S.D. Admin. R. 67:62:15:05

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

Section 67:62:15:05 - Categorical determinations for Level I

The Department of Social Services must make a categorical determination in one of the following situations:

(1) A terminal illness diagnosis, determined by a physician or hospice involvement that includes a life expectancy of 6 months or less;

(2) A severe physical illness that has resulted in coma or ventilator dependence;

(3) The age of an individual is 75 years or older; or

(4) A primary diagnosis of dementia, including Alzheimer's disease or a related disorder or a non-primary diagnosis of dementia without a primary diagnosis that is a serious mental illness.

For any of these situations, the Department of Social Services must complete a Level I screening form. A copy of the form must be sent to the division and any appropriate facility. A categorical determination may warrant Medicaid certified swing bed or nursing facility services but does not warrant mental health services or specialized services.

S.D. Admin. R. 67:62:15:05

43 SDR 80, effective 12/5/2016

General Authority: SDCL 1-36-25(4).

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