South Dakota Administrative Rules
Title 67 - Department of Social Services
Article 67:16 - Covered medical services
Chapter 67:16:40 - Care management - Rehabilitation, psychiatric, neonatal
Section 67:16:40:01 - Definitions

(1) "Activities of daily living," an individual's physical functions including the ability to bathe, dress, eat, toilet, and move;

(2) "Care conference," a meeting of medical professionals specifically involved in an individual's care used to determine the individual's plan of care and the disposition of medical treatment;

(3) "Care management," the monitoring of certain inpatient admissions to assure the medical necessity of the admission, monitor the need for a continued stay in the unit, and assist in facilitating the individual's discharge from the unit;

(4) "Care management consultant," a physician or psychiatrist who has a contract with the Department of Social Services to review case files;

(5) "Care manager," a medical professional or medical review organization employed by or under contract with the Department of Social Services who is responsible for care management;

(6) "Functional," the ability to perform the activities of daily living either independently or with assistance from another individual;

(7) "Hospital representative," the person designated by a participating hospital as the hospital's primary contact person for the care manager;

(8) "Long-term care hospital unit," a hospital within a licensed acute care hospital that provides long-term inpatient care to recipients who need acute care and are chronically ill, ventilator dependent, or in need of specialized monitoring; and

(9) "Working day," the days of the week consisting of Monday through Friday except those days considered holidays as specified in SDCL 1-5-1.