reglab/statecodes huggingface dataset:
Administrative Rules of Montana › Department 37 - PUBLIC HEALTH AND HUMAN SERVICES › Chapter 37.106 - HEALTH CARE FACILITIES › Subchapter 37.106.20 - Mental Health Center: Foster Care for Adults With Mental Illnesses › Rule 37.106.2047 - SECURED CRISIS STABILIZATION FACILITY: CLIENT DISCHARGE

Current through Register Vol. 13, July 5, 2024
(1) Each SCSF shall prepare a discharge
				summary for each client no longer receiving services. The discharge summary
				must include:
(a) the reason for
				discharge;
(b) a summary of the
				services provided by the SCSF including recommendations for aftercare services
				and referrals to the other services, if applicable;
(c) an evaluation of the client's progress as
				measured by the treatment plan and the impact of the services provided by the
				facility; and
(d) the signature of
				the staff member who prepared the report and the date of preparation.
Administrative Rules of Montana › Department 37 - PUBLIC HEALTH AND HUMAN SERVICES › Chapter 37.106 - HEALTH CARE FACILITIES › Subchapter 37.106.20 - Mental Health Center: Foster Care for Adults With Mental Illnesses › Rule 37.106.2048 - SECURED CRISIS STABILIZATION FACILITY: EMERGENCY PROCEDURES

Current through Register Vol. 13, July 5, 2024
(1) Each SCSF shall develop a written plan
				for emergency procedures. At a minimum, the plan must include:
(a) emergency evacuation procedures to be
				followed in the case of fire or other emergency;
(b) procedures for contacting emergency
				service responders; and
(c) the
				names and phone numbers for contacting other crisis response facility staff in
				emergency situations.
Administrative Rules of Montana › Department 37 - PUBLIC HEALTH AND HUMAN SERVICES › Chapter 37.106 - HEALTH CARE FACILITIES › Subchapter 37.106.21 - Intermediate Care Facilities for the Developmental Disabled ( ICF /DD) › Rule 37.106.2101 - INTERMEDIATE CARE FACILITIES FOR THE DEVELOPMENTALLY DISABLED ( ICF /DD) : APPLICATION OF OTHER RULES: COURT ORDERS

Current through Register Vol. 13, July 5, 2024
(1)
				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 to
				intermediate care facility for the developmentally disabled (ICF
				/DD).
(2) Notwithstanding the
				requirements of this chapter, the facility shall comply with the terms and
				conditions of an order issued by a court of competent jurisdiction, including,
				but not limited to, the observance of any limitations placed upon a client's
				rights by the court.
Sec.
					 50-5-103
					 and
					 50-5-238,
					 MCA; IMP, Sec.
					 53-5-103,
					 50-5-201 and
					 50-5-238,
					 MCA;
Administrative Rules of Montana › Department 37 - PUBLIC HEALTH AND HUMAN SERVICES › Chapter 37.106 - HEALTH CARE FACILITIES › Subchapter 37.106.21 - Intermediate Care Facilities for the Developmental Disabled ( ICF /DD) › Rule 37.106.2105 - GOVERNING BODY AND MANAGEMENT

Current through Register Vol. 13, July 5, 2024
(1) The
				facility must identify an individual or individuals to constitute the governing
				body of the facility. The governing body must:
(a) exercise general policy, budget, and
				operating direction over the facility; and
(b) appoint the administrator of the
				facility.
Administrative Rules of Montana › Department 37 - PUBLIC HEALTH AND HUMAN SERVICES › Chapter 37.106 - HEALTH CARE FACILITIES › Subchapter 37.106.21 - Intermediate Care Facilities for the Developmental Disabled ( ICF /DD) › Rule 37.106.2106 - COMPLIANCE WITH APPLICABLE LAWS

Current through Register Vol. 13, July 5, 2024
(1) The
				facility must be in compliance with all applicable provisions of state and
				local laws, regulations and codes.
Sec.
					 50-5-103
					 and
					 50-5-238,
					 MCA; IMP, Sec.
					 53-5-103,
					 50-5-201 and
					 50-5-238,
					 MCA;
Administrative Rules of Montana › Department 37 - PUBLIC HEALTH AND HUMAN SERVICES › Chapter 37.106 - HEALTH CARE FACILITIES › Subchapter 37.106.21 - Intermediate Care Facilities for the Developmental Disabled ( ICF /DD) › Rule 37.106.2109 - CLIENT RECORDS

