Ariz. Admin. Code § 9-10-223

Current through Register Vol. 30, No. 50, December 13, 2024

Section R9-10-223 - Perinatal Services

A. An administrator of a hospital that provides perinatal organized services shall ensure that:

1. Perinatal services are provided in a designated area under the direction of a medical staff member;

2. Only medical and surgical procedures approved by the medical staff are performed in the perinatal services unit;

3. The perinatal services unit has the capability to initiate an emergency cesarean delivery within the time-frame established by the medical staff and documented in policies and procedures;

4. Only a patient in need of perinatal services or gynecological services receives perinatal services or gynecological services in the perinatal services unit;

5. A patient receiving gynecological services does not share a room with a patient receiving perinatal services;

6. A chronological log of perinatal services provided to patients is maintained that includes:

a. The patient's name;

b. The date, time, and mode of the patient's arrival;

c. The disposition of the patient including discharge, transfer, or admission time;

d. The following information for a delivery of a neonate:

i. The neonate's name or other identifier;

ii. The name of the medical staff member who delivered the neonate;

iii. The delivery time and date; and

iv. Complications of delivery, if any; and

e. If an abortion procedure was performed at or after 20 weeks gestational age, whether the fetus was delivered alive;

7. The chronological log required in subsection (A)(6) is maintained by the hospital in the perinatal services unit for at least 12 months after the date the perinatal services are provided and then maintained by the hospital for at least an additional 12 months;

8. The perinatal services unit provides fetal monitoring;

9. The perinatal services unit has ultrasound capability;

10. Except in an emergency, a neonate is identified as required by policies and procedures before moving the neonate from a delivery area;

11. Policies and procedures specify:

a. Security measures to prevent neonatal abduction, and

b. How the hospital determines to whom a neonate may be discharged;

12. A neonate is discharged only to an individual who:

a. Is authorized according to subsection (A)(11), and

b. Provides identification;

13. A neonate's medical record identifies the individual to whom the neonate is discharged;

14. A patient or the individual to whom the neonate is discharged receives perinatal education, discharge instructions, and a referral for follow-up care for a neonate in addition to the discharge planning requirements in R9-10-209;

15. Intensive care services for neonates comply with the requirements in R9-10-221;

16. At least one registered nurse is on duty in a nursery when there is a neonate in the nursery except as provided in subsection (A)(17);

17. A nursery occupied only by a neonate, who is placed in the nursery for the convenience of the neonate's mother and does not require treatment as established in this Article, is staffed by a nurse;

18. Equipment and supplies are available to a nursery, labor-delivery-recovery room, or labor-delivery-recovery-postpartum room to meet the needs of each neonate; and

19. In a nursery, only a neonate's bed or bassinet is used for changing diapers, bathing, or dressing the neonate.

B. An administrator of a hospital that does not provide perinatal organized services shall comply with the requirements in R9-10-217(C).

C. In addition to applicable requirements in A.R.S. Title 36, Chapter 20, an administrator of a hospital in which an abortion procedure is performed shall ensure that:

1. Policies and procedures are established, documented, and implemented to protect the health and safety of a patient that require:

a. For an abortion procedure performed at or after 20 weeks gestational age, a personnel member or medical staff member qualified according to policies and procedures to perform neonatal resuscitation, other than the physician performing the abortion procedure, is in the room in which the abortion procedure is performed before the delivery of the fetus;

b. Compliance with A.R.S. § 36-2301.01, if applicable;

c. Neonatal resuscitation of a fetus delivered alive, according to A.R.S. § 36-2301(D)(3); and

d. A medical record to be established and maintained for a fetus delivered alive;

2. The medical record of a patient receiving an abortion procedure contains:

a. Documentation from the physician providing the abortion procedure and other personnel members present certifying that the fetus was not delivered alive, or

b. A link to the medical record of a fetus delivered alive; and

3. For a fetus delivered alive, a medical record contains:

a. An identification of the fetus, including:

i. The name of the patient from whom the fetus was delivered alive, and

ii. The date the fetus was delivered alive;

b. Orders issued by a physician, physician assistant, or registered nurse practitioner;

c. A record of medical services, nursing services, and health-related services provided to the fetus delivered alive;

d. If applicable, information about medication administered to the fetus delivered alive; and

e. If the fetus had a lethal fetal condition, the results of the confirmation of the lethal fetal condition.

Ariz. Admin. Code § R9-10-223

Former Section R9-10-223 renumbered as R9-10-319 as an emergency effective February 22, 1979, new Section R9-10-223 adopted effective February 23, 1979 (Supp. 79-1). Section repealed; new Section made by final rulemaking at 8 A.A.R. 2785, effective October 1, 2002 (Supp. 02-2). Section R9-10-223 renumbered to R9-10-224; new Section R9-10-223 renumbered from R9-10-222 and amended by exempt rulemaking at 19 A.A.R. 2015, effective October 1, 2013 (Supp. 13-2). Amended by exempt rulemaking at 20 A.A.R. 1409, effective 7/1/2014. Amended by final rulemaking at 24 A.A.R. 3020, effective 10/2/2018.