R426-9-600. Trauma Center Designation Process

  (1) Hospitals seeking voluntary designation and all designated Trauma Centers desiring to remain designated, shall apply for designation by submitting the following information to the Department at least 30 days prior to the date of the scheduled site visit:

  (a) a completed and signed application and appropriate fees for trauma center verification;

  (b) a letter from the hospital administrator of continued commitment to comply with current trauma center designation standards as applicable to the applicant's designation level;

  (c) the data specified under R426-9-700 are current;

  (d) Level I and Level II Trauma Centers must submit a copy of the Pre-review Questionnaire (PRQ) from the American College of Surgeons in lieu of the application in 1a above;

  (e) Level III and Level IV and Level V trauma centers must submit a complete Department approved application.

  (2) Hospitals desiring to be designated as Level I and Level II Trauma Centers must be verified by the American College of Surgeons (ACS) within three (3) months of the expiration date of previous designation and must submit a copy of the full ACS report detailing the results of the ACS site visit. A Department representative must be present during the entire ACS verification or consultation visit. Hospitals desiring to be Level III or Level IV Trauma Centers must be designated by hosting a formal site visit by the Department.

  (3) Hospitals not previously designated as a Level I or a Level II trauma center, applying for designation after December 31, 2016, will be considered for designation implementing the point system suggested by the American College of Surgeons as follows and using data from the Utah Trauma Registry:

  (a) population as defined by the federal Office of Management and Budget total Metropolitan Statistical Area (MSA);

  (i) total MSA population of less than 600,000 receives 2 points,

  (ii) total MSA population of 600,000 to 1,200,000 receives 4 points,

  (iii) total MSA population of 1,200,000 to 1,800,000 receives 6 points,

  (iv) total MSA population of 1,800,000 to 2,400,000 receives 8 points,

  (v) total MSA population of greater than 2,400,000 receives 10 points.

  (b) Median Transport Times (combined air and ground -- scene only no transfer);

  (i) median transport time of less than 10 minutes received 0 points,

  (ii) median transport time of 10 -- 20 minutes receives 1 points,

  (iii) median transport time of 21 -- 30 minutes receives 2 points,

  (iv) median transport time of 31 -- 40 minutes receives 3 points,

  (v) median transport time of greater than 41 minutes receives 4 points.

  (c) Department/System Stakeholder/Community Support;

  (i) Department support for a trauma center(if none exist)or an additional trauma center in the MSA -- 5 points,

  (ii) Department position that no additional trauma centers are needed -- negative 5 points,

  (iii) Trauma System Advisory Committee (or equivalent body) statement of support for a trauma center (if none exist) or an additional trauma center in the MSA -- 5 points,

  (iv) community support demonstrated by letters of support from 25- 50% of city and county governing bodies within the MSA -- 1 points,

  (v) community support demonstrated by letters of support from over 50% of city and county governing bodies within the MSA -- 2 points.

  (d) Severely injured patients (ISS more than 15) discharged from acute care facilities not designated as Level I, II, or III trauma centers;

  (i) discharges of 0-200 severely injured patients receives 0 points,

  (ii) discharges of 201 -- 400 severely injured patients receives 1 points,

  (iii) discharges of 401 -- 600 severely injured patients receives 2 points,

  (iv) discharges of 601 -- 800 severely injured patients receives 3 points,

  (v) discharges of greater than 800 severely injured patients receives 4 points.

  (e) Level I Trauma Centers;

  (i) for the existence of each verified Level I trauma center already in the MSA assign 1 negative point,

  (ii) for the existence of each verified Level II trauma center already in the MSA assign 1 negative point,

  (iii) for the existence of each verified Level III trauma center already in the MSA assign 0.5 negative points.

  (f) Numbers of severely injured patients (ISS more than 15) seen in trauma centers (Level I and II) already in the MSA. The expected number of high-ISS patients is calculated as: 500 x (Number of Level I and Level II centers in the MSA) = (Expected Number of high ISS patients);

  (i) if the MSA has more than 500 severely injured patients above the expected number assign 2 points,

  (ii) if the MSA has 0 - 500 severely injured patients above the expected number assign 1 point,

  (iii) if the MSA has 0 - 500 fewer severely injury patients than the expected number assign 1 negative point,

  (iv) if the MSA has more than 500 fewer severely injured patients than the expected number assign 2 negative points.

  (g) The following scoring system shall be used to allocate trauma centers within the MSAs:

  (i) MSAs with scores of 5 points or less shall be allocated 1 Level I or II trauma center;

  (ii) MSAs with scores of 6 - 10 points shall be allocated 2 Level I or II trauma centers;

  (iii) MSAs with score of 11 - 15 points shall be allocated 3 Level I or II trauma centers;

  (iv) MSAs with scores of 16 - 20 points shall be allocated 4 Level I or II trauma centers.

  (h) If the number of trauma centers allocated by the model is greater than the existing number of Level I or II trauma centers in the MSA, efforts should be undertaken to recruit and designate additional trauma centers.

  (i) If the number of Level I and II trauma centers allocated by the model is less than or equal to the number currently designated, the Department should not designate additional Level I or II trauma centers in the MSA.