Level II SCN Requirements 
(a) The Level II SCN will provide comprehensive care of infants born ≥32 wk or with birth wt ≥1500 g who2 :
1. are mild to moderately ill with physiologic immaturity or who have conditions that are expected to resolve quickly2 ;
2. are not anticipated to require subspecialty services on an urgent basis2 ;
3. require continuous positive airway pressure (CPAP) or short-term (less than 24 h) conventional mechanical ventilation for a condition expected to resolve rapidly or until transfer to a higher-level facility is achieved2 ; or
4. are back transferred from a higher-level facility for convalescent care.2  
Neonatal Medical Director 
(b) The neonatal medical director (NMD) will:
1. be a board eligible or certified neonatologist or a board-certified pediatrician with sufficient training and expertise to assume responsibility of care for infants who require level II care, including endotracheal intubation, assisted ventilation, and CPAP management, or equivalent5 ;
i. if the neonatologist or pediatrician is certified by The American Board of Pediatrics, they will meet maintenance of certification (MOC) requirements;
2. complete annual continuing medical education (CME) specific to neonatology; and
3. demonstrate a current status of NRP completion. 
Neonatologists 
(c) If the NMD and/or on-site provider is not a neonatologist, the privileged care provider must maintain a consultative relationship with a board certified or eligible neonatologist at a higher-level neonatal facility; and
1. the facility must have a written policy or guideline that defines the criteria for neonatologist consultation at a higher-level neonatal facility. 
Privileged Care Providers 
(d) Privileged care providers with pediatric- or neonatal-specific training qualified to manage the care of infants with mild to moderate critical conditions, including emergencies, will5 :
1. be continuously available on-site, or on-call and available to arrive on-site within an appropriate time frame as defined by the facility’s policies and procedures;
i. if the on-site or on-call provider is not a physician, a written policy will be in place that defines the criteria for notification and time frame for on-site physician presence, and a tracking mechanism for compliance is required;
ii. if an infant is maintained on a ventilator, a pediatric- or neonatal-specific privileged care provider who can manage respiratory emergencies will be immediately available on-site;
2. demonstrate a current status of NRP completion;
3. complete annual continuing education requirements specific to neonatology; and
4. have credentials reviewed at least every 2 years by the NMD.
(e) At least 1 person with the skills to perform a complete neonatal resuscitation including endotracheal intubation, establishment of vascular access, and administration of medications must be immediately available on-site 24/77 ; and
1. demonstrate a current status of NRP completion.
(f) The facility will establish a written policy for backup privileged care provider coverage that establishes flexibility for variable census and acuity. This policy will document the criteria for notification and time frame for on-site presence, be based on allocating the appropriate number of competent medical providers to a care situation, attend to a safe and high-quality work environment, and be operationally reviewed annually for adequacy and adherence.9  
Nursing Leadership 
(g) The level II SCN nurse leader will:
1. be a registered nurse (RN) with experience and training in perinatal nursing and neonatal conditions, with nursing certification preferred5 ;
2. have at least a Bachelor of Science in Nursing, Master’s preferred;
3. demonstrate a current status of NRP completion;
4. have sufficient experience and expertise to create, and/or support, a program that provides care to infants who require level II SCN care;
5. be responsible for inpatient activities in the level II SCN and, as appropriate, obstetrical, well newborn, and/or pediatric units;
6. coordinate with respective neonatal, pediatric, and obstetric care services, as appropriate;
7. provide oversight of annual neonatal-specific education, which includes low-volume, high-risk procedures consistent with the care provided in the level II SCN; and
8. foster collaborative relationships with multidisciplinary team members, facility leadership, and higher-level facilities to create a diverse, equitable, and inclusive environment focused on the quality of care and patient care outcomes.5  
Clinical Nurse Staffing 
(h) A written nurse staffing plan is in place that establishes flexibility for variable census and acuity. This plan and actual staffing will be based on allocating the appropriate number of competent RNs to a care situation, attend to a safe and high-quality work environment, and be operationally reviewed annually for adequacy and adherence.9,10  
Clinical Nurse Staff 
(i) Each clinical nurse will:
1. be an RN, with nursing certification specific to the care environment preferred;
2. demonstrate a current status of NRP completion;
3. participate in annual simulation and skills verification, which includes low-volume, high-risk procedures consistent with the types of care provided in the level II SCN; and
4. promote a family-centered approach to care, including but not limited to skin-to-skin care, appropriate developmental positioning based on gestational age, lactation and breastfeeding support, and engagement of families in their infant’s care.
