Section 11-93-54 - Administration(a) The administrative personnel under the direction of an administrator shall develop and carry out such administrative procedures as are necessary to achieve the objectives and policies of the governing body.(b) The administrator shall establish policies and develop procedures to ensure that all employees are free of infectious diseases. These policies shall include an annual physical examination specifically oriented to rule out infectious disease conducted by a licensed physician. (1) If the tuberculin skin test is significant, a standard chest x-ray and appropriate medical follow up shall be obtained. A yearly chest x-ray for three successive years thereafter shall be required. Additional chest x-rays may be required at the discretion of the director.(2) If the tuberculin skin test is negative, a second skin test shall be done after one week but not later than three weeks after the first test. The results of the second test are to be considered the baseline and are used to determine the appropriate follow up. If the second test is negative it shall be repeated once yearly thereafter until it becomes significant.(3) Any employee who develops evidence of an infectious disease shall be immediately excluded from any duties relating to food handling and direct patient contact and shall remain excluded until such time as a physician certifies that it is safe for the individual to resume normal duties. Skin lesions, respiratory tract symptoms and diarrhea shall be considered presumptive evidence of infectious disease.(4) There shall be adequate documentation that all employees have been fully informed about, and understand, paragraphs (1) to (4).(c) The administrator shall formulate written patient care policies and procedures which shall include but not be limited to: (1) Method for and transfer of mothers and newborns who, during the course of pregnancy or delivery can no longer be considered low risk mothers and newborns.(2) Arrangements for consultation, backup services, transfer and transport of a mother or newborns to a hospital where appropriate care is available. Each hospital shall not be more than thirty minutes transport from birthing room in the facility to definitive treatment room in the hospital. At the discretion of the director, a demonstration trial run may be required. The transfer policy must include advance notice to the hospital.(3) Provision for the education of the mother, family and support persons in birthing and newborn care.(4) Plans for the follow up of mother and newborns after discharge from the birthing facility.(5) Registration of births and fetal deaths in accordance with the laws of the State of Hawaii.[Eff. MAR 3, 1986] (Auth: HRS §§ 321-9, 321-10) (Imp: HRS §§ 321-10, 338-8, 338-8)