC-SU to the Office of the State Fire Marshal (OSFM) for
					 licensing approval.
D. A CRC-SU
					 shall not operate until it has been licensed by the Health Standards Section
					 (HSS) as a specialty unit of the hospital. No retroactive licenses shall be
					 granted.
E. A CRC-SU shall be
					 located in a designated area of the hospital or offsite campus of the hospital.
					 The CRC-SU shall not relocate to another location, even within the hospital,
					 without prior written approval from HSS.
F. If the CRC-SU is located at the main
					 campus of the hospital, the hospital shall have a dedicated emergency
					 department which shall comply with all Emergency Medical Treatment and Active
					 Labor Act (EMTALA) regulations.
G.
					 If the CRC-SU is located at an offsite campus or is at a free-standing
					 psychiatric hospital which does not have a dedicated emergency department, the
					 CRC-SU shall be considered a dedicated emergency department. The CRC-SU shall
					 comply with all EMTALA regulations if the unit meets one of the following
					 criteria:
1. the entity is licensed by the
					 state as an emergency department of the hospital;
2. holds itself out to the public as
					 providing emergency care; or
3.
					 during the preceding calendar year, the entity provided at least one-third of
					 its outpatient visits for the treatment of emergency medical
					 conditions.
Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 3 - Licensing and Certification › Chapter 96 - Hospitals-Crisis Receiving Centers › Subchapter A - General Provisions › Section I-9605 - Licensing Process

Current through Register Vol. 50, No. 6, June 20, 2024
A. The hospital
					 shall submit the following items to the department in order to add a CRC-SU to
					 its existing license:
1. a licensing
					 application on the department's designated form;
2. the required licensing fee, if
					 applicable;
3. a copy of the
					 prerequisite approval from OBH and/or the appropriate human service district or
					 authority; and
4. other
					 documentation as required by the department, including a current Office of
					 Public Health (OPH)/Sanitation approval and Office of State Fire Marshal
					 approval for occupancy and licensing plan review.
Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 3 - Licensing and Certification › Chapter 96 - Hospitals-Crisis Receiving Centers › Subchapter A - General Provisions › Section I-9607 - Discharges, Referrals or Transfers

Current through Register Vol. 50, No. 6, June 20, 2024
A. Patients who are discharged home from the
					 CRC-SU shall be given verbal and written discharge instructions and any
					 referral information, including information for appointments regarding
					 follow-up care and treatment.
B. If
					 it is deemed necessary that the patient be admitted for inpatient behavioral
					 health services, the CRC-SU shall provide an appropriate and immediate
					 mechanism for transporting the individual to such inpatient facility. Copies of
					 pertinent patient information shall be transferred to the treating
					 facility.
C. The CRC-SU shall
					 establish and implement a standard method of follow-up to ensure that the
					 patient has been received and engaged in the referred service(s).
AUTHORITY NOTE:
						Promulgated in accordance with
						R.S.
						36:254 and R.S.
						40:2100-2115.
Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 3 - Licensing and Certification › Chapter 96 - Hospitals-Crisis Receiving Centers › Subchapter A - General Provisions › Section I-9609 - Training Requirements

Current through Register Vol. 50, No. 6, June 20, 2024
A. A CRC-SU
					 shall ensure that all staff providing direct patient care has documentation of
					 successful completion of crisis services and intervention training in
					 accordance with this Chapter.
B.
					 Crisis services and intervention training shall include, but is not limited to
					 the following:
1. an organized training
					 program that includes an initial 40 hours of training to be completed upon hire
					 and a minimum of 12 hours of training to be completed annually thereafter.
					 Required training includes, but is not limited to the following areas:
a. components of the crisis cycle;
b. recognizing the signs of anxiety and
					 escalating behavior;
c. therapeutic
					 communication;
d. high-risk
					 behavior assessment techniques;
e.
					 verbal de-escalation techniques;
f.
					 positive behavior management and limit-setting;
g. nonviolent physical intervention
					 techniques;
h. establishing a
					 therapeutic rapport and professional boundaries;
i. levels of observation;
j. maintaining a safe and therapeutic
					 milieu;
k. an overview of mental
					 illness and substance abuse diagnoses and treatment;
l. safe application of physical and
					 mechanical restraints;
m. physical
					 assessment of the restrained individual;
n. statutes, regulations, standards and
					 policies related to seclusion and restraint;
o. confidentiality and Health Insurance
					 Portability and Accountability Act (HIPAA) regulations; and
p. an overview of behavioral health settings
					 and levels of care.
Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 3 - Licensing and Certification › Chapter 96 - Hospitals-Crisis Receiving Centers › Subchapter B - Level I Crisis Receiving Centers › Section I-9615 - General Provisions

