California Code of Regulations
Title 22 - Social Security
Division 3 - Health Care Services
Subdivision 1 - California Medical Assistance Program
Chapter 3 - Health Care Services
Article 4 - Scope and Duration of Benefits
Section 51335.5 - Subacute Care Services
Current through Register 2024 Notice Reg. No. 12, March 22, 2024
(a) Subacute care services are a type of skilled nursing facility service which is provided by a subacute care unit which meets the requirements of Sections 51215.5 and 51215.6.
(b) Subacute care services provided in the subacute care unit are covered pursuant to the requirements specified in Sections 51124.5 and 51335(a) through (e) except for (b)(1) and (c)(1).
(c) A Treatment Authorization Request shall be required for each admission to a subacute unit caring for adult patients, and may be granted for a period of up to six months and reauthorized for a period of up to six months.
(d) Medi-Cal beneficiaries at the subacute level of care in the facility shall be visited by their attending physician as provided for in the Manual of Criteria for Medi-Cal Authorization--Subacute Level of Care Criteria, referenced in Title 22, California Code of Regulations, Section 51003(e).
(e) Services to subacute patients shall be covered only on the signed order of the physician responsible for the care of the patient.
(f) Subacute bedhold will be authorized during acute hospitalization of a Medi-Cal beneficiary in accordance with Section 51535.1.
(g) Leave of absence for a Medi-Cal beneficiary at the subacute level of care will be authorized in accordance with Section 51535.
(h) A medical review of all beneficiaries receiving subacute care services shall be performed by a medical review team.
1. New
section filed 6-3-86 as an emergency; effective upon filing (Register 86, No.
23). A Certificate of Compliance must be transmitted to OAL within 120 days or
emergency language will be repealed on 10-1-86.
2. Section refiled
11-3-86 as an emergency; effective 10-1-86 (Register 86, No. 45). A Certificate
of Compliance must be transmitted to OAL within 120 days or emergency language
will be repealed on 1-29-87.
3. Certificate of Compliance including
amendment filed 1-20-87 (Register 87, No. 4).
4. Amendment of
subsection (e), repealer of subsection (i) and relettering of former subsection
(j) to subsection (i) filed 10-27-88 as an emergency; operative 10-27-88
(Register 88, No. 45). A Certificate of Compliance must be transmitted to OAL
within 120 days or emergency language will be repealed on
2-24-89.
5. Certificate of Compliance transmitted to OAL 2-24-89 and
filed 3-27-89 (Register 89, No. 13).
6. Amendment of subsections
(c), (d), (h) and NOTE filed 4-13-94; operative 4-1-94. Emergency amendment
submitted to OAL for printing only pursuant to section
4, AB 36 (chapter 1030, Statutes
of 1993) (Register 94, No. 15).
7. Certificate of Compliance as to
4-13-94 order including amendment of section transmitted to OAL 9-26-94 and
filed 10-20-94 (Register 94, No. 42).
8. Editorial correction of
HISTORY 6 and 7 (Register 95, No. 14).
Note: Authority cited: Sections 10725, 14105 and 14124.5, Welfare and Institutions Code. Reference: Sections 14114 and 14132.25, Welfare and Institutions Code.
