HAR §17-1737-117. General provisions

(a) Beds shall be specifically certified for subacute care and costs for providing subacute services shall be shown separately on the facility's cost report. Each participating facility shall be required to establish a subacute unit (SACU) as follows: (1) Freestanding SNF - A minimum of six to a maximum of sixty beds; or (2) Acute care hospital - A minimum of six to a maximum of sixty beds or more with the department's approval. (b) The facility shall accept and retain only those subacute patients for whom it can provide adequate care. (c) The facility shall maintain complete and accurate patient information, in sufficient detail to provide for continuity of care, for patients transferred to a subacute unit. UNOFFICIAL 1737-115 (d) The freestanding SNF shall maintain written agreements with one or more acute care hospitals to ensure that the acute services are accessible in emergency situations and to facilitate the transfer of patients. (e) The subacute unit shall have provisions for twenty-four hour emergency services including but not limited to laboratory, radiology, respiratory therapy, and pharmacy services, and if necessary, ventilator support by qualified respiratory technicians. (f) The subacute unit shall make arrangements for emergency medical care as needed and shall consult with the attending physician or designee when available. Pulmonologist consultant shall be available twenty-four hours a day for telephone consultations and visits or both whenever a facility has ventilator patients. The telephone numbers of those physician(s) shall be posted in a conspicuous area in the subacute unit. (g) Freestanding subacute units shall be licensed specifically as freestanding subacute units in the State of Hawaii by the department of health. (h) The facilities caring for group III and group IV pediatric patients shall provide all mandated developmental and educational services. (i) The department through its medical consultants will determine the medical necessity of the subacute level of care for patients who do not have a medically justified need for the acute level of care, do not qualify for the skilled nursing facility (SNF) level of care, or the intermediate care facility (ICF) level of care, and who meet the criteria of the subacute level of care and cannot be discharged from the acute care facility. [Eff 11/25/96; am 06/19/00 ] (Auth: HRS §346-14; 42 C.F.R §431.10) (Imp: HRS §346-14)