641—134.2 (147A) Trauma care facility categorization and verification. Categorization and verification of hospitals and emergency care facilities shall be made by the department based upon the hospitals’ or emergency care facilities’ resources available for providing trauma care services.
	 134.2(1) Categorization.
	  a.   	 Categorization as a trauma care facility shall be determined by the department from self-reported information provided to the department by a hospital or emergency care facility through a self-assessment categorization application provided by the department.
	  b.   	 Categorization applications shall be submitted by all hospitals. New hospitals shall submit a categorization application no later than 90 days after licensing by the department of inspections and appeals, health facilities division. Categorization applications may be submitted by emergency care facilities. New emergency care facilities may submit a categorization application no later than 90 days after opening or reopening.
	  c.   	 Categorization applications may be obtained from the department upon written request to: Iowa Department of Public Health, Bureau of Emergency Medical Services, Lucas State Office Building, Des Moines, Iowa 50319-0075.
	 134.2(2) Categorization levels for trauma care facilities shall be identified as:
	  a.   	 Resource (Level I).
	  b.   	 Regional (Level II).
	  c.   	 Area (Level III).
	  d.   	 Community (Level IV).
	 134.2(3) Adoption by reference.
	  a.   	 “Resources for Optimal Care of the Injured Patient” (2006) published by the American College of Surgeons Committee on Trauma is incorporated and adopted by reference for Resource (Level I) hospital and emergency care facility categorization criteria. “Iowa Trauma System Regional (Level II) Hospital and Emergency Care Facility Categorization Criteria” (2013) is incorporated and adopted by reference for Regional (Level II) hospital and emergency care facility categorization criteria. “Iowa Trauma System Area (Level III) Hospital and Emergency Care Facility Categorization Criteria” (2013) is incorporated and adopted by reference for Area (Level III) hospital and emergency care facility categorization criteria. “Iowa Trauma System Community (Level IV) Hospital and Emergency Care Facility Categorization Criteria” (2013) is incorporated and adopted by reference for Community (Level IV) hospital and emergency care categorization criteria. For any differences which may occur between the adopted references and these administrative rules, the administrative rules shall prevail.
	  b.   	 “Iowa Trauma System Regional (Level II) Hospital and Emergency Care Facility Categorization Criteria” (2013), “Iowa Trauma System Area (Level III) Hospital and Emergency Care Facility Categorization Criteria” (2013) and “Iowa Trauma System Community (Level IV) Hospital and Emergency Care Facility Categorization Criteria” (2013) are available through the Iowa Department of Public Health, Bureau of EMS, Lucas State Office Building, Des Moines, Iowa 50319-0075, or the bureau of EMS Web site (www.idph.state.ia.us/ems).
	 134.2(4) Categorization shall not be construed to imply any guarantee on the part of the department as to the level of trauma care services available at a hospital or emergency care facility.
	 134.2(5) A hospital, emergency care facility, or trauma care facility may apply to the department for a change in level of categorization through submission of a self-assessment categorization application.
	 134.2(6) Verification. Verification of a trauma care facility shall be determined by the department upon successful completion of the categorization application and completion of a verification survey. All categorized hospitals and emergency care facilities shall be verified.
	 134.2(7) The department shall conduct a verification survey for categorized hospitals or emergency care facilities.
	  a.   	 A verification survey shall assess the ability of the hospital or emergency care facility to meet criteria for the level of categorization pursuant to 134.2(3).
	  b.   	 The department shall approve trauma care facility verification when the department is satisfied that the proposed facility will provide services and be operated in compliance with Iowa Code section 147A.23 and these administrative rules.
	  c.   	 The department shall notify the applicant, in writing, as to the approval or denial of verification as a trauma care facility within 90 days after the completion of a verification survey.
	  d.   	 Verification shall not be construed to imply any guarantee on the part of the department as to the level of trauma care services available at a hospital or emergency care facility.
	  e.   	 Trauma care facility verification is valid for a period of three years from the effective date unless otherwise specified on the certificate of verification or unless sooner suspended or revoked.
	  f.   	 Trauma care facilities shall be fully operational at their verified level upon the effective date specified on the certificate of verification. Trauma care facilities shall meet all requirements of Iowa Code section 147A.23 and these administrative rules.
	  g.   	 As part of the verification and renewal process, the department may conduct periodic on-site reviews of the services and facilities of trauma care facilities.
	  h.   	 Trauma care facilities that are unable to maintain their categorization or verification, or both, shall notify the department within 48 hours.
	  i.   	 The director, pursuant to rule, may grant a variance from the requirements of rules adopted under this chapter for any hospital or emergency care facility provided that the variance is related to undue hardships in complying with this chapter or the rules adopted pursuant to this chapter.
	  j.   	 Hospitals currently verified by the American College of Surgeons shall be accepted as equivalent for categorization and verification as a trauma care facility in Iowa provided that all policy, reporting, and administrative rules have been met. Documentation shall be provided to the department including, but not limited to, a current copy of the ACS verification certification, the hospital’s completed ACS verification application or a completed Self-Assessment Categorization Application (SACA).
	 134.2(8) Prohibited acts. A hospital or emergency care facility that imparts or conveys, or causes to be imparted or conveyed, that it is a trauma care facility, or that uses any other term to indicate or imply that the hospital or emergency care facility is a trauma care facility without having obtained a certificate of verification by the department is subject to civil penalty not to exceed $100 per day for each offense. The director may apply to the district court for a writ of injunction to restrain the use of the term “trauma care facility.”
	 134.2(9) Nothing in Iowa Code section 147A.23 or these administrative rules shall be construed to restrict a hospital or emergency care facility from providing any services for which it is duly authorized.
[ARC 9445B, IAB 4/6/11, effective 5/11/11; ARC 1079C, IAB 10/2/13, effective 1/6/14]