Iowa Admin. Code r. 641-134.2 - Trauma care facility categorization and verification
Categorization and verification of trauma care facilities shall be made by the department based upon the trauma care facilities' resources available for providing trauma care services.
(1) Categorization.
a. Categorization as a trauma care facility
shall be determined by the department from self-reported information provided
to the department by a hospital or emergency care facility through a
self-assessment categorization application provided by the
department.
b. Categorization
applications shall be submitted by all hospitals. New hospitals shall submit a
categorization application no later than 90 days after licensing by the
department of inspections and appeals, health facilities division.
Categorization applications may be submitted by emergency care facilities. New
emergency care facilities may submit a categorization application no later than
90 days after opening or reopening.
c. Categorization applications may be
obtained from the department upon written request to: Iowa Department of Public
Health, Bureau of Emergency and Trauma Services, Lucas State Office Building,
Des Moines, Iowa 50319-0075.
(2) Categorization levels for trauma care
facilities shall be identified as:
a. Level
I.
b. Level II.
c. Level III.
d. Level IV.
(3) Adoption by reference.
a. Criteria specific to Level I trauma care
facilities identified in the "Resources for Optimal Care of the Injured Patient
2014" (6th edition) published by the American College of Surgeons Committee on
Trauma (ACS-COT) is incorporated and adopted by reference for Level I hospital
and emergency care facility categorization criteria. Criteria specific to Level
II trauma care facilities identified in the "Resources for Optimal Care of the
Injured Patient 2014" (6th edition) published by the American College of
Surgeons Committee on Trauma is incorporated and adopted by reference for Level
II hospital and emergency care facility categorization criteria. Criteria
specific to Level III trauma care facilities identified in the "Resources for
Optimal Care of the Injured Patient 2014" (6th edition) published by the
American College of Surgeons Committee on Trauma is incorporated and adopted by
reference for Level III hospital and emergency care facility categorization
criteria. Criteria specific to Level IV trauma care facilities identified in
the "Resources for Optimal Care of the Injured Patient 2014" (6th edition)
published by the American College of Surgeons Committee on Trauma is
incorporated and adopted by reference for Level IV hospital and emergency care
categorization criteria. For any differences which may occur between the
adopted references and these administrative rules, the administrative rules
shall prevail.
b. "Resources for
Optimal Care of the Injured Patient 2014" (6th edition) published by the
American College of Surgeons Committee on Trauma is available through the Iowa
Department of Public Health, Bureau of Emergency and Trauma Services (BETS),
Lucas State Office Building, Des Moines, Iowa 50319-0075, or the BETS website
(idph.iowa.gov/BETS/Trauma).
c. Trauma care facilities shall transition to
the criteria outlined in paragraph 134.2(3)"a."
(1) Level IV trauma care facilities shall
transition to the criteria outlined in paragraph 134.2(3)"a"
on or before October 1, 2017.
(2)
Level III trauma care facilities shall maintain, at a minimum, the criteria
requirements effective in 2013 until a transition to the criteria in paragraph
134.2(3) "a" at the next scheduled verification visit. Transition to paragraph
134.2(3)"a" criteria shall be completed on or before December
31, 2020.
(3) Level II trauma care
facilities shall maintain, at a minimum, the criteria requirements effective in
2013 until American College of Surgeons Committee on Trauma verification on or
before October 31, 2021.
d. The 2013 criteria for all levels of trauma
care facilities are available through the Iowa Department of Public Health,
Bureau of Emergency and Trauma Services, Lucas State Office Building, Des
Moines, Iowa 50319-0075, or the BETS website
(idph.iowa.gov/BETS/Trauma).
(4) Categorization shall not be construed to
imply any guarantee on the part of the department as to the level of trauma
care services available at a trauma care facility.
(5) A trauma care facility may apply to the
department for a change in level of categorization through submission of a
self-assessment categorization application. Hospitals, emergency care
facilities, or trauma care facilities applying for initial verification or a
change in level of categorization shall be verified based on the criteria
outlined in paragraph 134.2(3)"a."
