Section R414-515-2 - Definitions(1) "Admission" means the acceptance of a Medicaid member for LTAC and treatment when the member meets established evidence-based criteria for severity of illness and intensity of service and the required service cannot be provided in a lesser level -of -care setting.(2) "Comprehensive documentation" means applicable, relevant information including a history and physical, operative reports, daily physician progress notes, vital signs, laboratory test results, medications administration records, respiratory therapy notes, wound care notes, nutrition notes, physical therapy notes, occupational therapy notes, speech therapy notes, and other pertinent information the Division of Integrated Healthcare needs to decide on an LTAC request.(3) "Continued stay review" means a periodic, supplemental, or interim review of clinical information for an LTAC member.(4) "Inpatient" means an individual whose severity of illness and intensity of service meet the evidence-based criteria for an LTAC hospital stay.(5) "Intensity of service" means the measure of the number, technical complexity, or attendant risk of services provided.(6) "LTAC" hospital means an inpatient transitional care hospital designed to treat members with multiple, serious medical conditions requiring intense, acute care as determined by a physician.(7) "Retroactive review" means a review of clinical information for a patient who had previously been admitted to an LTA C hospital, but never received prior authorization for the initial or continued stay due to retroactive eligibility approval.(8) "Severity of illness" means the extent of a member's organ system derangement or physiologic decompensation.Utah Admin. Code R414-515-2
Adopted by Utah State Bulletin Number 2018-1, effective 12/12/2017Amended by Utah State Bulletin Number 2019-8, effective 3/21/2019Amended by Utah State Bulletin Number 2023-22, effective 11/1/2023