The Maternal Levels of Care Verification Program
With the goal of reducing maternal mortality and morbidity in the United States, ACOG has partnered with The Joint Commission on the development of a new Maternal Levels of Care (MLC) Verification program, effective January 1, 2022.
The Levels of Maternal Care (LoMC) Obstetric Care Consensus, first published in 2015 by ACOG and the Society for Maternal–Fetal Medicine (SMFM), defines the required minimal capabilities, physical facilities, and medical and support personnel for each level of care, which include:
- Level I (basic care)
- Level II (specialty care)
- Level III (subspecialty care)
- Level IV (regional perinatal health care centers)
The voluntary verification process will be conducted by The Joint Commission and will involve an on-site comprehensive review of the maternal services available in hospitals and critical-access hospitals, as well as a level of maternal care determination.
Please see below for answers to frequently asked questions about this collaborative agreement.
Frequently Asked Questions
The LoMC Obstetric Care Consensus, first published in 2015 by ACOG and SMFM, defines the required minimal capabilities, physical facilities, and medical and support personnel for four levels of obstetric care. Based on these guidelines, The Joint Commission and ACOG developed the criteria for the MLC Verification program.
The MLC Verification program will play a key part in decreasing maternal mortality and severe maternal morbidity by ensuring that pregnant and postpartum individuals receive risk-appropriate maternal care. The new program will involve an on-site comprehensive review of the maternal services available in community hospitals and critical-access hospitals that will inform a level of maternal care determination. The verification process will help hospitals gain a clear understanding of their capabilities and resources, including personnel; the types of patients that the hospital is equipped to manage; and circumstances in which pregnant and postpartum patients should be transferred to a collaborating health care facility that has the resources to provide risk-appropriate care.
Following the launch of an LoMC verification program in Texas, there was increasing demand across states for LoMC verification. To help accommodate hospitals and states and eliminate the complexities involved in implementation, ACOG determined that a partnership with The Joint Commission to launch a verification program based on the ACOG and SMFM guidance would be beneficial. The program will enable a broader, more streamlined, more consistent, and more rapid expansion of LoMC across the country and give states and hospitals an opportunity to further their efforts to improve maternal health.
No, this is a voluntary program.
While a hospital does not need to be accredited by The Joint Commission to participate in the MLC verification program, organizations that have obstetric services must be compliant with applicable federal laws, including Medicare Conditions of Participation, to participate.
No, the process and the criteria considered in the MLC verification program are different from accreditation. MLC Verification is a voluntary program that will include a one- to two-day survey (depending on level) with surveyors ensuring that the organization has the appropriate resources, personnel, training, and processes in place to designate the specific level of care. Hospitals will receive specific feedback and will have 60 days to address level-related standards that were identified as not met during the survey.
Every three years.
ACOG worked collaboratively with The Joint Commission to incorporate the criteria from the LoMC Obstetric Care Consensus into the MLC Verification program requirements, or standards. These include Elements of Performance, which define the steps a hospital needs to take to meet each standard. The Joint Commission will administer the MLC Verification program, conduct the site surveys to evaluate compliance with these standards, and verify a level of maternal care. ACOG will not be involved in the on-site survey process or in designating a level of maternal care.
The MLC verification program is beneficial to hospitals, health care professionals, and patients. By helping hospitals identify and fill gaps in capabilities and personnel, this program will help ensure that pregnant and postpartum individuals receive risk-appropriate maternal care, thereby contributing to regional and national efforts to decrease maternal mortality and severe maternal morbidity. The program aligns with national standards developed by ACOG and SMFM and supports the development of effective collaborative relationships between hospitals with different resources and designations for levels of maternal care. MLC verification levels will allow collaborating hospitals and health systems to establish systems for transferring care based on risk and map geographic distribution of maternity care resources to identify needs for improving access to care.
The verified level will be available online at The Joint Commission’s Quality Check.
If you have additional questions, email LMC@acog.org.