Iowa Admin. Code r. 641-150.5 - [Effective 7/1/2025] Maternal and neonatal levels of care-categorization and verification
Categorization and verification of hospitals participating in Iowa's regionalized system of perinatal health care will be made by the department based on national recommendations from the American Academy of Pediatrics and the American Congress of Obstetricians and Gynecologists.
(1)
Application for initial
verification.
a. An application for
initial verification may be submitted when:
(1) A new hospital with a perinatal service
is opened;
(2) A hospital is
reopening after a previously inactive obstetrical unit; or
(3) A hospital requests a change to a
higher-level designation in maternal care or neonatal care.
b. A hospital requesting an initial
verification may obtain application materials from the department.
c. Upon receipt of an application from a
hospital that is requesting to change to a higher level of maternal or neonatal
care, the department will request and review copies of the results of the last
site visit to the hospital by the statewide perinatal team or request a site
visit. The results of the site visit along with the application will be shared
with the statewide perinatal team and any clinical experts appointed by the
department to determine if all requirements are met. The recommendations will
be sent to the department, which will notify the hospital if its application is
approved or denied. If the application is denied, the applicant will be
informed of the applicant's right to appeal the department's
decision.
(2)
Application for a hospital that has previously participated in the
regionalized system of perinatal health care.
a. If a hospital chooses to continue its
participation, the hospital must select the levels for maternal care and
neonatal care appropriate for the hospital's capacity to provide perinatal
health care in accordance with the criteria outlined in these rules.
b. To maintain continuous participation in
the regionalized system of perinatal health care, a hospital must complete the
levels-of-care assessment tool and an attestation statement. These can be
obtained from the department.
c.
The department will set dates when each hospital's certification of
verification will expire based on the statewide perinatal health care team's
site visit schedule and the level of care selected.
(3)
Reverification of level
designation. The levels-of-care assessment tool will be used for all
reverifications. The process of reverification of a hospital participating in
the regionalized system of perinatal health care will take place once every six
years as follows:
a. Reverification of a
Level I, Level II or Level III maternal care or neonatal care hospital will be
completed through use of the levels-of-care assessment tool and an on-site
reverification visit. A hospital must complete and return the levels-of-care
assessment tool to the department at least 120 days before the hospital's
certification is due to expire. The department will ensure that arrangements
are made for the onsite reverification visit. Level II and Level III hospitals
may utilize one of two on-site reverification visit options:
(1) A review conducted by the statewide
perinatal care team, or
(2) A
review by an independent out-of-state team identified by the hospital, approved
by the department and paid for by the hospital.
b. Reverification of a Level IV maternal care
and neonatal care hospital will be completed through the same process as that
for a Level I, Level II or Level III maternal care or neonatal care hospital
except that the on-site reverification team will consist of an out-of-state
team identified by the hospital and approved by the department. The team will
include, at a minimum, a maternal-fetal specialist, a neonatologist, an
obstetrical nurse and a neonatal nurse. The Level IV hospital will pay the
expense of the review team. All department staff and staff contracted by the
department involved in the on-site reverification process will sign a
confidentiality statement that will be kept on file at the
department.
c. Reverification shall
not be construed to imply any guarantee on the part of the department as to the
level of perinatal health care services available at a hospital.
d. Hospital reverification of the level of
care is valid for a period of six years from the effective date unless
otherwise specified on the certificate of verification or unless sooner
suspended or revoked.
e. As part of
the reverification and renewal process, the department or a designated survey
team may conduct periodic on-site reviews of the services of the maternal care
and neonatal care hospitals, including chart reviews.
(4)
Level designation maintenance,
waiver and confidential records.
a.
A hospital that is unable to maintain its designated level of care will notify
the department, in writing, within 60 days of the change in capacity to meet
the designated level of care.
b.
The director may grant a waiver from the requirements of rules adopted under
this chapter for any hospital participating in the regionalized system of
perinatal health care.
c.
Proceedings, records, and reports developed pursuant to this chapter are
confidential pursuant to Iowa Code section
135.11(22) and
constitute peer review records under Iowa Code section
147.135, and are not subject to
discovery, subpoena, or other means of legal compulsion for their release to a
person other than the affected hospital, and are not admissible in evidence in
a judicial or administrative proceeding other than a proceeding involving
verification of the participating hospital.
Notes
State regulations are updated quarterly; we currently have two versions available. Below is a comparison between our most recent version and the prior quarterly release. More comparison features will be added as we have more versions to compare.
The
1. Certify a hospital 's capacity to provide perinatal health care in accordance with criteria established under these rules.
2. Provide technical assistance to the hospitals that choose to participate.
3. Review the submitted levels-of-care assessment tool from all participating hospitals.
4. Conduct or coordinate the on-site verification of determined levels of care for maternal and neonatal care hospitals designated as Level II, Level III and Level IV.
5. Facilitate all meetings of the perinatal guidelines advisory committee . This rule is intended to implement Iowa Code section 135.11(27).