Rules and Regulations of the State of Georgia
 

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  1. In the address bar, type about:config and press Enter.
  2. Click "I'll be careful, I promise" if a warning message appears.
  3. In the search box, search for javascript.enabled
  4. Toggle the "javascript.enabled" preference (right-click and select "Toggle" or double-click the preference) to change the value from "false" to "true".
  5. Click on the "Reload current page" button of the web browser to refresh the page.
  • 1. In the address bar, type about:config and press Enter.
  • 2. Click "I'll be careful, I promise" if a warning message appears.
  • 3. In the search box, search for javascript.enabled
  • 4. Toggle the "javascript.enabled" preference (right-click and select "Toggle" or double-click the preference) to change the value from "false" to "true".
  • 5. Click on the "Reload current page" button of the web browser to refresh the page.




ie Internet Explorer

  1. On web browser menu click "Tools" icon and select "Internet Options".
  2. In the "Internet Options" window select the "Security" tab.
  3. On the "Security" tab click on the "Custom level..." button.
  4. When the "Security Settings - Internet Zone" dialog window opens, look for the "Scripting" section.
  5. In the "Active Scripting" item select "Enable".
  6. When the "Warning!" window pops out asking "Are you sure you want to change the settings for this zone?" select "Yes".
  7. In the "Internet Options" window click on the "OK" button to close it.
  8. Click on the "Refresh" button of the web browser to refresh the page.
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 Internet Explorer < 9
  1. On web browser menu click "Tools" and select "Internet Options"
  2. In the "Internet Options" window select the "Security" tab.
  3. On the "Security" tab click on the "Custom level..." button.
  4. When the "Security Settings - Internet Zone" dialog window opens, look for the "Scripting" section.
  5. In the "Active Scripting" item select "Enable".
  6. When the "Warning!" window pops out asking "Are you sure you want to change the settings for this zone?" select "Yes".
  7. In the "Internet Options" window click on the "OK" button to close it.
  8. Click on the "Refresh" button of the web browser to refresh the page.
  • 1. ie 01
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chrome Google Chrome

  1. On the web browser menu click on the "Customize and control Google Chrome" and select "Settings".
  2. In the "Settings" section click on the "Show advanced settings..."
  3. Under the the "Privacy" click on the "Content settings...".
  4. When the dialog window opens, look for the "JavaScript" section and select "Allow all sites to run JavaScript (recommended)".
  5. Click on the "OK" button to close it.
  6. Close the "Settings" tab.
  7. Click on the "Reload this page" button of the web browser to refresh the page.
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opera Opera

  • 1. a) Click on "Menu", hover mouse on the "Settings" then hover mouse on the "Quick preferences" and mark the "Enable Javascript" checkbox.
  • 1. b) If "Menu bar" is shown click on the "Tools", hover mouse on the "Quick preferences" and mark the "Enable Javascript" checkbox.
1. a) opera10 a 1. b) opera10 b




safari Apple Safari

  1. On the web browser menu click on the "Edit" and select "Preferences".
  2. In the "Preferences" window select the "Security" tab.
  3. In the "Security" tab section "Web content" mark the "Enable JavaScript" checkbox.
  4. Click on the "Reload the current page" button of the web browser to refresh the page.
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<xmp>.</xmp> <form name="form1" method="post" action="290-5-41?urlRedirected=yes&amp;data=admin&amp;lookingfor=290-5-41" id="form1"> <input type="hidden" name="__VIEWSTATE" id="__VIEWSTATE" value="/wEPDwUKLTY5ODkwOTM2Nw8WAh4Ec3BhbQIIFgJmD2QWAgIFDw8WAh4EVGV4dAUFNCArIDRkZGQECJ5R6UIbfQf3MHxVUZLsn5vLdQ==" /> <input type="hidden" name="__VIEWSTATEGENERATOR" id="__VIEWSTATEGENERATOR" value="EEBB6393" /> <input type="hidden" name="__EVENTVALIDATION" id="__EVENTVALIDATION" value="/wEWCAKcoMOqAQLniKOhBALV5cpNAoa5iIEFAoznisYGAsrv5u0MAsrv4u0MAsrv3u0MmH5qUTSztQDY1dAjIF8jmFBnEBg=" /> <div class='popup'> <div class='cnt223'> <div style="margin-bottom:6px;"> <img alt="Rules and Regulations of the State of Georgia" src="/images/new.gif"/> </div> <div class="header"> Terms and Conditions of Agreement for Access to Rules and Regulations of the State of Georgia Website </div> <div class="scroll"> <p>(Note: certain features of this site have been disabled for the general public to prevent digital piracy. If you are an entitled government entity pursuant the Georgia Administrative Procedures Act, <a target="_new" href="http://links.casemakerlegal.com/states/GA/books/Code_of_Georgia/browse?ci=25id=gasos&amp;codesec=50-13-7&amp;title=50&amp;#50-13-7(d)">O.C.G.A.§ 50-13-7(d)</a> contact the State of Georgia's Administrative Procedures Division at 678-364-3785 to enable these features for your location.)</p> <p>To access this website, you must agree to the following: </p> <p> These terms of use are a contract between you and/or your employer (if any), and Lawriter, LLC. </p> <p> You agree that you will not copy, print, or download anything from this website for any commercial use. </p> <p> You agree not to use any web crawler, scraper, or other robot or automated program or device to obtain data from the website.</p> <p> You agree that you will not sell, will not license, and will not otherwise make available in exchange for anything of value, anything that you download, print, or copy from this site.</p> <p> You agree that you will not copy, print, or download any portion of the regulations posted on this site exceeding a single chapter of regulations for sale, license, or other transfer to a third party, except that you may quote a reasonable portion of the regulations in the course of rendering professional advice.</p> <p> If you violate this agreement, or if you access or use this website in violation of this agreement, you agree that Lawriter will suffer damages of at least $20,000. </p> <p> THIS WEBSITE AND ITS CONTENT ARE PROVIDED "AS IS." THE STATE OF GEORGIA AND LAWRITER EXPRESSLY DISCLAIM ALL WARRANTIES, INCLUDING THE WARRANTIES OF MERCHANTABILITY, FITNESS FOR A PARTICULAR PURPOSE, AND NON-INFRINGEMENT AND ARE NOT LIABLE TO ANY PERSON FOR ANY ERRORS IN INACCURACIES CONTAINED IN THIS WEBSITE. </p> <p> If you accept these terms enter the information below and click “I AGREE”.</p> </div> <table border="0" style="width: 810px"> <tr> </tr> <tr> <td style="vertical-align: text-top; width: 243px;"> Full Name:</td> <td style="width: 532px; vertical-align:super;"> <input name="firstName" type="text" id="firstName" class="txt" /> <span id="lbl_fname"><font color="Red"></font></span> </td> </tr> <tr><td style="width: 243px"> Human verification: <b> <span id="lblStopSpam">4 + 4</span>&nbsp;= </b></td><td style="width: 532px"> <input name="captcha" type="text" id="captcha" class="txt" /> <span id="lbl_captcha"><font color="Red"></font></span> &nbsp; <input name="sum" type="hidden" id="sum" value="8" /> </td></tr> </table> <input type="submit" name="Button1" value="I AGREE" id="Button1" disabled="disabled" /> <span id="alrtmsg"><font color="Red"></font></span> <input name="v1" type="hidden" id="v1" /> <input name="v2" type="hidden" id="v2" /> <input name="v3" type="hidden" id="v3" /> <p>Privacy Policy: the above information is for internal use only as related to this agreement and will not be sold or distributed.