South Dakota Administrative Rules
Title 67 - Department of Social Services
Article 67:16 - Covered medical services
Chapter 67:16:43 - Care management - Medically complex children
Section 67:16:43:01 - Definitions

(1) "Care management," the monitoring of admissions to the medically complex program to assure the medical necessity of the admission, monitor the need for a continued stay in the program, and assist in facilitating a child's discharge from the program;

(2) "Care manager," a registered nurse employed by or under contract with the Department of Social Services who is responsible for care management;

(3) "Care plan," a written plan of care designed for a particular child and prepared by an interdisciplinary team;

(4) "Child," a person under the age of 21;

(5) "Complex medical care," care requiring professional nursing on a 24-hour basis that can only be done by or under the direction of a professional nurse;

(6) "Facility," a specialized hospital providing services under this chapter;

(7) "Interdisciplinary team," a team consisting of professionals involved in the child's care, the child's parent, guardian, or other authorized representative, and the child, if appropriate;

(8) "Medically complex care program," an inpatient program provided by a specialized hospital for a child who does not require acute care hospitalization but who cannot be cared for at home because of the need for complex medical care on a 24-hour basis; and

(9) "Specialized hospital," a facility licensed by the Department of Health which provides only one service or a combination of services but which does not provide all of the services required to qualify as a general hospital.