Current through Register Vol. 13, July 5, 2024
(1) 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, individual treatment plan, progress notes, social information, and
				protection of the client's rights.
(2) The facility must keep confidential all
				information contained in the client's records, regardless of the form or
				storage method of the records.
(3)
				The facility must develop and implement policies and procedures governing the
				release of any client information, including consents necessary from the client
				or legal guardian.
(4) Any
				individual who makes an entry in a client's record must make it legibly, date
				it, and sign it.
(5) The facility
				must provide a legend to explain any symbol or abbreviation used in a client's
				record.
(6) The facility must
				provide each identified residential living unit with appropriate aspects of
				each client's record.
Sec.
					 50-5-103
					 and
					 50-5-238,
					 MCA; IMP, Sec.
					 53-5-103,
					 50-5-201 and
					 50-5-238,
					 MCA;
Administrative Rules of Montana › Department 37 - PUBLIC HEALTH AND HUMAN SERVICES › Chapter 37.106 - HEALTH CARE FACILITIES › Subchapter 37.106.21 - Intermediate Care Facilities for the Developmental Disabled ( ICF /DD) › Rule 37.106.2110 - SERVICES PROVIDED UNDER AGREEMENTS WITH OUTSIDE PROVIDERS

Current through Register Vol. 13, July 5, 2024
(1) 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 emergency and other health care.
(2) The agreement must:
(a) contain the responsibilities, functions,
				objectives, and other terms agreed to by both parties; and
(b) provide that the facility is responsible
				for assuring that the outside services meet the standards for quality of
				services contained in this subchapter.
Administrative Rules of Montana › Department 37 - PUBLIC HEALTH AND HUMAN SERVICES › Chapter 37.106 - HEALTH CARE FACILITIES › Subchapter 37.106.21 - Intermediate Care Facilities for the Developmental Disabled ( ICF /DD) › Rule 37.106.2115 - CLIENT PROTECTIONS, THE PROTECTION OF RESIDENTS' RIGHTS

Current through Register Vol. 13, July 5, 2024
(1) The facility must ensure the rights of
				all of the clients and must:
(a) inform each
				client or legal guardian of the client's rights and the rules of the
				facility;
(b) inform each client or
				legal guardian of the client's medical condition, developmental and behavioral
				status, attendant risks of treatment, and of the right to refuse
				treatment;
(c) inform the
				individual client of their rights as a client of the facility, including the
				right to file complaints, the right to protection against any retaliation when
				filing a complaint and the right to due process;
(d) allow the individual client to manage
				their financial affairs and teach them to do so to the extent of their
				capabilities;
(e) ensure that each
				client is not subjected to abuse, sexual abuse, neglect, exploitation or
				punishment;
(f) ensure that each
				client is free from unnecessary drugs and unnecessary physical
				restraints;
(g) provide each client
				with the opportunity for personal privacy and ensure privacy during treatment
				and care of personal needs;
(h)
				ensure that each client is not compelled to perform services for the facility
				and ensure that each client who does work for the facility is compensated for
				their efforts at prevailing wages and commensurate with their
				abilities;
(i) ensure each client
				the opportunity to communicate, associate and meet privately with individuals
				and to send and receive unopened mail, except that these rights may be
				restricted as provided in Title 53, part 20, MCA;
(j) ensure that each client has access to
				telephones with privacy for incoming and outgoing local and long distance
				calls, except that these rights may be restricted as provided in Title 53, part
				20, MCA;
(k) ensure that each
				client has the right to retain and use appropriate personal possessions and
				clothing, and ensure that each client is dressed in their own clothing each
				day, except that these rights may be restricted as provided in Title 53, part
				20, MCA;
(l) ensure the client the
				opportunity to participate in social, religious and community group activities,
				except that these rights may be restricted as provided in Title 53, part 20,
				MCA; and
(m) permit a husband and
				wife who both reside in the facility to share a room. This right may only be
				limited by written order of the individual treatment planning team when there
				is no less restrictive means for preventing imminent bodily harm to either
				partner, or when either partner requests a separate room. The written order
				must explain the reason for the restriction and must be reviewed monthly by the
				individual treatment planning team if the restriction is to be
				continued.
Administrative Rules of Montana › Department 37 - PUBLIC HEALTH AND HUMAN SERVICES › Chapter 37.106 - HEALTH CARE FACILITIES › Subchapter 37.106.21 - Intermediate Care Facilities for the Developmental Disabled ( ICF /DD) › Rule 37.106.2116 - CLIENT FINANCES

