North Dakota Code § 23-43-02

Designation of comprehensive stroke center, primary stroke centers, and
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acute stroke-ready hospitals.
1. The department of health and human services shall identify hospitals that meet the 
criteria as a comprehensive stroke center, primary stroke center, or acute stroke -ready 
hospital. In order to receive a designation under this section, a hospital shall apply to 
the department of health and human services and shall demonstrate to the satisfaction 
of the department the hospital meets the applicable criteria.
2. In order to qualify for designation as a comprehensive stroke center, an accredited 
acute care hospital must be certified as a comprehensive stroke center by a 
department-approved, nationally recognized guidelines -based organization, which 
provides comprehensive stroke center hospital certification for stroke care. As a 
condition of retaining designation as a comprehensive stroke center, an acute care 
hospital shall maintain its certification.
3. In order to qualify for designation as a primary stroke center, an accredited acute care 
hospital must be certified as a primary stroke center by a department -approved, 
nationally recognized guidelines -based organization, which provides primary stroke 
center certification for stroke care. As a condition of retaining designation as a primary 
stroke center, an acute care hospital shall maintain its certification.
4. In order to qualify for designation as an acute stroke -ready hospital, an accredited 
acute care hospital must be certified as an acute stroke -ready hospital by 
department-approved, nationally recognized guidelines -based criteria. As a condition 
of retaining designation as an acute stroke -ready hospital, an acute care hospital shall 
maintain its certification.
5. Through agreement, a comprehensive stroke center and primary stroke center may 
coordinate with an acute stroke -ready hospital to provide appropriate access to care 

for acute stroke patients. The coordinating stroke care agreement must be in writing 
and include, at a minimum:
a. The transfer agreement for the transport and acceptance of a stroke patient seen 
by the acute stroke-ready hospital for stroke treatment therapies the stroke center 
or primary care center is not capable of providing; and
b. Communication criteria and protocol with the acute stroke-ready hospital.
6. If the department determines the hospital is not in compliance with the requirements 
set for designation level, after notice and a hearing, the department of health and 
human services may suspend or revoke a hospital's state designation as a 
comprehensive stroke center, primary stroke center, or acute stroke-ready hospital.
7. Any facility that is not designated, must have a predetermined plan for the triage of 
acute stroke patients. The plan must be filed annually with the department of health 
and human services, division of emergency medical services and trauma.

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