31-11-132. Office of Cardiac Care; level designations and requirements.

There shall be established the Office of Cardiac Care within the Department of Public Health. The office shall administer the designation process provided for in this article, including, but not limited to, data collection, analysis and reporting, and site visits.#

The office shall designate hospitals that meet the criteria set forth in this article as emergency cardiac care centers. Each emergency cardiac care center shall be further designated as Level I, Level II, or Level III by the office. The criteria for each level designation shall be established by the office and shall include, at a minimum, the following:#

1. (1)

   Level I shall have:#

   1. (A)

      Cardiac catheterization and angioplasty facilities available 24 hours, seven days per week, 365 days per year;#

   2. (B)

      On-site cardiothoracic surgery capability available 24 hours, seven days per week, 365 days per year;#

   3. (C)

      Established protocols for therapeutic hypothermia for out-of-hospital cardiac arrest patients;#

   4. (D)

      The ability to implant percutaneous left ventricular assist devices for support of hemodynamically unstable patients experiencing out-of-hospital cardiac arrest or heart attack;#

   5. (E)

      Neurologic protocols to measure functional status at hospital discharge; and#

   6. (F)

      The ability to implant automatic implantable cardioverter defibrillators;#

2. (2)

   Level II shall have:#

   1. (A)

      Cardiac catheterization and angioplasty facilities available 24 hours, seven days per week, 365 days per year, but no on-site cardiothoracic surgery capability;#

   2. (B)

      Established protocols for therapeutic hypothermia for out-of-hospital cardiac arrest patients;#

   3. (C)

      Neurologic protocols to measure functional status at hospital discharge; and#

   4. (D)

      A written transfer plan with one or more Level I emergency cardiac care centers for patients who need left ventricular assist devices or cardiothoracic surgery;#

3. (3)

   Level III shall have:#

   1. (A)

      Established protocols for therapeutic hypothermia for out-of-hospital cardiac arrest patients; and#

   2. (B)

      A written plan for systematic transfer to a Level I or Level II facility; and#

4. (4)

   The department shall be authorized to establish one or more additional levels of cardiac care centers as necessary based upon advancements in medicine and patient care.#

Emergency cardiac care centers are encouraged to coordinate, through agreement, with other level emergency cardiac care centers throughout the state to provide appropriate access to care for cardiac patients. The coordinating agreements shall be in writing and include at a minimum:#

1. (1)

   Transfer agreements for the transport and acceptance of:#

   1. (A)

      Cardiac patients seen by a Level I emergency cardiac care center which a Level II or III emergency cardiac care center is not capable of providing; or#

   2. (B)

      Cardiac patients seen by a Level II emergency cardiac care center which a Level III emergency cardiac care center is not capable of providing; and#

2. (2)

   Communication criteria and protocols between the emergency cardiac care centers.#