HEALTH CARE FACILITIES

37.106.201 PURPOSE OF COMMUNITY BENEFITS AND FINANCIAL ASSISTANCE RULES Each hospital, critical access hospital, or rural emergency hospital that operates as a nonprofit health care facility under section 501(c)(3) of the Internal Revenue Code, 26 U.S.C. § 501(c)(3) (referred to …

37.106.2011 MENTAL HEALTH CENTER: FOSTER CARE FOR ADULTS WITH MENTAL ILLNESSES, ADULT FOSTER CARE SPECIALIST A mental health center providing foster care shall employ or contract with at least one adult foster care specialist. The adult foster care specialist shall have the knowl…

37.106.2015 MENTAL HEALTH CENTER: FOSTER CARE FOR ADULTS WITH MENTAL ILLNESSES, CLIENT ADMISSION CRITERIA AND NEEDS ASSESSMENT A mental health center providing foster care shall establish admission criteria which assesses the client's needs and the appropriateness of foster care …

37.106.2016 MENTAL HEALTH CENTER: FOSTER CARE FOR ADULTS WITH MENTAL ILLNESSES, TREATMENT PLAN A mental health center providing foster care shall implement a treatment plan for each client that: structures rehabilitation and treatment activities to promote increasing levels of in…

37.106.2017 MENTAL HEALTH CENTER: FOSTER CARE FOR ADULTS WITH MENTAL ILLNESSES, CLIENT PLACEMENT AGREEMENTS The mental health center shall enter into an individual placement agreement which sets forth the terms of the client's placement, the responsibilities of the foster care pr…

37.106.2018 MENTAL HEALTH CENTER: FOSTER CARE FOR ADULTS WITH MENTAL ILLNESSES, CLIENT RIGHTS AND RESPONSIBILITIES Upon admission a mental health center providing foster care shall provide each client with: a written statement of the client's rights which, at a minimum, include t…

37.106.202 DEFINITIONS For the purposes of this subchapter, the following definitions apply: "Community benefit" means initiatives and activities undertaken by a nonprofit hospital, critical access hospital, or rural emergency hospital to improve health in the communities it serv…

37.106.2025 APPLICATION OF OTHER RULES In addition to the requirements established in this subchapter, each mental health center providing a secured inpatient crisis stabilization program shall comply with all the requirements established in ARM 37.106.1945 and 37.106.1946 with t…

37.106.2026 SCOPE OF THIS RULE This rule is intended to apply to all state licensed mental health centers or hospitals providing a secured crisis stabilization service as part of the crisis service continuum. Authorizing statute(s): 50-5-103, MCA Implementing statute(s): 50-5-201…

37.106.2027 DEFINITIONS In addition to the definitions in 50-5-101, MCA, the following definitions apply to this subchapter: "Crisis plan" means an initial, brief, individualized plan that: lists client problems identified by the secured crisis stabilization facility's mental hea…

37.106.203 Community benefit and financial assistance requirements The duty of nonprofit hospitals, critical access hospitals, and rural emergency hospitals to provide community benefits and financial assistance is established in 50-5-121, MCA. To satisfy the requirements, a nonp…

37.106.2031 CONSTRUCTION REQUIREMENTS Prior to construction, floor plans for the secured in-patient crisis stabilization facility must be submitted to the Licensure Bureau of the Department of Public Health and Human Services for review, comment, and approval. Prior to occupancy,…

37.106.2032 PATIENT TOILETS AND BATHING There will be at least one toilet available for every four patients in the facility. There will be at least one bathing unit for every six patients in the facility. A shower or tub is not required if the facility utilizes a central bathing …

37.106.2033 SPECIAL LOCKING ARRANGEMENTS The facility must follow the provisions of the 2000 Edition of the NFPA 101, Life Safety Code, (LSC). A copy of this publication can be obtained from the Department of Public Health and Human Services, Quality Assurance Division, Licensure…

37.106.2034 SECLUSION AND RESTRAINT A SCSF must be capable of providing restraint or seclusion and must ensure that the restraint or seclusion is performed in compliance with 42 CFR 482.13(f)(1) through (7). The department adopts and incorporates by reference 42 CFR 482.13(f)(1) …

