(a)

1. (1) Each institution shall have an administrator responsible for the management of the institution.

2. (2) The responsibilities of the administrator shall include:

   1. (A) Keeping the governing body fully informed of the status of the freestanding birthing center by:

(i) Submitting periodic written reports; or

1. (ii) Attending meetings of the governing body;

   1. (B) Conducting meetings at regular intervals and maintaining minutes of the meetings; and
   2. (C) Preparation of an annual operating budget to be submitted to the governing body for approval.

(b)

1. (1) Policies and procedures shall be provided for:

   1. (A) The general administration of the facility; and
   2. (B) Each service.
2. (2) All policies and procedures shall have evidence of ongoing review and/or revision.

3. (3) The first page of each manual shall have the:

   1. (A) Annual review date; and

   2. (B) Signature of the department supervisor and/or person or persons conducting the review.

      1. (c) Provisions shall be made for safe storage of patients’ valuables.
      2. (d)
4. (1) Each facility shall develop and maintain a written disaster plan that includes provisions for complete evacuation of the facility.
5. (2) The plan shall provide for widespread disasters as well as for disasters occurring within the local community and freestanding birthing center.
6. (3) The disaster plan shall be rehearsed at least twice a year, preferably as part of a coordinated drill in which other community emergency agencies participate.
7. (4) One (1) drill shall simulate a disaster of internal nature and the other external.
8. (5) Written reports and evaluation of all drills shall be maintained.

(e)

1. (1) There shall be a posted list of names, telephone numbers, and addresses available for emergency use.

2. (2) The list shall include:

   1. (A) Center management personnel and staff;
   2. (B) The local police department;
   3. (C) The fire department;
   4. (D) Ambulance service;
   5. (E) The Red Cross; and
   6. (F) Other available emergency units.
3. (3) The list shall be reviewed and updated at least every six (6) months.

(f) There shall be current reference material available onsite to meet the professional and technical needs of freestanding birthing center personnel, including current:

1. (1) Books;
2. (2) Periodicals; and
3. (3) Other pertinent materials.

(g) All employees shall be required to have annual in-services on:

1. (1) Safety;
2. (2) Fire safety;
3. (3) Back safety;
4. (4) Infection control;
5. (5) Standard precautions;
6. (6) Disaster preparedness; and
7. (7) Confidential information.

(h)

1. (1) Procedures shall be developed for the retention and accessibility of the patients' medical records if the freestanding birthing center closes.

2. (2) The medical records shall be:

   1. (A) Stored within the State of Arkansas for the required retention period; and

   2. (B) Accessible for patient use.

      1. (i)
3. (1) Any freestanding birthing center that closes shall meet the requirements for new construction in order to be eligible for relicensure.
4. (2) Once a facility closes, it is no longer licensed.
5. (3) The license shall be immediately returned to the Division of Health Facilities Services.
6. (4) To be eligible for licensure, all the referenced National Fire Codes (NFPA) and health regulations shall be met.

(j)

1. (1) The freestanding birthing center administrator shall develop policies and procedures that, upon request of the patient, an itemized statement of all services shall be provided within thirty (30) days after discharge or thirty (30) days after request, whichever is later.
2. (2) The policy shall include a statement advising the patient in writing of her right to receive the itemized statement of all services.

(k)

1. (1) A general consent for medical treatment and care shall be signed by the patient or legal guardian.

2. (2) Written or verbal consent shall not release the facility or its personnel from upholding the rights of its patients, including but not limited to the right to:

   1. (A) Privacy;
   2. (B) Dignity;
   3. (C) Security;
   4. (D) Confidentiality; and

   5. (E) Freedom from abuse or neglect.

      1. (l)
3. (1) The center shall have a procedure for infant identification at the time of birth that shall be sufficient to identify the infant or infants with one (1) mother.
4. (2) Large freestanding birthing centers shall use waterproof plastic identification bands with tag inserts written in waterproof ink.

5. (3) These shall be placed on the mother and infant in the birthing room at the time of delivery and shall remain in place during the entire stay.

   1. (m) A record book shall:
6. (1) Be kept up-to-date; and

7. (2) Contain the following information:

   1. (A) Mother's maiden name and father’s name;

   2. (B) Baby's:

      1. (i) Sex;
      2. (ii) Date, time, and place of birth; and
   3. (C) Physicians', certified nurse midwives’, and/or registered nurses’ names.

(p) Policies and procedures shall include but are not limited to:

1. (1) Initial risk assessment;
2. (2) Criteria for maternal transfer to an acute care facility during the antepartal, intrapartal, and postpartum phases;
3. (3) Criteria for infant transfer to an acute care facility;
4. (4) Admission criteria;
5. (5) Nursing assessment;
6. (6) Family support and participation;
7. (7) Medication administration;
8. (8) Care of the newborn, to include administration of prophylactic medications required by the Department of Health;
9. (9) Emergency procedures;
10. (10) Fetal demise;
11. (11) Vital statistics registration;
12. (12) Infection control; and
13. (13) Aftercare of the mother and infant.