Nursing Facility Level of Care Criteria:
1. The child is dependent on medical equipment on a daily basis; or
2. Skilled nursing care or comprehensive rehabilitative interventions are necessary, including:
- Medications are necessary throughout the day
- There is a high probability for complications or adverse reactions
- Specialized professional training and monitoring are needed to assist parents
- The child’s condition substantially interferes with the ability to engage in everyday activities and perform age appropriate activities of daily living at home and in the community
- The daily routine is altered by the need to complete these specialized treatments or the need for assistance with self care activities.
3. The level of care indicated above shall meet all
of the following criteria:
- The child’s condition is expected to last at least one year
- Hands on nursing or rehabilitative care must be provided daily
- The child requires direct hands on assistance to perform treatments.
Hospital Level of Care Criteria:
1. The child has a severe, chronic health condition that is expected to last for at least one year.
2. The child requires a skilled nursing level of care daily including:
- Hands on medical interventions
- Rehabilitative care
- Direct medical monitoring
- Intense medical regimen
3. The child requires daily medical treatments including:
- Substantial amount of time to complete
- Training to perform treatment safely
- The ability to recognize changes that require prompt interventions
- The ability to modify treatment plans during the day.