§ 10 CCR 2505-10-8.408 - LEVELS OF CARE DEFINED SKILLED NURSING CARE

  1. § 10 CCR 2505-10-8.408.1 - SPECIFIC SERVICES WHICH ARE SKILLED
  2. § 10 CCR 2505-10-8.408.2 - SPECIFIC SERVICES WHICH ARE SUPPORTIVE
  3. § 10 CCR 2505-10-8.408.3 - ORGANIZATION OF SKILLED NURSING SERVICE
  4. § 10 CCR 2505-10-8.408.4 - PROFESSIONAL PERSONNEL (§ 10 CCR 2505-10-8.408.41 to 10 CCR 2505-10-8.408.44)
  5. § 10 CCR 2505-10-8.408.5 - CLINICAL RECORDS (§ 10 CCR 2505-10-8.408.51 to 10 CCR 2505-10-8.408.54)
  6. § 10 CCR 2505-10-8.408.6 - MEDICAL BASIS FOR CARE SKILLED NURSING FACILITY CARE (§ 10 CCR 2505-10-8.408.61 to 10 CCR 2505-10-8.408.63)
  7. § 10 CCR 2505-10-8.408.7 - MEDICAL REVIEW AND MEDICAL INSPECTION SKILLED NURSING CLIENTS (§ 10 CCR 2505-10-8.408.71 to 10 CCR 2505-10-8.408.76)

Current through Register Vol. 44, No. 18, September 25, 2021

A. Skilled nursing services in a licensed nursing care facility are those services performed by

licensed nursing personnel, or personnel under their supervision. These services must be performed according to a plan of treatment written by a physician licensed to practice medicine in the State of Colorado. These services apply to clients whose condition(s) require medical services to maintain a degree of stability, which has been achieved. Components of these services include:

1. The medical need for the attending physician to visit the client on a professional basis at least once every thirty (30) days.
2. Observation and assessment of the total needs of the client, utilizing skilled nursing judgment.
3. Planning, organizing, and managing the client care plan which requires specialized training to accomplish delivery of health care, or to attain the desired results or to render direct services to "the patient".
B. These health care services require regular medical care and 24-hour licensed nursing services for illnesses, injury, or disability. Nursing service shall be organized and maintained to provide 24hour licensed nursing services under the direction of a registered professional nurse employed full time and at least two (2) hours total nursing staff time for each patient per 24-hour day.
C. Covered skilled nursing services must adhere to one or more of the following principles:
1. A service which requires a substantial specialized judgment and skill based on knowledge and application of the principles of biological, physical, and social sciences, necessary to perform or supervise effectively the services rendered, or
2. A service that is unskilled but which requires skilled performance, supervision, or observation because of special medical complications. Medical complications and special services must be documented by the physician's order and the nursing notes.
D. In addition to meeting the definition of skilled nursing services, coverage of such services is warranted only if skilled nursing personnel must be available on a continuous 24-hour basis. In determining whether the continuous availability of such personnel is warranted, the following principles apply:
1. Frequency of Services - The frequency of skilled nursing services required, rather than their regularity, is the controlling factor in determining whether the continuous availability of skilled nursing personnel is warranted.
2. Observation - Where observation is the principle continuous service provided, because symptoms exist that indicate the need for immediate modification of treatment of institution of medical procedures.
E. The purpose of the above-stated components and principles, and of 10 CCR 2505 -10 section 8.408.1 et seq., is to provide general direction and guidelines for admission, utilization review, and medical review; with the intent that the individual's overall medical situation (including mental condition) shall be taken into account in evaluation and determination of the level of care to be provided.

Notes

38 CR 07, April 10, 2015, effective 5/1/2015

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