Definitions Applicable to 105 CMR 130.601 through 130.650

The following definitions apply in 105 CMR 130.000 when used with regard to maternal and newborn services: Antepartum Patient. Any pregnant person who is characterized as having a high-risk obstetric complication or a pregnant patient with a medical or surgical condition. Audiologist. An audiologist licensed by the Commonwealth of Massachusetts pursuant to the Board of Registration of Speech-language Pathology and Audiology regulations at 260 CMR 1.00: Standards, Complaint and Grievance Procedure, who meets such requirements for additional experience as defined by the Department in the Universal Newborn Hearing Screening Guidelines. Birth Hospital. For the purposes of 105 CMR 130.000, a hospital with a maternal and newborn service, as designated by the Department pursuant to 105 CMR 130.000, or a hospital without a maternal and newborn service but with a pediatric service, as designated by the Department pursuant to 105 CMR 130.700, from which an infant may be initially discharged to home. Birthing Room. A room designed to provide family-centered care in a "homelike" environment for low-risk mothers throughout the labor, delivery and immediate recovery periods. Certified Nurse Midwife. An individual authorized by the Board of Registration in Nursing under M.G.L. c. 112, § 80C and authorized to practice as a nurse-midwife pursuant to 244 CMR 4.00: Advanced Practice Registered Nursing. Cesarean/Delivery Room. A room staffed and equipped to handle low-risk to high-risk deliveries, including cesarean births, and have capabilities of administering all forms of anesthesia, including inhalation agents. Clinical Nurse Specialist. A registered nurse with a current license from the Massachusetts Board of Registration in Nursing. For the purpose of 105 CMR 130.601 through 130.650, the clinical nurse specialist must be master’s prepared with clinical expertise in advance nursing practice in the specialty area of maternal or neonatal health. Continuing Care Nursery. A nursery that is specially equipped and staffed to offer a variety of specialized services as specified in 105 CMR 130.630(E) to mild or moderately ill infants born at the level IB hospital or to retrotransferred stable - growing or recovery infants who do not require intensive or special care. Critical Care Obstetrics Team. A team including representatives from the following available 24 hours a day, seven days a week: Maternal-fetal medicine consultant; in-house obstetrician; in-house nursing staff with demonstrated competency in critical care; in-house anesthesia; in- house neonatologist and other medical specialties available, as needed, including at a minimum infectious disease, pulmonary, surgery, and cardiology. Critical Congenital Heart Disease. A group of defects that cause severe and life-threatening symptoms and require intervention within the first days or first year of life. Designated Service Levels. Levels of care based on services provided by the hospital as approved by the Department of Public Health. Family-centered Care. A method of providing services that fosters the establishment and maintenance of parent-newborn-family relationships. The family may consist of the parent(s) and child and may include other identified support persons (biologically or nonbiologically related) for the birthing person and infant. Family Practitioner. A physician licensed by the Massachusetts Board of Registration in Medicine who has completed a residency in family medicine, which includes training in internal medicine, pediatrics and obstetrics and is certified or board eligible for certification by the American Board of Family Practice. Freestanding Pediatric Hospital with Neonatal Subspecialty Services. A service that has the capabilities to provide care to moderatelyto severelyill newborns who require neonatal intensive care services and to newborns with medical problems. Hearing Screening. A test to detect hearing thresholds of 30 decibels or greater in either ear in the speech frequency range. The methodology shall be one defined as acceptable by the American Academy of Pediatrics and the American Speech and Hearing Association for the purposes of newborn infant hearing screening. The hospital’s or birth center’s screening outcomes shall meet referral rates established by the Department in the Universal Newborn Hearing Screening Guidelines. Labor Room. An area in which the birthing person experiences the first stage of labor. Labor-delivery Suite. That part of a maternal and newborn service used to care for patients during labor, delivery and recovery. It shall include physically contiguous labor room(s), cesarean/delivery room(s) and ancillary facilities. Labor-delivery-recovery-postpartum Room (LDRP or Single-Room Maternity Care). A room designed, staffed and equipped to care for birthing people, newborns and their families throughout the labor, delivery, recovery and postpartum periods. Labor-delivery-recovery Room (LDR). A room designed, staffed and equipped to care for birthing people, newborns and their families throughout the labor, deliveryand recoveryperiods. Lactation Consultant. An individual certified as an International Board Certified Lactation Consultant (IBCLC) or an individual with equivalent training and experience. Level I - Community-based Maternal and Newborn Service. A community-based maternal and newborn service including Level IA and Level IB services that meets the requirements in 105 CMR 130.630. Level IA Service. A community-based maternal and newborn service with