</p> </div> </div> </form> <html> <head runat="server"> <title>GA - GAC</title> <link href="_files/main.css" media="all" rel="Stylesheet" type="text/css" /> <link href="_files/treeview_old.css" media="all" rel="Stylesheet" type="text/css" /> <link href="/_files/popup.css" media="all" rel="stylesheet" type="text/css" /> <script type="text/javascript" src="/_files/treeview.js"></script> <script type="text/javascript" src="/_files/jquery-1.8.0.min.js"></script> <script type="text/javascript" src="/_files/jquery-1.10.2.js"></script> <script type="text/javascript" src="/_files/popup.js"></script> <script type="text/javascript" src="http://code.jquery.com/jquery-1.8.2.js"></script> <script type="text/javascript" src="https://ajax.googleapis.com/ajax/libs/jquery/1.8/jquery.min.js" /> <script type="text/javascript" src="/_files/jquery.popup.js"></script> <script type="text/javascript" src="/_files/jquery.popup.min.js"></script> <script type="text/javascript" src="/_files/ValidateForm.js"></script> <script src="https://code.jquery.com/jquery-1.11.3.js"></script> <link href="/_files/enablejs.css" rel="Stylesheet" type="text/css" /> <link href="/_files/forJavascript.css" rel="Stylesheet" type="text/css" /> <style type="text/css"> .collapse{background-image:url('/images/expcoll_right.png');} .expand{background-image:url('/images/expcoll_down.png');} </style> <script type="text/javascript"> $(document).ready(function(){ $("#History-parent").click(function(){ $("#History-Childs").toggle(); if ($('#History-parent img').hasClass('expand')) { $('#History-parent img').addClass('collapse'); $('#History-parent img').removeClass('expand'); $('#History-parent img').attr('src', '/images/expcoll_right.png'); } else { $('#History-parent img').removeClass('collapse'); $('#History-parent img').addClass('expand'); $('#History-parent img').attr('src', '/images/expcoll_down.png'); } }); $("#History-Childs").hide(); var tocnode=document.getElementById('toc-children'); if (tocnode != null) { if(tocnode.childNodes.length != 0) { document.getElementById("doc-content").style.width="72%"; document.getElementById("toc").style.width="21%"; document.getElementById("toc").style.padding="10px"; } else { document.getElementById('toc').style.display="none"; } } }); function fnsetRDVal(id) { if (id=="y") { document.getElementById("y").value="yes" document.getElementById("n").value="" } else { document.getElementById("n").value="no" document.getElementById("y").value="" } } </script> <script type="text/javascript"> function TermsCon() { var overlay = $('<div id="overlay"></div>'); overlay.show(); overlay.appendTo(document.body); $('.popup2').show(); $('#btnAgree').click(function () { $('.popup2').hide(); $("#overlay").hide(); overlay.appendTo(document.body).remove(); }); $("#btnprint").click(function () { var contents = $("#popupterms").html(); var frame1 = $('<iframe />'); frame1[0].name = "frame1"; frame1.css({ "position": "absolute", "top": "-1000000px" }); $("body").append(frame1); var frameDoc = frame1[0].contentWindow ? 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If you are an entitled government entity pursuant the Georgia Administrative Procedures Act, <a target="_new" href="http://links.casemakerlegal.com/states/GA/books/Code_of_Georgia/browse?ci=25id=gasos&amp;codesec=50-13-7&amp;title=50&amp;#50-13-7(d)">O.C.G.A.§ 50-13-7(d)</a> contact the State of Georgia's Administrative Procedures Division at 678-364-3785 to enable these features for your location.)</p> <p>To access this website, you must agree to the following: </p> <p> These terms of use are a contract between you and/or your employer (if any), and Lawriter, LLC. </p> <p> You agree not to use any web crawler, scraper, or other robot or automated program or device to obtain data from the website. </p> <p> You agree that you will not sell or license anything that you download, print, or copy from this website.</p> <p> THIS WEBSITE AND ITS CONTENT ARE PROVIDED "AS IS." 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name="section" class="searchfield" value="Go to Citation...." onfocus="if (this.value == 'Go to Citation....') {this.value = '';}" onblur="if (this.value == '') {this.value = 'Go to Citation....';}" type="text" /> <input class="searchbutton" value="Go" type="submit" /> <input type="hidden" name="from" value="gac" /> </div> </form> </div> </div> <HTML xmlns:xs="http://www.w3.org/2001/XMLSchema" xmlns:msxsl="urn:schemas-microsoft-com:xslt" xmlns:nll="uuid:{D3B28627-934D-41bc-8B7A-0549A8802FE4}"> <HEAD> <META http-equiv="Content-Type" content="text/html; charset=UTF-16"> </HEAD> <div id="infobar"><a href="javascript:;" accesskey="r" Name="Route" title="Route" class="quickkey"><em class="mnemonic">R</em>oute </a>:<div class="searchtips" style="float:right;margin-right:10px;color: rgb(47, 79, 79);"> <a style="text-decoration:none;color: rgb(47, 79, 79);" title="search tips" name="searchtip" href="../help.aspx#searching" target="_blank"><em class="mnemonic">S</em>earch tips</a></div><ul class="breadcrumb"> <li><a href="/GAC" name="GAC" title="GAC">GA R&amp;R</a></li> <li>&raquo; <a href="/GAC/290" title="290">Department 290</a></li> <li>&raquo; <a href="/GAC/290-5" title="290-5">Chapter 290-5</a></li> <li>&raquo; Subject 290-5-41</li> </ul> </div> </div><div id="doc" class="container"> <div id="doc-content" class="content"> <h1><nllsubject>Subject 290-5-41 BIRTH CENTERS</nllsubject></h1> <h2><a href="/GAC/290-5-41-.01" name="290-5-41-.01" title="290-5-41-.01">Rule 290-5-41-.01 Definitions</a></h2> <P>Unless a different meaning is required by the context, the following terms as used in these rules and regulations shall have the meaning hereinafter respectively ascribed to them:</P> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="290-5-41-.01(a)">(a)</a></td> <td valign="top" style="text-align:left" class="leftalign"> "Administrator" means the individual who is responsible for the day to day management of the center.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="290-5-41-.01(b)">(b)</a></td> <td valign="top" style="text-align:left" class="leftalign"> "Birth Center","Birthing Center" or "Center" means a facility, other than the laboring woman's legal residence, which admits persons for the purpose of childbearing and which facility has not been classified and licensed by the Department as a hospital.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="290-5-41-.01(c)">(c)</a></td> <td valign="top" style="text-align:left" class="leftalign"> "Birth Room" means any room within a center which is provided as an area where births take place.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="290-5-41-.01(d)">(d)</a></td> <td valign="top" style="text-align:left" class="leftalign"> "Certified Nurse Midwife" means an individual who is a Registered Nurse currently licensed in the State of Georgia and who is also certified by the American College of Nurse Midwives.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="290-5-41-.01(e)">(e)</a></td> <td valign="top" style="text-align:left" class="leftalign"> "Department" means the Georgia Department of Human Resources.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="290-5-41-.01(f)">(f)</a></td> <td valign="top" style="text-align:left" class="leftalign"> "General Anesthesia" means any drug, element or other material which is administered to eliminate all sensation and which, when administered, is accompanied by a state of unconsciousness.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="290-5-41-.01(g)">(g)</a></td> <td valign="top" style="text-align:left" class="leftalign"> "Governing Body" or "Management" means the board of directors, trustees, partnership, corporation, association, or person or group of persons who maintain and control the operation of the center and who are legally responsible for its operation.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="290-5-41-.01(h)">(h)</a></td> <td valign="top" style="text-align:left" class="leftalign"> "Hospital" means any facility which meets the requirements of and is currently licensed as a hospital under the provisions of OCGA Chapter 31-7, Article 1, and is in compliance with all rules and regulation of the Department pertaining to Maternity, Obstetrics and Newborn services.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="290-5-41-.01(i)">(i)</a></td> <td valign="top" style="text-align:left" class="leftalign"> "Local Anesthesia" means any drug which, when administered, provides localized temporary loss of sensation, but not accompanied by a state of unconsciousness.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="290-5-41-.01(j)">(j)</a></td> <td valign="top" style="text-align:left" class="leftalign"> "Low Risk Patient" means an individual who: <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="290-5-41-.01(j)1.">1.</a></td> <td valign="top" style="text-align:left" class="leftalign"> is in general good health with uncomplicated prenatal course;</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="290-5-41-.01(j)2.">2.</a></td> <td valign="top" style="text-align:left" class="leftalign"> is participating in an ongoing prenatal care and education program;</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="290-5-41-.01(j)3.">3.</a></td> <td valign="top" style="text-align:left" class="leftalign"> has no major medical problems;</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="290-5-41-.01(j)4.">4.</a></td> <td valign="top" style="text-align:left" class="leftalign"> has no significant signs or symptoms of hypertension, toxemia, hydramnios, abruptio placenta, chorioamnionitis, malformed fetus, multiple gestation, intrauterine growth retardation, fetal meconium, fetal distress, alcoholism, or drug addiction, Rh or other blood group antigen sensitization;</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="290-5-41-.01(j)5.">5.</a></td> <td valign="top" style="text-align:left" class="leftalign"> has no history of fetal wastage or premature delivery;</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="290-5-41-.01(j)6.">6.