37.106.2038 ADMISSIONS PROCEDURES The facility will develop and implement a written policy outlining the admission criteria for placing a client into the secured service. Authorizing statute(s): 50-5-103, MCA Implementing statute(s): 50-5-201, MCA History: NEW, 2008 MAR p. 1993, …

37.106.2039 DISCHARGE PROCEDURES The facility shall develop and implement discharge and transfer criteria for discharging a client from the secured setting. At the end of the detention the facility must: discharge the patient; refer the patient to a licensed nonsecured inpatient …

37.106.204 REPORTING requirements Each nonprofit hospital, rural emergency hospital, or critical access hospital shall submit to the department, with the annual hospital financial report required in ARM 37.106.138, the following documents within 30 days of its filing of the appli…

37.106.2042 STAFF QUALIFICATIONS AND ORGANIZATIONAL STRUCTURE Each SCSF shall employ or contract with a site based administrator who has daily overall management responsibility for the operation of the SCSF. The administrator of the mental health center or hospital if they are si…

37.106.2046 SECURED CRISIS STABILIZATION FACILITY: CLIENT ASSESSMENTS Each SCSF shall employ or contract with licensed mental health professionals to conduct clinical intake assessments which may be abbreviated assessments focusing on the crisis issues and safety. Abbreviated int…

37.106.2047 SECURED CRISIS STABILIZATION FACILITY: CLIENT DISCHARGE Each SCSF shall prepare a discharge summary for each client no longer receiving services. The discharge summary must include: the reason for discharge; a summary of the services provided by the SCSF including rec…

37.106.2048 SECURED CRISIS STABILIZATION FACILITY: EMERGENCY PROCEDURES Each SCSF shall develop a written plan for emergency procedures. At a minimum, the plan must include: emergency evacuation procedures to be followed in the case of fire or other emergency; procedures for cont…

37.106.205 ENFORCEMENT AND Penalties for noNCOMPLIANCE WITH community benefit and financial assistance requirements OR REPORTING requirements When the department establishes community benefit and financial assistance standards, it will also establish the applicable penalties for …

37.106.2101 INTERMEDIATE CARE FACILITIES FOR THE DEVELOPMENTALLY DISABLED ( ICF /DD) : APPLICATION OF OTHER RULES: COURT ORDERS To the extent that other licensure rules in ARM Title 37 conflict with the provisions of this subchapter, the provisions of this subchapter will apply t…

37.106.2102 DEFINITIONS "Abuse" is defined at 52-3-803 , MCA. "Administrator" means a designated individual having daily overall management responsibility for the operation of a facility. "Client" means an adult resident, 18 years of age or older, receiving services from a facili…

37.106.2105 GOVERNING BODY AND MANAGEMENT The facility must identify an individual or individuals to constitute the governing body of the facility. The governing body must: exercise general policy, budget, and operating direction over the facility; and appoint the administrator o…

37.106.2106 COMPLIANCE WITH APPLICABLE LAWS The facility must be in compliance with all applicable provisions of state and local laws, regulations and codes. Authorizing statute(s): Sec. 50-5-103 and 50-5-238, MCA Implementing statute(s): Sec. 53-5-103, 50-5-201 and 50-5-238, MCA…

37.106.2109 CLIENT RECORDS The facility must develop and maintain a recordkeeping system that includes a separate record for each client and that documents the client's health care, treatment and habilitation, including preliminary evaluation, comprehensive functional assessments…

37.106.2110 SERVICES PROVIDED UNDER AGREEMENTS WITH OUTSIDE PROVIDERS If a service required under this subchapter is not provided directly, the facility must have a written agreement with an outside program, resource, or service to furnish the necessary service, including emergen…

37.106.2115 CLIENT PROTECTIONS, THE PROTECTION OF RESIDENTS' RIGHTS The facility must ensure the rights of all of the clients and must: inform each client or legal guardian of the client's rights and the rules of the facility; inform each client or legal guardian of the client's …

37.106.2116 CLIENT FINANCES The facility must establish and maintain a system that: assures a full and complete accounting of each client's personal funds entrusted to the facility on behalf of each client; and precludes any commingling of a client's funds with facility funds or …

37.106.2117 COMMUNICATION WITH CLIENTS, PARENTS, AND GUARDIANS The facility must: promote participation of the legal guardian in the process of providing treatment and habilitation to a client unless their participation is unobtainable or inappropriate; answer communications from…

