After a review of the clinical information provided by Maimonides Medical Center the Medical Director has determined that admission to a skilled nursing facility is not medically necessary. Based on the clinical information received and InterQual criteria (a decision based program to determine medical need) for admission to a skilled nursing facility the clinical guidelines were not met because you do not have any skilled needs. Your needs can be managed at a lower level of care such as hospice care in a skilled nursing facility. You are ready for a lower level of care in your home or other setting. In light of the lack of progress and since you are being admitted to hospice care, the request for skilled admission is not medically necessary.
