Definitions and Coverage for Inmates Receiving Inpatient Care in Certain Medical Institutions 510-05-35-95-05-10

(Revised 1/1/2025 ML #3916)

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For purposes of the Coverage for Inmates Receiving Inpatient Care in Certain Medical Institutions section:

1. Inpatient: A patient who has been admitted to a medical institution as an ‘inpatient’ on recommendation of a physician or dentist and:

1. Receives room, board and professional services in the institution for a 24 hour period or longer, or
2. Is expected by the institution to receive room, board and professional services in the institution for a 24 hour period or longer even though the patient dies, is discharged or is transferred to another facility and does not actually stay in the institution for 24 hours.

NOTE: An inmate may be placed in a hospital under an ‘observation’ status, which is an ‘outpatient’ category. These inmates are not considered receiving inpatient medical care and Medicaid would remain in suspended status.

2. Medical Institution means an institution that:

1. Is organized to provide medical care, including nursing and convalescent care;
2. Has the necessary professional personnel, equipment, and facilities to manage the medical, nursing, and other health needs of patients on a continuing basis in accordance with accepted standards;
3. Is authorized under State law to provide medical care; and
4. Is staffed by professional personnel who are responsible to the institution for professional medical and nursing services. The services must include adequate and continual medical care and supervision by a physician; registered nurse or licensed practical nurse supervision and services and nurses' aid services, sufficient to meet nursing care needs; and a physician's guidance on the professional aspects of operating the institution.

3. Department of Corrections and Rehabilitation includes the ND State Penitentiary and Missouri River Correctional Center in Bismarck, Dakota Women’s Correctional and Rehabilitation Center in New England, James River Correctional Center in Jamestown, and the North Dakota Youth Correctional Center in Mandan.
   
   
4. County Jail means a place of confinement for persons held in lawful custody under the jurisdiction of a local government. A listing of county jails in North Dakota can be found at: http://www.nd.gov/docr/county/jails.html

Note: This does not include Tribal run jails.