Missouri Code of State Regulations
Title 19 - DEPARTMENT OF HEALTH AND SENIOR SERVICES
Division 30 - Division of Regulation and Licensure
Chapter 41 - Head and Spinal Cord Injuries
Section 19 CSR 30-41.010 - Head and Spinal Cord Injury Reporting Requirements

(1) Based on information provided by the reporting physician or his/her designee, all Missouri hospitals shall report on forms supplied by the Department of Health registry information on the following patients:

(2) The registry forms for patients discharged during any one (1) month shall be completed and sent to the Department of Health by the last day of the following month.

(3) The registry form shall include, but not be limited to the following items: hospital name and hospital medical record number; patient name, Social Security number, date of birth, sex and race; previous treatment for the same injury; if minor (under 18) name of parent or guardian and Social Security number; date of injury; time of injury; external cause (E code); scene of injury; place of injury; factors related to the injury such as blood alcohol content, use of all-terrain vehicle, use of restraint and use of helmet; mode of arrival; ambulance service number; ambulance report number; ambulance times; if transfer in, sending hospital; data and time of arrival in emergency department; glasgow coma score and cardiopulmonary functions at arrival in the emergency department; time intubated, sent to ct scan and sent to X-ray; time of arrival in emergency department of the trauma surgeon, orthopedic surgeon and neurosurgeon; time of discharge from emergency department; emergency department disposition; if transferred out, receiving hospital; date and time of arrival in operating room; time anesthetist arrived in operating room; operating room procedures ranked by apparent severity; final diagnoses ranked by apparent severity; date admitted; date discharged; total ICU days; disposition at discharge; degree of disability and disability related to; and expected main source of payment.