<html> <head> <title>Rule 67:16:40:05 Procedure for admission to psychiatric and neonatal units when care manager not available.</title> <META NAME="Keywords" Content="Administrative Rules 67:16:40:05"> <META NAME="Description" Content="Administrative Rules 67:16:40:05 Procedure for admission to psychiatric and neonatal units when care manager not available."> <meta name=Generator content="Microsoft Office HTML Filter 2.0"> <meta http-equiv=Content-Type content="text/html; charset=windows-1252"> <meta name=Originator content="Microsoft Word 10"> <style> <!-- --> </style> </head> <body lang=EN-US> <div> <p><font size=3 face="Times New Roman">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <b>67:16:40:05.&nbsp;&nbsp;Procedure for admission to psychiatric and neonatal units when care manager not available.</b> 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 §&nbsp;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.</font></p> <p><font size=3 face="Times New Roman">&nbsp;</font></p> <p><font size=3 face="Times New Roman">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; 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:</font></p> <p><font size=3 face="Times New Roman">&nbsp;</font></p> <p><font size=3 face="Times New Roman">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; (1)&nbsp;&nbsp;If the individual admitted is a recipient, notification must be by the first working day after the date of admission;</font></p> <p><font size=3 face="Times New Roman">&nbsp;</font></p> <p><font size=3 face="Times New Roman">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; (2)&nbsp;&nbsp;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</font></p> <p><font size=3 face="Times New Roman">&nbsp;</font></p> <p><font size=3 face="Times New Roman">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; (3)&nbsp;&nbsp;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.</font></p> <p><font size=3 face="Times New Roman">&nbsp;</font></p> <p><font size=3 face="Times New Roman">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Failure to notify the care manager is cause for denial of the claim.</font></p> <p><font size=3 face="Times New Roman">&nbsp;</font></p> <p><font size=3 face="Times New Roman">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <b>Source:</b> 21 SDR 123, effective January 19, 1995; 26 SDR 168, effective July 1, 2000.</font></p> <p><font size=3 face="Times New Roman">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <b>General Authority:</b> SDCL <A HREF="/statutes/DisplayStatute.aspx?Type=Statute&Statute=28-6-1">28-6-1.</A></font></p> <p><font size=3 face="Times New Roman">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <b>Law Implemented:</b> SDCL <A HREF="/statutes/DisplayStatute.aspx?Type=Statute&Statute=28-6-1">28-6-1.</A></font></p> <p><font size=3 face="Times New Roman">&nbsp;</font></p> </div> </body> </html>