A. Psychiatric treatment

The situation is usually questionable where the primary diagnosis or the primary needs of the patient are psychiatric rather than medical. An institution primarily engaged in treating psychiatric disorders cannot participate as an SNF. This type of active psychiatric treatment requires considerably more sophisticated nursing techniques and physician attention than are available in the usual SNF; therefore, the type of mental condition which could be adequately handled in most SNF's would be one which requires only a supportive environment without daily skilled services. However, in some cases a patient suffering from mental illness may need the type of services which constitute extended care because the mental condition was secondary to another more acute medical disorder.