Partial hospitalization - psychiatric care
Partial hospitalization 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. It is intended to be provided up to 8 hours per day, up to 7 times per week.
Applies to adult, adolescent and child patients.
A. Medical necessity
All 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 patient.
B. Admission criteria
All criteria must be met to recommend admission.
- The patient's mental condition requires skilled medical and nursing observation (e.g. serial mental status checks, medication administration, monitor vital signs) and is likely to improve with this intervention.
- Clinical documentation clearly indicates that the patient could not be treated safely at a lower level of care or that partial hospitalization could safely substitute for acute inpatient care.
- The patient's psychosocial supports are such that the patient can be supervised and maintained without clinical supervision for that period of time outside the program.
- The patient's condition requires multidisciplinary intervention for four (or more) hours daily and more than three 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 which themselves meet the criteria for PHP 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 PHP 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.
