S.D. Admin. R. 46:11:13:15

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

Section 46:11:13:15 - Individuals not requiring swing bed or nursing facility services but requiring specialized services - 30 month determination

(1) If the individual has continuously resided in a Medicaid certified swing bed or nursing facility at least 30 months prior to a determination of eligibility, and determined not eligible for swing bed or nursing home services, but who require specialized services, the Department of Social Services and the Department of Human Services, in consultation with the individual's family or legal representative and caregivers, shall:

(a) Offer the choice of remaining in the nursing facility or of receiving services in an alternative setting;

(b) Inform the individual of the institutional and noninstitutional alternatives covered under the state Medicaid plan;

(c) Clarify the effect on the individual's eligibility for Medicaid services under the state plan if the individual chooses to leave the nursing facility, including the effect on readmission to the nursing facility; and

(d) Provide for, or arrange for the provision of, specialized services for the intellectual disability or developmental disability; or

(2) If the individual has been residing in a Medicaid certified swing bed or nursing facility less than 30 months prior to a determination of eligibility, and determined not eligible for swing bed or nursing home services, but who requires specialized services, the Department of Social Services and Department of Human Services, in consultation with the individual's family or legal representative and caregivers, shall:

(a) Arrange for the safe and orderly discharge of the individual from the facility;

(b) Prepare and orient the individual for discharge; and

(c) Provide for, or arrange for the provision of, specialized services for the intellectual disability or developmental disability.

S.D. Admin. R. 46:11:13:15

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.