California Code of Regulations › Title 22 - Social Security › Division 3 - Health Care Services › Subdivision 1 - California Medical Assistance Program › Chapter 3 - Health Care Services › Article 4 - Scope and Duration of Benefits › Section 51335.5 - Subacute Care Services

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a)
					 Subacute care services are a type of skilled nursing facility service which is
					 provided by a subacute care unit which meets the requirements of Sections
					 51215.5 and
					 51215.6.
(b) Subacute care services provided in the
					 subacute care unit are covered pursuant to the requirements specified in
					 Sections 51124.5 and
					 51335(a) through
					 (e) except for (b)(1) and (c)(1).
(c) A Treatment Authorization Request shall
					 be required for each admission to a subacute unit caring for adult patients,
					 and may be granted for a period of up to six months and reauthorized for a
					 period of up to six months.
(d)
					 Medi-Cal beneficiaries at the subacute level of care in the facility shall be
					 visited by their attending physician as provided for in the Manual of Criteria
					 for Medi-Cal Authorization--Subacute Level of Care Criteria, referenced in
					 Title 22, California Code of Regulations, Section
					 51003(e).
(e) Services to subacute patients shall be
					 covered only on the signed order of the physician responsible for the care of
					 the patient.
(f) Subacute bedhold
					 will be authorized during acute hospitalization of a Medi-Cal beneficiary in
					 accordance with Section
					 51535.1.
(g) Leave of absence for a Medi-Cal
					 beneficiary at the subacute level of care will be authorized in accordance with
					 Section 51535.
(h) A medical review of all beneficiaries
					 receiving subacute care services shall be performed by a medical review
					 team.
1. New
						section filed 6-3-86 as an emergency; effective upon filing (Register 86, No.
						23). A Certificate of Compliance must be transmitted to OAL within 120 days or
						emergency language will be repealed on 10-1-86.
2. Section refiled
						11-3-86 as an emergency; effective 10-1-86 (Register 86, No. 45). A Certificate
						of Compliance must be transmitted to OAL within 120 days or emergency language
						will be repealed on 1-29-87.
3. Certificate of Compliance including
						amendment filed 1-20-87 (Register 87, No. 4).
4. Amendment of
						subsection (e), repealer of subsection (i) and relettering of former subsection
						(j) to subsection (i) filed 10-27-88 as an emergency; operative 10-27-88
						(Register 88, No. 45). A Certificate of Compliance must be transmitted to OAL
						within 120 days or emergency language will be repealed on
						2-24-89.
5. Certificate of Compliance transmitted to OAL 2-24-89 and
						filed 3-27-89 (Register 89, No. 13).
6. Amendment of subsections
						(c), (d), (h) and NOTE filed 4-13-94; operative 4-1-94. Emergency amendment
						submitted to OAL for printing only pursuant to section
						4, AB 36 (chapter 1030, Statutes
						of 1993) (Register 94, No. 15).
7. Certificate of Compliance as to
						4-13-94 order including amendment of section transmitted to OAL 9-26-94 and
						filed 10-20-94 (Register 94, No. 42).
8. Editorial correction of
						HISTORY 6 and 7 (Register 95, No. 14).
Note: Authority cited: Sections
						  10725,
						  14105
						  and
						  14124.5,
						  Welfare and Institutions Code. Reference: Sections
						  14114
						  and
						  14132.25,
						  Welfare and Institutions Code.