(j) If the facility utilizes licensed practical nurses (LPNs) or nonlicensed direct care providers to support the clinical nursing staff, the facility must:
1. have written criteria that define the LPNs’ or nonlicensed direct care providers’ scope of neonatal care;
2. provide annual education specific to the care of the neonatal population served; and
3. have a written staffing plan that establishes collaborative work assignments in accordance with the facility’s policies and procedures. 
Nursing Orientation and Education 
(k) Level II SCN nursing orientation will incorporate didactic education, simulation, skills verification, and competency and will be tailored to the individual needs of the nurse based on clinical experience.9 
(l) The facility will document an annual educational needs assessment to determine the educational needs of the clinical nursing staff and ancillary team members.
(m) Annual nursing education will address the annual needs assessment and incorporate simulation and skills verification of low-volume, high-risk procedures consistent with the types of care provided in the level II SCN and include education related to serious safety events. 
Clinical Nurse Educator 
(n) The level II SCN clinical nurse educator or perinatal nurse educator will:
1. be an RN, with nursing certification specific to the care environment preferred;
2. have at least a Bachelor of Science in Nursing, Master’s preferred;
3. demonstrate a current status of NRP completion;
4. cultivate collaborative relationships with the neonatal nurse leader and facility leadership to improve the quality of care and patient care outcomes5 ; and
5. have experience and expertise to evaluate the educational needs of the clinical staff, develop didactic and skill-based educational tools, oversee education and skills verification, and evaluate retention of content, critical thinking skills, and competency relevant to level II neonatal care.9 
(o) The facility will have a dedicated individual with sufficient time allocated to perform the roles and responsibilities of the clinical nurse educator. 
Neonatal Transport 
(p) The facility will have policies and procedures in place to identify a local neonatal transport program to facilitate neonatal transport to a higher-level neonatal facility. 
Pediatric Medical Subspecialists and Pediatric Surgical Specialists 
(q) Policies and procedures will be in place for referral to a higher level of neonatal care when pediatric medical subspecialty or pediatric surgical specialty consultation and/or intervention is needed. 
Laboratory Services 
(r) Laboratory services will have:
1. laboratory personnel on-site 24/7;
2. the ability to determine blood type, crossmatch, and perform antibody testing;
3. a blood bank capable of providing blood component therapy and irradiated, leukoreduced or cytomegalovirus (CMV)-negative blood;
4. the ability to perform neonatal blood gas monitoring; and
5. the ability to perform analysis on small volume samples.
(s) Low-volume specialty laboratory services may be provided by an outside laboratory, but the facility will have policies and procedures in place to verify timely and direct communication of all critical value results. 
Pharmacy 
(t) The facility will have at least 1 registered pharmacist with experience in neonatal and/or pediatric pharmacology who will:
1. be available for consultation on-site, or by telehealth or telephone, 24/7;
2. complete continuing education requirements specific to pediatric and neonatal pharmacology; and
3. participate in multidisciplinary care, as needed.
(u) The pharmacy will have policies and procedures in place to address drug shortages and to verify medications are appropriately allocated to the level II SCN; and
1. have policies and procedures in place to verify neonatal competency for pharmacy staff supporting and preparing medications for neonatal patients. 
Diagnostic Imaging 
(v) Radiology services will have:
1. appropriately trained radiology personnel continuously available on-site to meet routine diagnostic imaging needs and to address emergencies;
2. personnel appropriately trained in ultrasonography, including cranial ultrasonography, on-call and/or available on-site to perform advanced imaging as requested; and
3. the ability to provide timely imaging interpretation by radiologists with pediatric expertise as requested. 
Respiratory Therapy 
(w) The respiratory care leader will:
1. be a full-time respiratory care practitioner, with neonatal and pediatric respiratory care certification preferred;
2. have sufficient time allocated to oversee the respiratory therapists (RTs) who provide care in the level II SCN;
3. provide oversight of annual simulation and skills verification, which includes neonatal respiratory care modalities and low-volume, high-risk neonatal respiratory procedures;
4. develop a written RT staffing plan that establishes flexibility for variable census and acuity. This plan and actual staffing will be based on allocating the appropriate number of competent RTs to a care situation, attend to a safe and high-quality work environment, and be operationally reviewed annually for adherence and to verify respiratory therapy staffing is adequate for patient care needs9 ; and
5. maintain appropriate staffing ratios for infants receiving supplemental oxygen and positive pressure ventilation.