a well newborn nursery that provides for the care and management of maternal conditions consistent with American College of Obstetricians and Gynecologists (ACOG) guidelines, including management of pregnancies judged unlikely to deliver before 35 weeks gestation. Level IB Service. A Level I community-based maternal and newborn service with a continuing care nursery that provides for the care and management of maternal conditions consistent with ACOG guidelines, including management of pregnancies judged unlikely to deliver before 35 weeks gestation. Level II Service. A community-based maternal and newborn service with a Special Care Nursery including Level IIA and Level IIB services that meets the requirements in 105 CMR 130.640. Level IIA Service. A community-based Level II maternal and newborn service with a Special Care Nursery that provides for the care and management of maternal conditions consistent with ACOG guidelines, including management of pregnancies judged unlikely to deliver before 34 weeks gestation. Level IIB Service. A community-based maternal and newborn service with a Special Care Nursery that provides for the care and management of maternal conditions consistent with ACOG guidelines, including management of pregnancies judged unlikely to deliver before 32 weeks gestation. Level III Maternal and Newborn Service. A maternal and newborn service that provides for the care and management of maternal conditions consistent with ACOG guidelines, including pregnancies at all gestational ages and that meets the requirements in 105 CMR 130.650. Maternal and Newborn Service. That part of the hospital in which care is routinely delivered to birthing people and newborns. Maternal-fetal Medicine Specialist. An obstetrician/gynecologist who is licensed by the Massachusetts Board of Registration in Medicine and is certified or board eligible for certification in the subspecialty of maternal-fetal medicine by the American Board of Obstetrics and Gynecology. Neonatal Fellow. A physician licensed by the Massachusetts Board of Registration in Medicine who is enrolled in a fellowship in neonatology. Neonatal Intensive Care Unit. A unit located either in a hospital with a Level III maternal and newborn service or a freestanding pediatric hospital with neonatology specialty services that provides a comprehensive range of specialty and subspecialty services to severely ill infants. Neonatal Nurse Practitioner. An individual authorized by the Massachusetts Board of Registration in Nursing under M.G.L. c. 112, § 80B and authorized to practice as a nurse practitioner pursuant to 244 CMR 4.00: Advanced Practice Registered Nursing who holds certification as a neonatal nurse practitioner from a nationally recognized accrediting body acceptable to the Board. Neonatal Resuscitation Program (NRP). The American Academyof Pediatrics’ course designed to teach resuscitation of the newborn. Neonatologist. A physician licensed by the Massachusetts Board of Registration in Medicine who is either certified or board eligible for certification in neonatology by the American Board of Pediatrics. Newborn Infant. For the purposes of 105 CMR 130.000, an infant younger than three months old. Obstetrician. A physician licensed by the Massachusetts Board of Registration in Medicine and who is certified or board eligible for certification by the American Board of Obstetrics and Gynecology. Pediatrician. A physician licensed by the Massachusetts Board of Registration in Medicine who is certified or board eligible for certification in pediatrics by the American Board of Pediatrics. Postpartum Unit. That part of a maternal and newborn service that is used exclusively for postpartum care. Postpartum beds include beds located in labor-delivery-recovery- postpartum rooms. Recovery Area. A specifically designated area within the labor-delivery suite used to care for patients recovering immediately after delivery. Retro-transfer or Retrotransferred Infant. An infant who required transfer to a more acute level facility for diagnosis or treatment not available in the birth hospital, who no longer requires these services, and is transferred back to the birth hospital or to another hospital with the level of service meeting his or her needs. Risk Assessment of the Maternal Patient. The process of medically evaluating the birthing person to determine whether they have special risks or combination of risks to her own health and well-being or to that of the fetus in order to determine the need for specialized services and which includes a review of social, economic, genetic and/or medical conditions during the prenatal, intrapartum, and/or postpartum periods. Risk Assessment of the Maternal Patient. The process of medically evaluating the birthing person to determine whether they have special risks or combination of risks to her own health and well-being or to that of the fetus in order to determine the need for specialized services and which includes a review of social, economic, genetic and/or medical conditions during the prenatal, intrapartum, and/or postpartum periods. Special Care Nursery. A nursery that is specially equipped and staffed to offer a variety of specialized services to moderately ill infants who do not require intensive care. Transfer Infant. Any infant who is transferred from the birth hospital because he or she requires acute services for diagnosis and treatment not available at the birth hospital. Well Newborn Nursery. A room housing newborns who do not need continuing care, special care of intensive care newborn services.