N.H. Admin. Code § He-M 1302.05

Current through Register No. 45, November 7, 2024

Section He-M 1302.05 - Exemptions and Exclusions

(a) An applicant shall be exempt from level II evaluation and determination if he or she:

(1) Is admitted to a nursing facility from a hospital after receiving acute care;

(2) Needs nursing facility services;

(3) Requires services for the condition for which he or she received acute care at the hospital; and

(4) Has a physician who certifies that the individual is likely to require nursing facility services for less than 30 days.

(b) For persons admitted pursuant to (a) above whose nursing facility stay exceeds 30 days, the PASRR office shall perform a level II evaluation and determination before the 40th day from the individual's admission to the nursing facility.

(c) An applicant with a diagnosis of dementia and MI shall be excluded from the level II evaluation and determination if:

(1) The MI will not likely be the focus of treatment again; and

(2) The referral source has documented that:

a. Dementia is the primary diagnosis; and

b. The dementia is advanced such that the MI will not likely be the primary focus of treatment.

(d) An applicant who has MI or DD shall be exempt from level II evaluation and determination if he or she has a notice on file with the PASRR office per He-M 1302.03(e) and:

(1) Is being re-admitted to a nursing facility from a hospital; or

(2) Is transferring from one nursing facility to another with or without an intervening hospital stay.

N.H. Admin. Code § He-M 1302.05

#6063 eff 8-1-95; ss by #7920, INTERIM, eff 8-2-03, EXPIRED: 1-29-04

New. #8035, eff 2-7-04; amd by #8430, eff 9-17-05; paras (a)-(c) expired 2-7-12; amd by #10123, INTERIM, eff 4-30-12, EXPIRES: 10-29-12; ss by #10215, eff 10-29-12