</a></td> <td valign="top" style="text-align:left" class="leftalign"> has no previous significant obstetrical complications likely to recur, nor previous uterine wall surgery or Caesarean section;</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="290-5-41-.01(j)7.">7.</a></td> <td valign="top" style="text-align:left" class="leftalign"> has parity under six unless a justification for a variation is documented by clinical staff;</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="290-5-41-.01(j)8.">8.</a></td> <td valign="top" style="text-align:left" class="leftalign"> is not a nullipara of greater than thirty six years of age;</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="290-5-41-.01(j)9.">9.</a></td> <td valign="top" style="text-align:left" class="leftalign"> is not less than sixteen years of age at onset of pregnancy;</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="290-5-41-.01(j)10.">10.</a></td> <td valign="top" style="text-align:left" class="leftalign"> is appropriate for a setting where anesthesia is limited to local infiltration of the perineum, or a pudendal block, and analgesia is limited;</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="290-5-41-.01(j)11.">11.</a></td> <td valign="top" style="text-align:left" class="leftalign"> while in active labor: <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="290-5-41-.01(j)11.(i)">(i)</a></td> <td valign="top" style="text-align:left" class="leftalign"> demonstrates no significant signs, or symptoms, or evidence of anemia, significant hypertension, placenta previa, malpositioned fetus or breech;</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="290-5-41-.01(j)11.(ii)">(ii)</a></td> <td valign="top" style="text-align:left" class="leftalign"> is progressing normally;</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="290-5-41-.01(j)11.(iii)">(iii)</a></td> <td valign="top" style="text-align:left" class="leftalign"> is without prolonged ruptured membranes; and</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="290-5-41-.01(j)11.(iv)">(iv)</a></td> <td valign="top" style="text-align:left" class="leftalign"> is not in premature labor.</td> </tr> </table> </td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="290-5-41-.01(j)12.">12.</a></td> <td valign="top" style="text-align:left" class="leftalign"> is not postmature.</td> </tr> </table> </td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="290-5-41-.01(k)">(k)</a></td> <td valign="top" style="text-align:left" class="leftalign"> "Patient" means any woman who receives antepartum, intrapartum and postpartum care, or any newborn who receives medical care, in facilities governed by these regulations.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="290-5-41-.01(l)">(l)</a></td> <td valign="top" style="text-align:left" class="leftalign"> "Permit" or "License" means an authorization granted by the Department to the Governing Board to operate a birth center.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="290-5-41-.01(m)">(m)</a></td> <td valign="top" style="text-align:left" class="leftalign"> "Physician" means an individual who is currently licensed to practice medicine in the State of Georgia and is board certified or board eligible in obstetrics, family practice or pediatrics.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="290-5-41-.01(n)">(n)</a></td> <td valign="top" style="text-align:left" class="leftalign"> "Plan of Correction" means an acceptable written plan submitted to the Department by the person or persons responsible for the center and which states proposed procedures and methods to correct the areas of non-compliance within an acceptable time frame.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="290-5-41-.01(o)">(o)</a></td> <td valign="top" style="text-align:left" class="leftalign"> "Practitioner" means a physician or a certified nurse midwife.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="290-5-41-.01(p)">(p)</a></td> <td valign="top" style="text-align:left" class="leftalign"> "Professional Staff" means the group of physicians, certified nurse midwives, other registered nurses, licensed practical nurses and other health professionals who require special licensure, certification or registration, who provide patient services at the center.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="290-5-41-.01(q)">(q)</a></td> <td valign="top" style="text-align:left" class="leftalign"> "Provisional Permit" means an authorization granted by the Department to operate a birth center on a conditional basis in order to allow a newly established center a reasonable but limited period of time, as determined by the Department, to demonstrate that operational procedures are in satisfactory compliance with these rules and regulations, or to allow an established and operating center a specific length of time to comply with these regulations, provided said center shall first present an acceptable plan of correction.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="290-5-41-.01(r)">(r)</a></td> <td valign="top" style="text-align:left" class="leftalign"> "Regional Anesthesia" means any drug, element or other material which, when administered, is accompanied by temporary sectional loss of sensation.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="290-5-41-.01(s)">(s)</a></td> <td valign="top" style="text-align:left" class="leftalign"> "Special Care Capability" means availability of on-site equipment for use in providing emergency care to adult and newborn patients.</td> </tr> </table> <h2><a href="/GAC/290-5-41-.02" name="290-5-41-.02" title="290-5-41-.02">Rule 290-5-41-.02 Application for Permits</a></h2> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="290-5-41-.02(1)">(1)</a></td> <td valign="top" style="text-align:left" class="leftalign"> The governing body shall submit an application to the Department for a permit using forms provided by the Department. No center shall be operated in Georgia without a valid permit which shall be displayed in a conspicuous place within the center. Failure or refusal by the governing body of any facility existing at the time these rules become effective to file an application for a permit within ninety (90) days shall constitute a violation of law and shall be dealt with as provided by law.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="290-5-41-.02(2)">(2)</a></td> <td valign="top" style="text-align:left" class="leftalign"> The applicant for a permit to operate a birth center shall submit a completed application and a certification that the applicant is able and willing to comply with the minimum standards for a birth center and with the rules and regulations lawfully promulgated. Each applicant shall be responsible for complying with applicable fire safety laws and shall present evidence of such compliance, prior to receiving a permit.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="290-5-41-.02(3)">(3)</a></td> <td valign="top" style="text-align:left" class="leftalign"> The application shall include complete information concerning the name and address of the applicant and the services to be provided; the ownership of the property and operation; if organized as a corporation, the names and addresses of each officer and members of the board of directors of the corporation; if organized as a partnership, the names and addresses of each partner; the identity of the medical director of the facility; and any other information which the Department may require.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="290-5-41-.02(4)">(4)</a></td> <td valign="top" style="text-align:left" class="leftalign"> The applicant shall submit evidence of approval from the State Health Planning and Development Agency, as a part of the application to the Department for a permit.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="290-5-41-.02(5)">(5)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Plans for birth centers shall be submitted to the Department for review and approval in two stages of development: <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="290-5-41-.02(5)(a)">(a)</a></td> <td valign="top" style="text-align:left" class="leftalign"> schematic drawings; and</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="290-5-41-.02(5)(b)">(b)</a></td> <td valign="top" style="text-align:left" class="leftalign"> final working drawings and specifications.</td> </tr> </table> </td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="290-5-41-.02(6)">(6)</a></td> <td valign="top" style="text-align:left" class="leftalign"> A permit shall be issued to the person or persons named only for the premises listed on the application for licensure.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="290-5-41-.02(7)">(7)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Permits are not transferable or assignable.