Utah Admin. Code R911-9-600 - Trauma Center Designation Process

(1) Hospitals seeking voluntary designation and any designated trauma centers desiring to remain designated, shall apply for designation by submitting the following information to the department at least 30 days before the date of the scheduled site visit:

(a) a completed and signed application and appropriate fees for trauma center verification;

(b) a letter from the hospital administrator of continued commitment to comply with current trauma center designation standards as applicable to the applicant's designation level;

(c) the data specified under Section R911-9-700 is current;

(d) Level I and Level II trauma centers must submit a copy of the Pre-review Questionnaire (PRQ) from the ACS in lieu of the application in Subsection R911-9-600(1)(a);

(e) Level III and Level IV and Level V trauma centers must submit a complete department approved application.

(2) Hospitals desiring to be designated as Level I and Level II trauma centers must be verified by the ACS within three months of the expiration date of previous designation and must submit a copy of the full ACS report detailing the results of the ACS site visit. A department representative must be present during the entire ACS verification or consultation visit. Hospitals desiring to be Level III or Level IV trauma centers must be designated by hosting a formal site visit by the department.

(3) Hospitals not previously designated as a Level I or a Level II trauma center, applying for designation after December 31, 2016, will be considered for designation implementing the point system suggested by the ACS as follows and using data from the Utah Trauma Registry:

(a) population as defined by the federal Office of Management and Budget total Metropolitan Statistical Area (MSA):

(i) total MSA population of less than 600,000 receives two points;

(ii) total MSA population of 600,000 to 1,200,000 receives four points;

(iii) total MSA population of 1,200,000 to 1,800,000 receives six points;

(iv) total MSA population of 1,800,000 to 2,400,000 receives eight points; and

(v) total MSA population of greater than 2,400,000 receives ten points;

(b) median transport times, combined air and ground time at scene only, not to include transfer:

(i) median transport time of less than 10 minutes receives zero points;

(ii) median transport time of 10 -- 20 minutes receives one point;

(iii) median transport time of 21 -- 30 minutes receives two points;

(iv) median transport time of 31 -- 40 minutes receives three points; and

(v) median transport time of greater than 41 minutes receives four points;

(c) department, system stakeholder, or community support:

(i) department support for a trauma center, if none exist, or an additional trauma center in the MSA -- five points;

(ii) department position that no additional trauma centers are needed -- negative five points;

(iii) Trauma System Advisory Committee, or equivalent body, statement of support for a trauma center if none exist, or an additional trauma center in the MSA -- five points;

(iv) community support demonstrated by letters of support from 25% - 50% of city and county governing bodies within the MSA -- one point; and

(v) community support demonstrated by letters of support from over 50% of city and county governing bodies within the MSA -- two points;

(d) severely injured patients, ISS more than 15, discharged from acute care facilities not designated as Level I, II, or III trauma centers:

(i) discharges of 0-200 severely injured patients receives zero points;

(ii) discharges of 201 -- 400 severely injured patients receives one point;

(iii) discharges of 401 -- 600 severely injured patients receives two points;

(iv) discharges of 601 -- 800 severely injured patients receives three points; and

(v) discharges of greater than 800 severely injured patients receives four points;

(e) Level I trauma centers:

(i) for the existence of each verified Level I trauma center already in the MSA assign one negative point;

(ii) for the existence of each verified Level II trauma center already in the MSA assign one negative point; and

(iii) for the existence of each verified Level III trauma center already in the MSA assign one half negative point;

(f) numbers of severely injured patients, ISS more than 15, seen in Level I and Level II trauma centers already in the MSA. The expected number of high-ISS patients is calculated as: 500 times the number of Level I and Level II centers in the MSA equals the expected number of high-ISS patients:

(i) if the MSA has more than 500 severely injured patients above the expected number assign two points;

(ii) if the MSA has 0 - 500 severely injured patients above the expected number assign one point;

(iii) if the MSA has 0 - 500 fewer severely injury patients than the expected number assign one negative point; and

(iv) if the MSA has more than 500 fewer severely injured patients than the expected number assign two negative points.

(g) The following scoring system shall be used to allocate trauma centers within the MSAs:

(i) MSAs with scores of five points or less shall be allocated 1 Level I or II trauma center;

(ii) MSAs with scores of six - ten points shall be allocated 2 Level I or II trauma centers;

(iii) MSAs with score of 11 - 15 points shall be allocated 3 Level I or II trauma centers; and

(iv) MSAs with scores of 16 - 20 points shall be allocated 4 Level I or II trauma centers.

(h) If the number of trauma centers allocated by the model is greater than the existing number of Level I or II trauma centers in the MSA, efforts should be undertaken to recruit and designate additional trauma centers.

(i) If the number of Level I and II trauma centers allocated by the model is less than or equal to the number currently designated, the department should not designate additional Level I or II trauma centers in the MSA.

Notes

Utah Admin. Code R911-9-600

Adopted by Utah State Bulletin Number 2024-14, effective 7/1/2024