Current through Register Vol. 54, No. 50, December 14, 2024
Section 1151.81 - Inspections of care: general(a) The Department's Federally required inspection of care team will evaluate the care and services provided to each recipient under 21 years of age or 65 years of age or older in a participating psychiatric hospital at least annually by making an onsite inspection. The hospital will be notified no earlier than 48 hours prior to the inspection and advised of the scheduled arrival of the team. The hospital shall make MA medical records readily available to the team. The team's inspection includes:(1) Personal contact with, and observation of, each recipient under 21 years of age.(2) Review of a recipient's medical record.(3) Personal contact with and observation of the recipient if the recipient is 65 years of age or older and the medical record contains incomplete reports.(b) The team will determine in its inspections whether: (1) Services are available and adequate to meet the recipient's health needs.(2) It is medically necessary and desirable for the recipient to remain in the hospital.(3) It is feasible for the hospital to meet the recipient's health needs and rehabilitative needs or whether the recipient's needs could be met through alternative institutional or noninstitutional services.(4) A recipient under 21 years of age is receiving active treatment.(5) The medical, social and psychological evaluations and the plan of care are complete and current and are being followed, and ordered services are provided and recorded.(6) The recipient receives adequate services based on personal observations; that is, the recipient is clean; there are no bedsores; there are no signs of malnutrition or dehydration; and there is apparent maintenance of maximum physical, mental and psychosocial function.(7) Service needs are met by the facility or by outside arrangements.(8) The recipient needs continued placement in the hospital or there is an appropriate plan to transfer the recipient to alternate care.(c) This section applies only to private psychiatric hospitals.The provisions of this § 1151.81 adopted September 30, 1983, effective 7/1/1983, 13 Pa.B. 2796; amended October 29, 1993, effective 7/1/1993, 23 Pa.B. 5241.The provisions of this § 1151.81 amended under sections 201 and 443.1(1) of the Public Welfare Code (62 P. S. §§ 201 and 443.1(1)).