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="290-5-41-.02(8)">(8)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Changes in ownership shall be subject to prior review and approval as required by the State Health Planning and Development Agency. Each planned change of ownership or lease shall be reported to the Department and to the State Health Planning and Development Agency at least sixty (60) days prior to such change along with an application from the proposed new owners for a new permit.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="290-5-41-.02(9)">(9)</a></td> <td valign="top" style="text-align:left" class="leftalign"> The Center shall file a new application, prior to change in ownership or location. A written amendment to the current application shall be filed when there is a change in management or operational objectives.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="290-5-41-.02(10)">(10)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Separate applications and permits are required for centers maintained in separate premises, even though they are owned or operated by the same person(s), business or corporation, and may be doing business under the same title.</td> </tr> </table> <h2><a href="/GAC/290-5-41-.03" name="290-5-41-.03" title="290-5-41-.03">Rule 290-5-41-.03 Permits</a></h2> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="290-5-41-.03(1)">(1)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Following inspection and evidence of compliance with these regulations, the Department may issue a permit. Each permit shall indicate the classifications of services to be provided and patient capacity of the center.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="290-5-41-.03(2)">(2)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Permits issued shall remain in force and effect until revoked or suspended for failure to comply with these rules and regulations.</td> </tr> </table> <h2><a href="/GAC/290-5-41-.04" name="290-5-41-.04" title="290-5-41-.04">Rule 290-5-41-.04 Provisional Permits</a></h2> <P>Provisional permits may be issued by the Department for a time specific period based on an acceptable written plan for correcting deficiencies (plan of correction) found during an inspection. Provisional permits may be revoked by the Department due to prevailing circumstances which are not acceptable to the Department. Centers which are established and operating prior to adoption of these rules and regulations may be issued provisional permits when additional time is needed to meet physical plant standards.</P> <h2><a href="/GAC/290-5-41-.05" name="290-5-41-.05" title="290-5-41-.05">Rule 290-5-41-.05 Inspections</a></h2> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="290-5-41-.05(1)">(1)</a></td> <td valign="top" style="text-align:left" class="leftalign"> The center shall be open at all reasonable hours for observation and examination by properly identified representatives of the Department.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="290-5-41-.05(2)">(2)</a></td> <td valign="top" style="text-align:left" class="leftalign"> The governing body shall notify the Department of the anticipated opening date of a newly constructed center in order that a pre-opening licensure inspection of the center may be conducted to determine compliance with these rules and regulations.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="290-5-41-.05(3)">(3)</a></td> <td valign="top" style="text-align:left" class="leftalign"> The administrator (or a designated representative) shall accompany the Department representative on all tours of inspection and shall sign the completed inspection report.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="290-5-41-.05(4)">(4)</a></td> <td valign="top" style="text-align:left" class="leftalign"> The center may be inspected at the discretion of the Department to determine whether it is continuing to meet these requirements or is making satisfactory progress in accordance with approved plans of correction.</td> </tr> </table> <h2><a href="/GAC/290-5-41-.06" name="290-5-41-.06" title="290-5-41-.06">Rule 290-5-41-.06 Organization and Administration</a></h2> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="290-5-41-.06(1)">(1)</a></td> <td valign="top" style="text-align:left" class="leftalign"> The birth center shall be organized with an identifiable governing body which is responsible for establishing objectives and policies and which assumes full legal responsibilities for the overall conduct of the center, including compliance with laws and regulations pertaining to the center. The governing body and its membership shall be identified in the application for licensure.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="290-5-41-.06(2)">(2)</a></td> <td valign="top" style="text-align:left" class="leftalign"> The ownership of the center shall be fully disclosed in the application. This disclosure shall include the names and addresses of all corporate officers and any person(s) having a five percent (5.0%) or more financial interest in the center.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="290-5-41-.06(3)">(3)</a></td> <td valign="top" style="text-align:left" class="leftalign"> The governing body shall be responsible for professional staff appointments, shall establish effective mechanisms for quality assurance, and shall ensure the accountability of the professional staff.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="290-5-41-.06(4)">(4)</a></td> <td valign="top" style="text-align:left" class="leftalign"> The organizational objectives of the center shall be clearly stated in the policies and procedures of the center.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="290-5-41-.06(5)">(5)</a></td> <td valign="top" style="text-align:left" class="leftalign"> The governing body shall appoint an administrator and shall notify the Department of such person's name.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="290-5-41-.06(6)">(6)</a></td> <td valign="top" style="text-align:left" class="leftalign"> The center shall be at all times under the personal and daily supervision and control of the administrator (or a designated representative) whose authority, duties and responsibilities shall be defined in writing. This information shall be available to the Department on request.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="290-5-41-.06(7)">(7)</a></td> <td valign="top" style="text-align:left" class="leftalign"> The center shall be available for occupancy 24 hours per day, with professional staff on call at all times.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="290-5-41-.06(8)">(8)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Criteria for admission to the center shall be clearly identified in the center's policies. The admission policy shall be submitted with the application for licensure. At a minimum, admission criteria shall include a provision that only low-risk patients will be admitted and that there will be no discrimination according to race.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="290-5-41-.06(9)">(9)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Each patient shall be provided with a copy of the fee schedule and policy regarding payment.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="290-5-41-.06(10)">(10)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Admissions to the center shall be restricted to low-risk patients who have received antepartum care in accordance with the facility's policies. The center's policies and procedures regarding management of complications shall be explained by a staff physician or certified nurse midwife.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="290-5-41-.06(11)">(11)</a></td> <td valign="top" style="text-align:left" class="leftalign"> The center shall have written policies and procedures for antepartum, intrapartum, postpartum and newborn care including physician consultation, referral, transfer and transport to the hospital and registration of vital records. A written procedure shall be established to maintain these policies.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="290-5-41-.06(12)">(12)</a></td> <td valign="top" style="text-align:left" class="leftalign"> The center shall have a written policy regarding visitation or attendance during the birth process.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="290-5-41-.06(13)">(13)</a></td> <td valign="top" style="text-align:left" class="leftalign"> The mother and newborn shall be discharged within twenty-four (24) hours after delivery, in a condition which will not endanger the well-being of either the mother or newborn, or shall be transferred to a licensed hospital. The mother and newborn will be discharged in the care of another responsible adult who will assist in their transport from the birth center.