Current through Register Vol. 50, No. 6, June 20, 2024
A. A Level
					 I CRC-SU shall operate 24 hours per day, seven days per week.
B. The length of a patient stay for a Level I
					 CRC-SU shall not exceed 24 hours, unless there is documented evidence of the
					 CRC-SU's measures taken to transfer the patient to the appropriate level of
					 needed care and the reasons the transfer of the patient exceeds 24
					 hours.
C. Services required of a
					 Level I CRC-SU include, but are not limited to:
1. 24-hour telephone hotline;
2. triage and screening services;
3. assessment services, including medication
					 management;
4. brief intervention
					 and stabilization; and
5. linking
					 and referral services.
Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 3 - Licensing and Certification › Chapter 96 - Hospitals-Crisis Receiving Centers › Subchapter B - Level I Crisis Receiving Centers › Section I-9617 - Level I Services

Current through Register Vol. 50, No. 6, June 20, 2024
A. 24-Hour
					 Telephone Hotline
1. A Level I CRC-SU shall
					 either maintain a telephone hotline that operates 24 hours per day, seven days
					 per week or enter into a formal cooperative agreement with an existing 24-hour
					 hotline as specified in the region's crisis response systems plan.
2. The hotline shall be staffed at all times
					 by trained crisis workers.
a. A trained
					 crisis worker is one who is:
i. trained in
					 the assessment and management of crisis phone calls;
ii. able to assess the priority of the call;
					 and
iii. able to provide
					 interventions that are appropriate to the level of acuity of the
					 caller.
b. The trained
					 crisis worker shall have resource data available whenever calls are answered in
					 order to facilitate crisis intervention.
c. The trained crisis worker shall have the
					 ability to provide active intervention (i.e. contacting emergency medical
					 services, police, fire department, etc.) in life-threatening
					 situations.
3. The
					 CRC-SU shall have written procedures for handling crisis calls.
4. The telephone settings shall be set up so
					 as to protect the confidentiality of callers.
5. The CRC-SU shall have well written
					 procedures to expand the facility's capacity to handle multiple calls coming
					 into the CRC-SU simultaneously.
Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 3 - Licensing and Certification › Chapter 96 - Hospitals-Crisis Receiving Centers › Subchapter B - Level I Crisis Receiving Centers › Section I-9619 - Staffing Requirements

Current through Register Vol. 50, No. 6, June 20, 2024
A. A Level
					 I CRC-SU shall be under the direction of a qualified member of the medical
					 staff of the hospital.
B. A Level I
					 CRC-SU shall have the following staff on duty at all times:
1. a registered nurse in charge of the unit
					 who meets the following criteria:
a.
					 currently licensed in Louisiana and in good standing;
b. has one year of experience in the field of
					 behavioral health; and
c. has
					 documented crisis services and intervention training in accordance with the
					 provisions of this Chapter; and
Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 3 - Licensing and Certification › Chapter 96 - Hospitals-Crisis Receiving Centers › Subchapter B - Level I Crisis Receiving Centers › Section I-9621 - Physical Environment

Current through Register Vol. 50, No. 6, June 20, 2024
A. A Level
					 I CRC-SU shall be located in an exterior area of the hospital which is easily
					 accessible to patients seeking CRC-SU services. Patients shall not be required
					 to go through other areas of the hospital to get to a Level I CRC-SU. The
					 CRC-SU may share an entrance with an emergency department.
1. A Level I CRC-SU may also be located in a
					 licensed offsite location of the hospital.
Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 3 - Licensing and Certification › Chapter 96 - Hospitals-Crisis Receiving Centers › Subchapter C - Level II Crisis Receiving Centers › Section I-9631 - General Provisions