Current through Register Vol. 13, July 5, 2024
(1) The facility
				must establish and maintain a system that:
(a) assures a full and complete accounting of
				each client's personal funds entrusted to the facility on behalf of each
				client; and
(b) precludes any
				commingling of a client's funds with facility funds or with the funds of any
				person other than another client.
Administrative Rules of Montana › Department 37 - PUBLIC HEALTH AND HUMAN SERVICES › Chapter 37.106 - HEALTH CARE FACILITIES › Subchapter 37.106.21 - Intermediate Care Facilities for the Developmental Disabled ( ICF /DD) › Rule 37.106.2117 - COMMUNICATION WITH CLIENTS, PARENTS, AND GUARDIANS

Current through Register Vol. 13, July 5, 2024
(1) The facility must:
(a) promote participation of the legal
				guardian in the process of providing treatment and habilitation to a client
				unless their participation is unobtainable or inappropriate;
(b) answer communications from the client's
				family and friends promptly and appropriately;
(c) permit visits by the guardian to any area
				of the facility that provides direct client care services to the client,
				consistent with the right of that client's and other clients'
				privacy;
(d) notify the client or
				client's guardian of changes in the client's condition including, but not
				limited to, serious illness, accident, death, abuse, or unauthorized absence in
				a timely manner as indicated by an assessment of the individual
				incident.
Administrative Rules of Montana › Department 37 - PUBLIC HEALTH AND HUMAN SERVICES › Chapter 37.106 - HEALTH CARE FACILITIES › Subchapter 37.106.21 - Intermediate Care Facilities for the Developmental Disabled ( ICF /DD) › Rule 37.106.2118 - PREVENTION, INVESTIGATION, AND REPORTING OF CLIENT ABUSE, SEXUAL ABUSE, NEGLECT AND EXPLOITATION

Current through Register Vol. 13, July 5, 2024
(1) The facility
				must develop and implement written policies and procedures to prevent abuse,
				sexual abuse, neglect, or exploitation of the client.
(2) Facility staff must report all known or
				suspected incidents of client abuse, sexual abuse, neglect or exploitation to
				the facility administrator, and the facility administrator or his or her
				designee shall report said incidents to the department in accordance with the
				requirements of Title 52, chapter 3, part 8, MCA.
(3) The facility must develop and implement
				written policies and procedures for the investigation of allegations of client
				abuse, sexual abuse, neglect or exploitation.
(4) The results of all facility
				investigations of client abuse, sexual abuse, neglect or exploitation must be
				reported to the department when the investigation has been initiated and upon
				completion. If an allegation of client abuse, sexual abuse, neglect or
				exploitation is verified, appropriate corrective action must be
				taken.
Sec.
					 50-5-103
					 and
					 50-5-238,
					 MCA; IMP, Sec.
					 53-5-103,
					 50-5-201 and
					 50-5-238,
					 MCA;
Administrative Rules of Montana › Department 37 - PUBLIC HEALTH AND HUMAN SERVICES › Chapter 37.106 - HEALTH CARE FACILITIES › Subchapter 37.106.21 - Intermediate Care Facilities for the Developmental Disabled ( ICF /DD) › Rule 37.106.2119 - PROFESSIONAL PROGRAM SERVICES