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="290-5-41-.06(14)">(14)</a></td> <td valign="top" style="text-align:left" class="leftalign"> The center shall have an organized professional staff which is responsible for the development of patient care policies and procedures and for maintaining the level of professional performance through a continuing program of staff education, and review and evaluation of care. Records of staff attendance at educational programs shall be maintained.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="290-5-41-.06(15)">(15)</a></td> <td valign="top" style="text-align:left" class="leftalign"> The center shall have a medical director who is a physician, designated by the governing body, who shall be responsible for the direction and coordination of all professional aspects of the center's program.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="290-5-41-.06(16)">(16)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Practitioners applying for center privileges shall sign an agreement to abide by the center's policies and procedures.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="290-5-41-.06(17)">(17)</a></td> <td valign="top" style="text-align:left" class="leftalign"> The center shall have specific policies and procedures for infection control, which include a mechanism for reporting to the Department those infections which develop within 6 weeks after discharge of the patient from the center, using forms provided by the Department.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="290-5-41-.06(18)">(18)</a></td> <td valign="top" style="text-align:left" class="leftalign"> The center shall submit annually to the Department a statistical summary of morbidity and mortality data on forms supplied by the Department.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="290-5-41-.06(19)">(19)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Nothing in these rules and regulations shall prevent a licensed hospital from organizing and providing a birth center as an integral part of its facility, so long as the provided services are included in the application under which the hospital license is granted.</td> </tr> </table> <h2><a href="/GAC/290-5-41-.07" name="290-5-41-.07" title="290-5-41-.07">Rule 290-5-41-.07 Transfer and Transport Capability</a></h2> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="290-5-41-.07(1)">(1)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Each birth center shall have a written agreement with a hospital(s) which is licensed to provide obstetrical services, for emergency care. Each physician practicing in the birth center shall have admitting privileges at the back-up hospital.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="290-5-41-.07(2)">(2)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Each birth center shall have a written agreement with the emergency back-up hospital for acceptance and examination of laboratory specimens to expedite treatment, prior to formal admission procedures.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="290-5-41-.07(3)">(3)</a></td> <td valign="top" style="text-align:left" class="leftalign"> The center shall have the capability to transfer and transport the adult and/or newborn patients to the contract hospital within thirty (30) minutes of initiation of transfer procedure to the arrival on the obstetric/newborn service of the hospital. Documentation of each transfer shall be maintained by the center to substantiate to the Department that it has met this requirement.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="290-5-41-.07(4)">(4)</a></td> <td valign="top" style="text-align:left" class="leftalign"> The center shall have a written contract with a licensed ambulance service which will assure timely response.</td> </tr> </table> <h2><a href="/GAC/290-5-41-.08" name="290-5-41-.08" title="290-5-41-.08">Rule 290-5-41-.08 Professional Services</a></h2> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="290-5-41-.08(1)">(1)</a></td> <td valign="top" style="text-align:left" class="leftalign"> All services provided by or in the center shall be performed by persons who are appropriately licensed or certified to perform such services in accordance with the laws of the State of Georgia. There shall be qualified staff members to provide for patient needs. At least one physician, certified nurse midwife or registered nurse shall be present at all times that the facility is open whenever a patient (mother or new born) is in the facility. </td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="290-5-41-.08(2)">(2)</a></td> <td valign="top" style="text-align:left" class="leftalign"> All services shall occur within a health care system which provides for medical consultation, collaborative management or referral. </td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="290-5-41-.08(3)">(3)</a></td> <td valign="top" style="text-align:left" class="leftalign"> All intrapartal services shall be under the direct supervision of a physician or a certified nurse midwife. At least one other member of the professional staff shall also be present at each delivery. </td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="290-5-41-.08(4)">(4)</a></td> <td valign="top" style="text-align:left" class="leftalign"> The center shall establish written policies and procedures for emergency services to patients and shall require each professional staff member to receive instruction in emergency treatment of adult and infant patients, upon employment and at least annually thereafter. </td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="290-5-41-.08(5)">(5)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Each medical staff member shall have admitting privileges or a written agreement with a staff physician to provide services at the contract hospital. Documentation to show compliance with this requirement shall be maintained in the center. </td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="290-5-41-.08(6)">(6)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Definite means of identification shall be applied to every infant immediately after birth. Such identification shall remain on the infant until discharged. The permanent records of each newborn shall include footprints. </td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="290-5-41-.08(7)">(7)</a></td> <td valign="top" style="text-align:left" class="leftalign"> The center shall have written policies and procedures to ensure (a) metabolic screening of all newborns within one week of age, (b) assessment of newborn status, including Apgar score at one and five minutes, (c) prevention of eye infection, (d) umbilical cord care, and (e) periodic observation and assessment after birth until the infant's condition is stable. These policies shall be developed in consultation with a pediatrician. </td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="290-5-41-.08(8)">(8)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Policies, procedures and facilities shall be provided for proper collection, storage and laboratory testing of cord blood for necessary studies on Rh Negative and O Positive mothers and a supply of Rhogam or other appropriate treatment material shall be readily available for use when needed. </td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="290-5-41-.08(9)">(9)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Prior to discharge, each newborn shall be examined by a physician. </td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="290-5-41-.08(10)">(10)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Verbal and written instructions shall be provided for observation and care of both the mother and newborn after discharge. </td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="290-5-41-.08(11)">(11)</a></td> <td valign="top" style="text-align:left" class="leftalign"> A joint conference involving physicians, nurses, representatives of administration and other health personnel responsible for obstetric and newborn care shall be conducted at least quarterly to discuss morbidity and mortality. All fetal and newborn deaths and transfers occurring within the interval since the previous conference shall be reviewed. Minutes shall be kept of the meetings and shall be available to the Department. </td> </tr> </table> <h2><a href="/GAC/290-5-41-.09" name="290-5-41-.09" title="290-5-41-.09">Rule 290-5-41-.09 Personnel</a></h2> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="290-5-41-.09(1)">(1)</a></td> <td valign="top" style="text-align:left" class="leftalign"> The center shall require that each employee receives a health examination up on employment. The examination shall be in sufficient detail, including pertinent laboratory and tuberculosis screening, to assure that the employee is able to perform assigned tasks. The center shall have a policy for monitoring the health status of employees.