Section 6210.51. Attending physician decision on level of care

(a) In response to changes in the recipient’s medical condition, the attending physician may order a change in the recipient’s level of care which is different from the level of care for which payment is authorized.

(b) If the attending physician recommends that a recipient’s level of care be changed, the attending physician shall document the change in the recipient’s medical record and notify the Department of the level of care recommendation on the Attending Physician Request for Change Summary Form. A copy of the form shall be kept in the recipient’s medical record.

(c) If the recipient’s level of care is changed as a result of a determination by the Department’s Inspection of Care Team, the attending physician may order a change in the recipient’s level of care only if the recipient’s medical condition changes subsequent to the date of the Inspection of Care Team’s determination and the change in the recipient’s medical condition warrants another level of care.

(d) The physician shall date and sign the documentation of the change in the recipient’s medical condition and state the alternate care recommendation in the recipient’s record.