SECTION 340:100-15-6. Categorical determinations regarding need of nursing facility and specialized services

  The State Mental Retardation Authority does not make advance categorical dispositions that specialized services are needed. Such determinations are based on an extensive individualized evaluation to determine the exact nature of the specialized services that are needed. The State Mental Retardation Authority does make categorical determinations that nursing facility level of care is needed in the categories listed in (1) and (2) of this subsection.

(1)   Individuals with a terminal illness as defined for Hospice purposes are granted a categorical determination for nursing facility level of care and a negative specialized services determination by the State Mental Retardation Authority. Hospice criteria will include late stage disease process with a life expectancy of six months or less and must be physician referred/certified.

(2)   Individuals requiring convalescent care or extended hospital discharge as certified by a physician (that the individual is likely to require 30 days or less of nursing facility convalescent care) are granted a categorical determination for nursing facility level of care and a negative specialized services determination by the State Mental Retardation Authority.

[Source: Added at 11 Ok Reg 4119, eff 6-21-94 (emergency); Added at 12 Ok Reg 1761, eff 6-12-95]