(x) Respiratory care practitioners assigned to the SCN will:
1. be a respiratory care practitioner with documented experience and training in the respiratory support of newborns and infants, with neonatal or pediatric respiratory care certification preferred;
2. be on-site 24/7 and immediately available when an infant is supported by assisted ventilation or CPAP;
3. be able to attend deliveries and assist with resuscitation as requested;
4. demonstrate a current status of NRP completion;
5. participate in annual simulation and respiratory skills verification, which includes low-volume, high-risk procedures consistent with the types of respiratory care provided in the SCN; and
6. have their credentials reviewed by the respiratory care leader annually for adequacy and adherence. 
Dietitian 
(y) The facility must have, or have the ability to consult with, at least 1 registered dietitian or nutritionist who has specialized training in neonatal nutrition, who will5 :
1. collaborate with the medical team to establish feeding protocols, develop patient-specific feeding plans, and help determine nutritional needs at discharge;
2. establish policies and procedures to verify proper preparation and storage of human milk and formula; and
3. have policies and procedures for dietary consultation for patients in the SCN. 
Neonatal Nutrition 
(z) The facility will:
1. provide a specialized area or room, with limited access and away from the bedside, to accommodate mixing of formula or additives to human milk5 ;
2. develop standardized feeding protocols for the advancement of feedings based on the availability of, and family preference for human milk, donor human milk, fortification of human milk and formula; and
3. have policies and procedures in place for accurate verification and administration of human milk and formula, and to avoid misappropriation. 
Lactation and Breastfeeding Support 
(aa) The facility will:
1. have personnel with the knowledge and skills to support lactation available at all times;
2. have a certified lactation counselor (CLC), international board-certified lactation consultant (IBCLC) preferred, available for on-site consultation on weekdays and accessible by telehealth or telephone 24/7; and
3. operationally review CLC and/or IBCLC personnel on an annual basis to establish adequately trained lactation coverage based on the specific need and volume of the neonatal population served.11  
Neonatal Therapists 
(bb) If the facility does not have in-house access to neonatal therapy expertise, the facility will have a formal process in place for providing on-site consultative services by qualified neonatal therapists to address the 6 core practice domains (environment, family or psychosocial support, sensory system, neurobehavioral system, neuromotor and musculoskeletal systems, and oral feeding and swallowing) and to provide the appropriate care for the neonatal population served. The facility will have on-site access to the following as needed12 :
1. an occupational or physical therapist with neonatal expertise, and neonatal therapy certification preferred5 ; and
2. at least 1 individual skilled in the evaluation and management of neonatal feeding and swallowing concerns, with neonatal therapy certification preferred.5 
(cc) The facility will operationally review neonatal therapist personnel on an annual basis to maintain adequate multidisciplinary neonatal therapist coverage based on the specific need and volume of the neonatal population served.12  
Social Worker 
(dd) The SCN social worker will:
1. be a Master’s prepared medical social worker with perinatal and/or pediatric experience.5 
(ee) The facility will:
1. provide 1 social worker for every 30 beds providing level II neonatal care and/or specialty and subspecialty perinatal care5 ;
2. have a written description that clearly identifies the responsibilities and functions of the SCN social worker; and
3. have social services available for each family with an infant in the SCN as needed. 
Pastoral Care 
(ff) Personnel skilled in pastoral care will be available as needed and by family request, and will represent, or have the ability to consult, multiple religious affiliations representative of the population served.5  
Retinopathy of Prematurity 
(gg) If the facility back transfers infants for convalescent care, the facility must have a process in place to appropriately identify infants at risk for retinopathy of prematurity to guarantee timely examination and treatment by having13 :
1. documented policies and procedures for the monitoring, treatment, and follow-up of retinopathy of prematurity5,13 ; and
2. the ability to perform on-site retinal examinations, or off-site interpretation of digital photographic retinal images, by a pediatric ophthalmologist or retinal specialist with expertise in retinopathy of prematurity, if needed.5,13  
Discharge and Follow-up 
(hh) Systems will be in place to establish preparation for SCN discharge, including postdischarge follow-up by general and subspecialty pediatric care providers, home care arrangements and community service resources, and enrollment in a developmental follow-up program as needed.
1. The facility will:
i. have written medical, neurodevelopmental, and psychosocial criteria that automatically warrant high-risk neonatal follow-up with appropriate developmental follow-up services; and
ii. have a written referral agreement with a developmental follow-up clinic or practice, when possible, to provide neurodevelopmental services for the neonatal population served. 
