Section 410 IAC 39-5-2 - Neonatal Level II facility requirementsAuthority: IC 16-21-13-5
Affected: IC 16-21-13
Sec. 2.
(a) A Neonatal Level II facility is a Neonatal Level I facility plus the ability to provide specialty care for infants born at thirty-two (32) weeks gestation or more and weighing one thousand five hundred (1,500) grams or more at birth who have physiologic immaturity or who are moderately ill with problems that are expected to resolve rapidly and who would not be anticipated to need subspecialty-level services on an urgent basis. Level II facilities can stabilize ill newborn infants who are born at less than thirty-two (32) weeks gestation until they can be transferred to a facility where the appropriate level of neonatal care is provided. In addition to the requirements of a Neonatal Level I facility, a Neonatal Level II facility shall meet the requirements set forth in this section.(b) A Neonatal Level II facility shall demonstrate as follows its capability of providing neonatal care through written standards, protocols, guidelines, and training, including (Neonatal Level I plus the following):(1) Each Neonatal Level II facility shall have the following facility capabilities: (A) Provide care for infants convalescing after intensive care.(B) Accept risk-appropriate neonatal transports.(C) Provide either: (i) mechanical ventilation for brief duration (less than twenty-four (24) hours);(ii) continuous positive airway pressure (CPAP); or(2) Each Neonatal Level II facility shall have the equipment necessary to provide CPAP or mechanical ventilation.(3) The medication requirements for Neonatal Level II are the same as for Neonatal Level I.(4) Each Neonatal Level II facility shall have a written plan for accepting neonates as back transports for ongoing convalescent care, including accepting patient information on the required case.(c) Each Neonatal Level II facility shall ensure the following staffing requirements are met, including (Neonatal Level I plus the following): (1) Physician services, as follows: (A) Provider board certified in pediatrics or in neonatal-perinatal medicine shall be a member of the medical staff, have privileges for neonatal care, and have responsibility for neonatal unit services.(B) The hospital shall have consulting relationships in place with a pediatric cardiologist, a surgeon, and an ophthalmologist who has experience and expertise in neonatal retinal examination.(2) Nursing services, as follows: (A) Nursing care shall be under the leadership of a registered nurse (RN) with demonstrated expertise in perinatal care.(B) RN skilled in the recognition and nursing management of the neonate with complications readily available at all times.(3) Care of newborn infants at high risk shall be provided by appropriately qualified personnel including pediatricians, neonatologists, pediatric hospitalists, or advance practice providers. This specialized personnel shall be physically present at all times when an infant is maintained on a ventilator.(4) Personnel, such as physicians, specialized nurses, respiratory therapists, radiology technicians, and laboratory technicians, readily available at all times to provide ongoing care and to address emergencies.(5) Respiratory therapist experienced in the delivery of CPAP, mechanical ventilation, or both, readily available at all times.Indiana State Department of Health; 410 IAC 39-5-2; filed 8/14/2019, 3:32 p.m.: 20190911-IR-410180416FRA