Cal. Code Regs. Tit. 22, § 51124 - Skilled Nursing Facility Level of Care

(a) "Skilled Nursing facility level of care" means that level of care provided by a skilled nursing facility meeting the standards for participation as a provider under the Medi-Cal program as set forth in Section 51215 of this division.

(b) The skilled nursing facility level of care is the level of care needed by Medi-Cal beneficiaries who do not require the full range of health care services provided in a hospital as hospital acute care or hospital extended care, but who require the continuous availability of skilled nursing care provided by licensed registered or vocational nurses, or the equivalent thereof, as set forth in Section 51215.

(c) Skilled nursing care provided in participating skilled nursing facilities is the composite of necessary observation, assessment, judgment, supervision, documentation, and teaching of the patient and includes specific tasks and procedures.

(d) Skilled nursing procedures provided as a part of skilled nursing care are those procedures which must be furnished under the direction of a registered nurse in response to the attending physician's orders, and are either performed or supervised by a licensed registered nurse, a licensed vocational nurse or in the case of institutions for mentally retarded or distinct parts of institutions which are certified as skilled nursing facilities and providing care for mentally retarded patients, by a licensed psychiatric technician. A need for one or more skilled nursing procedures does not necessarily indicate a medical need for skilled nursing facility services. Rather, the need must be for a level of service which includes the continuous availability of procedures such as, but not necessarily limited to, the following: administration of intravenous, intramuscular, or subcutaneous injections, and intravenous or subcutaneous infusions; gastric tube or gastrostomy feedings; nasopharygeal aspiration; insertion or replacement of catheters; application of dressings involving prescribed medications and aseptic techniques; treatment of extensive decubiti and other widespread skin disorders; heat treatments which require observation by licensed personnel to evaluate the patient's progress; administration of medical gases under prescribed therapeutic regimen; and restorative nursing procedures which require the presence of a licensed nurse.

(e) Other health care services, such as physical, occupational or speech therapy, require specialized training for proper performance. The need for such therapies does not necessarily indicate a need for nursing facility services.

Notes

Cal. Code Regs. Tit. 22, § 51124

1. New section filed 9-27-72; designated effective 11-1-72 (Register 72, No. 40).
2. Amendment filed 7-13-73; effective thirtieth day thereafter (Register 73, No. 28).
3. Change without regulatory effect adding NOTE (Register 86, No. 49).
4. Editorial correction of printing error in section heading (Register 94, No. 17).

Note: Authority cited: Sections 10725, 14105 and 14124.5, Welfare and Institutions Code. Reference: Sections 14108 and 14110, Welfare and Institutions Code.

1. New section filed 9-27-72; designated effective 11-1-72 (Register 72, No. 40).
2. Amendment filed 7-13-73; effective thirtieth day thereafter (Register 73, No. 28).
3. Change without regulatory effect adding NOTE (Register 86, No. 49).
4. Editorial correction of printing error in section heading (Register 94, No. 17).