A. The purpose of the therapeutic leave (the leave must be listed in the plan of care along with the objectives, goals and frequency of this therapy)

B. The destination or location (the place where the recipient will go for this therapy must be recorded, as well as the date and time of departure and return and the person(s) responsible for the recipient during the leave period)

C. A therapeutic leave evaluation (documentation must be in a form that provides unquestionable support to the plan of care objectives and goals)

D. Progress notes (progress notes must provide periodic statements that track a recipient's actions and reactions and must clearly reveal the recipient's achievements or regressions)

A Medicaid recipient who has been admitted to the hospital may not leave the hospital and receive Medicaid covered outpatient services prior to being discharged. Unless a patient has been discharged from the hospital and is no longer considered an inpatient, the patient is not eligible for outpatient services covered by Medicaid. For example, a patient may not be prescribed therapeutic leave for 8 hours per day in order to receive day treatment services through a Community Mental Health Center. Even though a patient is on therapeutic leave from an acute/general hospital, he or she is still considered an inpatient.