Pennsylvania Code › Title 55 - HUMAN SERVICES › Part III - MEDICAL ASSISTANCE MANUAL › Chapter 1151 - INPATIENT PSYCHIATRIC SERVICES › GENERAL PROVISIONS › Section 1151.2 - Definitions

Current through Register Vol. 54, No. 28, July 13, 2024
The following words and terms, when used in this chapter,
					 have the following meanings, unless the context clearly indicates
					 otherwise:
Acute psychiatric services
-Psychiatric
					 services rendered in response to a severe psychiatric condition requiring
					 intervention to bring the patient's symptoms under control.
Certified day
-A day of inpatient hospital
					 care approved by the Department under this chapter.
Day of inpatient hospital care
-Room, board
					 and professional services furnished to a patient on a continuous 24-hour-a-day
					 basis in a semiprivate room of a hospital. The term includes items and services
					 ordinarily furnished by the hospital for the care and treatment of inpatients
					 provided in an institution other than one maintained primarily for treatment
					 and care of patients with tuberculosis.
Emergency admission
-The unscheduled
					 admission of a person with a severe mental disability who requires immediate
					 treatment, to an inpatient psychiatric facility.
Fiscal year
-A period of time beginning
					 July 1 and ending June 30 of the following year.
General hospital
-A facility licensed as a
					 hospital under 28 Pa. Code Part IV, Subpart A (relating to general and special
					 hospitals) which provides equipment and services primarily for inpatient care
					 to persons who require treatment for injury, illness, disability or pregnancy.
					 The term does not include public or private psychiatric hospitals, general
					 nursing facilities, county-operated nursing facilities, intermediate care
					 facilities for the mentally retarded or psychiatric transitional
					 facilities.
Inpatient psychiatric facility
-The term
					 refers to private psychiatric hospitals and distinct part psychiatric units of
					 general hospitals.
Patient pay amount
-Income or assets that
					 the CAO has determined to be available to a recipient to meet the cost of
					 medical care. The recipient, not the MA Program, pays this amount toward the
					 cost of care.
Private psychiatric hospital
-An
					 institution, other than a general hospital, not directly operated or controlled
					 by the Department that is engaged in providing acute short-term psychiatric
					 services on an inpatient basis.
Public psychiatric hospital
-An
					 institution, other than a general hospital, controlled, operated and funded
					 directly by the Department and engaged in providing long-term and short-term
					 inpatient psychiatric services for the diagnosis, treatment and care of
					 individuals with mental diseases.
Recipient under 21 years of age
-A
					 recipient who is one of the following:
(i) Under 21 years of age.
(ii) Age 21 and was receiving inpatient
				  psychiatric services in a psychiatric hospital the day preceding the date the
				  recipient reached age 21. This recipient continues to be recognized as a
				  recipient under 21 years of age until the earlier of the date the recipient
				  either:
(A) No longer requires inpatient
				  psychiatric facility services.
(B)
				  Reaches age 22.