Rule 3701-7-11.1 | Freestanding children's hospitals with level III or level IV neonatal care services that provide special delivery services.
(A) A freestanding children's hospital licensed under this chapter may provide special delivery services to pregnant women as part of a comprehensive multidisciplinary program of fetal and neonatal care when it is determined that the fetus, once delivered, will require immediate highly subspecialty neonatal intensive care or neonatal surgery typically provided by a level III or level IV neonatal care service. Special delivery services shall only be available to pregnant women when it is determined, after evaluation of the patient and review of their medical history and other contributing factors leading up to labor and delivery by an appropriately qualified obstetric provider, the woman is less likely to experience intrapartum and postpartum medical and surgical complications.
(B) Each freestanding children's hospital that provides special delivery services shall, in conjunction with contracted obstetric staff or a licensed obstetrical service, develop and follow a patient care plan for both the pregnant woman and the newborn for each delivery. The comprehensive care plan shall, include, at minimum:
(1) A delineation of responsibilities for the provision of obstetrical care and neonatal care, including support personnel and services at all stages of labor;
(2) Provision of antepartum and postpartum care of the pregnant woman, to include supervision by an obstetrician or maternal-fetal medicine specialist, and on-site nursing services provided by a least two registered nurses competent in obstetric care with additional registered nurses based on the acuity of the patient;
(3) Parameters for transfer of the pregnant woman should risks present themselves before, during, or after pregnancy; and
(4) A staffing plan for when actively providing special delivery services, in addition to the requirements of paragraphs (F) to (K) of rule 3701-7-11 of the Administrative Code, that includes, at minimum, the following qualified staff on-site to attend each delivery
(a) An obstetrician or maternal fetal medicine specialist capable of performing a cesarean section;
(b) A neonatologist to attend to the newborn;
(c) Maternal-fetal medicine or fetal surgeon during operative procedures;
(d) A neonatal multidisciplinary team of staff for deliveries, headed by a neonatologist with additional registered nurse staff competent in neonatal care based on the acuity of newborn; and
(e) At least two registered nurses competent in obstetric care with additional registered nurses based on the acuity of the patient.
(C) Each freestanding children's hospital that provides special delivery services shall meet the following:
(1) Rooms in which special delivery services are provided shall meet all requirements for labor, delivery, and recovery rooms as set forth in rule 3701-7-06 of the Administrative Code; and
(2) Perform cesarean deliveries in an operating room that is in or nearby the area where special delivery services are provided.
(D) When being used for delivery, each freestanding children's hospital that provides special delivery services shall have the ability to perform all the following:
(1) An emergency cesarean delivery in accordance with facility policy, but no later than thirty minutes from the time that the decision is made to perform the procedure;
(2) Fetal monitoring; and
(3) Resuscitation and stabilization of newborns and emergency care for the mother and newborn.
Supplemental Information