Section 0720-25-.05 - ADMISSIONS, DISCHARGES, AND TRANSFERS(1) Prior to admission for services, the birthing center shall inform the patient of: (a) The qualifications of the birthing center staff;(b) The risks related to out-of-hospital childbirth;(c) The benefits of out-of-hospital childbirth; and(d) The possibility of referral or transfer if complications arise during pregnancy or labor.(2) The birthing center clinical staff shall obtain the patient's written consent for birthing center services.(3) The signed consent form shall be included with the patient's individual clinical record.(4) The facility shall ensure that no person on the grounds of race, color, national origin, or handicap, will be excluded from participation in, be denied benefits of, or otherwise subjected to discrimination in the provision of any care or service of the facility. The facility shall protect the civil rights of residents under the Civil Rights Act of 1964 and Section 504 of the Rehabilitation Act of 1973.(5) Birthing center patients are limited to those women who are initially determined to be at low risk and who are evaluated regularly throughout pregnancy to assure that they remain at low risk.(6) Each birthing center shall establish a written risk assessment system which shall be a part of the policy and procedure manual. The individual risk assessment shall be included in the patient's clinical record.(7) Written policies, procedures and practice guidelines for management of emergencies and discharge must be developed and implemented.(8) Each birthing center shall have a written agreement with a hospital(s), which is licensed to provide obstetrical services, for emergency care. Each physician practicing or consulting in the birthing center shall have admitting privileges at a designated back-up hospital.(9) The birthing center shall have written practice guidelines which shall include at a minimum:(a) The name, address, telephone numbers and contact persons of the licensed transport service, the hospital licensed to provide emergency obstetrical and neonatal services and other hospitals in the vicinity;(b) The criteria to determine risk status which require medical consultation or transfer to a hospital will be outlined in the clinical practice guidelines; and,(c) The criteria and practice guidelines for transfer shall be readily accessible to clinical staff at all times.(10) The names and telephone numbers of the ambulance service, neonatal transport service, and hospital shall be clearly posted at each telephone in the birthing center.(11) Infant Abandonment. (a) Any birthing center shall receive possession of any newborn infant left on birthing center premises with any birthing center employee or member of the professional medical community, if the infant:1. Was born within the preceding seventy-two (72) hour period, as determined within a reasonable degree of medical certainty;2. Is left in an unharmed condition; and3. Is voluntarily left by a person who purported to be the child's mother and who did not express an intention of returning for the infant.(b) The birthing center, any birthing center employee and any member of the professional medical community at such birthing center shall inquire whenever possible about the medical history of the mother or newborn and whenever possible shall seek the identity of the mother, infant, or the father of the infant. The birthing center shall also inform the mother that she is not required to respond, but that such information will facilitate the adoption of the child. Any information obtained concerning the identity of the mother, infant or other parent shall be kept confidential and may only be disclosed to the Department of Children's Services. The birthing center may provide the parent contact information regarding relevant social service agencies, shall provide the mother the name, address and phone number of the department contact person, and shall encourage the mother to involve the Department of Children's Services in the relinquishment of the infant. If practicable, the birthing center shall also provide the mother with both orally delivered and written information concerning the requirements of these rules relating to recovery of the child and abandonment of the child.(c) The birthing center, any birthing center employee and any member of the professional medical community at such birthing center shall perform any act necessary to protect the physical health or safety of the child.(d) As soon as reasonably possible, and no later than twenty-four (24) hours after receiving a newborn infant, the birthing center shall contact the Department of Children's Services, but shall not do so before the mother leaves the birthing center premises. Upon receipt of notification, the department shall immediately assume care, custody and control of the infant.(e) Notwithstanding any provision of law to the contrary, any birthing center, any birthing center employee and any member of the professional medical community shall be immune from any criminal or civil liability for damages as a result of any actions taken pursuant to the requirements of these rules, and no lawsuit shall be predicated thereon; provided, however, that nothing in these rules shall be construed to abrogate any existing standard of care for medical treatment or to preclude a cause of action based upon violation of such existing standard of care for medical treatment.Tenn. Comp. R. & Regs. 0720-25-.05
Original rule filed March 31, 1998; effective June 12, 1998. Amendment filed September 17, 2002; effective December 1, 2002. Transferred from chapter 1200-08-24 pursuant to Public Chapter 1119 of 2022 effective 7/1/2022.Authority: T.C.A. §§ 4-5-202, 4-5-204, 68-11-202, 68-11-204, 68-11-206, 68-11-209, and 68-11-255.