Ariz. Admin. Code § R9-4-503 - Review of Records; Information Collected
A. Upon notice from the Department of at
least five business days, the following persons or facilities shall allow the
Department access to the facility and the electronic or written records
specified in subsection (B)(1) to collect the information specified in
subsection (B)(2):
1. A hospital,
2. A clinic,
3. A physician,
4. A midwife,
5. A registered nurse practitioner,
6. A genetic testing facility,
7. A prenatal diagnostic facility,
8. A physician assistant,
9. A clinical laboratory, or
10. A medical examiner.
B. The Department may:
1. Review any of the following records in
electronic or written format, as are applicable to the person or facility
specified in subsection (A):
a. Patient
medical records;
b. Medical records
for the mother of a patient;
c.
Reports from:
i. Physicians or other
individuals who clinically evaluated, diagnosed, or treated a patient or the
patient's mother, including physical therapists, as defined in A.R.S. §
32-2001;
occupational therapists, as defined in A.R.S. §
32-3401;
podiatrists, as defined in A.R.S. §
32-801;
and speech-language pathologists, licensed according A.R.S. Title 35, Chapter
17;
ii. High-risk perinatal
practices;
iii. Prenatal diagnostic
facilities;
iv. Genetic testing
facilities;
v. Pathology
laboratories; or
vi. Other
facilities or clinical laboratories that performed a test for a patient or the
patient's mother;
d.
Logs and registers containing information about surgical procedures, as
specified in A.A.C.
R9-10-215(6)
or A.A.C.
R9-10-911(A);
e. Other logs that may contain information
about a patient or the mother of a patient with a birth defect, such as:
i. Labor and delivery unit logs,
ii. Nursery unit logs,
iii. Pediatric unit logs,
iv. Intensive care unit logs,
v. Autopsy logs, and
vi. Ultrasound logs;
f. Autopsy reports; and
g. Records other than those specified in
subsections (B)(1)(a) through (f) that contain information about or may lead to
information about:
i. A patient,
ii. The patient's mother, or
iii. The patient's biological sibling; and
2. Collect
the following information from a person or facility specified in subsection
(A), as applicable to a patient or the mother of a patient:
a. The name, address, and telephone number of
the person or facility, or the identification number assigned by the Department
to the person or facility;
b. The
date of first contact and the date of last contact;
c. The date the patient was admitted to a
hospital;
d. The date the patient
was discharged from a hospital;
e.
The dates the mother of the patient was admitted to and discharged from a
hospital for:
i. The birth of the patient,
or
ii. Treatment related to a
possible birth defect in the patient;
f. The name and address of the hospital or
other location in which the patient was born;
g. The name and address of a hospital in
which the patient or the mother of the patient was admitted for treatment
related to a possible birth defect in the patient;
h. The specific unit of a hospital that
provided medical services to the patient or the patient's mother;
i. The medical record number of the patient
or the patient's mother;
j. The
patient's name and any other name by which the patient is known;
k. The names, addresses, and dates of birth
of the patient's parents;
l. The
name, address and telephone number of the patient's guardian, if a parent of
the patient does not have physical custody of the patient;
m. The patient's date of birth and hour of
birth;
n. The estimated date of
confinement for the pregnancy resulting in the patient's birth;
o. The estimated gestational age, length,
weight, and head circumference of the patient at birth;
p. The patient's gender, race, and ethnicity;
q. The race and ethnicity of the
patient's biological mother and father;
r. The address of the patient's mother at the
time of the patient's birth;
s.
