Application Process
To be eligible for approval as a Level I, Level II, or pediatric trauma center, a hospital must complete the applicable application and submit all requested information to the Florida Department of Health’s Division of Emergency Preparedness and Community Support, Bureau of Emergency Medical Oversight, Trauma Section, for review. The application requirements are outlined in Chapter 395, Part II, Florida Statutes, and Chapter 64J-2, Florida Administrative Code.
- Trauma Center Standards, DOH Pamphlet 150-9, January 2010
The following documents should be completed, as applicable:
- Level I Trauma Center Application Manual, January 2010
- Level II Trauma Center Application Manual, January 2010
- Pediatric Trauma Center Application Manual, January 2010
Certificate of Approval
Each hospital approved as a trauma center shall be issued a certificate of approval, which are incorporated by reference and available from the Florida Department of Health (DOH), as defined by subsection 64J-2.001(4), F.A.C.
The certificates shall include:
- DH Form 2032-Z, January 2010, Level I Trauma Center Certificate of Approval
- DH Form 2043-Z, January 2010, Level II Trauma Center Certificate of Approval
- DH Form 1721-Z, January 2010, Pediatric Trauma Center Certificate of Approval
Renewal Notice
At least 14 months prior to the expiration of the trauma centerโs certificate, an email will be sent to eligible trauma centersโ trauma program managers of their right to submit an Application to Renew, DH Form 2032R, January 2010, form for renewal of the trauma centerโs certification.
Should the hospital choose to renew the certification, a completed Application to Renew, DH Form 2032R, January 2010, form must be submitted to DOH within 15 calendar days of receipt of the email. If the hospital chooses not to renew, please refer to section 395.4025(2)(d)(8), F.S.
All renewing trauma centers shall receive an onsite survey after DOH’s receipt of the completed application. Your hospital will be notified as soon as possible when the onsite survey is scheduled.
Submit the completed DH Form 2032R, January 2010, form to: DEPCS.TraumaNCompl@FLHealth.gov.
Please send original to:
Florida Department of Health
DEPCS, Attn: Trauma Coordinator
4052 Bald Cypress Way, Bin A-22
Tallahassee, FL 32399
Site Survey
Floridaโs trauma centers are subject to onsite evaluations to determine compliance with standards published in DOH Pamphlet 150-9, January 2010, and to evaluate the quality of trauma care provided by the hospital. The onsite evaluation is conducted by a review team comprised of out-of-state reviewers with comprehensive knowledge of trauma patient management and experience in trauma care at a designated trauma center that has been approved by the governing body of the state in which they are licensed.
DOH notifies each trauma center of the results of the site survey within 30 working days from completion of the site visit. The hospital has 30 calendar days to respond to DOH.
Patient charts to be reviewed shall be selected by DOH from cases meeting the criteria listed in Standard XVIII B.2., published in DHP 150-9.
Between 6-9 months prior to the date of the onsite survey, the trauma center will be notified by DOH of the date of the survey. Following the notification of the date of the survey, the trauma centerโs CEO, trauma medical director, and trauma program manager will be provided a package containing information to help guide the trauma center in preparation for the survey.
Samples of documentation sent
- Notification Letter
- Preparation Document
- Medical Record Review Additional Information
- Day Agenda
- Survey Team
- Survey Teamโs CVs
Tools used by the out-of-state survey team to determine whether the hospital is in compliance with standards published in DOH Pamphlet 150-9, January 2010:
- Level I Site Survey Report
- Level II Site Survey Report
- Pediatric Site Survey Report
- Trauma Surgeon Medical Record Review Tool
- Neurosurgeon Medical Record Review Tool
- Emergency Physician Medical Record Review Tool
- Trauma Nurse Medical Record Review Tool
- Trauma Quality Management Worksheet
Trauma Center Standards, Department of Health Pamphlet 150-9, January 2010
Section 395.401(2) and (3), F.S., directs DOH to adopt by rule, standards for approval and verification of trauma centers. Pamphlet 150-9, January 2010, contains the trauma center standards referenced in section 64J-2.011, F.A.C.
Site Survey Deficiency Report
Within 30 working days from the date of the survey, DOH will provide the trauma center the deficiency report. The trauma center has 30 calendar days to respond.
The deficiency action plan should be utilized by the trauma center to respond to DOH. The trauma center may modify the action plan to fit the need of the trauma centerโs response.
Electronic Pre-Survey Questionnaire (EPSQ)
The trauma center is required to complete the EPSQ and return to the DOH roughly six weeks prior to the survey.
The EPSQ zip file contains the following documents:
- Instructions on how to complete the EPSQ
- EPSQ document
- File folder for documents requested in the EPSQ
DOH sends the EPSQ to the out-of-state survey team for their review. The EPSQ is a gathering tool of information shared with the survey team prior to going onsite. The information gathered includes trauma services, outreach, research, disaster planning, demographics, quality management, physician credentials, and nursing education. It is imperative that the trauma center staff follow the instructions on how to complete the document in its entirety. An incomplete questionnaire may result in unnecessary deficiencies on the day of the survey.