Hospitals within the state shall determine whether to
participate in Iowa's regionalized system of perinatal health care and shall
select the hospital's level of participation in the regionalized system. A
hospital having determined to participate in the regionalized system shall
comply with the rules appropriate to the levels of participation for maternal
care and neonatal care selected by the hospital. Maternal levels of designation
and neonatal levels of designation are evaluated separately, and a hospital may
have a level of designation for maternal care that is different from the level
of designation for neonatal care; however, a pregnant woman should be cared for
at the hospital that best meets both her and her newborn infant's needs.
Iowa's regionalized system of perinatal health care helps
practitioners in rural Iowa to rapidly access specialty services for their
patients even though such services may not exist in the local community. This
is predicated on several factors, including the willingness of certain
hospitals in moderate-to-large Iowa cities to provide specialty services and
the presence of a functional system of patient transportation. These rules
address how participating Iowa hospitals relate to the regionalized system and
suggest a level of functioning which should identify the role each
participating hospital plays in the system.
The following rules present a description of the levels of care
among Iowa perinatal hospitals. The levels are as follows: maternal levels of
care, which include Level I maternal care hospital, Level II maternal care
hospital, Level III maternal care hospital and Level IV maternal care hospital,
and neonatal levels of care, which include Level I neonatal care hospital,
Level II neonatal care hospital, Level III neonatal care hospital and Level IV
neonatal care hospital. Due to the need for organization of limited resources
in a rural state, the rules are designed to encourage and support the presence
of Level II and Level III maternal care and neonatal care hospitals in areas
not populous enough to support a Level IV maternal care and neonatal care
hospital.
The rules are not meant to hold Iowa hospitals and Iowa
perinatal professionals to an impractical ideal. The rules specify particulars
for a tiered provision of care on the basis of functional capabilities, based
on national recommendations from the American Academy of Pediatrics and the
American Congress of Obstetricians and Gynecologists.
The primary purpose of the level of care designation is to
ensure Iowa perinatal patients receive appropriate maternal and neonatal care
as close to their homes as possible.
The rules provide a framework to ensure that, when a
participating hospital represents itself at a particular level of perinatal
care, the hospital is capable of providing that care. The public is entitled to
know the level of functioning of a hospital. The rules provide the framework
for defining and evaluating the level of perinatal services offered by a
hospital.
