S.D. Admin. R. 67:45:01:03

Current through Register Vol. 51, page 57, November 12, 2024
Section 67:45:01:03 - Nursing facility level of care classification

The department may assign an individual to a nursing facility level of care classification if the individual requires any of the following services:

(1) Continuing direct care services that have been ordered by a physician and can only be provided by or under the supervision of a licensed nurse. These services include daily management, direct observation, monitoring, or performance of complex nursing procedures. For purposes of this section, continuing direct care is repeated application of the procedures or services at least once every twenty-four hours, frequent monitoring, and documentation of the individual's condition and response to the procedures or services;
(2) The assistance of another person for the performance of any activity of daily living according to an assessment of the individual's needs; or
(3) Skilled therapeutic services:
(a) Physical therapy, occupational therapy, or speech-language therapy in any combination that is provided at least once a week;
(b) Continuing mental health services provided under chapter 67:62:12 with a documented need for waiver services to prevent nursing facility placement by a staff member who meets the requirements of subdivision 67:62:06:03(2); or
(c) Continuing mental health services provided under chapter 67:62:13 with a documented need for waiver services to prevent nursing facility placement by a staff member who meets the requirements of subdivision 67:62:06:03(2).

The department must complete a classification assignment for an eligible individual before payment is made for services provided.

S.D. Admin. R. 67:45:01:03

18 SDR 67, effective 10/13/1991; 27 SDR 32, effective 10/11/2000; 38 SDR 123, effective 1/23/2012; 50 SDR 063, effective 11/27/2023; 51 SDR 013, effective 8/12/2024

General Authority: SDCL 28-6-1.

Law Implemented: SDCL 28-6-1.

Redetermination of level of care classification, § 67:45:01:08. Requirements for staff providing direct services and supports to clients, § 67:62:06:03.