Section 17-1737-31 - Determining the applicant's or recipient's need for long-term institutional services(a) The provision for the determination of need for admission to a long-term institution are based on a physician's and other appropriate health care professional's assessment of the applicant's or recipient's condition and recommendation of the applicant's or recipient's need for a specific acuity level (or level of medical care).(b) Their recommendation of the applicant's or recipient's need for a specific acuity level (or level of medical care) shall be based on the following criteria: (1) Acuity Level A recipient requires licensed nursing and ancillary nursing personnel services on a regular and long-term basis to maintain, improve, or safeguard health, or to minimize disability or pain. The services provided shall be beyond room, board, and personal care services available in personal care home, and shall: (A) Be available to recipients who require assistance with the normal activities of daily living twenty-four hours a day;(B) Be ordered by a physician and shall be provided under the direction of the attending physician or staff physician;(C) Be planned, provided, and maintained by licensed and ancillary nursing personnel and other professional personnel, in accordance with a written resident care plan;(D) Be provided on an inpatient basis only after consideration of the recipient's condition and the feasibility and availability of utilizing more economical alternative facilities and services have been ruled out; and(E) Be less than twenty-four hours of skilled nursing or regular rehabilitation services;(2) Acuity Level B recipient shall: (A) Be evaluated by an interdisciplinary professional team, who shall recommend admission based on their evaluation, which shall be completed not more than three months prior to admission, or before the ICF-MR requests payment for a client applying for medicaid after admission;(B) Be diagnosed as mentally retarded or with other related conditions; and(C) Require the medical care and special services that are appropriately obtained from an ICF-MR as described in section 17-1737-30; and(3) Acuity Level C recipient requires skilled nursing services provided directly or under the general supervision of registered professional nurses on a twenty-four hour basis, rehabilitation services, or both and shall: (A) Be provided on a seven-days a week basis, except rehabilitation services may be needed by the recipient and provided on a five-days a week basis; and(B) Include subparagraphs (1) (A), (B), (C), and (D).Haw. Code R. § 17-1737-31
[Eff 08/01/94] (Auth: HRS §§ 346-14, 346-49; Pub. L. No. 100-203; 42 C.F.R. §§430.10, 431.10 ) (Imp: Pub. L. No. 100-203; 42 C.F.R. §§435.1009, 440.40, 440.150, 456.270, 456.271, 456.370, 483.30, 483.440 )