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Medical Necessity Criteria:
Admission Criteria
• Individuals must meet all of the following criteria:
The individual has experienced a recent behavioral health crisis (within 72 hours of admission) or the individual is transitioning from or at risk of a higher level of care and requires short-term support with identifying and engaging in the services necessary to maintain safety and stability in the community; Documentation indicates evidence that the individual meets criteria for a primary diagnosis consistent with the most recent version of the Diagnostic and Statistical Manual.
• There is evidence from the individual or collateral contact indicating at least one of the following is present:
High potential for crisis; cycling without this support; Individual does not have the ability and/or the resources to support maintenance of safety and/or stability in the community until longer term services are available/accessible; Individual has been engaged in alternative crisis services or treatment and no longer meets criteria for those services but continues to require community stabilization support.
The individual currently has moderate to high intensity behavioral and/or emotional needs and without intervention, will further interfere with their ability to function in at least one life domain: family, living situation, school, social, work or community.