Page 115

(f) The subacute unit shall make arrangements for emergency medical care as needed and shall consult with the attending physician or designee when available. Pulmonologist consultant shall be available twenty-four hours a day for telephone consultations and visits or both whenever a facility has ventilator patients. The telephone numbers of those physician(s) shall be posted in a conspicuous area in the subacute unit.

(g) Freestanding subacute units shall be licensed specifically as freestanding subacute units in the State of Hawaii by the department of health.

(h) The facilities caring for group III and group IV pediatric patients shall provide all mandated developmental and educational services.

(i) The department through its medical consultants will determine the medical necessity of the subacute level of care for patients who do not have a medically justified need for the acute level of care, do not qualify for the skilled nursing facility (SNF) level of care, or the intermediate care facility (ICF) level of care, and who meet the criteria of the subacute level of care and cannot be discharged from the acute care facility. [Eff 11/25/96; am 06/19/00 ] (Auth: HRS §346-14; 42 C.F.R §431.10) (Imp: HRS §346-14)

§17-1737-118 Staffing standards. (a) For the purpose of this section, each licensed nursing staff shall be counted as one. Each subacute unit shall be under the supervision of a registered nurse twenty-four hours a day.

(b) Subacute units authorized to provide care to respirator or ventilator dependent patients shall provide a minimum daily average of 9.0 nursing care hours of which 5.0 hours shall be provided by the nursing staff. Where there is a mix of ventilator- dependent and other patients, the facility shall provide no less than 5.0 licensed and certified hours per patient per day. Subacute units without