[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: 42CFR441.155]



[Page 278]

 

                         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 D_Inpatient Psychiatric Services for Individuals Under Age 21 in 

                   Psychiatric Facilities or Programs

 

Sec.  441.155  Individual plan of care.



    (a) ``Individual plan of care'' means a written plan developed for 

each recipient in accordance with Sec. Sec.  456.180 and 456.181 of this 

chapter, to improve his condition to the extent that inpatient care is 

no longer necessary.

    (b) The plan of care must--

    (1) Be based on a diagnostic evaluation that includes examination of 

the medical, psychological, social, behavioral and developmental aspects 

of the recipient's situation and reflects the need for inpatient 

psychiatric care;

    (2) Be developed by a team of professionals specified under Sec.  

441.156 in consultation with the recipient; and his parents, legal 

guardians, or others in whose care he will be released after discharge;

    (3) State treatment objectives;

    (4) Prescribe an integrated program of therapies, activities, and 

experiences designed to meet the objectives; and

    (5) Include, at an appropriate time, post-discharge plans and 

coordination of inpatient services with partial discharge plans and 

related community services to ensure continuity of care with the 

recipient's family, school, and community upon discharge.

    (c) The plan must be reviewed every 30 days by the team specified in 

Sec.  441.156 to--

    (1) Determine that services being provided are or were required on 

an inpatient basis, and

    (2) Recommend changes in the plan as indicated by the recipient's 

overall adjustment as an inpatient.

    (d) The development and review of the plan of care as specified in 

this section satisfies the utilization control requirements for--

    (1) Recertification under Sec. Sec.  456.60(b), 456.160(b), and 

456.360(b) of this subchapter; and

    (2) Establishment and periodic review of the plan of care under 

Sec. Sec.  456.80, 456.180, and 456.380 of this subchapter.



[43 FR 45229, Sept. 29, 1978, as amended at 46 FR 48560, Oct. 1, 1981; 

61 FR 38398, July 24, 1996]