Thrombectomy-Capable Stroke Centers.

22 CCR 100153.03

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22 CCR 100153.03

§ 100153.03. Thrombectomy-Capable Stroke Centers.

(a)

Eligibility. A licensed general acute care hospital (GACH) that meets the requirements of this section may be designated by the local EMS agency (LEMSA) as a thrombectomy-capable stroke center.

(b)

Requirements. The GACH must meet all requirements for a primary stroke center, as set forth in Section 100153.02(b) of this subarticle, as well as the following additional requirements:

(1)

Capabilities.

(A)

Mechanical Thrombectomy Services. Twenty-four (24) hours a day, seven (7) days a week, 365 days per year ability to perform mechanical thrombectomy for the treatment of ischemic stroke.

(B)

Bed Capacity. Twenty-four (24) hours a day, seven (7) days a week, 365 days per year availability of sufficient dedicated neuro-intensive care unit beds to care for acute ischemic stroke patients.

(C)

Imaging. Twenty-four (24) hours a day, seven (7) days a week, 365 days per year ability to perform advanced imaging including, at a minimum:

(i)

Computed tomography angiography (CTA);

(ii)

Diffusion-weighted magnetic resonance imaging (MRI) or computed tomography (CT) perfusion;

(iii)

Catheter angiography;

(iv)

Magnetic resonance angiography (MRA);

(v)

The following modalities when clinically necessary:

(I)

Carotid duplex ultrasound;

(II)

Transesophageal echocardiography (TEE);

(III)

Transthoracic Echocardiography (TTE).

(D)

Staff Qualifications.

(i)

Meet the following staffing and staff qualification requirements:

(I)

A qualified physician who is board-certified by the American Board of Radiology, American Osteopathic Board of Radiology, American Board of Psychiatry and Neurology, or the American Osteopathic Board of Neurology and Psychiatry, with neuro-interventional angiographic training and skills confirmed by the GACH's credentialing committee;

(II)

A qualified neuro-radiologist who is board-certified by the American Board of Radiology or the American Osteopathic Board of Radiology; and

(III)

A qualified vascular neurologist who is board-certified by the American Board of Psychiatry and Neurology or the American Osteopathic Board of Neurology and Psychiatry, or with appropriate education and experience as defined by the GACH credentials committee.

(ii)

If the GACH uses teleradiology for image interpretation, the remote physicians must still meet the same staffing and qualification standards set forth in clause (i) of this section and the GACH shall maintain documentation of those roles and qualifications.

(2)

Transfer Acceptance. Written transfer agreements with inter-LEMSA and regional comprehensive, primary stroke centers, and acute stroke ready hospitals to accept the transfer of patients needing neurosurgical intervention, when clinically appropriate.

(3)

Data Collection, QI, and Evaluation. Thrombectomy-capable stroke centers designated under this section are subject to the requirements of Article 5 of this subdivision.

(4)

Additional Requirements. A LEMSA medical director may establish requirements for designation as a thrombectomy-capable stroke center in addition to those required under this section.

(c)

Thrombectomy-Capable Stroke Centers Designated Prior to Effective Date of Regulations. A thrombectomy-capable stroke center designated by the LEMSA prior to the effective date of these regulations may continue to operate as a thrombectomy-capable stroke center; however, any such thrombectomy-capable stroke center shall meet the requirements of these regulations within twelve (12) months following a program review described in Article 5, Section 100154.03(a) of this subchapter.

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