N.M. Admin. Code § 8.370.17.24

Current through Register Vol. 35, No. 23, December 10, 2024

Section 8.370.17.24 - RISK ASSESSMENT, CLIENT ACCEPTANCE AND LABOR ADMISSION CRITERIA

All licensed facilities shall follow and maintain written clinical practice guidelines which address, at a minimum, eligibility for care, ongoing eligibility, medical consultation, and transfer criteria in accordance with the scope of practice authorized under each practitioner's individual license(s) to be reviewed and updated by the internal quality committee at least annually.

A. Risk assessment: A licensed practitioner shall make risk assessments of all clients that at a minimum include:

(1) an initial assessment which documents the general health and eligibility of a potential client and which includes a detailed medical, social and family history, a physical examination, and routine prenatal labs; the assessment may also include ultrasounds to determine whether the client meets the criteria for the facility's scope of care;

(2) completing, maintaining, and documenting an initial risk assessment and an on-going risk assessment in the client record which include compliance with admission criteria prior to client acceptance and throughout the pregnancy with the clinical director making the final determination of each client's risk;

(3) if a client before 32 weeks gestation has failed to register for freestanding birth center care and has not received prenatal care, the client shall not be accepted for care at the facility unless the client obtains a medical consultation outside of the facility, meets all other eligibility criteria, and a written, signed exception is made by the clinical director on a case-by-case basis;

(4) clear documentation of referrals, consultations and transfers to other providers for ineligible clients or medical transfers;

(5) assessing each client's risk status on admission in labor and throughout labor for continuation of services;

(6) whether the facility will have adequate space and sufficient staff to support the client newborn during labor, birth and postpartum;

(7) written criteria for antepartum, intrapartum, postpartum and newborn acceptance and transfer to a hospital which delineates the transfer process from the facility to an accepting hospital; and

(8) limitations on the number of active labor clients at the facility to the number of birth rooms available at the facility.

B. Ineligibility for admission: If any of the following conditions exist, birth at the facility shall be considered inappropriate or improper:

(1) breech or non-vertex presentation at labor and delivery;

(2) gestation less than 37 weeks or greater than 42 weeks;

(3) multiple gestation;

(4) medication controlled gestational diabetes mellitus; or

(5) vaginal birth after cesarean (VBAC) candidates with more than one previous cesarean section, previous incision that is not low transverse, placenta location, anterior and low-lying over the old scar.

N.M. Admin. Code § 8.370.17.24

Adopted by New Mexico Register, Volume XXXV, Issue 12, June 25, 2024, eff. 7/1/2024