The patient was admitted with the diagnosis of dehydration.The patient presented to the emergency department with a three-day history of vomiting and fever to 103°, and a one week history of cold symptoms. He was known to be exposed to viral illness in daycare. Vital signs on presentation: temperature 101.4°, heart rate 154, respiratory rate 32, blood pressure 114/72, and oxygen saturation 100% on room air.

The health plan's determination is upheld. The inpatient admission was not medically necessary. This patient had mild to moderate dehydration and required IV hydration, which could have been accomplished at a lower level of care. The patient's elevated HR was secondary to a fever and came down to normal with oral antipyretic treatment. The patient had normal lab studies. This patient's hospital stay did not meet any criteria for an inpatient level care. Observation for overnight hydration at a lower level of care would have been appropriate.