Current through Register Vol. 13, July 5, 2024
(1) 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 directly with each client and with paraprofessional, nonprofessional and
				other professional program staff who work with each client.
(2) The facility must have available program
				staff to carry out and monitor the interventions in accordance with the stated
				goals and objectives of every individual treatment plan.
(3) Program staff must participate as members
				of the interdisciplinary team in relevant aspects of the treatment and
				habilitation process.
(4)
				Professional program staff must be licensed, certified, or registered, as
				applicable, by the state of Montana to provide professional services.
(5) Program staff must serve the special
				needs of the client as defined by the individual treatment plan.
Sec.
					 50-5-103
					 and
					 50-5-238,
					 MCA; IMP, Sec.
					 53-5-103,
					 50-5-201 and
					 50-5-238,
					 MCA;
Administrative Rules of Montana › Department 37 - PUBLIC HEALTH AND HUMAN SERVICES › Chapter 37.106 - HEALTH CARE FACILITIES › Subchapter 37.106.21 - Intermediate Care Facilities for the Developmental Disabled ( ICF /DD) › Rule 37.106.2125 - FACILITY STAFFING

Current through Register Vol. 13, July 5, 2024
(1) The facility
				must not depend upon the client or volunteers to perform direct care services
				for the facility.
(2) 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 action in case of injury,
				illness, fire or other emergency.
(3) The facility must provide sufficient
				support staff so that direct care staff are not required to perform support
				services to the extent that these duties interfere with the exercise of their
				primary direct client care duties.
Sec.
					 50-5-103
					 and
					 50-5-238,
					 MCA; IMP, Sec.
					 53-5-103,
					 50-5-201 and
					 50-5-238,
					 MCA;
Administrative Rules of Montana › Department 37 - PUBLIC HEALTH AND HUMAN SERVICES › Chapter 37.106 - HEALTH CARE FACILITIES › Subchapter 37.106.21 - Intermediate Care Facilities for the Developmental Disabled ( ICF /DD) › Rule 37.106.2126 - DIRECT CARE STAFF

Current through Register Vol. 13, July 5, 2024
(1) The facility
				must provide sufficient direct care staff to manage and supervise each client
				in accordance with their individual treatment plan.
(2) Direct care staff must be provided by the
				facility in the following minimum ratios of direct care staff to clients:
(a) a staff to client ratio of 1 to 3.2 for
				each defined residential living unit serving:
(i) any severely and profoundly retarded
				client;
(ii) a client with severe
				physical disabilities;
(iii) any
				client who is aggressive, assaultive, or a security risk; or
(iv) any client who manifests severely
				hyperactive or psychotic-like behavior.
Administrative Rules of Montana › Department 37 - PUBLIC HEALTH AND HUMAN SERVICES › Chapter 37.106 - HEALTH CARE FACILITIES › Subchapter 37.106.21 - Intermediate Care Facilities for the Developmental Disabled ( ICF /DD) › Rule 37.106.2127 - STAFF TRAINING

Current through Register Vol. 13, July 5, 2024
(1) 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.
(2) For staff members
				who work with any client, training must focus on skills and competencies
				directed toward the client's developmental, behavioral, and health
				needs.
(3) Staff must be able to
				demonstrate the skills and techniques necessary to administer interventions to
				manage the inappropriate behavior of any client.
(4) Staff must be able to demonstrate the
				skills and techniques necessary to implement the individual treatment plan for
				each client for whom they are responsible.
Sec.
					 50-5-103
					 and
					 50-5-238,
					 MCA; IMP, Sec.
					 53-5-103,
					 50-5-201 and
					 50-5-238,
					 MCA;
Administrative Rules of Montana › Department 37 - PUBLIC HEALTH AND HUMAN SERVICES › Chapter 37.106 - HEALTH CARE FACILITIES › Subchapter 37.106.21 - Intermediate Care Facilities for the Developmental Disabled ( ICF /DD) › Rule 37.106.2131 - INDIVIDUAL RESIDENTIAL TREATMENT AND HABILITATION NEEDS

Current through Register Vol. 13, July 5, 2024
(1) 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 services described in this subchapter, that is directed toward:
(a) the acquisition of the behaviors
				necessary for the client to function with as much self determination and
				independence as possible; and
(b)
				the prevention or deceleration of regression or loss of current optimal
				functional status.
Administrative Rules of Montana › Department 37 - PUBLIC HEALTH AND HUMAN SERVICES › Chapter 37.106 - HEALTH CARE FACILITIES › Subchapter 37.106.21 - Intermediate Care Facilities for the Developmental Disabled ( ICF /DD) › Rule 37.106.2132 - ADMISSIONS, TRANSFERS, DISCHARGE AND FAIR HEARING

