37.106.1014    OPERATION STANDARDS FOR OUTPATIENT CENTERS FOR PRIMARY CARE: BIRTH CENTERS

(1) A birth center organization:

(a) maintains a governing body that meets regularly; and

(b) actively seeks and takes appropriate action on feedback from its consumers.

(2) A birth center administration shall:

(a) operate under a clearly defined mission, philosophy, and goals;

(b) follow generally accepted accounting principles and take measures to make sure it is fiscally responsible, including a plan to cover shortfalls; and

(c) ensure continuity of leadership and quality of care.

(3) Facility requirements for a birth center include:

(a) compliance with regulations established in the local jurisdiction, including applicable local and state codes for construction, fire prevention, public safety and access, annual inspections by the fire department, building inspector, and other officials concerned with public safety as determined by the local jurisdiction; and

(b) an emergency plan in the event of fire and natural disasters and documents practice of the plan on an annual basis.

(4) Equipment requirements for a birth center include:

(a) a readily available emergency cart or tray for the mother and newborn that is equipped to carry out the written emergency procedures of the birth center and securely placed with a written log of routine maintenance; and

(b) regular inspections of all medical equipment and documents accordingly.

(5) A birth center shall maintain sufficient supplies, including basic medical supplies for both mothers and babies, on hand, for the number of childbearing families served at the birth center.

(6) Quality of service requirements for a birth center include:

(a) respect for health care rights of all clients, including privacy;

(b) standard HIPAA practices; and

(c) providers who practice midwifery and support the normal birth process including:

(i) careful screening for potential complications;

(ii) honoring the mother's needs and desires throughout labor;

(iii) assisting the mother in managing pain; and

(iv) paying close attention to the mother and baby's status in labor.

(d) limits its services to normal labor, therefore it does not utilize interventions such as:

(i) vacuum extraction;

(ii) medications to speed up labor;

(iii) continuous electronic monitoring; and

(iv) epidural nerve block.

(7) The birth center has a specific plan for transferring to a hospital if complications arise before, during labor, or after birth and interventions are required.

(8) Staffing and personnel requirements for a birth center include:

(a) professional staff and consulting specialists licensed to practice their profession and having the knowledge and skills required to provide the services offered by the birth center;

(b) at least two staff members attending every birth who are trained and certified in CPR and newborn resuscitation;

(c) staff members who are trained according to the policies and procedures of the birth center;

(d) the birth center must keep a schedule for clinical staff on call, to make sure all shifts are covered, day and night, seven days a week; and

(e) the birth center must conduct regular emergency drills to make sure staff members are prepared to manage unexpected situations with laboring mothers and newborns.

(9) Health record requirements for a birth center include:

(a) forms appropriate for use in a birth center, and clinicians document patient care accordingly;

(b) use of the chart supports a full prenatal exam to ensure that all clients are low risk;

(c) educates clients on self-care in pregnancy, including:

(i) nutritional counseling;

(ii) informed decision-making about pain relief in labor; and

(iii) newborn care.

(10) The birth center maintains a plan for coordinating the transfer of the patient chart to another facility if the mother or newborn needs to be transferred and clearly communicates this plan to the mother.

(11) Quality assessment and improvement activity requirements for a birth center include:

(a) a well defined quality improvement program;

(b) reviews of its practices and clinical outcomes on a regular basis to ensure that it follows its own policies;

(c) procedures to actively seek client feedback, and then evaluate complaints and suggestions and work to improve client satisfaction on a regular basis; and

(d) staff must be evaluated on a regular basis to ensure competency and alignment with birth center policies.

History: 50-5-103, 53-6-106, MCA; IMP, 50-5-103, 50-5-201, MCA; NEW, 2011 MAR p. 578, Eff. 4/15/11.