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="290-5-41-.09(2)">(2)</a></td> <td valign="top" style="text-align:left" class="leftalign"> There shall be a separate personnel folder maintained for each employee. This personnel file shall contain all pertinent information concerning the employee, including the application for employment and qualifications for employment, verifications of physical examinations, job description and a copy of current Georgia license for those required to be licensed.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="290-5-41-.09(3)">(3)</a></td> <td valign="top" style="text-align:left" class="leftalign"> There shall be an on-going program of continuing education for all personnel. This shall include aspects of fire safety and the disaster plan for moving personnel and patients to safety and for handling patient emergencies.</td> </tr> </table> <h2><a href="/GAC/290-5-41-.10" name="290-5-41-.10" title="290-5-41-.10">Rule 290-5-41-.10 Health Services Information System</a></h2> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="290-5-41-.10(1)">(1)</a></td> <td valign="top" style="text-align:left" class="leftalign"> The birth center shall establish and maintain an organized health services information system for the collection, processing, maintenance, storage and retrieval of information concerning health services received by the patient.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="290-5-41-.10(2)">(2)</a></td> <td valign="top" style="text-align:left" class="leftalign"> An individual medical record shall be maintained within the system for each patient, and shall include the following data: <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="290-5-41-.10(2)(a)">(a)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Identification-name, address, identifying number, date of first visit, age or birth date, sex, marital status, occupation, telephone number, and name and telephone number of person to contact in event of an emergency;</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="290-5-41-.10(2)(b)">(b)</a></td> <td valign="top" style="text-align:left" class="leftalign"> An initial health evaluation including a chronological record of past medical history, drug use profile, personal and family history and results of physical examinations, including laboratory and x-ray reports;</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="290-5-41-.10(2)(c)">(c)</a></td> <td valign="top" style="text-align:left" class="leftalign"> A health care plan which includes information regarding each visit;</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="290-5-41-.10(2)(d)">(d)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Clinical diagnosis or impression, studies ordered, treatment given, disposition, recommendations, and instructions to patient, complete with a progress note for each follow-up visit.</td> </tr> </table> </td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="290-5-41-.10(3)">(3)</a></td> <td valign="top" style="text-align:left" class="leftalign"> The system shall be kept current and available to staff or agencies authorized to use the system.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="290-5-41-.10(4)">(4)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Medical records shall be preserved as original records, microfilms or other usable forms and shall be such as to afford a basis for complete audit of professional information. Centers shall retain all medical records or shall assure that they are maintained in a manner acceptable to the Department at least until the sixth anniversary of the patient's discharge. In the case of patients who have not attained majority at the time of the discharge, centers shall retain such records for at least six (6) years after the patient reaches age of majority. In the event a center shall cease operation, the Department shall be advised of the location of said records.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="290-5-41-.10(5)">(5)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Sufficient space and equipment for record processing, storage and retrieval shall be provided.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="290-5-41-.10(6)">(6)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Policies and procedures shall be written and implemented to assure organization and continuous maintenance of the health information system.</td> </tr> </table> <h2><a href="/GAC/290-5-41-.11" name="290-5-41-.11" title="290-5-41-.11">Rule 290-5-41-.11 Clinical Laboratory Services</a></h2> <P>If laboratory services are provided on site, the laboratory shall be licensed under the provisions of the Georgia Laboratory Licensure Law of 1970, O.C.G.A. Chapter 31-22, and applicable rules and regulations.</P> <h2><a href="/GAC/290-5-41-.12" name="290-5-41-.12" title="290-5-41-.12">Rule 290-5-41-.12 Drug Storage and Administration</a></h2> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="290-5-41-.12(1)">(1)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Each center shall provide adequate space and equipment and staff to assure that drugs are stored and administered in compliance with State and Federal laws and regulations.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="290-5-41-.12(2)">(2)</a></td> <td valign="top" style="text-align:left" class="leftalign"> No drugs shall be dispensed at the facility unless pharmacy regulations are met.</td> </tr> </table> <h2><a href="/GAC/290-5-41-.13" name="290-5-41-.13" title="290-5-41-.13">Rule 290-5-41-.13 Food Service</a></h2> <P>If food services are provided, the facility must comply with Georgia Laws and Food Services Rules and Regulations of the Department.</P> <h2><a href="/GAC/290-5-41-.14" name="290-5-41-.14" title="290-5-41-.14">Rule 290-5-41-.14 Anesthesia</a></h2> <P>General or regional anesthesia shall not be utilized in a birth center. Local or pudendal anesthesia is permitted.</P> <h2><a href="/GAC/290-5-41-.15" name="290-5-41-.15" title="290-5-41-.15">Rule 290-5-41-.15 Physical Plant and Operational Standards</a></h2> <P>The following minimum physical plant and operational standards shall be met:</P> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="290-5-41-.15(a)">(a)</a></td> <td valign="top" style="text-align:left" class="leftalign"> The center shall provide sufficient space and equipment for patient and visitor waiting area, examination and treatment rooms, birth rooms, special care capability, and for staff and administrative areas. Birthrooms shall each have at least 100 square feet of area, exclusive of bathroom, toilet or entry way, and be designed and located to prevent traffic through them to any other part of the center.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="290-5-41-.15(b)">(b)</a></td> <td valign="top" style="text-align:left" class="leftalign"> The Department may deny the center a permit if it does not comply with Federal, State and local laws, codes, ordinances, and regulations which apply to its location, construction, maintenance and operation.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="290-5-41-.15(c)">(c)</a></td> <td valign="top" style="text-align:left" class="leftalign"> It shall be the responsibility of the governing body to assure that the center is in a safe condition at all times, and that a fire inspection record is maintained on equipment, systems, and areas that may present a hazard to occupants.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="290-5-41-.15(d)">(d)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Fire and internal disaster drills shall be conducted at least quarterly and the time of the drill and results documented.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="290-5-41-.15(e)">(e)</a></td> <td valign="top" style="text-align:left" class="leftalign"> In addition to requirements specified herein, and those required by local ordinances or regulations, the construction of a birth center shall meet the requirements of the Georgia Safety Fire Commissioner, Chapter 120-3-3,* March 1, 1979, and subsequent revisions thereto. Applications for licensure shall be accompanied by written evidence that these requirements have been met.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="290-5-41-.15(f)">(f)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Entrances for patients shall be connected to the public right-of-way by a hard-surfaced, unobstructed walkway in good rapair. Access for handicapped individuals shall be provided at a minimum of one entrance. A hard-surfaced, unobstructed road or driveway for use by ambulances or other emergency vehicles shall run from at least one entrance of the building to the public right-of-way. The doorway of such entrance shall be immediately adjacent to the road or driveway. If such doorway is not on the same level as the road, a ramp shall provide a continuous, unobstructed plane to the entrance.