[Code of Federal Regulations]

[Title 42, Volume 4]

[Revised as of October 1, 2006]

From the U.S. Government Printing Office via GPO Access

[CITE: 42CFR441.102]



[Page 276]

 

                         TITLE 42--PUBLIC HEALTH

 

  CHAPTER IV--CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF 

                  HEALTH AND HUMAN SERVICES (CONTINUED)

 

PART 441_SERVICES: REQUIREMENTS AND LIMITS APPLICABLE TO SPECIFIC 

 

 Subpart C_Medicaid for Individuals Age 65 or Over in Institutions for 

                             Mental Diseases

 

Sec.  441.102  Plan of care for institutionalized recipients.



    (a) The Medicaid agency must provide for a recorded individual plan 

of treatment and care to ensure that institutional care maintains the 

recipient at, or restores him to, the greatest possible degree of health 

and independent functioning.

    (b) The plan must include--

    (1) An initial review of the recipient's medical, psychiatric, and 

social needs--

    (i) Within 90 days after approval of the State plan provision for 

services in institutions for mental disease; and

    (ii) After that period, within 30 days after the date payments are 

initiated for services provided a recipient.

    (2) Periodic review of the recipient's medical, psychiatric, and 

social needs;

    (3) A determination, at least quarterly, of the recipient's need for 

continued institutional care and for alternative care arrangements;

    (4) Appropriate medical treatment in the institution; and

    (5) Appropriate social services.