S.D. Admin. R. 67:16:40:09.01

Current through Register Vol. 51, page 57, November 12, 2024

Section 67:16:40:09.01 - Admission requirements - Long-term care hospital unit

Admissions to a long-term care hospital unit are limited to transfers from a general acute care hospital and must be more cost effective than if the entire length of stay had been in the general, acute care hospital.

An individual's admission to a long-term care hospital unit is a covered service if the hospital received authorization for the admission under § 67:16:40:04 and the care manager determines that the following requirements are met:

(1) The individual is medically stable;

(2) The individual has potential for functional gains within two weeks;

(3) The individual is able to participate in rehabilitation therapies and can demonstrate gains in functional abilities;

(4) The medical complications cause a significant decline in physical function; and

(5) There is no alternative course of treatment setting available for the recipient requesting the service which is more conservative or substantially less costly.

S.D. Admin. R. 67:16:40:09.01

31 SDR 39, effective 9/29/2004.

General Authority: SDCL 28-6-1.

Law Implemented: SDCL 28-6-1.