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
State regulations are updated quarterly; we currently have two versions available. Below is a comparison between our most recent version and the prior quarterly release. More comparison features will be added as we have more versions to compare.
(1) "Admission" means the acceptance of a Medicaid member for LTAC care 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 any other pertinent information the Division needs to make a decision regarding the 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 stay.
(5) "Intensity of Service" means measure of the number, technical complexity, or attendant risk of services provided.
(6) "Long-term acute care hospital" or "Long-term care hospital" (LTAC) 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 LTAC, but never received a prior authorization for the initial or continued stay due to retroactive eligibility approval.
(8) "Severity of Illness" means the extent of organ system derangement or physiologic decompensation for a patient.