Current through Register Vol. 13, July 5, 2024
(1) 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 committed to the facility by a court of competent
				jurisdiction shall be conducted pursuant to Title 53, chapter 20, part 1,
				MCA.
(2) A preliminary evaluation
				must contain background information as well as currently valid assessments of
				functional, developmental, behavioral, social, health and nutritional status to
				determine if the facility can provide for the client's needs and if the client
				is likely to benefit from placement in the facility.
(3) If a client is to be either transferred
				or discharged from the facility, the facility must:
(a) have documentation in the client's record
				that the client was transferred or discharged for good cause; and
(b) provide a reasonable time to prepare the
				client or guardian for the transfer or discharge (except in
				emergencies).
Administrative Rules of Montana › Department 37 - PUBLIC HEALTH AND HUMAN SERVICES › Chapter 37.106 - HEALTH CARE FACILITIES › Subchapter 37.106.21 - Intermediate Care Facilities for the Developmental Disabled ( ICF /DD) › Rule 37.106.2133 - INDIVIDUAL TREATMENT PLANS

Current through Register Vol. 13, July 5, 2024
(1) 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:
(a) identifying the client's needs, as
				described by the comprehensive functional assessments required in (3) ;
				and
(b) designing programs that
				meet the client's needs.
Administrative Rules of Montana › Department 37 - PUBLIC HEALTH AND HUMAN SERVICES › Chapter 37.106 - HEALTH CARE FACILITIES › Subchapter 37.106.21 - Intermediate Care Facilities for the Developmental Disabled ( ICF /DD) › Rule 37.106.2136 - PROGRAM IMPLEMENTATION

Current through Register Vol. 13, July 5, 2024
(1) 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
				frequency to support the achievement of the objectives identified in the
				individual treatment plan.
(2)
				Except for those facets of the individual treatment plan that must be
				implemented only by licensed personnel, each client's individual treatment plan
				must be implemented by all staff who work with the client.
Sec.
					 50-5-103
					 and
					 50-5-238,
					 MCA; IMP, Sec.
					 53-5-103,
					 50-5-201 and
					 50-5-238,
					 MCA;
Administrative Rules of Montana › Department 37 - PUBLIC HEALTH AND HUMAN SERVICES › Chapter 37.106 - HEALTH CARE FACILITIES › Subchapter 37.106.21 - Intermediate Care Facilities for the Developmental Disabled ( ICF /DD) › Rule 37.106.2137 - PROGRAM DOCUMENTATION

Current through Register Vol. 13, July 5, 2024
(1) Data
				relative to accomplishment of the criteria specified in client individual
				treatment plan objectives must be documented in measurable terms.
(2) The facility must document significant
				events that are related to the client's individual treatment plan and
				assessments and that contribute to an overall understanding of the client's
				ongoing level and quality of functioning.
(3) The facility staff must prepare progress
				notes which indicate whether or not the stated individual treatment plan has
				been implemented, and the degree to which the client is progressing, or failing
				to progress, toward stated treatment objectives. The progress notes must be
				entered into the client's clinical record at least weekly and upon the
				occurrence of any significant change in the client's condition.
Sec.
					 50-5-103
					 and
					 50-5-238,
					 MCA; IMP, Sec.
					 53-5-103,
					 50-5-201 and
					 50-5-238,
					 MCA;
Administrative Rules of Montana › Department 37 - PUBLIC HEALTH AND HUMAN SERVICES › Chapter 37.106 - HEALTH CARE FACILITIES › Subchapter 37.106.21 - Intermediate Care Facilities for the Developmental Disabled ( ICF /DD) › Rule 37.106.2138 - PROGRAM MONITORING AND CHANGE

