Ala. Admin. Code r. 560-X-63-.04

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

Section 560-X-63-.04 - Admission Criteria

(1) Admission is limited to ventilator-dependent and/or qualified tracheostomy residents.

(2) The ventilator-dependent resident and/or qualified tracheostomy resident must meet the current nursing facility level of care criteria established by Medicaid.

(3) All of the following criteria must be present in order for a resident to be considered ventilator-dependent:

(a) The resident is not able to breathe without a volume ventilator with a backup.

(b) The resident uses the ventilator seven days per week.

(c) The resident has a tracheostomy.

(d) The resident requires daily respiratory therapy intervention, i.e., oxygen therapy, tracheostomy care, chest physiotherapy or deep suctioning. These services must be available 24 hours a day.

(e) The resident must be medically stable and not require acute care services. A Registered Nurse or Licensed Practical Nurse must be readily available and have primary responsibility of the unit at all times.

(4) The resident will also be considered ventilator-dependent if all of the above requirements were met at admission but the resident is in the process of being weaned from the ventilator. This does not include residents who are only on C-PAP or Bi-PAP devices.

(5) All of the following criteria must be present in order for a resident to be considered for qualified tracheostomy care:

(a) The resident is not able to breathe without the use of a tracheostomy.

(b) The resident requires daily respiratory therapy intervention, i.e., oxygen therapy, tracheostomy care, chest physiotherapy, or deep suctioning. These services must be available 24 hours a day.

(c) The resident must be medically stable and not require acute care services.

(d) A Registered Nurse or Licensed Practical Nurse must be readily available and have primary responsibility of the unit.

Not withstanding the foregoing, a ventilator-dependent or qualified tracheostomy resident who is in the process of being weaned from being ventilator-dependent or needing qualified tracheostomy treatment shall continue to be considered a qualified resident until the weaning process is completed.

Ala. Admin. Code r. 560-X-63-.04

New Rule: Filed December 12, 2011; effective January 16, 2 012.

Author: Marilyn F. Chappelle, Director, Long Term Care Division

Statutory Authority: State Plan; Title XIX, Social Security Act; and 42 CFR Section 401, et seq., Section 483.75