Policies and Guidelines
Subacute Care - Standards of Participation
Standards for participation in the Subacute Care Program:
- Licensed as an acute care hospital with a distinct part (DP), skilled nursing facility (SNF), or
- Licensed as a freestanding (FS) SNF, and
- Certified as a long term care Medicare and Medi-Cal provider, and
- History of compliance with SNF regulations, and
- Professional staff with the documented ability to provide care to subacute patients and,
-
An emergency generator meeting requirements for the provision of life support.
If a DP/FS SNF meets the criteria above, they may apply to enter into a contractual agreement with DHCS to provide services to Medi-Cal subacute patients.
Adult Subacute Reimbursement Rates
Daily reimbursement rates for subacute facilities vary depending on the type of the facility and whether the patient is ventilator dependent or non-ventilator dependent. Reimbursement rates for each facility are established by the DHCS Rate Development Branch and are based upon the costs of the facility up to a median rate for DP facilities and weighted averages for FS facilities.
Pediatric Subacute Reimbursement Rates
Daily reimbursement rates for pediatric subacute facilities vary depending on the type of the facility and whether the patient is ventilator dependent or non-ventilator dependent. Reimbursement rates for each facility are established by the DHCS Rate Development Branch based on a model for pediatric subacute facilities.
Minimum Subacute Staff-To-Patient Ratios for Adult Subacute Care Units
Adult Facility
| RN and LVN requirement
| CNA requirement
|
SNFs with CNAs
| FS | 3.8
| 2.0 |
| DP | 4.0
| 2.0 |
| SNFs without CNAs | FS and DP
| 4.8
| -
|
Minimum Subacute Staff-To-Patient Ratios for Pediatric Subacute Care Units
Pediatric subacute care units must employ sufficient subacute staff, as required by subacute regulation. Staff-to-patient ratios are a minimum daily average of 5.0 unduplicated licensed nursing hours per patient day, and 4.0 certified nurse assistant hours per patient day. Additionally, Pediatric subacute care units must utilize a minimum of 3.0* respiratory care practitioner (RCP) hours for ventilator dependent patients, and 2.0* RCP hours for non-ventilator dependent patients, of medically necessary respiratory care services, when provided under the order of a person lawfully authorized to give such an order, and according to each pediatric subacute patient’s assessment and care plan.
| | | |
Subacute care unit |
Ventilator |
5.0 |
4.0 |
3.0* |
Non-ventilator |
2.0* |
Contact Information
Subacute Care Unit
Department of Health Care Services
1501 Capitol Avenue, MS 4504
P.O. Box 997419
Sacramento, CA 95899-7419
Phone: (916) 345-7187
Email:
subacute2@dhcs.ca.gov
To request Subacute resource and related reference materials
Contact the Subacute Care Unit at the information at subacute2@dhcs.ca.gov for the following materials, or visit the available web links below:
- Medi-Cal Subacute Care Contract Application (adult, pediatric) (new, bed increase, bed decrease, relocation, Change of Owner, Change of Name, etc)
-
California Code of Regulations and other applicable state and federal requirements related to the Subacute Care Program California Code of Regulations
- Current list of contracted subacute care providers and other reference materials
- Current subacute rates information - visit the
Long Term Care Reimbursement.
-
Subacute Care Programs: Pediatric (subacut ped) for the Pediatric Subacute Care Program criteria.
-
Subacute Care Programs: Adult (subacut adu) for the Adult Subacute Care Program criteria.
- Medi-Cal Provider Manual for other Subacute Care Program information – visit the Medi-Cal Provider Manual - Long Term Care
Helpful Links