Level II SCN Requirements 
(a) The Level II SCN will provide comprehensive care of infants born ≥32 wk or with birth wt ≥1500 g who2 :
1. are mild to moderately ill with physiologic immaturity or who have conditions that are expected to resolve quickly2 ;
2. are not anticipated to require subspecialty services on an urgent basis2 ;
3. require continuous positive airway pressure (CPAP) or short-term (less than 24 h) conventional mechanical ventilation for a condition expected to resolve rapidly or until transfer to a higher-level facility is achieved2 ; or
4. are back transferred from a higher-level facility for convalescent care.2  
Neonatal Medical Director 
(b) The neonatal medical director (NMD) will:
1. be a board eligible or certified neonatologist or a board-certified pediatrician with sufficient training and expertise to assume responsibility of care for infants who require level II care, including endotracheal intubation, assisted ventilation, and CPAP management, or equivalent5 ;
i. if the neonatologist or pediatrician is certified by The American Board of Pediatrics, they will meet maintenance of certification (MOC) requirements;
2. complete annual continuing medical education (CME) specific to neonatology; and
3. demonstrate a current status of NRP completion. 
Neonatologists 
(c) If the NMD and/or on-site provider is not a neonatologist, the privileged care provider must maintain a consultative relationship with a board certified or eligible neonatologist at a higher-level neonatal facility; and
1. the facility must have a written policy or guideline that defines the criteria for neonatologist consultation at a higher-level neonatal facility. 
Privileged Care Providers 
(d) Privileged care providers with pediatric- or neonatal-specific training qualified to manage the care of infants with mild to moderate critical conditions, including emergencies, will5 :
1. be continuously available on-site, or on-call and available to arrive on-site within an appropriate time frame as defined by the facility’s policies and procedures;
i. if the on-site or on-call provider is not a physician, a written policy will be in place that defines the criteria for notification and time frame for on-site physician presence, and a tracking mechanism for compliance is required;
ii. if an infant is maintained on a ventilator, a pediatric- or neonatal-specific privileged care provider who can manage respiratory emergencies will be immediately available on-site;
2. demonstrate a current status of NRP completion;
3. complete annual continuing education requirements specific to neonatology; and
4. have credentials reviewed at least every 2 years by the NMD.
(e) At least 1 person with the skills to perform a complete neonatal resuscitation including endotracheal intubation, establishment of vascular access, and administration of medications must be immediately available on-site 24/77 ; and
1. demonstrate a current status of NRP completion.
(f) The facility will establish a written policy for backup privileged care provider coverage that establishes flexibility for variable census and acuity. This policy will document the criteria for notification and time frame for on-site presence, be based on allocating the appropriate number of competent medical providers to a care situation, attend to a safe and high-quality work environment, and be operationally reviewed annually for adequacy and adherence.9  
Nursing Leadership 
(g) The level II SCN nurse leader will:
1. be a registered nurse (RN) with experience and training in perinatal nursing and neonatal conditions, with nursing certification preferred5 ;
2. have at least a Bachelor of Science in Nursing, Master’s preferred;
3. demonstrate a current status of NRP completion;
4. have sufficient experience and expertise to create, and/or support, a program that provides care to infants who require level II SCN care;
5. be responsible for inpatient activities in the level II SCN and, as appropriate, obstetrical, well newborn, and/or pediatric units;
6. coordinate with respective neonatal, pediatric, and obstetric care services, as appropriate;
7. provide oversight of annual neonatal-specific education, which includes low-volume, high-risk procedures consistent with the care provided in the level II SCN; and
8. foster collaborative relationships with multidisciplinary team members, facility leadership, and higher-level facilities to create a diverse, equitable, and inclusive environment focused on the quality of care and patient care outcomes.5  
Clinical Nurse Staffing 
(h) A written nurse staffing plan is in place that establishes flexibility for variable census and acuity. This plan and actual staffing will be based on allocating the appropriate number of competent RNs to a care situation, attend to a safe and high-quality work environment, and be operationally reviewed annually for adequacy and adherence.9,10  
Clinical Nurse Staff 
(i) Each clinical nurse will:
1. be an RN, with nursing certification specific to the care environment preferred;
2. demonstrate a current status of NRP completion;
3. participate in annual simulation and skills verification, which includes low-volume, high-risk procedures consistent with the types of care provided in the level II SCN; and
4. promote a family-centered approach to care, including but not limited to skin-to-skin care, appropriate developmental positioning based on gestational age, lactation and breastfeeding support, and engagement of families in their infant’s care.