Current through Register Vol. 13, July 5, 2024
(1) 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
				process set forth in ARM
				37.106.2133(3).
(2) The individual treatment plan for each
				client must be reviewed by the interdisciplinary team every 90 days and
				whenever there is a significant change in the client's condition. The
				individual treatment plan must be revised, as appropriate.
(3) The facility must designate and use a
				specially constituted committee or committees consisting of members of facility
				staff, legal guardians, clients (as appropriate), qualified persons who have
				either experience or training in contemporary practices to change inappropriate
				client behavior, and persons with no ownership or controlling interest in the
				facility to:
(a) review, approve, and monitor
				individual treatments designed to manage inappropriate behavior and other
				treatments that, in the opinion of the committee, involve risks to client
				protection and rights;
(b) ensure
				that these treatments are conducted only after the client or legal guardian has
				been informed; and
(c) review,
				monitor and make suggestions to the facility about its practices and programs
				as they relate to:
(i) drug usage;
(ii) physical restraints;
(iii) time out rooms;
(iv) application of painful or noxious
				stimuli;
(v) control of
				inappropriate behavior;
(vi)
				protection of client rights and funds; and
(vii) any other area that the committee
				believes needs to be addressed.
Administrative Rules of Montana › Department 37 - PUBLIC HEALTH AND HUMAN SERVICES › Chapter 37.106 - HEALTH CARE FACILITIES › Subchapter 37.106.21 - Intermediate Care Facilities for the Developmental Disabled ( ICF /DD) › Rule 37.106.2139 - MANAGEMENT OF CONDUCT BETWEEN STAFF AND THE CLIENT

Current through Register Vol. 13, July 5, 2024
(1) 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:
(a) promote the growth, development and
				independence of the client;
(b)
				address the extent to which the client's choice will be accommodated in daily
				decision-making, emphasizing self-determination and self-management, to the
				extent possible;
(c) specify client
				conduct to be allowed or not allowed; and
(d) be available to all staff, the client and
				the legal guardian.
Administrative Rules of Montana › Department 37 - PUBLIC HEALTH AND HUMAN SERVICES › Chapter 37.106 - HEALTH CARE FACILITIES › Subchapter 37.106.21 - Intermediate Care Facilities for the Developmental Disabled ( ICF /DD) › Rule 37.106.2140 - MANAGEMENT OF INAPPROPRIATE CLIENT BEHAVIOR

Current through Register Vol. 13, July 5, 2024
(1) 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 the provisions of
				ARM 37.106.2139, and must:
(a) specify all facility-approved
				interventions to manage inappropriate client behavior;
(b) designate these interventions on a
				hierarchy to be implemented, ranging from most positive or least intrusive, to
				least positive or most intrusive;
(c) ensure, prior to the use of more
				restrictive techniques, that the client's record documents that programs
				incorporating the use of less intrusive or more positive techniques have been
				tried systematically and demonstrated to be ineffective; and
(d) address the following:
(i) the use of secured units;
(ii) the use of observation and seclusion
				rooms;
(iii) the use of physical
				restraints;
(iv) the use of time
				out procedures;
(v) the use of
				appropriate medication to manage inappropriate behavior;
(vi) the application of painful or noxious
				stimuli;
(vii) the staff members
				who may authorize the use of specified interventions; and
(viii) a mechanism for monitoring and
				controlling the use of such interventions.
Administrative Rules of Montana › Department 37 - PUBLIC HEALTH AND HUMAN SERVICES › Chapter 37.106 - HEALTH CARE FACILITIES › Subchapter 37.106.21 - Intermediate Care Facilities for the Developmental Disabled ( ICF /DD) › Rule 37.106.2144 - OBSERVATION AND SECLUSION ROOMS

Current through Register Vol. 13, July 5, 2024
(1) 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:
(a) The placement is required because of an
				emergency situation requiring immediate action or for other therapeutic
				purposes.
(b) The client is under
				the direct constant visual supervision of designated staff.
(c) The door to the room may be locked. The
				lock must comply with the standards for locks in ARM
				37.106.2163(9).
(d) A licensed professional shall examine the
				client and provide written approval within the first three hours of placement
				unless the client has a long history of episodic violence. In these cases the
				examination and approval shall be obtained within the first 12 hours of
				placement.
Administrative Rules of Montana › Department 37 - PUBLIC HEALTH AND HUMAN SERVICES › Chapter 37.106 - HEALTH CARE FACILITIES › Subchapter 37.106.21 - Intermediate Care Facilities for the Developmental Disabled ( ICF /DD) › Rule 37.106.2145 - PHYSICAL RESTRAINTS