37.106.2118 PREVENTION, INVESTIGATION, AND REPORTING OF CLIENT ABUSE, SEXUAL ABUSE, NEGLECT AND EXPLOITATION The facility must develop and implement written policies and procedures to prevent abuse, sexual abuse, neglect, or exploitation of the client. Facility staff must report …

37.106.2119 PROFESSIONAL PROGRAM SERVICES Each client must receive the professional program services necessary to implement the treatment and habilitation program defined by each client's individual treatment plan. In providing these services, professional program staff must work…

37.106.2125 FACILITY STAFFING The facility must not depend upon the client or volunteers to perform direct care services for the facility. There must be responsible direct care staff on duty and awake on a 24 hour basis, when any client is present, to take prompt, appropriate act…

37.106.2126 DIRECT CARE STAFF The facility must provide sufficient direct care staff to manage and supervise each client in accordance with their individual treatment plan. Direct care staff must be provided by the facility in the following minimum ratios of direct care staff to …

37.106.2127 STAFF TRAINING The facility must provide each staff member with initial and continuing training that enables the employee to perform his or her duties effectively, efficiently, and competently. For staff members who work with any client, training must focus on skills …

37.106.2131 INDIVIDUAL RESIDENTIAL TREATMENT AND HABILITATION NEEDS Each client must be offered a treatment and habilitation program which includes aggressive, consistent implementation of a program of specialized and generic training, treatment, health services and related servi…

37.106.2132 ADMISSIONS, TRANSFERS, DISCHARGE AND FAIR HEARING Admission decisions must be based on a preliminary evaluation of the client that is conducted or updated by the facility or by outside sources, except that admission procedures regarding clients which have been committ…

37.106.2133 INDIVIDUAL TREATMENT PLANS Each client must have an individual treatment plan developed by an interdisciplinary team that represents the professions, disciplines or service areas that are relevant to: identifying the client's needs, as described by the comprehensive f…

37.106.2136 PROGRAM IMPLEMENTATION As soon as the interdisciplinary team has formulated a client's individual treatment plan, each client must be offered a continuous treatment and habilitation program consisting of needed interventions and services in sufficient number and frequ…

37.106.2137 PROGRAM DOCUMENTATION Data relative to accomplishment of the criteria specified in client individual treatment plan objectives must be documented in measurable terms. The facility must document significant events that are related to the client's individual treatment p…

37.106.2138 PROGRAM MONITORING AND CHANGE At least annually the comprehensive functional assessment of each client must be reviewed by the interdisciplinary team for relevancy and updated as needed, and the individual treatment plan must be revised, as appropriate, repeating the …

37.106.2139 MANAGEMENT OF CONDUCT BETWEEN STAFF AND THE CLIENT The facility must develop and implement written policies and procedures for the management of conduct between staff and the client. These policies and procedures must: promote the growth, development and independence …

37.106.2140 MANAGEMENT OF INAPPROPRIATE CLIENT BEHAVIOR The facility must develop and implement written policies and procedures that govern the management of inappropriate client behavior only as allowed in 53-20-146 , MCA. These policies and procedures must be consistent with th…

37.106.2144 OBSERVATION AND SECLUSION ROOMS A client may be placed in a an observation and seclusion room from which egress is prevented only as allowed in 53-20-146 , MCA and only if the following conditions are met: The placement is required because of an emergency situation re…

37.106.2145 PHYSICAL RESTRAINTS The facility may employ physical restraint only as allowed in 53-20-146 , MCA and only as: an emergency measure, but only if absolutely necessary to protect the client or others from injury; or a health-related protection prescribed by a physician,…

37.106.2146 DRUG USAGE Drugs used for control of inappropriate behavior must be approved by the interdisciplinary team and be used only as an integral part of the client's individual treatment plan that is directed specifically toward the reduction of and eventual elimination of …

37.106.2150 HEALTH CARE AND PHYSICIAN SERVICES The facility must ensure the availability of physician services 24 hours a day. The physician must develop, in coordination with licensed nursing personnel, a medical care plan of treatment for a client if the physician determines th…

37.106.2151 NURSING SERVICES AND STAFF The facility must provide each client with nursing services in accordance with their needs, including: participation as appropriate in the development, review, and update of an individual treatment plan as part of the interdisciplinary team …