Closer care for the tiniest patients: AdventHealth Ocala advances what a rural Level II NICU can do

OCALA, Fla. — When Pratima Toom, MD, arrived in Marion County in July 2020, she stepped into a community on the brink of rapid growth.

Over the next six years, the population would climb from about 377,000 to more than 457,000—an increase of nearly 20 percent.

With more families moving to the area, the number of babies being born locally was rising just as quickly, creating a growing need for advanced neonatal care close to home.

At the time, however, the level of care available didn’t match the needs of the community.

The most fragile newborns—those born too early or with complex medical conditions—often couldn’t stay in Ocala.

Instead, they were stabilized and quickly transported to hospitals in Orlando or Gainesville, separating families during one of the most critical moments in a baby’s life.

“When I first started here in July 2020, the neonatal unit was only able to offer care for babies from 35 weeks and above and weighing at least 3 lbs. 3 oz.,” Dr. Toom said. “Preterm babies needing advanced respiratory support had to be transferred to Orlando or Gainesville.”

Those transfers often happened during the “golden hour” after birth—a time when rapid, specialized care can significantly influence a baby’s survival and long-term health.

For parents, it also meant being separated from their newborn during one of life’s most vulnerable moments.

Dr. Toom saw both the clinical gap and the human impact. As the county’s only full-time neonatologist, she felt a responsibility to bring more advanced care closer to home—so families could stay together while their babies received the support they needed.

What followed was a transformation in care.

Recognizing the need for more advanced respiratory treatment, Dr. Toom led the creation of an Inhaled Nitric Oxide (INO) program at AdventHealth Ocala. The therapy supports newborns with serious breathing challenges and had not previously been available in a rural Level II NICU setting like this one.

The work required more than a clinical protocol—it depended on an entire care team aligning around a new level of capability.

“Both INO and PICC require a lot of education and training for the team members who care for the babies,” Dr. Toom said. “From nurses and respiratory therapists to lab technicians, pharmacy and radiology, everyone needs to be on the same page.”

In July 2025, the team reached a significant milestone with its first successful INO case—marking the first time in the United States that this type of program had been implemented in a rural Level II NICU.

Since then, patients have shown meaningful improvement, including reduced lengths of stay. The findings have been submitted to the American Academy of Pediatrics, contributing to broader advancements in neonatal care.

Dr. Toom also introduced a PICC (Peripherally Inserted Central Catheter) program, allowing newborns who need extended treatments, such as antibiotics, to remain in Ocala instead of being transferred elsewhere.

For families, this means fewer disruptions and the ability to stay close during critical days of healing.

Together, these programs have expanded what is possible at AdventHealth Ocala. Today, the NICU can care for babies born as early as 30 weeks gestational age, weighing as little as 2 pounds, 7 ounces—with a continued focus on growing those capabilities even further.

As care has advanced, so has trust. More families across the region are turning to AdventHealth Ocala, with NICU admissions increasing nearly 35 percent over the past five years.

That growth has been supported by an environment designed for both clinical excellence and whole-person healing.

The recently renovated mother-baby unit offers private, calming spaces for families along with features that support connection and peace of mind.

Cameras in both the NICU and post-birthing rooms allow families to see their babies at any time. HALO BassiNests © promote safe sleep, while advanced electronic fetal monitoring supported by AI is designed to improve outcomes. Specialized resources are also available across labor and delivery, OB operating rooms and the OB Emergency Department.

For Dr. Toom, the work is deeply personal.

“As a physician and a mother, helping these sick babies, supporting parents and keeping mothers and babies together is incredibly rewarding,” Dr. Toom said. “It’s more than a career, it’s a calling, and I can think of no better way to give back than by caring for mothers and their babies.”

That calling was evident in a pivotal moment in July 2025.

Dr. Toom identified that a newborn, Azario Pillay, had Congenital Rubella Syndrome—an exceedingly rare condition in the United States.

Her timely diagnosis ensured the baby received appropriate care without delay, while also helping to prevent potential exposure and spread of infection among healthcare workers and the broader community.

Today, Azario and his mother, Tiayra Naidoo, are able to visit Dr. Toom—returning not just to the place where he was cared for but to the physician who helped change the course of his story.

In Marion County, what once required leaving the community can now happen within it—bringing advanced care closer to home for the smallest patients and keeping families together when it matters most.

Learn more about Mom & Baby Care at AdventHealth Ocala.