Section 325.1051. Physical plant.

The physical plant shall provide the following in addition to the requirements of R 325.1021, R 325.1022, R 325.1023, R 325.1025, and R 325.1026:

(a)    A hospital providing maternity care shall provide for segregation of maternity patients from other patients by section, wing, or floor, except when the director, upon the application of a hospital, grants permission to use surplus maternity beds in the postpartum suite for clean gynecological patients. Such permission shall be subject to the  following restrictions:

(i)    The hospital shall have registered 500 or  more  births  in  the preceding calendar year.

(ii)   The hospital shall have 3 or more postpartum maternity beds over and above the number required to provide adequately for all  postpartum patients as determined by the director.

(iii)    The hospital shall have maintained a minimum 85% average occupancy in its medical or surgical beds in the preceding year.

(iv)    The average length of stay for all patients shall not exceed 9.0 days in the preceding calendar year, except that a hospital with a higher average length of stay shall be given an opportunity to justify its longer average length of stay when a denial is based on this standard.

(v)   The hospital shall be free from major physical plant or operational deficiencies and items of noncompliance as determined by the director.

(vi)    The hospital shall have submitted a written plan, acceptable to the director, which demonstrates to his satisfaction that alternatives, such as consolidation of hospital obstetrical  and  newborn  services  in  the

community or the reduction of postpartum maternity beds by assignment of surplus beds to another nursing unit, are not feasible or practical. The plan shall designate the rooms and beds to be utilized by clean gynecological patients, and indicate that such patients admitted to the surplus postpartum beds will not be patients with active infection, either acute or chronic; frank malignancy other than carcinoma in situ;  patients

admitted for radiotherapy; or patients already in the hospital who are     on any other service, including the gynecological service.

(vii)    The written plan submitted by a hospital shall be acceptable to the director from the standpoint of protecting the health of mothers and babies, as well as other hospitalized patients, and shall demonstrate the development and implementation of effective medical and administrative controls to carry out the plan.

(viii)   The plan, if approved by the director, shall be in effect during the license year in which it is issued. Requests for extension of the plan, or any modification thereof, shall  be  submitted  annually  to  the

director with a  hospital's  application  for renewal  of  licensure and certification.

(b)   Separate toilet facilities shall be provided for maternity patients.

(c)   There shall be a separate delivery room.

(d)  Separate nurseries shall be provided unless complete facilities for "rooming-in" are available.

(e)   Each nursery shall have a minimum floor space of 24 square feet per bassinet. Bassinets shall be placed not less than 2 feet apart with a minimum of 3 feet between rows.

(f)  A private room with a lavatory and a toilet shall be available for the isolation of any mothers with infection, fever, or diarrhea.

(g)    There shall be an isolation nursery or a private room with running water available for the isolation of infants.

History: 1954 AC; 1979 AC.