Current through Register Vol. 13, July 5, 2024
(1) The facility
				may employ physical restraint only as allowed in
				53-20-146,
				MCA and only as:
(a) an emergency measure,
				but only if absolutely necessary to protect the client or others from injury;
				or
(b) a health-related protection
				prescribed by a physician, but only if absolutely necessary during the conduct
				of a specific medical or surgical procedure, or only if absolutely necessary
				for client protection during the time that a medical condition
				exists.
Administrative Rules of Montana › Department 37 - PUBLIC HEALTH AND HUMAN SERVICES › Chapter 37.106 - HEALTH CARE FACILITIES › Subchapter 37.106.21 - Intermediate Care Facilities for the Developmental Disabled ( ICF /DD) › Rule 37.106.2146 - DRUG USAGE

Current through Register Vol. 13, July 5, 2024
(1) 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 the behaviors for which the drugs are employed.
(2) Drugs used for control of inappropriate
				behavior must not be used until it can be justified that the harmful effects of
				the behavior clearly outweigh the potentially harmful effects of the
				drugs.
(3) Drugs used for control
				of inappropriate behavior must be monitored closely, in conjunction with the
				physician and the drug regimen review requirement at ARM
				37.106.2153, for desired responses
				and adverse consequences by facility staff.
Sec.
					 50-5-103
					 and
					 50-5-238,
					 MCA; IMP, Sec.
					 53-5-103,
					 50-5-201 and
					 50-5-238,
					 MCA;
Administrative Rules of Montana › Department 37 - PUBLIC HEALTH AND HUMAN SERVICES › Chapter 37.106 - HEALTH CARE FACILITIES › Subchapter 37.106.21 - Intermediate Care Facilities for the Developmental Disabled ( ICF /DD) › Rule 37.106.2150 - HEALTH CARE AND PHYSICIAN SERVICES

Current through Register Vol. 13, July 5, 2024
(1) The
				facility must ensure the availability of physician services 24 hours a
				day.
(2) The physician must
				develop, in coordination with licensed nursing personnel, a medical care plan
				of treatment for a client if the physician determines that an individual client
				requires 24 hour licensed nursing care. This plan must be integrated in the
				individual treatment plan.
(3) The
				facility must provide or obtain preventive and general medical care as well as
				annual physical examinations of each client that at a minimum include the
				following:
(a) evaluation of vision and
				hearing;
(b) immunizations, using
				as a guide the recommendations of the public health service advisory committee
				on immunization practices or of the committee on the control of infectious
				diseases of the American academy of pediatrics;
(c) routine screening laboratory examinations
				as determined necessary by the physician, and special studies when needed;
				and
(d) tuberculosis control,
				appropriate to the facility's population, and in accordance with the
				recommendations of the American college of chest physicians or the rule of
				diseases of the chest of the American academy of pediatrics, or both.
Administrative Rules of Montana › Department 37 - PUBLIC HEALTH AND HUMAN SERVICES › Chapter 37.106 - HEALTH CARE FACILITIES › Subchapter 37.106.21 - Intermediate Care Facilities for the Developmental Disabled ( ICF /DD) › Rule 37.106.2151 - NURSING SERVICES AND STAFF

Current through Register Vol. 13, July 5, 2024
(1) The
				facility must provide each client with nursing services in accordance with
				their needs, including:
(a) participation as
				appropriate in the development, review, and update of an individual treatment
				plan as part of the interdisciplinary team process;
(b) the development, with a physician, of a
				medical care plan of treatment for a client when the physician has determined
				that an individual client requires such a plan;
(c) for each client who is certified as not
				needing a medical care plan, a review of their health status which must:
(i) be by a direct physical
				examination;
(ii) be by a licensed
				nurse;
(iii) be on a quarterly or
				more frequent basis depending on client need;
(iv) be recorded in the client's record;
				and
(v) result in any necessary
				action (including referral to a physician to address client health problems)
				;
(d) other nursing care
				as prescribed by the physician or as identified by client needs; and
(e) implementation of appropriate protective
				and preventive health measures that include, but are not limited to:
(i) training any client and staff as needed
				in appropriate health and hygiene methods;
(ii) control of communicable diseases and
				infections, including the instruction of other personnel in methods of
				infection control; and
(iii)
				training of direct care staff in detecting signs and symptoms of illness or
				dysfunction, first aid for accidents or illness, and basic skills required to
				meet the health needs of the client.
Administrative Rules of Montana › Department 37 - PUBLIC HEALTH AND HUMAN SERVICES › Chapter 37.106 - HEALTH CARE FACILITIES › Subchapter 37.106.21 - Intermediate Care Facilities for the Developmental Disabled ( ICF /DD) › Rule 37.106.2152 - DENTAL SERVICES AND TREATMENT

