inquiries or referrals, please contact our
Admissions Coordinator at 408.340.1501
Minimum California State Criteria Needed for Authorizing Pediatric Subacute Care
(insurance criteria as negotiated).
- Patient’s condition has stabilized to the point that acute care is NOT medically necessary; and
- Patient’s condition warrants 24 hour nursing care by a registered nurse; and
- Any one of the following four items:
- A tracheostomy with dependence on mechanical ventilation for a minimum of six hours each day; or
- Dependence on tracheostomy care requiring suctioning at least every six hours, and room air mist, or oxygen needed and dependence on one of the four treatment procedures listed in Section 4(b) through (e); or
- Dependence on total parental nutrition or other intravenous nutritional support requiring and dependence on one of the five treatment procedures listed in Section 4(a) through (e); or
- Dependence on skilled nursing care in the administration of any three treatment procedures listed in Section 4(a) through (e).
- Treatment Procedures:
- Intermittent suctioning at least every eight hours, and room air mist or oxygen as needed;
- Continuous intravenous therapy, including administration of therapeutic agents as necessary for hydration or of intravenous pharmaceuticals; or intravenous pharmaceutical administration of more than one agent, via peripheral or central line, without continuous infusion;
- Peritoneal dialysis treatments requiring at least four exchanges every 24 hours;
- Tube feeding, naso-gastric or gastrostomy tube;
- Other daily medical technologies required continuously which in the opinion of the attending physician and the Medi-Cal consultant require the services of a professional nurse.