S.D. Admin. R. 67:62:15:03

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

Section 67:62:15:03 - Level II review exemptions

An individual is exempt from a Level II review if:

(1) The diagnosis of mental illness is unsubstantiated;

(2) The individual is readmitted to a Medicaid certified swing bed or nursing facility from a hospital to which the individual was transferred for the purpose of receiving care;

(3) The individual is transferred from one Medicaid certified swing bed or nursing facility to another, and a preadmission screening and resident review has previously been completed;

(4) The physician identifies the need for convalescent care following hospitalization, for a duration of less than one hundred days;

(5) The physician orders a respite stay of thirty days or less;

(6) The individual has a diagnosis of situational depression that is of short duration, in direct relation to an occurrence in an individual's life, and does not appear to be a chronic disability;

(7) The individual is using psychotropic medication in the absence of a major mental illness diagnosis; or

(8) The individual has a diagnosis of an anxiety disorder that is not identified as severe and does not appear to be leading to a chronic disability.

The department shall complete a Level I screening form to notify appropriate parties of the determination of the exemption.

S.D. Admin. R. 67:62:15:03

43 SDR 80, effective 12/5/2016; 50 SDR 063, effective 11/27/2023

General Authority: SDCL 1-36-25.

Law Implemented: SDCL 1-36-25(4).