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="290-5-41-.15(g)">(g)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Services provided in multi-story buildings shall be accessible by an elevator of adequate size to accommodate a standard wheeled litter patient and two attendants. Multi-story buildings will be considered to have met this requirement when patients are located only on ground level floors with outside exits. A stairway or ramp of adequate dimensions shall be available for transfer of patients in case of power failure.</td> </tr> </table> <P><B>*EDITORIAL NOTE:</B> A copy of said Chapter 120-3-3, Rules and Regulations of the Safety Fire Commissioner, was filed with this Chapter 290-5-41 and is on file with same in the Office of Secretary of State.</P> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="290-5-41-.15(h)">(h)</a></td> <td valign="top" style="text-align:left" class="leftalign"> The birth center shall be constructed, equipped, and maintained to assure the safety of patients and personnel. The following requirements shall apply within the center: <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="290-5-41-.15(h)1.">1.</a></td> <td valign="top" style="text-align:left" class="leftalign"> Birth rooms shall be designed and located to prevent traffic through them to any other part of the center.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="290-5-41-.15(h)2.">2.</a></td> <td valign="top" style="text-align:left" class="leftalign"> The walls and floors of birth rooms, examination rooms and staff dressing and scrub areas shall be of material that will permit frequent washing and cleaning.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="290-5-41-.15(h)3.">3.</a></td> <td valign="top" style="text-align:left" class="leftalign"> Staff dressing rooms and scrub facilities shall be convenient to the birth rooms, and shall include a knee, elbow, wrist or foot operated sink soap dispenser and brushes.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="290-5-41-.15(h)4.">4.</a></td> <td valign="top" style="text-align:left" class="leftalign"> Toilet and handwashing facilities shall be accessible to patients from the birth room. Convenient handwashing facilities shall be provided for both staff and patient and shall be provided with soap dispenser and individual or disposable towels. The use of common towels is prohibited</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="290-5-41-.15(h)5.">5.</a></td> <td valign="top" style="text-align:left" class="leftalign"> The center shall be arranged and organized in such a manner as to ensure the comfort, safety, hygiene, privacy and dignity of patients treated therein.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="290-5-41-.15(h)6.">6.</a></td> <td valign="top" style="text-align:left" class="leftalign"> A clean up room for equipment shall be provided.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="290-5-41-.15(h)7.">7.</a></td> <td valign="top" style="text-align:left" class="leftalign"> The center shall have an audible alarm system with control switches in all birth rooms which can be activated during an emergency.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="290-5-41-.15(h)8.">8.</a></td> <td valign="top" style="text-align:left" class="leftalign"> The center shall have special care capability which includes but is not necessarily limited to the following, for both adults and infants: resuscitation equipment, intravenous solutions, drugs, oxygen, suction, infant stethoscope and transfer isolette. Such emergency equipment shall be provided on each floor on which patients are served.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="290-5-41-.15(h)9.">9.</a></td> <td valign="top" style="text-align:left" class="leftalign"> Each birthroom shall have an infant resuscitation tray with a laryngoscope, positive pressure bag and mask and endotracheal tubes.</td> </tr> </table> </td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="290-5-41-.15(i)">(i)</a></td> <td valign="top" style="text-align:left" class="leftalign"> The center shall provide space and facilities for administrative activities, including offices, medical records and other files and storage of supplies.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="290-5-41-.15(j)">(j)</a></td> <td valign="top" style="text-align:left" class="leftalign"> A waiting room and patient admissions area(s) shall be provided. There shall also be space for storage of personal belongings of staff, patients and visitors.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="290-5-41-.15(k)">(k)</a></td> <td valign="top" style="text-align:left" class="leftalign"> The center shall have adequate and conveniently located toilets and handwashing facilities for its staff, employees, patients and visitors.</td> </tr> </table> <h2><a href="/GAC/290-5-41-.16" name="290-5-41-.16" title="290-5-41-.16">Rule 290-5-41-.16 Housekeeping, Laundry, Maintenance and Sterile Supplies</a></h2> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="290-5-41-.16(1)">(1)</a></td> <td valign="top" style="text-align:left" class="leftalign"> The center shall ensure that housekeeping and maintenance is adequate to maintain the center and equipment in a clean condition and state of good repair. An equipment clean-up area with adequate plumbing, including a sink with counter, shall be provided within the center.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="290-5-41-.16(2)">(2)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Laundry service shall be provided either in house or by contractual arrangement. Separate space and facilities shall be provided for receiving, sorting and storing soiled laundry and for the sorting, storing and issuing of clean laundry, if reusable items are utilized.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="290-5-41-.16(3)">(3)</a></td> <td valign="top" style="text-align:left" class="leftalign"> There shall be adequate space and facilities for receiving, packaging and proper sterilization end storage of supplies and equipment consistent with the services to be provided.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="290-5-41-.16(4)">(4)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Special precaution shall be taken to ensure that sterile instruments and supplies are kept separate from nonsterile instruments and supplies. Equipment for sterilization of instruments and supplies shall be conveniently located and of adequate capacity for the work load. Records shall be maintained to assure quality control, including, date, time and temperature of each batch of sterilized supplies and equipment. Sterilization performance shall be checked and records shall be kept. Sterile items shall be dated and utilized, based on established procedures.</td> </tr> </table> <h2><a href="/GAC/290-5-41-.17" name="290-5-41-.17" title="290-5-41-.17">Rule 290-5-41-.17 Electrical Power</a></h2> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="290-5-41-.17(1)">(1)</a></td> <td valign="top" style="text-align:left" class="leftalign"> All electrical work and equipment shall be designed and installed in accordance with State and local laws and ordinances.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="290-5-41-.17(2)">(2)</a></td> <td valign="top" style="text-align:left" class="leftalign"> All areas of the center shall have sufficient artifical lighting, for designated purposes.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="290-5-41-.17(3)">(3)</a></td> <td valign="top" style="text-align:left" class="leftalign"> All centers shall have an alternative lighting source for emergency use in the event of a power failure.</td> </tr> </table> <h2><a href="/GAC/290-5-41-.18" name="290-5-41-.18" title="290-5-41-.18">Rule 290-5-41-.18 Sanitation and Waste Disposal</a></h2> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="290-5-41-.18(1)">(1)</a></td> <td valign="top" style="text-align:left" class="leftalign"> The center shall maintain sanitary conditions throughout the premises. This shall include the water supply, sewerage, and solid waste disposal systems. Such facilities shall meet local and State regulations.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="290-5-41-.18(2)">(2)</a></td> <td valign="top" style="text-align:left" class="leftalign"> All garbage, trash and waste shall be stored and disposed of in a manner that will not permit the transmission of disease, create a nuisance, or provide a breeding place for insects or rodents.