Utah Admin. Code R414-515-2 - Definitions
(1) "Admission" means the acceptance of a
Medicaid member for LTAC and treatment when the member meets established
evidence-based criteria for severity of illness and intensity of service and
the required service cannot be provided in a lesser level -of -care
setting.
(2) "Comprehensive
documentation" means applicable, relevant information including a history and
physical, operative reports, daily physician progress notes, vital signs,
laboratory test results, medications administration records, respiratory
therapy notes, wound care notes, nutrition notes, physical therapy notes,
occupational therapy notes, speech therapy notes, and other pertinent
information the Division of Integrated Healthcare needs to decide on an LTAC
request.
(3) "Continued stay
review" means a periodic, supplemental, or interim review of clinical
information for an LTAC member.
(4)
"Inpatient" means an individual whose severity of illness and intensity of
service meet the evidence-based criteria for an LTAC hospital stay.
(5) "Intensity of service" means the measure
of the number, technical complexity, or attendant risk of services
provided.
(6) "LTAC" hospital means
an inpatient transitional care hospital designed to treat members with
multiple, serious medical conditions requiring intense, acute care as
determined by a physician.
(7)
"Retroactive review" means a review of clinical information for a patient who
had previously been admitted to an LTA C hospital, but never received prior
authorization for the initial or continued stay due to retroactive eligibility
approval.
(8) "Severity of illness"
means the extent of a member's organ system derangement or physiologic
decompensation.
Notes
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