Code of Massachusetts Regulations › 104 CMR - DEPARTMENT OF MENTAL HEALTH › Title 104 CMR 27.00 - LICENSING AND OPERATIONAL STANDARDS FOR MENTAL HEALTH FACILITIES › Subpart C - OPERATIONAL STANDARDS FOR MENTAL HEALTH FACILITIES › Section 27.05 - General Admission Procedures

Current through Register 1525, July 5, 2024
(1) For the
				purpose of involuntary commitment, mental illness is defined as a substantial
				disorder of thought, mood, perception, orientation, or memory which grossly
				impairs judgment, behavior, capacity to recognize reality or ability to meet
				the ordinary demands of life, but shall not include intellectual or
				developmental disabilities, autism spectrum disorder, traumatic brain injury or
				psychiatric or behavioral disorders or symptoms due to another medical
				condition as provided in the
Diagnostic and Statistical Manual of
				Mental Disorders
(DSM-5), 5th edition
				published by the American Psychiatric Association, or except as provided in
				104 CMR
				27.18, alcohol and substance use disorders;
				provided however, that the presence of such conditions co-occurring with a
				mental illness shall not disqualify a person who otherwise meets the criteria
				for admission to a mental health facility.
(2) For the purposes of voluntary or
				conditional voluntary admission to mental health facilities in the
				Commonwealth, any degree of severity of a mental disorder, including
				co-occurring substance use disorders, may qualify a person for admission to a
				mental health facility at the discretion of the facility director or designee
				when it is determined that the person is in need of care and treatment, and
				that the admitting facility is suitable for such care and treatment.
(3) No facility licensed as Class III through
				VII shall have exclusion criteria for admission that would result in the
				rejection of any patient who has been determined by a designated physician or
				designated Psychiatric APRN of the facility to meet the clinical criteria for
				involuntary commitment pursuant to M.G.L. c. 123, § 12(b), or who has been
				committed pursuant to M.G.L. c. 123, § 12(e); provided however, that a
				facility that has been certified to treat specialty populations, such as for
				treating geriatric patients or patients with co-occurring intellectual or
				developmental disabilities, may preferentially admit such patients. Facilities
				may not deny admission to a patient for whom it has the clinical competency and
				staffing to appropriately treat, except as provided in 104 CMR 27.05(3) (b)
				through (d).
(a) A facility licensed as Class
				III through VII shall have the capacity to care for patients otherwise meeting
				admission criteria who have co-occurring medical needs in accordance with
				clinical competencies and operational standards determined by the
				Department.
(b) A facility may deny
				admission to a patient if such admission would result in a census exceeding the
				facility's operational capacity; provided however, that the facility is able to
				demonstrate that, despite its best efforts, it is unable to accommodate the
				additional capacity.
(c) A
				facility may deny admission to a patient if such admission would result in a
				census exceeding the facility's licensed capacity.
(d) A facility may deny admission to a
				patient whose needs have been determined by the facility medical director to
				exceed the facility's capability at the time admission is sought. The
				determination shall include the factors justifying denial of admission and why
				mitigating efforts, such as utilization of additional staff, would have been
				inadequate. This determination must be recorded in writing and shall be subject
				to review by the Department; provided however, that such written determination
				need not contain patient-identifiable information.
(e) Facilities shall keep data on patients
				referred for admission in a form and format and containing data elements as
				determined by the Department; provided however, that facilities shall not be
				required to maintain patient-identifiable data on individuals not accepted for
				admission. Such data shall be available for inspection by the Department upon
				request.