Wyoming Administrative Code
Agency 048 - Health, Department of
Sub-Agency 0037 - Medicaid
Chapter 19 - NURSING FACILITY PREADMISSION SCREENINGS
Section 19-5 - Admission of Persons Diagnosed as Mentally Ill or with an Intellectual Disability or Related Condition
Universal Citation: WY Code of Rules 19-5
Current through September 21, 2024
(a) Mentally ill individuals. Except as otherwise provided by this Section, a nursing facility shall not admit any mentally ill individual unless:
(i) Prior to admission, the state mental
health authority (SMHA) has determined, based on a physical and mental
evaluation performed by a person or entity other than the state mental health
authority, that the individual requires nursing facility services because of
his or her physical and mental condition; and
(ii) If the individual requires nursing
facility services, the SMHA has also determined whether the individual requires
specialized services.
(b) Individuals or persons with an intellectual disability or related conditions. Except as otherwise provided by this Section, a facility shall not admit any individual with an intellectual disability or related condition unless:
(i)
Prior to admission, the state intellectual disability authority (SIDA) has
determined, based on a physical and mental evaluation performed by a person or
entity other than the SIDA, that the individual requires nursing facility
services because of his or her physical and mental condition; and
(ii) If the individual requires nursing
facility services, the SIDA has also determined whether the individual requires
specialized services.
(c) Penalty for admission prior to screening. Any facility that admits any mentally ill individual or any individual with an intellectual disability or related condition prior to a determination of appropriate placement shall be subject to:
(i) Denial of Medicaid payment for a
Medicaid-eligible individual; and
(ii) Regardless of the individual's payment
source, the Department may impose any of the remedies specified in Chapter 5,
using the procedures specified in Chapter 5.
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