Manual notes

• The 23 Hour Crisis Stabilization provider may use a psychiatric evaluation completed within 24 hours prior to admission by a psychiatrist or psychiatric nurse practitioner to meet this requirement. Documentation that the 23 Hour Crisis Stabilization psychiatrist or psychiatric nurse practitioner has reviewed and updated (as clinically necessary) the evaluation within four hours of admission, must be in the clinical record.

Requiring review by doctor level or NP level within 4 hours, will still be a burden to the system, and reimbursement models do not support the cost of this coverage. It is not necessary to have a physician or NP to review if there has been an evaluation in 24 hours and there is already other clinical and nursing assessment happening.

Recommend changing and adding nurse:  “psychiatry, psychiatric nurse practitioner, nurse practitioner, or nurse, has reviewed and updated the evaluation within 4 hours of admission.