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 67:16:40:09.01 - Admission requirements - Long-term care hospital unit
Current through Register Vol. 51, page 43, September 23, 2024
Admissions to a long-term care hospital unit are limited to transfers from a general acute care hospital and must be more cost effective than if the entire length of stay had been in the general, acute care hospital.
An individual's admission to a long-term care hospital unit is a covered service if the hospital received authorization for the admission under § 67:16:40:04 and the care manager determines that the following requirements are met:
(1) The individual is medically stable;
(2) The individual has potential for functional gains within two weeks;
(3) The individual is able to participate in rehabilitation therapies and can demonstrate gains in functional abilities;
(4) The medical complications cause a significant decline in physical function; and
(5) There is no alternative course of treatment setting available for the recipient requesting the service which is more conservative or substantially less costly.
General Authority: SDCL 28-6-1.
Law Implemented: SDCL 28-6-1.
