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 2 - Definitions › Section 51124 - Skilled Nursing Facility Level of Care

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) "Skilled Nursing facility level of care"
					 means that level of care provided by a skilled nursing facility meeting the
					 standards for participation as a provider under the Medi-Cal program as set
					 forth in Section
					 51215 of this division.
(b) The skilled nursing facility level of
					 care is the level of care needed by Medi-Cal beneficiaries who do not require
					 the full range of health care services provided in a hospital as hospital acute
					 care or hospital extended care, but who require the continuous availability of
					 skilled nursing care provided by licensed registered or vocational nurses, or
					 the equivalent thereof, as set forth in Section
					 51215.
(c) Skilled nursing care provided in
					 participating skilled nursing facilities is the composite of necessary
					 observation, assessment, judgment, supervision, documentation, and teaching of
					 the patient and includes specific tasks and procedures.
(d) Skilled nursing procedures provided as a
					 part of skilled nursing care are those procedures which must be furnished under
					 the direction of a registered nurse in response to the attending physician's
					 orders, and are either performed or supervised by a licensed registered nurse,
					 a licensed vocational nurse or in the case of institutions for mentally
					 retarded or distinct parts of institutions which are certified as skilled
					 nursing facilities and providing care for mentally retarded patients, by a
					 licensed psychiatric technician. A need for one or more skilled nursing
					 procedures does not necessarily indicate a medical need for skilled nursing
					 facility services. Rather, the need must be for a level of service which
					 includes the continuous availability of procedures such as, but not necessarily
					 limited to, the following: administration of intravenous, intramuscular, or
					 subcutaneous injections, and intravenous or subcutaneous infusions; gastric
					 tube or gastrostomy feedings; nasopharygeal aspiration; insertion or
					 replacement of catheters; application of dressings involving prescribed
					 medications and aseptic techniques; treatment of extensive decubiti and other
					 widespread skin disorders; heat treatments which require observation by
					 licensed personnel to evaluate the patient's progress; administration of
					 medical gases under prescribed therapeutic regimen; and restorative nursing
					 procedures which require the presence of a licensed nurse.
(e) Other health care services, such as
					 physical, occupational or speech therapy, require specialized training for
					 proper performance. The need for such therapies does not necessarily indicate a
					 need for nursing facility services.
1. New
						section filed 9-27-72; designated effective 11-1-72 (Register 72, No.
						40).
2. Amendment filed 7-13-73; effective thirtieth day thereafter
						(Register 73, No. 28).
3. Change without regulatory effect adding
						NOTE (Register 86, No. 49).
4. Editorial correction of printing
						error in section heading (Register 94, No. 17).
Note: Authority cited: Sections
						  10725,
						  14105
						  and
						  14124.5,
						  Welfare and Institutions Code. Reference: Sections
						  14108
						  and
						  14110,
						  Welfare and Institutions Code.