SOUTH CAROLINA DEPARTMENT OF MENTAL HEALTH
Columbia, South Carolina

OFFICE OF THE STATE DIRECTOR OF MENTAL HEALTH DIRECTIVE No. 802-96
(5-100)

TO:                  All Organizational Components

SUBJECT:       Admission Procedure to South Carolina Department of Mental Health Nursing
                        Homes

I.      Purpose:

The purpose of this directive is to describe the admission procedure to Department of Mental Health Nursing Homes - C.M. Tucker, Jr./Dowdy Gardner Nursing Care Center and the Richard M. Campbell Veterans Nursing Home.

II.   Policy:

It is the policy of the South Carolina Department of Mental Health to reserve its limited nursing home capacity for those individuals who both meet established criteria indicating that they are in need of nursing home care and who receive the approval of the facility admissions committee. All admissions to the Richard M. Campbell Veterans Nursing Home and all eligible veteran admissions to C.M. Tucker, Jr./Dowdy Gardner Nursing Care Center must additionally be referred through the William Jennings Bryan Dorn Veterans Hospital.

III.     Admission Procedure:

A.      Prior to admission, all proposed residents must be evaluated by Community
          Long Term Care (CLTC) personnel who will complete the Pre-Admission
          Screening.

          If CLTC determines that nursing home level care is needed and appropriate
          and the proposed resident is accepted for admission by the facility admissions
          committee, then admission may occur subject to the availability of appropriate
          beds within C.M. Tucker, Jr./Dowdy Gardner Nursing Care Center
          (T/DGNCC) and/or the Richard M. Campbell Veterans Nursing Home
          (CVNH).

          In the event a bed is not available, individuals accepted for admission will have
          their names placed on a waiting list. Generally, accepted individuals will be
          admitted in the order in which their names were placed on the list. However,
          the Director of the Division of Long Term Care may direct the early admission
          of an accepted individual in extenuating circumstances.

B.      Except in unusual circumstances, all admissions to T/DGNCC and CVNH
         shall be voluntary admissions. If the proposed resident at the time of
         acceptance for admission is being cared for in another SCDMH facility, he
         or she will be discharged from such facility prior to transfer and admission
         to T/DGNCC or CVNH.

C.     The proposed resident must sign the SCDMH form entitled "Application for
         Admission to Department of Mental Health Nursing Home," and indicate a
         willingness to cooperate in the usual, routine and standard treatment methods
         of South Carolina Department of Mental Health nursing care facilities.

1.      In the event that the proposed resident lacks the apparent capacity to consent
         to admission, another individual with legal authority to consent to medical
         treatment for the proposed resident must make application on the proposed
         resident's behalf If the proposed resident has been adjudicated incapacitated
         by the probate court or if it is determined and certified by two licensed
         physicians that the proposed resident is unable to consent to admission, the
         application shall be signed by one of the following, in order of priority:

a.      A guardian appointed by the Probate Court pursuant to the
         procedures of the South Carolina Probate Code;

b.      An attorney-in-fact appointed by the proposed resident in a
         durable Power of Attorney executed pursuant to South Carolina
         law, if the decision is within the scope of such individual's
         authority;

c.      The spouse of the proposed resident, unless the spouse and the
         proposed resident are formally separated by written agreement or
         court order;

d.      A parent or adult child of the proposed resident;

e.      An adult sibling, grandparent or adult grandchild of the proposed
         resident;

f.      Any other adult relative by blood or marriage who is reasonably
        believed by the attending physician to have a close personal
        relationship with the proposed resident.

In the event it has been determined that the proposed resident is unable to consent to admission, and in the further event that there is no substitute decision-maker reasonably available and willing to be consulted, admission may be made without an application upon certification by a member of the medical staff of T/DGNCC or CVNH that the proposed resident is in need of nursing home care for the relief of suffering or restoration of bodily function or to preserve the life, health or bodily integrity of the proposed resident.

2.      When it is impracticable for a proposed resident who lacks the apparent
         capacity to consent to admission to be examined by two physicians prior
         to admission, the individual who would have authority to consent on the
         proposed resident's behalf if the proposed resident is subsequently
         determined unable to consent, shall sign the application, and the proposed
         resident shall also sign the application, if able.

IV.     Charges for Care:

All residents receiving treatment in a Department of Mental. Health nursing home will be charged the established fee for care and treatment as approved by the South Carolina Mental Health Commission.

This directive rescinds and replaces SCDMH Directive No. 769-92, "Admission Procedure to South Carolina Department of Mental Health Nursing Homes."

                                                                                       morris.GIF (2166 bytes)
                                                                                        John A. Morris, M.S.W.
                                                                                        Interim State Director of Mental Health

November 1, 1996