10A ncac 13B .4305      ORGANIZATION OF NEONATAL SERVICES

(a)  The governing body shall approve the scope of all neonatal services and the facility shall classify its capability in providing a range of neonatal services using the following criteria:

(1)           LEVEL I: Full-term and pre-term neonates that are stable without complications. This may include infants who are small for gestational age or neonates who are large for gestational age.

(2)           LEVEL II: Neonates or infants that are stable without complications but require special care and frequent feedings; infants of any weight who no longer require LEVEL III or LEVEL IV neonatal services, but who still require more nursing hours than normal infant. This may include infants who require close observation in a licensed acute care bed.

(3)           LEVEL III: Neonates or infants that are high-risk, small or approximately 32 and less than 36 completed weeks of gestational age but otherwise healthy, or sick with a moderate degree of illness that are admitted from within the hospital or transferred from another facility requiring intermediate care services for sick infants, but not requiring intensive care. The beds in this level may serve as a "step-down" unit from Level IV. Level III neonates or infants require less constant nursing care, but care does not exclude respiratory support.

(4)           LEVEL IV (Neonatal Intensive Care Services): High-risk, medically unstable, or critically ill neonates under 32 weeks of gestational age, or infants, requiring constant nursing care or supervision that includes continuous cardiopulmonary or respiratory support, complicated surgical procedures, or other intensive supportive interventions.

(b)  The facility shall provide for the availability of equipment, supplies, and clinical support services.

(c)  The medical and nursing staff shall develop and approve policies and procedures for the provision of all neonatal services.

History Note:        Authority G.S. 143B-165;

Eff. January 1, 1996;

Temporary Amendment Eff. March 15, 2002;

Amended Eff. April 1, 2003;

Readopted Eff. August 1, 2023.