Adult crisis residential care
Crisis Residential is a level of care tantamount to the acute level of care with the singular exception that the patient does not require 24-hour medical and nursing care, but may benefit from a 24-hour supervised, structured living arrangement for patients receiving partial hospitalization day treatment programming.
A. Medical necessity
All criteria are required to consider for admission.
- The patient must have been diagnosed with a psychiatric disorder by a licensed mental 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 the patient.
B. Admission criteria
All criteria must be met to recommend admission.
- The patient's mental condition requires a supervised, 24-hour setting and services to provide ongoing management with the potential for urgent referral, evaluation by a licensed mental health clinician and access to further medical services as needed.
- Clinical documentation clearly indicates that the patient could not be treated safely at a lower level of care or that crisis residential programming could safely substitute for acute inpatient care.
- The patient's psychosocial supports are severely limited such that the patient could not be maintained without clinical supervision outside the program.
- The patient's condition requires multidisciplinary intervention for 4 (or more) hours daily, 7 days per week.
C. Continuing care criteria
All criteria must be met to recommend continuing care.
- Despite adequate treatment, the patient continues to exhibit signs and symptoms that led to the admission, or new problems have emerged that themselves meet the criteria for crisis residential admission.
- The patient's problems must be clearly documented in the medical record, and there must be a progress note by the provider for each day of treatment.
- There must be clear clinical documentation that transition of the patient to a lower level of care would result in exacerbation or re-emergence of symptoms sufficient to meet crisis residential admission criteria.
- Additional child/adolescent criterion: There is documented evidence of significant family involvement at least twice weekly or clear documentation that such is medically contraindicated.
