La. Admin. Code tit. 48 § I-5711

Current through Register Vol. 50, No. 9, September 20, 2024

Section I-5711 - Medically Monitored Inpatient Withdrawal Management (Medically Supported) (ASAM Level 3.7-WM) (Adults Only)

A. The provider shall:

1. admit only clients clinically appropriate for ASAM level 3.7-WM into its Medically Monitored Inpatient Withdrawal Management Program;

2. ensure that:

a. a physical examination is conducted by a physician, PA or APRN within 24 hours of admission; or

b. the providers admitting physician reviews and approves a physical examination conducted by a physician, PA or APRN within 24 hours prior to admission;

3. ensure that each clients progress is assessed at least daily;

4. ensure that each clients physical condition, including vital signs, is assessed at least daily, or more frequently as indicated by physicians order or change in the clients status;

5. have a reliable, adequately sized emergency power system to provide power during an interruption of normal electrical service;

6. provide case management that is conducted:

a. by a care coordinator who is on duty as needed; or

b. by the clinical staff.

B. Emergency Admissions

1. If a client is admitted under emergency circumstances, the admission process may be delayed until the client can be interviewed, but no longer than 24 hours unless seen by a physician.

2. The provider shall orient the direct care staff to monitor, observe and recognize early symptoms of serious illness and to access emergency services promptly.

C. Staffing

1. The provider shall have a physician on call 24 hours per day, seven days per week, and on duty as needed for management of psychiatric and medical needs of the clients.

2. Nursing

a. The provider shall have at least one RN on call 24 hours per day, seven days per week to perform nursing duties.

b. There shall be at least one licensed nurse on duty during all shifts with additional as needed based upon the providers census and the clients acuity levels.

c. There shall be a RN on-site no less than 40 hours per week who is responsible for conducting nursing assessments upon admission and delegating staffing assignments to the nursing staff based on the assessments and the acuity levels of the clients.

d. The provider shall ensure that its on-site nursing staff is solely responsible for III.7D program and does not provide services for other levels of care at the same time.

e. The nursing staff is responsible for:

i. monitoring clients progress; and

ii. administering medications in accordance with physician orders.

3. Clinical Supervisor and UPs

a. The provider shall have a clinical supervisor available for clinical supervision when needed and by telephone for consultation.

b. The LMHP/UP caseload shall not exceed 1:10.

4. There shall be at least one direct care aide on all shifts with additional as needed based upon the providers census and the clients acuity levels.

5. The provider shall have at least one employee on duty certified in CPR.

La. Admin. Code tit. 48, § I-5711

Promulgated by the Department of Health and Hospitals, Bureau of Health Services Financing, LR 411718 (9/1/2015), Amended LR 481287 (5/1/2022).

AUTHORITY NOTE: Promulgated in accordance with R.S. 36:254 and R.S. 40:2151-2161.