Ala. Admin. Code r. 560-X-41-.11

Current through Register Vol. 43, No. 1, October 31, 2024

Section 560-X-41-.11 - Inpatient Continued Stay Reviews

(1) The provider's interdisciplinary treatment team is responsible for performing continued stay reviews on recipients who require continued inpatient hospitalization. These continued stay review dates will be determined by the PA Unit following an evaluation of the information submitted on the Psychiatric Admission form.

(2) Continued stay updates must include:

(a) Master Treatment Plan and subsequent changes;

(b) Utilization review worksheet;

(c) Physician's progress notes, nursing progress notes and, if requested, social worker's progress notes (individual and family sessions, discharge planning). The PA Unit may request this information when documentation included in (a) and (b) is insufficient to justify the continued hospital stay.

(3) Continued stay updates will be reviewed by the PA Unit and the next continued stay review date assigned upon approval of the continued hospitalization. Continued stay updates not received by the next review date will be approved on the date the information is received by the PA Unit provided the review criteria are met. These stays must be split billed to separate the authorized days from the non-authorized days.

Author: Lynn Sharp, Associate Director, Policy Development Unit

Ala. Admin. Code r. 560-X-41-.11

Emergency adoption effective August 21, 1991. Permanent adoption effective November 13, 1991. Amended: Filed August 7, 2000; effective September 11, 2000. Amended: Filed November 8, 2001; effective December 13, 2001.

Statutory Authority: Title XIX, Social Security Act; State Plan, Attachment 3.1-A, pp. 7, 7.16; 42 C.F.R. §§ 456.233 -.234.