Current through Bulletin 2024-24, December 15, 2024
Section R414-501-3 - Preadmission Authorization(1) A nursing facility will perform a preadmission assessment when admitting a nursing facility applicant. Preadmission authorization is not transferable from one nursing facility to another.(2) A nursing facility must obtain approval from the Department when admitting a nursing facility applicant. The nursing facility must submit a request for prior approval to the Department no later than the next business day after the date of admission. A request for prior approval may be in writing or by telephone and will include: (a) the name, age, and Medicaid eligibility of the nursing facility applicant;(b) the date of transfer or admission to the nursing facility;(c) the reason for acute care inpatient hospitalization or emergency placement, if any;(d) a description of the care and services needed;(e) the nursing facility applicant's current functional and mental status;(f) the established diagnoses;(g) the medications and treatments currently ordered for the nursing facility applicant;(h) a description of the nursing facility applicant's discharge potential;(i) the name of the hospital discharge planner or nursing facility employee who is requesting the prior approval;(j) the Preadmission Screening and Resident Review (PASRR) Level I screening, except the screening is not required for admission to an intermediate care facility for people with mental retardation; and(k) the Preadmission Screening and Resident Review (PASRR) Level II determination, as required by 42 CFR 483.112.(4) If the Department gives a telephone prior approval, the nursing facility will submit to the Department within five working days a preadmission transmittal for the nursing facility applicant, and will begin preparing the complete contact for the nursing facility applicant. The complete contact is a written application containing all the elements of a request for prior authorization plus: (a) the preadmission continued stay transmittal;(b) a history and physical;(c) the signed and dated physician's orders, including physician certification; and(d) an MDS assessment completed no later than 14 calendar days after the resident is admitted to a nursing facility.(5) The requirements in Section R414-501-3 do not apply in cases in which a facility is seeking Retroactive Authorization described in Section R414-501-5.Utah Admin. Code R414-501-3