(6) Verification. Verification of a trauma
care facility shall be determined by the department upon successful completion
of the categorization application and completion of a verification survey. All
categorized hospitals and emergency care facilities shall be verified.
a. Level I and Level II trauma care
facilities shall be verified by the American College of Surgeons Committee on
Trauma on or before October 31, 2021.
b. Trauma care facilities verified by the
American College of Surgeons Committee on Trauma shall be accepted by the
department as equivalent for categorization and verification as a trauma care
facility in Iowa provided that all policy, reporting, and administrative rules
have been met. The department may issue a certification of verification
provided that the trauma care facility has been verified by the American
College of Surgeons Committee on Trauma. The facility shall provide the
department documentation including, but not limited to, a current copy of the
ACS-COT verification.
c. A Level I
or Level II trauma care facility which fails to attain American College of
Surgeons Committee on Trauma verification shall submit an application to the
department to be verified as a Level III or Level IV trauma care facility to
ensure compliance with Iowa Code section
147A.23(2)
"a."
d. Level III
and Level IV trauma care facilities shall be verified by the department in
consultation with the trauma survey team.
(7) The department shall conduct a
verification survey for categorized hospitals or emergency care facilities.
a. A verification survey shall assess the
ability of the hospital or emergency care facility to meet criteria for the
level of categorization pursuant to 134.2(3).
b. Verification criteria are weighted by
criteria types, Type I and Type II, as indicated in the "Resources for Optimal
Care of the Injured Patient 2014" (6th edition) published by the American
College of Surgeons Committee on Trauma and adopted in
134.2(3)"a."
c.
Type II criteria deficiencies identified during the verification process may
result in disciplinary action. Criteria deficiencies shall be resolved in
accordance with the trauma care facility's final report. Failure to rectify
deficiencies in accordance with the trauma care facility's final report shall
result in disciplinary action.
d.
Type I criteria deficiencies or persistently occurring Type II criteria
deficiencies identified during the verification process shall result in
disciplinary action. The department shall notify the trauma care facility's
governing body of Type I or persistently occurring Type II criteria
deficiencies. The trauma care facility shall implement a plan of correction
within 45 days of issuance of the trauma facility's final report. Criteria
deficiencies shall be resolved in accordance with the trauma care facility's
final report and the implemented plan of correction. Failure to rectify
deficiencies shall result in disciplinary action.
e. The department may conduct electronic
review or on-site verification that criteria deficiencies have been resolved as
outlined in final reports or disciplinary actions.
f. The department shall approve trauma care
facility verification when the department is satisfied that the proposed
facility will provide services and be operated in compliance with Iowa Code
section
147A.23
and these administrative rules.
g.
The department shall notify the applicant, in writing, as to the approval or
denial of verification as a trauma care facility within 90 days after the
completion of a verification survey.
h. Verification shall not be construed to
imply any guarantee on the part of the department as to the level of trauma
care services available at a hospital or emergency care facility.
i. Trauma care facility verification is valid
for a period of three years from the effective date unless otherwise specified
on the certificate of verification or unless sooner suspended or
revoked.
j. Trauma care facilities
shall be fully operational at their verified level upon the effective date
specified on the certificate of verification. Trauma care facilities shall meet
all requirements of Iowa Code section
147A.23
and these administrative rules.
k.
As part of the verification and renewal process, the department or its
designated trauma survey team may conduct periodic on-site reviews of the
services and facilities of trauma care facilities including chart review at
those facilities.
l. Trauma care
facilities that are unable to maintain their categorization or verification, or
both, shall notify the department within 48 hours.
m. The director, pursuant to 641-Chapter 178,
may grant a waiver from the requirements of rules adopted under this chapter
for any trauma care facility.
n.
Proceedings, records, and reports developed pursuant to this chapter constitute
peer review records under Iowa Code section
147.135,
and are not subject to discovery by subpoena or admissible as evidence. All
information and documents received from a hospital, emergency care facility, or
trauma care facility under Iowa Code chapter 147A shall be confidential
pursuant to Iowa Code section
272C.6(4).
(8) Prohibited acts. A hospital or emergency
care facility that imparts or conveys, or causes to be imparted or conveyed,
that it is a trauma care facility, or that uses any other term to indicate or
imply that the hospital or emergency care facility is a trauma care facility
without having obtained a certificate of verification by the department is
subject to civil penalty not to exceed $100 per day for each offense. The
director may apply to the district court for a writ of injunction to restrain
the use of the term "trauma care facility."
(9) Nothing in Iowa Code section
147A.23
or these administrative rules shall be construed to restrict a hospital or
emergency care facility from providing any services for which it is duly
authorized.
Notes
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