Current through Register Vol. 50, No. 6, June 20, 2024
A. A Level
					 II CRC-SU is an intermediate level of care unit that provides for:
1. an increased opportunity for
					 observation;
2. improved diagnostic
					 accuracy;
3. brief
					 interventions;
4. psychotropic
					 medications;
5. the ability to
					 denote response to intervention; and
6. an appropriate referral and coordination
					 of care for extended services as necessary.
Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 3 - Licensing and Certification › Chapter 96 - Hospitals-Crisis Receiving Centers › Subchapter C - Level II Crisis Receiving Centers › Section I-9633 - Level II Services

Current through Register Vol. 50, No. 6, June 20, 2024
A. In addition
					 to the services required in
					 §9617 of this
					 Chapter, the Level II CRC-SU shall provide the following services.
1. A Level II CRC-SU shall provide continuous
					 observation of the patient in order to determine the following:
a. adherence to the initial service
					 plan;
b. response to
					 medications;
c. response to
					 therapeutic interventions; and
d.
					 evidence of deterioration or stabilization of behaviors.
Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 3 - Licensing and Certification › Chapter 96 - Hospitals-Crisis Receiving Centers › Subchapter C - Level II Crisis Receiving Centers › Section I-9635 - Staffing Requirements

Current through Register Vol. 50, No. 6, June 20, 2024
A. A Level
					 II CRC-SU shall meet all of the staffing requirements of the Level I CRC-SU in
					 addition to the following requirements.
1. A
					 Level II CRC-SU shall have an RN in charge of the unit at all times. This RN
					 may be the same nurse in charge of the Level I CRC-SU, providing he/she is not
					 assigned to provide patient care to patients in the Level II CRC-SU.
2. The Level II CRC-SU shall have sufficient
					 numbers and types of qualified staff on duty and available at all times to
					 provide necessary care, services, treatment and safety, based on the acuity of
					 the patients, the mix of the patients present in the CRC-SU, the need for
					 extraordinary levels of care and to meet the needs of the patient throughout
					 the length of any patient stay in the CRC-SU.
Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 3 - Licensing and Certification › Chapter 96 - Hospitals-Crisis Receiving Centers › Subchapter C - Level II Crisis Receiving Centers › Section I-9637 - Physical Environment

Current through Register Vol. 50, No. 6, June 20, 2024
A. A Level
					 II CRC-SU shall meet the physical requirements of a Level I CRC-SU unless
					 otherwise specified herein.
B. A
					 Level II-CRC-SU may be located in an interior area of the hospital provided
					 that it is immediately adjacent to the Level I CRC-SU.
1. A Level II CRC-SU may be located in a
					 licensed offsite location of the hospital.
Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 3 - Licensing and Certification › Chapter 97 - Nursing Facilities › Subchapter A - General Provisions › Section I-9703 - Licensing Process

Current through Register Vol. 50, No. 6, June 20, 2024
A. All nursing
					 facilities shall be licensed by the department. It shall be unlawful to operate
					 a nursing facility without possessing a current, valid license issued by the
					 department. The department is the only licensing authority for nursing
					 facilities in Louisiana. Each nursing facility shall be separately
					 licensed.
B. An institution that is
					 primarily for the care and treatment of mental diseases cannot be a skilled
					 nursing facility or nursing facility.
C. A nursing facility shall be in compliance
					 with all required federal, state and local statutes, laws, ordinances, rules,
					 regulations and fees.
D. A nursing
					 facility license shall:
1. be issued only to
					 the person or entity named in the license application;
2. be valid only for the nursing facility to
					 which it is issued and only for the specific geographical address of that
					 nursing facility;
3. be valid for
					 up to one year from the date of issuance, unless revoked, suspended, modified
					 or terminated prior to that date, or unless a provisional license is
					 issued;
4. expire on the expiration
					 date listed on the license, unless timely renewed by the nursing
					 facility;
5. not be subject to
					 sale, assignment, donation or other transfer, whether voluntary or involuntary;
					 and
6. be posted in a conspicuous
					 place on the licensed premises at all times.
Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 3 - Licensing and Certification › Chapter 97 - Nursing Facilities › Subchapter A - General Provisions › Section I-9704 - Alzheimer's Special Care Disclosure