(j) If the facility utilizes licensed practical nurses (LPNs) or nonlicensed direct care providers to support the clinical nursing staff, the facility must:
1. have written criteria that define the LPNs’ or nonlicensed direct care providers’ scope of neonatal care;
2. provide annual education specific to the care of the neonatal population served; and
3. have a written staffing plan that establishes collaborative work assignments in accordance with the facility’s policies and procedures. 
Nursing Orientation and Education 
(k) Level II SCN nursing orientation will incorporate didactic education, simulation, skills verification, and competency and will be tailored to the individual needs of the nurse based on clinical experience.9 
(l) The facility will document an annual educational needs assessment to determine the educational needs of the clinical nursing staff and ancillary team members.
(m) Annual nursing education will address the annual needs assessment and incorporate simulation and skills verification of low-volume, high-risk procedures consistent with the types of care provided in the level II SCN and include education related to serious safety events. 
Clinical Nurse Educator 
(n) The level II SCN clinical nurse educator or perinatal nurse educator will:
1. be an RN, with nursing certification specific to the care environment preferred;
2. have at least a Bachelor of Science in Nursing, Master’s preferred;
3. demonstrate a current status of NRP completion;
4. cultivate collaborative relationships with the neonatal nurse leader and facility leadership to improve the quality of care and patient care outcomes5 ; and
5. have experience and expertise to evaluate the educational needs of the clinical staff, develop didactic and skill-based educational tools, oversee education and skills verification, and evaluate retention of content, critical thinking skills, and competency relevant to level II neonatal care.9 
(o) The facility will have a dedicated individual with sufficient time allocated to perform the roles and responsibilities of the clinical nurse educator. 
Neonatal Transport 
(p) The facility will have policies and procedures in place to identify a local neonatal transport program to facilitate neonatal transport to a higher-level neonatal facility. 
Pediatric Medical Subspecialists and Pediatric Surgical Specialists 
(q) Policies and procedures will be in place for referral to a higher level of neonatal care when pediatric medical subspecialty or pediatric surgical specialty consultation and/or intervention is needed. 
Laboratory Services 
(r) Laboratory services will have:
1. laboratory personnel on-site 24/7;
2. the ability to determine blood type, crossmatch, and perform antibody testing;
3. a blood bank capable of providing blood component therapy and irradiated, leukoreduced or cytomegalovirus (CMV)-negative blood;
4. the ability to perform neonatal blood gas monitoring; and
5. the ability to perform analysis on small volume samples.
(s) Low-volume specialty laboratory services may be provided by an outside laboratory, but the facility will have policies and procedures in place to verify timely and direct communication of all critical value results. 
Pharmacy 
(t) The facility will have at least 1 registered pharmacist with experience in neonatal and/or pediatric pharmacology who will:
1. be available for consultation on-site, or by telehealth or telephone, 24/7;
2. complete continuing education requirements specific to pediatric and neonatal pharmacology; and
3. participate in multidisciplinary care, as needed.
(u) The pharmacy will have policies and procedures in place to address drug shortages and to verify medications are appropriately allocated to the level II SCN; and
1. have policies and procedures in place to verify neonatal competency for pharmacy staff supporting and preparing medications for neonatal patients. 
Diagnostic Imaging 
(v) Radiology services will have:
1. appropriately trained radiology personnel continuously available on-site to meet routine diagnostic imaging needs and to address emergencies;
2. personnel appropriately trained in ultrasonography, including cranial ultrasonography, on-call and/or available on-site to perform advanced imaging as requested; and
3. the ability to provide timely imaging interpretation by radiologists with pediatric expertise as requested. 
Respiratory Therapy 
(w) The respiratory care leader will:
1. be a full-time respiratory care practitioner, with neonatal and pediatric respiratory care certification preferred;
2. have sufficient time allocated to oversee the respiratory therapists (RTs) who provide care in the level II SCN;
3. provide oversight of annual simulation and skills verification, which includes neonatal respiratory care modalities and low-volume, high-risk neonatal respiratory procedures;
4. develop a written RT staffing plan that establishes flexibility for variable census and acuity. This plan and actual staffing will be based on allocating the appropriate number of competent RTs to a care situation, attend to a safe and high-quality work environment, and be operationally reviewed annually for adherence and to verify respiratory therapy staffing is adequate for patient care needs9 ; and
5. maintain appropriate staffing ratios for infants receiving supplemental oxygen and positive pressure ventilation.
