Definitions Relating to Birthing Centers and Procedures for Licensing Birthing Centers

PURPOSE: This rule defines terminology used in this chapter and establishes procedures for licensing birthing centers. (1) The following definitions shall be used in the interpretation and enforcement of 19 CSR 30-30.090 through 19 CSR 30-30.110: (A) Administrator—A person who is designated to provide daily supervision and the administration of the birthing center; (B) Birthing center—A facility, not licensed as part of a hospital, which provides maternity care away from the mother’s usual residence and where low risk births are planned to occur following a normal uncomplicated pregnancy; (C) Certified nurse-midwife (CNM)—A person licensed to practice professional nursing under section 335.046, RSMo and currently certified by examination by the American College of Nurse-Midwives; (D) Complication—A condition according to written risk criteria of the birthing center that contraindicates continued care in the birthing center; (E) Department—The Missouri Department of Health; (F) Discharge plan—A plan for continuing maternal and infant health care following birth; (G) Health assessment—A determination of a patient’s physical and mental status; (H) Low risk—Normal, uncomplicated prenatal course as determined by adequate prenatal care and prospects for a normal, uncomplicated birth as defined by reasonable and currently accepted criteria of maternal and fetal health; (I) Person—Any individual, firm, partnership, corporation or association; (J) Physician—A person licensed to practice medicine under Chapter 334, RSMo who has admitting privileges at a hospital; (K) Primary care giver—A physician or a certified nursemidwife who has attended the mother during the prenatal period, will be present at delivery and will be responsible for care during the puerperium period; and (L) Qualified personnel—A person trained and competent in the services which s/he provides and is licensed or certified as required by statute or professional standard. (2) The following procedures are required for licensing a birthing center: (A) A license to establish and operate a birthing center shall be required of any facility other than a hospital or the mother’s residence where births are planned to occur and where childbirth deliveries may be performed; (B) Application for licensure of a birthing center shall be made in writing to the department on forms provided by the department. Each application for a license shall be accompanied by an annual license fee of two hundred dollars ($200); (C) The application shall be made by the person(s) or corporation operating the facility; (D) The licensee shall notify the department in writing of any change in the name of the facility or change in the ownership; (E) Separate licenses are required for facilities maintained on separate sites even though operated by the same owner; (F) The license shall be conspicuously posted in a public area in the facility; and (G) A license shall not be issued by the department until a facility is in compliance with all requirements of 19 CSR 3030.090. In addition, a facility shall be in compliance with 19 CSR 30-30.100 or 19 CSR 30-30.110, depending on the number of birthing rooms in the facility. SENIOR SERVICES AUTHORITY: section 197.225, RSMo 1994.* Emergency rule filed May 1, 1995, effective May 10, 1995, expired Sept. 7, 1995.* Original rule filed May 1, 1995, effective Nov. 30, 1995. Emergency amendment filed June 19, 1998, effective July 1, 1998, expired Feb. 25, 1999. Amended: Filed June 19, 1998, effective Jan. 30, 1999. *Original authority 1975, amended 1986.