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="290-5-41-.18(3)">(3)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Obstetrical wastes and contaminated materials shall be disposed of by incineration or other means acceptable to the Department.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="290-5-41-.18(4)">(4)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Effective means shall be provided at all outside doors, windows and other openings to the center to prevent the entrance and harborage of flies, other insects and rodents.</td> </tr> </table> <h2><a href="/GAC/290-5-41-.19" name="290-5-41-.19" title="290-5-41-.19">Rule 290-5-41-.19 Advertising</a></h2> <P>Any advertising of the services provided in or by a birth center shall be truthful and shall include the full name of the center and its Georgia license number, as shown on the face of the permit.</P> <h2><a href="/GAC/290-5-41-.20" name="290-5-41-.20" title="290-5-41-.20">Rule 290-5-41-.20 Waivers and Variances</a></h2> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="290-5-41-.20(1)">(1)</a></td> <td valign="top" style="text-align:left" class="leftalign"> The Department upon application may grant variances or waivers of specific rules and regulations as provided for in O.C.G.A. Section <a href="https://links.casemakerlegal.com/states/ga/books/Code_of_Georgia/browse?ci=25&amp;id=gasos&amp;codesec=31-2-4&amp;title=31#" target="_newtab">31-2-4</a>, when it has been shown that the rule or regulation is not applicable or to allow experimentation and demonstration of new and innovative approaches to delivery of services.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="290-5-41-.20(2)">(2)</a></td> <td valign="top" style="text-align:left" class="leftalign"> The Department may exempt classes of facilities from regulation as provided for in O.C.G.A. Section <a href="https://links.casemakerlegal.com/states/ga/books/Code_of_Georgia/browse?ci=25&amp;id=gasos&amp;codesec=31-2-4&amp;title=31#" target="_newtab">31-2-4</a>, when regulation would not permit the purpose intended or the class of facilities is subject to similar requirements under other rules and regulations.</td> </tr> </table> <h2><a href="/GAC/290-5-41-.21" name="290-5-41-.21" title="290-5-41-.21">Rule 290-5-41-.21 Enforcement</a></h2> <P>A birth center which fails to comply with these rules and regulations shall be subject to denial of a permit, revocation of its permit or provisional permit and other sanctions provided by law. The enforcement and administration of the rules and regulations: shall be as prescribed in O.C.G.A. Chapter 31-5, Enforcement and Administrative Procedure, which includes provision for:</P> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="290-5-41-.21(a)">(a)</a></td> <td valign="top" style="text-align:left" class="leftalign"> the misdemeanor penalty for violation of rules and regulations promulgated under this Title;</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="290-5-41-.21(b)">(b)</a></td> <td valign="top" style="text-align:left" class="leftalign"> injunctive relief under appropriate circumstances;</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="290-5-41-.21(c)">(c)</a></td> <td valign="top" style="text-align:left" class="leftalign"> the Inspection Warrant; and</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="290-5-41-.21(d)">(d)</a></td> <td valign="top" style="text-align:left" class="leftalign"> the due process requirements of notice, hearing and appeals.</td> </tr> </table> <h2><a href="/GAC/290-5-41-.22" name="290-5-41-.22" title="290-5-41-.22">Rule 290-5-41-.22 Applicability of Regulations</a></h2> <P>These regulations are applicable to any building or facility which is or shall be classified by the Department of Human Resources as a birth center and the services provided there in, and expressly do not modify or revoke any of the provisions of the published rules of the Department of Human Resources, Chapter 290-5-6 (Rules and Regulations for Hospitals), or of Chapter 290-5-32 (Rules and Regulations for Performance of Abortions After the First Trimester of Pregnancy and Reporting Requirements for all Abortions), or of revisions which may be made to said regulations.</P> <h2><a href="/GAC/290-5-41-.23" name="290-5-41-.23" title="290-5-41-.23">Rule 290-5-41-.23 Severability</a></h2> <P>In the event that any rule, sentence, clause or phrase of any of these rules and regulations may be construed by any court of competent jurisdiction to be invalid, illegal, unconstitutional, or otherwise unenforceable, such determination or adjudication shall in no manner affect the remaining rules or portions there of and such remaining rules or portions there of shall remain of full force and effect, as if such rule or portions there of so determined, declared or adjudged invalid or unconstitutional were not originally a part here of. It is the intent of the Board of Human Resources to establish rules and regulations that are constitutional and enforceable so as to safeguard the health and well-being of the people of the State.</P> </div> </div> </HTML> </div> <div id="toc" class="sidebar noprint"> <ul id="toc-children" class="children"><li><a href="/GAC/290-5-41-.01" name="290-5-41-.01" title="290-5-41-.01">Rule 290-5-41-.01 Definitions</a></li><li><a href="/GAC/290-5-41-.02" name="290-5-41-.02" title="290-5-41-.02">Rule 290-5-41-.02 Application for Permits</a></li><li><a href="/GAC/290-5-41-.03" name="290-5-41-.03" title="290-5-41-.03">Rule 290-5-41-.03 Permits</a></li><li><a href="/GAC/290-5-41-.04" name="290-5-41-.04" title="290-5-41-.04">Rule 290-5-41-.04 Provisional Permits</a></li><li><a href="/GAC/290-5-41-.05" name="290-5-41-.05" title="290-5-41-.05">Rule 290-5-41-.05 Inspections</a></li><li><a href="/GAC/290-5-41-.06" name="290-5-41-.06" title="290-5-41-.06">Rule 290-5-41-.06 Organization and Administration</a></li><li><a href="/GAC/290-5-41-.07" name="290-5-41-.07" title="290-5-41-.07">Rule 290-5-41-.07 Transfer and Transport Capability</a></li><li><a href="/GAC/290-5-41-.08" name="290-5-41-.08" title="290-5-41-.08">Rule 290-5-41-.08 Professional Services</a></li><li><a href="/GAC/290-5-41-.09" name="290-5-41-.09" title="290-5-41-.09">Rule 290-5-41-.09 Personnel</a></li><li><a href="/GAC/290-5-41-.10" name="290-5-41-.10" title="290-5-41-.10">Rule 290-5-41-.10 Health Services Information System</a></li><li><a href="/GAC/290-5-41-.11" name="290-5-41-.11" title="290-5-41-.11">Rule 290-5-41-.11 Clinical Laboratory Services</a></li><li><a href="/GAC/290-5-41-.12" name="290-5-41-.12" title="290-5-41-.12">Rule 290-5-41-.12 Drug Storage and Administration</a></li><li><a href="/GAC/290-5-41-.13" name="290-5-41-.13" title="290-5-41-.13">Rule 290-5-41-.13 Food Service</a></li><li><a href="/GAC/290-5-41-.14" name="290-5-41-.14" title="290-5-41-.14">Rule 290-5-41-.14 Anesthesia</a></li><li><a href="/GAC/290-5-41-.15" name="290-5-41-.15" title="290-5-41-.15">Rule 290-5-41-.15 Physical Plant and Operational Standards</a></li><li><a href="/GAC/290-5-41-.16" name="290-5-41-.16" title="290-5-41-.16">Rule 290-5-41-.16 Housekeeping, Laundry, Maintenance and Sterile Supplies</a></li><li><a href="/GAC/290-5-41-.17" name="290-5-41-.17" title="290-5-41-.17">Rule 290-5-41-.17 Electrical Power</a></li><li><a href="/GAC/290-5-41-.18" name="290-5-41-.18" title="290-5-41-.18">Rule 290-5-41-.18 Sanitation and Waste Disposal</a></li><li><a href="/GAC/290-5-41-.19" name="290-5-41-.19" title="290-5-41-.19">Rule 290-5-41-.19 Advertising</a></li><li><a href="/GAC/290-5-41-.20" name="290-5-41-.20" title="290-5-41-.20">Rule 290-5-41-.20 Waivers and Variances</a></li><li><a href="/GAC/290-5-41-.21" name="290-5-41-.21" title="290-5-41-.21">Rule 290-5-41-.21 Enforcement</a></li><li><a href="/GAC/290-5-41-.22" name="290-5-41-.22" title="290-5-41-.22">Rule 290-5-41-.22 Applicability of Regulations</a></li><li><a href="/GAC/290-5-41-.23" name="290-5-41-.23" title="290-5-41-.23">Rule 290-5-41-.23 Severability</a></li></ul> </div> </div> <!--content ends here--> <div id="footer" class="noprint"><span class="footer">Copyright &copy; 2020 Lawriter LLC - All rights reserved.</span>| <a href="mailto:support@casemakerlegal.com?subject=Rules and Regulations of the State of Georgia">Email Us</a> | 844-838-0769 | <a href="http://livechat.casemakerlegal.com/client.php?locale=en" target="_blank" onclick="if(navigator.userAgent.toLowerCase().indexOf('opera') != -1 && window.event.preventDefault)window.event.preventDefault();this.newWindow = window.open('http://livechat.casemakerlegal.com/client.php?locale=en&url='+escape(document.location.href)+'&referrer='+escape(document.referrer), 'webim','toolbar=0,scrollbars=0,location=0,status=1,menubar=0,width=640,height=480,resizable=1');this.newWindow.focus();this.newWindow.opener=window;return false;">Live Chat</a> </div> </div> </body> </html>