(x) Respiratory care practitioners assigned to the SCN will:
1. be a respiratory care practitioner with documented experience and training in the respiratory support of newborns and infants, with neonatal or pediatric respiratory care certification preferred;
2. be on-site 24/7 and immediately available when an infant is supported by assisted ventilation or CPAP;
3. be able to attend deliveries and assist with resuscitation as requested;
4. demonstrate a current status of NRP completion;
5. participate in annual simulation and respiratory skills verification, which includes low-volume, high-risk procedures consistent with the types of respiratory care provided in the SCN; and
6. have their credentials reviewed by the respiratory care leader annually for adequacy and adherence. 
Dietitian 
(y) The facility must have, or have the ability to consult with, at least 1 registered dietitian or nutritionist who has specialized training in neonatal nutrition, who will5 :
1. collaborate with the medical team to establish feeding protocols, develop patient-specific feeding plans, and help determine nutritional needs at discharge;
2. establish policies and procedures to verify proper preparation and storage of human milk and formula; and
3. have policies and procedures for dietary consultation for patients in the SCN. 
Neonatal Nutrition 
(z) The facility will:
1. provide a specialized area or room, with limited access and away from the bedside, to accommodate mixing of formula or additives to human milk5 ;
2. develop standardized feeding protocols for the advancement of feedings based on the availability of, and family preference for human milk, donor human milk, fortification of human milk and formula; and
3. have policies and procedures in place for accurate verification and administration of human milk and formula, and to avoid misappropriation. 
Lactation and Breastfeeding Support 
(aa) The facility will:
1. have personnel with the knowledge and skills to support lactation available at all times;
2. have a certified lactation counselor (CLC), international board-certified lactation consultant (IBCLC) preferred, available for on-site consultation on weekdays and accessible by telehealth or telephone 24/7; and
3. operationally review CLC and/or IBCLC personnel on an annual basis to establish adequately trained lactation coverage based on the specific need and volume of the neonatal population served.11  
Neonatal Therapists 
(bb) If the facility does not have in-house access to neonatal therapy expertise, the facility will have a formal process in place for providing on-site consultative services by qualified neonatal therapists to address the 6 core practice domains (environment, family or psychosocial support, sensory system, neurobehavioral system, neuromotor and musculoskeletal systems, and oral feeding and swallowing) and to provide the appropriate care for the neonatal population served. The facility will have on-site access to the following as needed12 :
1. an occupational or physical therapist with neonatal expertise, and neonatal therapy certification preferred5 ; and
2. at least 1 individual skilled in the evaluation and management of neonatal feeding and swallowing concerns, with neonatal therapy certification preferred.5 
(cc) The facility will operationally review neonatal therapist personnel on an annual basis to maintain adequate multidisciplinary neonatal therapist coverage based on the specific need and volume of the neonatal population served.12  
Social Worker 
(dd) The SCN social worker will:
1. be a Master’s prepared medical social worker with perinatal and/or pediatric experience.5 
(ee) The facility will:
1. provide 1 social worker for every 30 beds providing level II neonatal care and/or specialty and subspecialty perinatal care5 ;
2. have a written description that clearly identifies the responsibilities and functions of the SCN social worker; and
3. have social services available for each family with an infant in the SCN as needed. 
Pastoral Care 
(ff) Personnel skilled in pastoral care will be available as needed and by family request, and will represent, or have the ability to consult, multiple religious affiliations representative of the population served.5  
Retinopathy of Prematurity 
(gg) If the facility back transfers infants for convalescent care, the facility must have a process in place to appropriately identify infants at risk for retinopathy of prematurity to guarantee timely examination and treatment by having13 :
1. documented policies and procedures for the monitoring, treatment, and follow-up of retinopathy of prematurity5,13 ; and
2. the ability to perform on-site retinal examinations, or off-site interpretation of digital photographic retinal images, by a pediatric ophthalmologist or retinal specialist with expertise in retinopathy of prematurity, if needed.5,13  
Discharge and Follow-up 
(hh) Systems will be in place to establish preparation for SCN discharge, including postdischarge follow-up by general and subspecialty pediatric care providers, home care arrangements and community service resources, and enrollment in a developmental follow-up program as needed.
1. The facility will:
i. have written medical, neurodevelopmental, and psychosocial criteria that automatically warrant high-risk neonatal follow-up with appropriate developmental follow-up services; and
ii. have a written referral agreement with a developmental follow-up clinic or practice, when possible, to provide neurodevelopmental services for the neonatal population served. 
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