(a)

1. (1) Notwithstanding the provisions of this part, the Division of Health Facilities Services shall be empowered to permit the provision of skilled care.
2. (2) Certifies that the patient requires conditional emergency services that shall be defined as a medically indicated skilled-care case in which the patient requires specialized care of a registered nurse or a licensed practical nurse under the supervision of a registered nurse, not available through licensed agencies in the area, that if not provided would result in the patient being institutionalized.

3. (3) Furnishes such information on forms prescribed by the division regarding the patients receiving conditional emergency services that would include but not be limited to:

   1. (A) Name of patient;
   2. (B) Address of the patient;
   3. (C) Diagnosis; and
   4. (D) The type of specialized skilled extended care the patient requires and why the patient would require institutionalization if the care was not provided.

4. (4)

   1. (A) Furnishes information to the division ensuring that all agencies whose extended care licensed area encompasses the location of the patient were contacted to determine if the required services could be provided.
   2. (B) Such information should include the:

(i) Name of the agency contacted;

1. (ii) Name of the person contacted;

   1. (iii) Date and time of the contact; and

      1. (iv) Reason given for not being able to provide the care.
   2. (C) If the agency contacted does not respond with an answer within twenty-four (24) hours of the initial contact, the agency seeking to provide the services may proceed as required.
   3. (D) The lack of response should be noted in the information furnished to the division.

(b) In each case, the division shall maintain a file or register concerning the conditional emergency service.

1. (c)
2. (1) The approval will be for a period of one hundred eighty (180) days.

3. (2) For each consecutive one-hundred-eighty-day period thereafter, the agency will be required to submit documentation as required in subdivisions (a)(2) and (3) of this section.

   1. (d) If at the end of each one-hundred-eighty-day period services are available through an agency licensed for the area, the agency providing the service must:
4. (1) Notify the patient/caregiver of the availability of services through a licensed agency in the area; and
5. (2) Offer the opportunity to transfer.

(f)

1. (1) An agency operating outside its licensed service area must provide documentation to the division at the beginning of each one-hundred-eighty-day period that the patient was:

   1. (A) Informed of any new agencies providing extended care services in the area; and
   2. (B) Given the choice of transferring.
2. (2) The information shall be submitted on forms prescribed by the division.

(g)

1. (1) An agency operating outside its licensed geographic area to provide extended care may provide all services required by the patient until such time as the:

   1. (A) Skilled extended care is discontinued; or
   2. (B) Patient is transferred to an agency licensed to provide extended care services in the area.
2. (2) The discharging agency will be responsible for referring the patient to an agency licensed to serve the area in which the patient resides if the patient requires further service.