The address and telephone number of the patient at the date of last contact;
t. The county in which the patient
was born;
u. The name of each
physician, registered nurse practitioner, physician assistant, or other person
that clinically evaluated, diagnosed, ordered a test for, or treated the
patient or the patient's mother;
v. The names of any facility from which or to
which the patient or the patient's mother was transferred or referred;
w. Whether the patient was
referred for or approved to receive services under 9 A.A.C. 22, Article 13,
and, if so, the date of referral or approval;
x. Whether the patient is receiving any
medical services, nursing services, health-related services, or other services
to support the patient or the patient's parent related to a birth defect, other
than services under 9 A.A.C. 22, Article 13, and, if so, the name of the person
providing the services and the date the provision of the services began;
y. The name of the insurance
company, if applicable, that:
i. Paid for the
birth of the patient, and
ii. Is
currently covering medical expenses for the patient or the patient's mother;
z. Any perinatal risk
factors documented in:
i. The patient's
medical record,
ii. The patient's
mother's medical record, or
iii.
The patient's family medical history;
aa. Whether any tests were performed on the
patient or the patient's mother by a genetic testing facility and, if so:
i. The types of tests performed,
ii. The test dates,
iii. The test results,
iv. The age or estimated gestational age of
the patient at the time of each test,
v. The estimated date of confinement of the
patient's mother at the time of each test,
vi. The name of the genetic testing facility
that performed each test; and
vii.
The names of the individuals who interpreted the test results;
bb. Whether any tests were
performed on the patient or the patient's mother by a prenatal diagnostic
facility and, if so:
i. The types of tests
performed,
ii. The test
dates,
iii. The test
results,
iv. The estimated
gestational age of the patient at the time of each test,
v. The estimated date of confinement of the
patient's mother at the time of each test,
vi. The name of the prenatal diagnostic
facility that performed each test, and
vii. The names of the individuals who
interpreted the test results;
cc. Whether any other types of tests were
performed on the patient or the patient's mother that may enable the diagnosis
of a birth defect and, if so:
i. The types of
tests performed,
ii. The test
dates,
iii. The test
results,
iv. The age or estimated
gestational age of the patient at the time of each test,
v. The estimated date of confinement of the
patient's mother at the time of each test,
vi. The names of the facilities that
performed the tests, and
vii. The
names of the individuals who interpreted the test results;
dd. Whether any surgical procedures
associated with a birth defect were performed on the patient or the patient's
mother and, if so:
i. The types of surgical
procedures performed,
ii. The dates
of the surgical procedures,
iii.
The results of the surgical procedures,
iv. The ages or estimated gestational ages of
the patient at the time of the surgical procedures,
v. The estimated date of confinement of the
patient's mother at the times of the surgical procedures, and
vi. The names of the facilities at which the
surgical procedures were performed, and
vii. The names of the individuals who
performed the surgical procedures;
ee. For each diagnosis made for the patient
or the patient's mother:
i. The
diagnosis,
ii. Whether the
diagnosis is a principal or secondary diagnosis,
iii. The facility at which the diagnosis was
made,
iv. The date on which the
diagnosis was made, and
v. The name
of the individual who made the diagnosis;
ff. The number of times the patient's mother
has been pregnant;
gg. The number
of times a pregnancy of the patient's mother has lasted:
i. More than 37 weeks,
ii. Between 20 and 37 weeks, and
iii. Less than 20 weeks;
hh. The number of children who
were born as a result of the patient's mother's pregnancies, and whether the
children were born alive or dead;
ii. Whether the patient is from a singleton
or multiple gestation, and, if from a multiple gestation, whether a co-twin of
the patient:
i. Is identical or
fraternal;
ii. Is alive, and, if
not alive, the co-twin's date of death; and
iii. Has:
(1) The same birth defect as the
patient,
(2) A different birth
defect from that of the patient, or
(3) No birth defect;
jj. If the patient is being
adopted or living with a guardian rather than a parent;
kk. If the patient is being adopted, the
name, address, and telephone number of the individual who will adopt the
patient;
ll. The date of last
contact; and
mm. If the patient has
died:
i. The patient's date and county of
death,
ii. The facility in which
the patient's death occurred, and
iii. Whether an autopsy was performed on the
patient.
Notes
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