Admissions

ADMISSION THROUGH DISCHARGE

Special Descriptions of Services-Admission Through Discharge

Referral is accepted from any member, any member of the society can join and become a member. The ONLY acceptable referral for medical services are those authorized and consistent with the law or Court Ordered referral. Any one applying for a PRP service at this agency that provides no mental health services e. g. psychotherapy or that needs to see one, SHALL be referred to our Out Patient Mental Health Center-OMHC program at a sister agency or any other place of their choice. Nursing assessment and diagnosis to determine if the person meets the medical necessity and severity of condition/need required for our services shall be performed according to our policies and procedures and as approved by the Department of Health. Request for authorization must be submitted to the Administrative Service Organization (ASO), Insurance provider or payer of service for approval and until such authorization is obtained with confirmation authorization number, the individual will not be admitted into the program. Acceptance notification will not be sent out to the individual until such a time authorization for service is obtained. Admission for patients (members) will be based on severity of needs. Individuals with greater needs will take preference over those with less need.

Once a complete and appropriate referral is obtained, the Nurse Manager or (Marketing Admission Officer when assigned) shall make face-to-face contact with the individual within 5 working days, 2 hours, or depending on applicability law or feasibility or requirement procedures. During such meeting, the assigned staff shall schedule an appointment to conduct a face-to-face screening assessment to determine the Rehabilitation service needs:

1. a) Willingness to participate in the program and receive services
2. b) Our programs ability to address the needs identified in the assessment
3. c) If the person is not eligible or admitted, notify the person or guardian (if a minor) the reason why and recommendation for alternative services.
4. d) If the person is eligible or admitted, notify the person or guardian (if a minor) about the status of their eligibility or admission, including but not limited to the responsible staff and start date of service.

Within 5 working days of the screening assessment conducted as in (1) above, notify the person of the status of their application as in (1d) above. Such notice may include informing the individual what he/she needs to do to be enrolled, placing the individual on waiting list with option to seek for alternative services available, that the person will be enrolled when he/she is discharged from impatient facility, RTC, Detention center.

In line with COMAR,  all evaluation and planning services, rehabilitation assessment, individual rehabilitation plan, rehabilitation plan review, continuing evaluation, rehabilitation and support services provided, rehabilitation activities, medication services, promotion of illness management, on-call and emergency response, emergency care and discharges, SHALL follow procedures, formats, forms, guidelines as set forth in relevant law, regulation, questionnaire, surveys, or methods as approved by the State, laws, rules and regulations and accreditation guidelines; under method of implementation of each program part. Signature must be obtained from both individual and guardian, in case of a minor, where minor signature is not obtained, document the rational for refusing to sign all required forms in their medical records. Where the minor refused to sign any required form, the guardian is required to sign it to continue to participate in our program. Minor 16 years old can sign up without permission of the parent and in such case the 16 years old minor must sign consent for release of information before any staff can disclose any information to his/her parent about our services to the minor.

Additional services SHALL follow the following rules:

1. All evaluation and planning services, and rehabilitation assessment shall be completed within 14 working days. Where the individual has been scheduled later than 14 days, assigned staff shall document the reason justifying such prolonged process and must be approved by the Program Director. Any applicant whose intake process will be more than 30 working days regardless of the rational must be referred or recommendation be made for alternative services while waiting. The intake staff shall notify the Program Director. The Program Director shall notify the Core Service Agency-CSA and Administrative Service Organization-ASO. Such notification shall be documented in the individual’s medical records.
2. All individual rehabilitation plans shall be completed by the Rehabilitation Coordinators within 30 working days.

iii. All rehabilitation plan reviews shall be completed by the Rehabilitation Coordinators with the individual and guardian (for a minor) every three months to discuss progress and review medical records. Such review shall be documented.

1. All rehabilitation coordinators shall complete monthly summaries and submit it to their supervisors for review by the 15th of the month after the month under review unless otherwise included in at least one of the contact progress reports.
2. All continuing evaluations and continuing stay authorization requests from the ASO, insurance company or payer, shall be completed and submitted by the rehabilitation coordinator 14 working days prior to the end date of the most current authorization for the service.
3. The Rehabilitation Coordinators shall document all rehabilitation and support services provided, rehabilitation activities, medication services, promotion of illness management, on-call and emergency response, and emergency care which supports individual recovery, independent decision-making ability and create opportunities for choices regarding home, school, work, community, promoting use of community resources and good support systems within 24 hours.

vii. All discharges shall be made by the Rehabilitation Coordinator according to the discharge policy after the meeting of the Behavior Management Committee. Every discharged individual shall receive a discharge summary and a letter of discharge and SHALL include the individual and their significant others or representative. Where the individual failed to show up for discharge meetings scheduled, the discharge summary and letter shall be sent to the address on file within 5 working days.

5. Case management

The Case Managers shall document all case management, rehabilitation and support services provided, rehabilitation activities, medication services, promotion of illness management, on-call and emergency response, and emergency care which supports individual recovery, independent decision-making ability and create opportunities for choices regarding home, school, work, community promoting use of community resources and good support systems within 24 hours. They shall perform all the duties and responsibilities of Treatment and Rehabilitation Coordinators where and when they fail and/or any lack thereof and SHALL be credentialed and clinically privileged to do so.

The Customer Service Representative for medical records/Custodian shall keep all medical records of individuals in admission process as pending and SHALL NOT accept such records as completed until enrollment, screening, evaluations, plans and authorization is completed. It is the duty of the assigned staff to conduct the admission to ensure that this process is completed timely by all team members in line with this protocol. All staff shall follow their respective detailed job description, duties and responsibilities in ensuring that this protocol is not compromised. All Schedules must be coordinated centrally by the Administrative Assistants and support staff.