S.D. Admin. R. 46:11:13:04

Current through Register Vol. 51, page 67, December 16, 2024

Section 46:11:13:04 - Exempt hospital discharge

An individual is exempt from a PASRR following a hospital discharge if the following conditions are met:

(1) The individual is admitted to a Medicaid certified swing bed or nursing facility directly from a hospital after receiving acute inpatient care at the hospital;

(2) The individual requires Medicaid certified swing bed or nursing facility services for the same condition for which care was received in the hospital; and

(3) The individual's attending physician has certified before admission to the Medicaid certified swing bed or nursing facility that the individual is likely to require less than 30 calendar days of Medicaid certified swing bed or nursing facility services.

If an individual enters a Medicaid certified swing bed or nursing facility as an exempt hospital discharge and is later found to require more than 30 days of nursing care, the facility shall request a PASRR prior to the expiration of that 30 days.

S.D. Admin. R. 46:11:13:04

40 SDR 102, effective 12/3/2013; 40 SDR 229, effective 6/30/2014.

General Authority: SDCL 27B-2-26(8).

Law Implemented: SDCL 27B-2-26.