Current through Register Vol. 46, No. 3, March 25, 2022
For the purpose of these Standards, the following definitions
(a) Administrator means
the person who is delegated the responsibility for interpreting, implementing,
and applying policies and programs established by the governing authority.
He/she is delegated responsibility for the establishment of safe and effective
administrative management, and the control and operation of the services
(b) Birthing center means
a facility or other place where human births are planned to occur. This does
not include the usual residence of the mother or any facility which is licensed
as a hospital or the private practice of a physician who attends the
(c) Birthing room means a
room and environment designed, equipped and arranged to provide for the care of
a woman and newborn and to accommodate her support person(s) during the process
of vaginal birth.
(d) Board means
the South Carolina Board of Health and Environmental Control.
(e) Certified Nurse Midwife (CNM) means a
person licensed by the South Carolina State Board of Nursing as a Registered
Nurse with official recognition as a Certified Nurse Midwife.
(f) Clinical staff means the physicians,
certified nurse midwives and lay midwives appointed by the governing authority
to practice within the birthing center and governed by rules approved by the
means the South Carolina Department of Health and Environmental Control
(h) Governing body means an
individual or group which is legally responsible for the operation and
maintenance of the birthing center.
(i) Lay Midwife means an individual so
licensed by the Department.
Licensing agency means DHEC.
Low risk means normal, uncomplicated prenatal course as determined by adequate
prenatal care and prospects for a normal, uncomplicated birth as defined by
reasonable and generally accepted criteria of maternal and fetal
(l) Midwifery means the
application of scientific principles in "with woman" care during uncomplicated
pregnancy, birth, and puerperium including care of the newborn, support of the
family unit, and gynecologic health care.
(m) Person means a natural individual,
private or public organization, political subdivision, or other governmental
(n) Personnel means
individual(s) in training and/or employed by the birthing center.
(o) Physician means a doctor of medicine or
osteopathy with training in obstetrics or midwifery and licensed by the South
Carolina State Board of Medical Examiners to practice medicine.
(p) Recovery means that period or duration of
time starting at birth and ending with the discharge of a client from the
Nurse means a person licensed by the South Carolina State Board of Nursing as a
(a) No person shall
establish, conduct or maintain a birthing center without first obtaining a
license from the Department.
The license shall be posted in a conspicuous place in a public lobby or waiting
room. The issuance of a license does not guarantee adequacy of individual care,
treatment, personal safety, fire safety or the well-being of any occupant of a
facility. A license is not assignable or transferable and is subject to
revocation by the Department for failure to comply with the laws and
regulations of the State of South Carolina.
(c) Any birthing center which is in operation
at the time of promulgation of these regulations shall be given a reasonable
time, not to exceed one year from date of such promulgation, within which to
comply with such regulations.
Effective Date and Term of License: A license shall be effective for a 12-month
period following the date of issue and shall expire one year following such
date; however, a facility that has not been inspected during that year may
continue to operate under its existing license until an inspection is
(e) Separate Licenses:
Separate licenses are required for facilities not maintained on the same
premises. Separate licenses may be issued for facilities maintained in separate
buildings on the same premises.
Licensing Fees: Each applicant shall pay an annual license fee prior to
issuance of the license. The annual fee shall be $200.00.
(g) Inspections: Each facility submitting an
application for licensing or re-licensing shall be inspected prior to initial
licensure and at least annually by authorized representatives of the
Department. All licensed and prospective licensed facilities are subject to
inspection at any time. All facilities to which these requirements apply shall
permit entrance to all properties and access to every area, object and records
and reports by representatives of the Department.
(h) Initial License: A new facility or one
that has not been continuously licensed under these Standards, shall not
provide birthing center services until it has been issued an initial license.
Section L sets forth the prerequisites for initial license.
(i) Noncompliance: When noncompliances with
the Licensing Standards are detected, the applicant or licensee will be
notified of the violations and at the same time requested to provide
information as to how and when such items will be corrected. If an item of
noncompliance is of a serious nature and is not promptly corrected, a penalty
may be invoked or a license may be denied, suspended or revoked.
(j) Exceptions to Licensing Standards: The
Department reserves the right to make exceptions to these Standards where it is
determined that the health and welfare of the community requires the services
of the facility and that the exception, as granted, will have no significant
impact on the safety, security or welfare of the facility's
Change of License: A
facility shall request issuance of an amended license, by application to the
Department, prior to any of the following circumstances:
(1) Change of ownership by purchase or
(2) Change of facility's
name or address.
(3) Addition or
replacement of a birthing room or any part thereof.
Facilities shall be subject to a penalty for violating
Licensing Regulations. When the Department determines that a facility is in
violation of any statutory provision, rule or regulation relating to the
operation or maintenance of such facility, the following conditions shall
(a) Class I violations are
those which the Department determines present an imminent danger to the
patients or other occupants of the facility or a substantial probability that
death or serious physical harm could result therefrom. A physical condition,
one or more practices, means, methods or operations in use in a facility may
constitute such a violation. The condition or practice constituting a Class I
violation shall be abated or eliminated immediately unless a fixed period of
time, as stipulated by the Department, is required for correction. Each day
such violation shall exist after expiration of said time shall be considered a
(b) Class II
violations are those, other than Class I violations, which the Department
determines have a direct or immediate relationship to the health, safety or
security of the facility's patients or other occupants. The citation of a Class
II violation shall specify the time within which the violation is required to
be corrected. Each day such violation shall exist after expiration of said time
shall be considered a subsequent violation.
(c) Class III violations are those which are
not classified as serious in these regulations or those which are against the
best practices as interpreted by the Department. The citation of a Class III
violation shall specify the time within which the violation is required to be
corrected. Each day such violation shall exist after expiration of said time
shall be considered a subsequent violation.
(d) Class I and II violations are indicated
by notation after each applicable section, e.g., (I) or (II). Violations of
sections which are not annotated in that manner will be considered as Class III
(e) The Department may
deny, suspend, or revoke licenses or assess a monetary penalty for violations
of provisions of law or departmental regulations. The Department shall exercise
discretion in arriving at its decision to take any of these actions. The
Department will consider the following factors: specific conditions and their
impact or potential impact on health, safety or welfare; efforts by the
facility to correct; overall conditions; history of compliance; any other
decision is made to assess monetary penalties, the following schedule will be
used as a guide to determine the dollar amount.
Frequency of violation of standard within a 24-month
MONETARY PENALTY RANGES
6th and more