S.D. Admin. R. 67:16:40:05

Current through Register Vol. 50, page 162, June 24, 2024

Section 67:16:40:05 - Procedure for admission to psychiatric and neonatal units when care manager not available

If the admission is to a neonatal or psychiatric unit and the care manager is not available, the hospital may use the criteria established in § 67:16:40:07 or 67:16:40:08 as a guideline to determine whether to admit the individual. An admission made to a neonatal or psychiatric unit when the care manager is not available is subject to subsequent review and approval by the care manager.

If the care manager is not available and the individual is admitted, the hospital must notify the care manager of the admission within the following periods of time:

(1) If the individual admitted is a recipient, notification must be by the first working day after the date of admission;

(2) If the individual admitted has an application pending with either the medical assistance program or SSI, notification must be by the first working day after the hospital becomes aware the individual has an application pending; and

(3) If the individual obtains eligibility for the medical assistance program after admission, notification must be by the first working day after the hospital becomes aware of the individual's eligibility.

Failure to notify the care manager is cause for denial of the claim.

S.D. Admin. R. 67:16:40:05

21 SDR 123, effective 1/19/1995; 26 SDR 168, effective 7/1/2000.

General Authority: SDCL 28-6-1.

Law Implemented: SDCL 28-6-1.