23-hour observation
Criteria for all types of 23-hour observation care, all age groups
"23-hour beds" are defined as a period of up to 23 hours during which services are provided at less than an acute level of care. It is indicated for those situations where full criteria are not met because of external factors relative to information gathering or risk assessment yet the patient clearly at risk for harm to self or others.
A. Medical necessity criteria
All must be met to consider for treatment.
- The patient must have been assessed, to a reasonable degree of medical certainty, as having a psychiatric illness or substance abuse disorder by a licensed health professional.
- Symptoms of this illness must accord with those described in the Diagnostic and Statistical Manual of Mental Disorders, Edition IV (DSM-IV).
- The diagnosis must have been arrived at prior to admission in a face-to-face encounter between the professional and patient.
B. Admission criteria
Either 1 or 2 are sufficient to recommend treatment.
- The presenting clinical problem likely represents a transient disruption of the patient's clinical baseline, which will likely remit, with a period of structure and observation.
- The presenting clinical problem represents a clear, proximal risk of harm to self or others.
