Notwithstanding section 36-407, a hospital licensed pursuant to this article which has been certified pursuant to title XVIII of the social security act as a rural extended care hospital may provide nursing care services, for a period of not to exceed an average of forty-five days, which are within the scope of services authorized by the medicare extended care program to any patient who is a member of the Arizona long-term care system and for which the services are appropriate. A hospital shall not admit a patient to an extended care program pursuant to this section if the patient needs a clinical service which is not available in the extended care program or requires services below the skilled nursing level of care as defined by the director.