Montana Administrative Code

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 …

37.106.2152 DENTAL SERVICES AND TREATMENT The facility must provide or make arrangements for comprehensive dental diagnostic and treatment services for each client from qualified personnel, including licensed dentists and dental hygienists either through organized dental services…

37.106.2153 PHARMACY SERVICES AND DRUG REGIMEN REVIEW The facility must provide or make arrangements for the provision of routine and emergency drugs and biologicals to each client. Drugs and biologicals may be obtained from community or contract pharmacists or the facility may m…

37.106.2154 DRUG ADMINISTRATION, STORAGE, AND RECORDKEEPING The facility must have an organized system for drug administration that identifies each drug up to the point of administration. The system must assure that: all drugs are administered in compliance with the physician's o…

37.106.2160 LABORATORY SERVICES If a facility chooses to provide laboratory services, the laboratory must meet the requirements specified in 42 CFR part 493. If the laboratory chooses to refer specimens for testing to another laboratory, the referral laboratory must be certified …

37.106.2161 PHYSICAL ENVIRONMENT The facility must not: house any client of a grossly different age, developmental level, and social need in close physical or social proximity unless the housing is planned to promote the growth and development of all those housed together; or seg…

37.106.2162 EMERGENCY PLAN AND PROCEDURES The facility must develop and implement detailed written plans and procedures to meet all potential emergencies and disasters such as fire, severe weather, and a missing client. The facility must communicate, periodically review, make the…

37.106.2163 SECURED UNITS A secured unit within a facility shall have a written policy outlining resident admission criteria, transfer criteria and discharge criteria for the secured unit. Provisions should be made for secured unit residents to access large group activities when …

37.106.2164 FIRE PROTECTION The facility must meet the applicable provisions of either the health care occupancies chapters or the residential board and care occupancies chapter of the Life Safety Code ( LSC ) , 2000 edition, of the National Fire Protection Association ( NFPA ) ,…

37.106.2170 INFECTION CONTROL The facility must provide a sanitary environment to avoid sources and transmission of infections. There must be policies and procedures for the prevention, control and investigation of infection and communicable diseases. The facility must implement …

37.106.2171 DIETETIC SERVICES Each client must receive a nourishing, well-balanced diet including modified and specially-prescribed diets. A qualified dietitian must be employed either full-time, part-time or on a consultant basis at the facility's discretion. If a qualified diet…

37.106.2180 FACILITY FAIR HEARING A facility has the right to appeal licensure decisions as outlined in 50-5-208 , MCA. The department shall follow the hearing procedure for fair hearings as outlined at ARM 37.5.117. Authorizing statute(s): Sec. 50-5-103 and 50-5-238, MCA Impleme…

37.106.2201 RESIDENTIAL TREATMENT FACILITY: APPLICATION OF OTHER RULES To the extent that other licensure rules in this chapter conflict with the terms of ARM 37.106.2202 and 37.106.2203 , the terms of ARM 37.106.2202 and 37.106.2203 will apply to residential treatment facilities…

37.106.2202 RESIDENTIAL TREATMENT FACILITY: LICENSURE STANDARDS A residential treatment facility must meet the requirements of the following: the standards for the following categories, contained in the Joint Commission on Accreditation of Health Care Organizations′ 2017 Comprehe…

37.106.2203 RESIDENTIAL TREATMENT FACILITIES: SEPARATE LICENSES Separate residential treatment facility licenses are not required for separate buildings within the same community if they are utilized to provide residential psychiatric care under the same management. Authorizing s…

37.106.2301 MINIMUM STANDARDS FOR A HOSPICE PROGRAM: GENERAL The following definitions apply in this rule and ARM 37.106.2305 and 37.106.2311: "Bereavement" means that period of time during which survivors mourn a death and experience grief. "Bereavement services" means support s…

37.106.2305 MINIMUM STANDARDS FOR AN INPATIENT HOSPICE FACILITY In addition to complying with the standards contained in ARM 37.106.2301, an inpatient hospice facility must comply with the requirements of the conditions of participation for hospices providing inpatient care direc…

37.106.2311 MINIMUM STANDARDS FOR A RESIDENTIAL HOSPICE FACILITY A residential hospice facility must meet all of the requirements contained in ARM 37.106.2301 in addition to those contained in this rule. A residential hospice facility must be managed directly by a licensed hospic…

37.106.2401 HOME INFUSION THERAPY AGENCY: DEFINITIONS In addition to the definitions in 50-5-101, MCA, the following definitions apply to this subchapter: "Antineoplastic" means a pharmaceutical that has the capability of killing malignant cells. "Biological safety cabinet" means…

37.106.2404 HOME INFUSION THERAPY AGENCY: RESPONSIBILITY FOR SERVICES Where a home infusion therapy agency directly provides either the home infusion therapy services or skilled nursing services and arranges for the provision of the other services, the parties must enter into a w…

37.106.2405 HOME INFUSION THERAPY AGENCY: ADMINISTRATOR AND PERSONNEL Each home infusion therapy agency must employ an administrator who shall: organize and direct the home infusion therapy agency's ongoing functions; be responsible for ongoing oversight of the home infusion ther…

37.106.2406 HOME INFUSION THERAPY: CLINICAL SERVICES (REPEALED) Authorizing statute(s): 50-5-103, MCA Implementing statute(s): 50-5-103, 50-5-213, MCA History: NEW, 1996 MAR p. 2587, Eff. 10/4/96; TRANS, from DHES, 2002 MAR p. 185; REP, 2009 MAR p. 1668, Eff. 9/25/09.

37.106.2407 HOME INFUSION THERAPY AGENCY: QUALITY ASSESSMENT Each home infusion therapy agency shall prepare and maintain on file an annual report of improvements made as a result of a quality assessment program. Authorizing statute(s): 50-5-103, MCA Implementing statute(s): 50-5…