S.D. Admin. R. 67:16:24:03

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

Section 67:16:24:03 - Services covered

Personal care services are limited to medically necessary services contained in the recipient's case service plan and provided in the recipient's residence. Personal care services covered are limited to the following:

(1) Basic personal care and grooming, including bathing, shaving, dressing, and assisting the recipient with hair and teeth care;

(2) Assistance with bladder or bowel requirements, which does not include administration of a bowel program;

(3) Assisting the patient with medications which are ordinarily self-administered;

(4) Assistance with food, nutrition, and diet activities if they are incidental to a medical need;

(5) Performing those household services, if related to a medical need, that are essential to the patient's health and comfort in the patient's residence; or

(6) Maintenance nursing prescribed by a physician.

A personal care provider shall use SDCL chapter 36-9 to determine when the needed covered services must be delivered by a licensed nurse.

For purposes of this rule, a recipient's residence does not include a hospital, penal institution, detention center, school, nursing facility, assisted living center, congregate facility where services are available, other types of group settings, intermediate care facility for individuals with intellectual disabilities, or an institution which treats individuals for mental diseases.

S.D. Admin. R. 67:16:24:03

5 SDR 109, effective 7/1/1979; 7 SDR 66, 7 SDR 89, effective 7/1/1981; 16 SDR 235, effective 7/5/1990; 20 SDR 170, effective 4/18/1994; 23 SDR 92, effective 12/10/1996; 28 SDR 96, effective 12/30/2001; 40 SDR 122, effective 1/8/2014; 44 SDR 94, effective 12/4/2017; 49 SDR 021, effective 9/12/2022

General Authority: SDCL 28-6-1(1)(2).

Law Implemented: SDCL 28-6-1.

Covered services must be medically necessary, § 67:16:01:06.02; Practices not prohibited by chapter, SDCL 36-9-28.