Section 0720-31-.04 - ADMISSIONS, DISCHARGES AND TRANSFERS(1) A Basic, Primary, or General Facility shall be capable of providing resuscitation, stabilization and timely triage for all pediatric patients and, when appropriate, transfer of patients to a higher-level facility. A Basic, Primary, or General Pediatric Emergency Facility is responsible for having appropriate transfer agreements to assure that all pediatric patients receive timely emergency care at the most appropriate pediatric facility available to a specific region. Each facility shall be linked with a Comprehensive Regional Pediatric Center for pediatric consultation.(2) A Primary Pediatric Emergency Facility shall support Basic Facilities within a region when necessary by having triage and transfer agreements to receive appropriate patients as a part of a regional pediatric care network.(3) A General Pediatric Emergency Facility shall support the Basic and Primary Facilities within a region by having triage and transfer agreements to receive appropriate patients as a part of a regional pediatric care network.(4) A General Pediatric Emergency Facility shall have a defined separate pediatric inpatient service with a department of pediatrics within the medical staff structure.(5) A Comprehensive Regional Pediatric Center shall:(a) Assist with the provision of regional pre-hospital direct medical control for pediatric patients.(b) Promote a regional network of direct medical control by lower-level hospitals within the region by working closely with the regional Emergency Medical Services medical director to assure: 1. Standards for pre-hospital care;2. Triage and transfer guidelines; and3. Quality indicators for pre-hospital care.(c) Accept all patients from a defined region who require specialized care not available at lower-level hospitals within the region through: 1. Prearranged transfer agreements that network hospitals within a region to assure appropriate inter-emergency department triage and transfer to assure optimum care for seriously and critically ill or injured pediatric patients; and2. Prearranged transfer agreements for pediatric patients needing specialized care not available at the Comprehensive Regional Pediatric Center (e.g., burn specialty unit, spinal cord injury unit, specialized trauma care or rehabilitation facility).(d) Assure a pediatric transport service that:1. Is available to all regional participating hospitals;2. Provides a network for transport of appropriate patients from all regional hospitals to the Comprehensive Regional Pediatric Center or to an alternative facility when necessary; and3. Transports children to the most appropriate facility in their region for trauma care. Local destination guidelines for emergency medical services should assure that in regions with 2 Comprehensive Regional Pediatric Centers, or 1 Comprehensive Regional Pediatric Center and another facility with Level 1 Adult Trauma capability, that seriously injured children are cared for in the facility most appropriate for their injuries.(e) Provide 24-hour consultation to all lower-level facilities for issues regarding: 1. Emergency care and stabilization;2. Triage and transfer; and(f) Develop policies that describe mechanisms to achieve smooth and timely exchange of patients between emergency department, operating room, imaging facilities, special procedure areas, regular inpatient care areas, and the pediatric intensive care unit.Tenn. Comp. R. & Regs. 0720-31-.04
Original rule filed November 30, 1999; effective February 6, 2000. Transferred from chapter 1200-08-30 pursuant to Public Chapter 1119 of 2022 effective 7/1/2022.Authority: T.C.A. §§ 4-5-202, 4-5-204, 68-11-202, 68-11-209, and 68-11-251.