Current through Register Vol. 50, No. 6, June 20, 2024
A. Any provider offering a special program
					 for persons with Alzheimer's disease or a related disorder must disclose the
					 form of care or treatment that distinguishes it as being especially applicable
					 to or suitable for such persons. For the purpose of this section, a related
					 disorder means progressive, incurable dementia.
B. Prior to entering into any agreement to
					 provide care, a provider must make the disclosure to:
1. any person seeking services within an
					 Alzheimer's special care program; or
2. any person seeking such services on behalf
					 of a person with Alzheimer's disease or a related disorder within an
					 Alzheimer's special care program. A provider must make the disclosure upon
					 characterizing programs or services as specially suited for persons with
					 Alzheimer's disease or a related disorder. Additionally, a provider must give
					 copies of current disclosure forms to all designees, representatives or
					 sponsors of persons receiving treatment in an Alzheimer's special care
					 program.
Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 3 - Licensing and Certification › Chapter 97 - Nursing Facilities › Subchapter A - General Provisions › Section I-9705 - Initial Licensing Application Process

Current through Register Vol. 50, No. 6, June 20, 2024
A. An initial application for licensing as a
					 nursing facility shall be obtained from the department. A completed initial
					 license application packet for a nursing facility shall be submitted to and
					 approved by the department prior to an applicant providing nursing facility
					 services. The completed initial licensing application packet shall include:
1. a completed nursing facility licensure
					 application and the non-refundable licensing fee as established by statute. All
					 fees shall be submitted by certified or company check or U.S. Postal money
					 order only, made payable to the department. All state owned nursing facilities
					 are exempt from fees;
2. a copy of
					 the released architectural plan review project report for the nursing facility
					 from OSFM;
3. a copy of the on-site
					 inspection report with determination as acceptable for occupancy by
					 OSFM;
4. a copy of the health
					 inspection report with approval of occupancy from the Office of Public Health
					 (OPH);
5. a disclosure of the name
					 and address of all individuals with 5 percent or more ownership interest, and
					 in the instance where the nursing facility is a corporation or partnership, the
					 name and address of each officer or director, and board members;
6. a disclosure of the name of the management
					 firm and employer identification number, or the name of the lessor
					 organization, if the nursing facility is operated by a management company or
					 leased in whole or in part by another organization;
7. if applicable, clinical laboratory
					 improvement amendments (CLIA) certificate or CLIA certificate of
					 waiver;
8. a floor sketch or
					 drawing of the premises to be licensed; and
9. any other documentation or information
					 required by the department for licensure.
Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 3 - Licensing and Certification › Chapter 97 - Nursing Facilities › Subchapter A - General Provisions › Section I-9709 - Changes in Licensee Information

Current through Register Vol. 50, No. 6, June 20, 2024
A. Any change regarding the nursing facility
					 name, "doing business as" name, mailing address, phone number or any
					 combination thereof, shall be reported in writing to the department within five
					 days of the change. Any change regarding the nursing facility name or "doing
					 business as" name requires a change to the nursing facility license and shall
					 require the appropriate fee for the issuance of an amended license.
B. A change of ownership (CHOW) of the
					 nursing facility shall be reported in writing to the department at least five
					 days prior to the change of ownership.
1. The
					 license of a nursing facility is not transferable or assignable. The license
					 cannot be sold.
2. In the event of
					 a CHOW, the new owner shall submit the legal CHOW document, all documents
					 required for a new license, and the applicable licensing fee. Once all of the
					 application requirements are completed and approved by the department, a new
					 license shall be issued to the new owner.
3. A nursing facility that is under license
					 revocation, provisional licensure or denial of license renewal may not undergo
					 a CHOW.