A significant cause of infant mortality is prematurity. In Arkansas as elsewhere, maternal and newborn intensive care for very premature deliveries and births has reduced mortality for those most at risk. However, access to perinatal intensive care services in NICUs (Neonatal Intensive Care Units) is inconsistent and this state has lacked formal public policy to address the inconsistencies. Regionalization of NICUs will increase the likelihood that a mother and infant receive risk-appropriate medical care in order to reduce maternal and infant morbidity and mortality, and to minimize cost. With this in mind, a NICU Regionalization Committee (later renamed the Arkansas Perinatal Regionalization Committee) was created by the Arkansas Department of Health to examine the issue and to make recommendations. Their recommendations include the following levels:
- Level IV is the highest level and includes facilities that are able to offer the most advanced level of care for infants requiring specialty pediatric care, including extracorporeal membrane oxygenation (ECMO). Arkansas Children’s Hospital is the only facility in the State meeting those criteria.
- Level III is separated into two categories: Level IIIA and Level IIIB. Level IIIB facilities are able to provide care for high risk infants that are less than 26 weeks or less than 750 grams, but who do not need the services provided by a Level IV facility; a Level IIIA facility can treat infants who are 26 weeks or more and weigh 750 grams or more who have specialty needs, but not at the level of a IIIB or higher facility. Deliveries of these high risk neonates should occur at the appropriate Level III facilities.
- Level II facilities provide care for infants greater than 32 weeks and 1500 grams who are moderately ill and have problems that are expected to resolve rapidly. These facilities can care for neonates who are ventilated for less than 24 hours
- Level I facilities provide basic neonatal service and can care for low risk infants greater than 35 weeks.
The Perinatal Regionalization Committee report, and an attachment to the report with more detailed information on the recommend levels of care, may be found in the links below.
- Arkansas Perinatal Regionalization Committee Report
- Arkansas Perinatal Regionalization Levels of Care
*These are recommendations, approved by the Arkansas Board of Health, and are not regulations at this point in time.
In June 2015, birthing hospitals across the state of Arkansas agreed to participate in a voluntary self-verification of their nursery classification levels. The process includes self-evaluation and classification by each hospital nursery, followed by verification through site visit (for levels III and IV) or review of the self-evaluation checklist (for levels I and II) by physicians on the Perinatal Regionalization Committee.
The following birthing hospitals and Arkansas Children’s Hospital have completed the voluntary verification process as of May 1, 2016
- Arkansas Children’s Hospital
- Baptist Health Medical Center – Little Rock
- Mercy Hospital Fort Smith
- Mercy Hospital Northwest Arkansas – Rogers
- St. Bernards Medical Center
- Washington Regional Medical Center
- Willow Creek Women's Hospital
- Baptist Health Medical Center – North Little Rock
- Baxter Regional Medical Center
- CHI St. Vincent – Hot Springs
- CHI St. Vincent Infirmary – Little Rock
- Conway Regional Health System
- Jefferson Regional Medical Center
- Medical Center of South Arkansas
- National Park Medical Center
- Saline Memorial Hospital
- St. Mary’s Regional Medical Center
- Siloam Springs Regional Hospital
- Sparks Regional Medical Center
- White River Medical Center
- Ashley County Medical Center
- Bradley County Medical Center
- Delta Memorial Hospital
- Forrest City Medical Center
- Great River Medical Center
- Helena Regional Medical Center
- Johnson Regional Medical Center
- Magnolia Regional Medical Center
- Mena Regional Health System
- NEA Baptist Memorial Hospital
- North Arkansas Regional Medical Center
- Ouachita County Medical Center