Section 721.6 - Qualification and Responsibilities of Physicians and Other Licensed Obstetrical Practitioners At Each Designated Level of Care

Section 721.6 Qualifications and responsibilities of physicians and other licensed obstetrical practitioners at each designated level of care. The qualifications and responsibilities of licensed obstetrical practitioners at each designated level of care shall be:

(a) Level I perinatal care: A physician or licensed midwife with appropriate training and expertise shall attend all deliveries. At least one person capable of initiating neonatal resuscitation shall be present at every delivery. An ultrasound machine shall be readily available to labor and delivery. A radiologist or obstetrician skilled in interpretation of ultrasound scans shall be available within a timeframe appropriate to meet the patient's needs;

(b) Level II perinatal care: A physician or licensed midwife with appropriate training and expertise shall attend all deliveries. At least one person capable of initiating neonatal resuscitation shall be present at every delivery. An ultrasound machine shall be readily available to labor and delivery. A radiologist or obstetrician skilled in interpretation of ultrasound scans shall be available 24 hours a day within a timeframe appropriate to meet the patient's needs. Portable, neonatal-appropriate equipment and appropriately trained personnel to administer the service must be available within a timeframe appropriate to meet the patient's needs. Care for moderately high-risk women and neonates shall be provided by appropriately qualified physicians. General pediatricians and general obstetricians with the expertise to assume responsibility for acute care for infants and women, shall be immediately available within 20 minutes, 24 hours a day to provide needed services. The chief of obstetric anesthesia services shall be board-certified in anesthesia and shall have training and experience in obstetric anesthesia. A neonatologist shall be available on-site within 20 minutes 24 hours a day to provide needed services. The hospital staff shall also include a radiologist skilled in interpretation of ultrasound scans, a clinical pathologist , personnel qualified to administer specialized pharmaceutical services to newborns, and a designated, in-house credentialed person for neonatal resuscitation, all of whom shall be available 24 hours a day. Personnel with credentials to administer obstetric anesthesia shall be readily available. Specialized adult and pediatric medical and surgical consultation shall be readily available;

(c) Level III and RPC perinatal care: A physician or licensed midwife with appropriate training and expertise shall attend all deliveries. At least one person capable of initiating neonatal resuscitation shall be present at every delivery. An ultrasound machine shall be readily available to labor and delivery. A radiologist, obstetrician or maternal-fetal medicine specialist skilled in interpretation of ultrasound scans shall be available in-house 24 hours a day. Portable, neonatal-appropriate equipment and appropriately trained personnel to administer the service must be available within a timeframe appropriate to meet the patient's needs. Maternal-fetal medicine specialists and neonatologists who care for high-risk mothers and newborns in the Level III or RPC hospital shall have qualifications equivalent to those of the chief of their service as described in section 721.5(c) and (d) of this Title or at a minimum will have successfully completed a fellowship in maternal fetal medicine or in neonatal medicine, whichever is appropriate. A maternal-fetal medicine specialist and a neonatologist shall be available on-site within 20 minutes 24 hours a day to provide needed services. Obstetric and neonatal diagnostic imaging, provided by radiologists with special expertise in diagnosis of maternal and neonatal disease and its complications, shall be available 24 hours a day. Pediatric and adult subspecialists in cardiology, neurology, hematology, genetics, nephrology, metabolism, endocrinology, gastroenterology, nutrition, radiology, infectious diseases, pulmonology, immunology, and pharmacology shall be available for consultation. In addition, pediatric surgeons and pediatric surgical subspecialists, e.g., cardiovascular, neurological, orthopedic, ophthalmologic, urologic, and otolaryngological surgeons, shall be available for consultation and care. Pathologists with special competence in placental, fetal, and neonatal disease shall be members of the Level III or regional perinatal center staff. A clinical pathologist shall be available 24 hours a day. A board-certified anesthesiologist with special training or experience in maternal-fetal anesthesia shall be in charge of obstetric anesthesia services at a Level III or regional perinatal center facility, and personnel with credentials in the administration of obstetric anesthesia shall be available for all deliveries. Personnel with credentials in the administration of neonatal and pediatric anesthesia shall be readily available as needed. Personnel qualified to prepare, dispense and administer specialized pharmaceutical services to newborns shall be available 24 hours a day.

Effective Date: 
Wednesday, September 14, 2005
Doc Status: 
Complete