NAC449.3655. Obstetrical services: Transfer or discharge of patient.

     1. No person may be transferred or discharged from an obstetric department of a hospital unless:

     (a) The transfer or discharge is appropriate based on a risk assessment of the patient;

     (b) A physician determines that the patient is not in active labor; or

     (c) A physician determines that the medical needs of the patient exceed the capability of the obstetric department.

     2. The criteria for the transfer of a patient must be in writing and included in the manual for policies and procedures of the obstetric department.

     3. A patient in the obstetric department may be transferred only to a hospital capable of providing a higher level of obstetrical and neonatal care and for which there are written documents which verify that the receiving hospital agrees to accept emergency patients without regard to their ability to pay.

     4. The obstetric department shall establish written protocols for the discharge of patients from the hospital, which include, without limitation:

     (a) The provision of instructions to the mother regarding the care and feeding of her newborn;

     (b) Plans for the examination of the mother and newborn after discharge;

     (c) The provision of instructions to the mother regarding the availability of consultation services by telephone or home visit, as needed or requested by the mother; and

     (d) The criteria and conditions under which a patient or newborn should be considered for transfer. Such a determination must be made by a qualified member of the medical staff and the criteria and conditions must be included in the written policies and procedures of clinical practices for the obstetric department. The written policies must be reviewed periodically by a qualified member of the medical staff and a review of all such transfers must be included in the quality improvement program established pursuant to NAC 449.3152.

     (Added to NAC by Bd. Health by R050-99, eff. 9-27-99)