37.40.101    LEVEL OF CARE DETERMINATIONS

(1) The three basic considerations in every level of care determination are the individual patient's medical, psychological, and social needs; the specific services required to fill these needs; and the health and other personnel required to adequately provide these services. Specific level of care criteria, as well as preadmission screening procedures, are found in ARM 37.40.201.

(2) Assessing a patient's medical condition and evaluating the appropriateness of services for that condition is primarily a nurse coordinator's function. If questions arise regarding the patient's medical condition or the propriety of some or all of the services ordered by the attending physician, physician advisor review, including peer review, may be requested by the attending physician.

(3) Assessing a patient's psychological and social condition and evaluating the appropriate services for that condition is primarily a function of the department or its designee.�

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History: 53-2-201, 53-6-113, 53-6-402, MCA; IMP, 53-2-201, 53-6-101, 53-6-131, 53-6-402, MCA; NEW, Eff. 1/3/77; AMD, 1983 MAR p. 863, Eff. 7/15/83; TRANS, from SRS, 2000 MAR p. 489; AMD, 2017 MAR p. 193, Eff. 2/4/17.