Current through Register Vol. 13, July 5, 2024
(1) 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 in-house or through arrangement.
(2) If appropriate, dental professionals must
				participate in the development, review and update of an individual treatment
				plan as part of the interdisciplinary process either in person or through
				written report to the interdisciplinary team.
(3) The facility must provide education and
				training in the maintenance of oral health.
(4) Comprehensive dental diagnostic services
				must include:
(a) a complete extraoral and
				intraoral examination, using all diagnostic aids necessary to properly evaluate
				the client's oral condition, not later than one month after admission to the
				facility (unless the examination was completed within 12 months before
				admission) ;
(b) periodic
				examination and diagnosis performed at least annually, including radiographs
				when indicated and detection of manifestations of systemic disease;
				and
(c) a review of the results of
				examination and entry of the results in the client's dental record.
Administrative Rules of Montana › Department 37 - PUBLIC HEALTH AND HUMAN SERVICES › Chapter 37.106 - HEALTH CARE FACILITIES › Subchapter 37.106.21 - Intermediate Care Facilities for the Developmental Disabled ( ICF /DD) › Rule 37.106.2153 - PHARMACY SERVICES AND DRUG REGIMEN REVIEW

Current through Register Vol. 13, July 5, 2024
(1) 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 maintain a licensed
				pharmacy.
(2) A pharmacist with
				input from the interdisciplinary team must review the drug regimen of each
				client at least quarterly, and:
(a) report
				any irregularities in the client's drug regimen to the prescribing physician
				and interdisciplinary team; and
(b)
				prepare a record of each client's drug regimen reviews which must be maintained
				by the facility.
Administrative Rules of Montana › Department 37 - PUBLIC HEALTH AND HUMAN SERVICES › Chapter 37.106 - HEALTH CARE FACILITIES › Subchapter 37.106.21 - Intermediate Care Facilities for the Developmental Disabled ( ICF /DD) › Rule 37.106.2154 - DRUG ADMINISTRATION, STORAGE, AND RECORDKEEPING

Current through Register Vol. 13, July 5, 2024
(1) 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:
(a) all drugs are administered in compliance
				with the physician's orders;
(b)
				all drugs, including those that are self-administered, are administered without
				error;
(c) each client is taught
				how to administer their own medications if the interdisciplinary team
				determines that self-administration of medications is an appropriate objective,
				and if the physician does not specify otherwise;
(d) the client's physician is informed of the
				interdisciplinary team's decision that self-administration of medications is an
				objective for the client;
(e) no
				client self-administers medications until he or she demonstrates the competency
				to do so;
(f) drugs used by any
				client while not under the direct care of the facility are packaged and labeled
				in accordance with Montana law; and
(g) drug administration errors and adverse
				drug reactions are recorded and reported immediately to a physician.
Administrative Rules of Montana › Department 37 - PUBLIC HEALTH AND HUMAN SERVICES › Chapter 37.106 - HEALTH CARE FACILITIES › Subchapter 37.106.21 - Intermediate Care Facilities for the Developmental Disabled ( ICF /DD) › Rule 37.106.2160 - LABORATORY SERVICES

Current through Register Vol. 13, July 5, 2024
(1) If a facility
				chooses to provide laboratory services, the laboratory must meet the
				requirements specified in 42 CFR part 493.
(2) If the laboratory chooses to refer
				specimens for testing to another laboratory, the referral laboratory must be
				certified in the appropriate specialties and subspecialities of service in
				accordance with the requirements of 42 CFR part 493.
Sec.
					 50-5-103
					 and
					 50-5-238,
					 MCA; IMP, Sec.
					 53-5-103,
					 50-5-201 and
					 50-5-238,
					 MCA;
Administrative Rules of Montana › Department 37 - PUBLIC HEALTH AND HUMAN SERVICES › Chapter 37.106 - HEALTH CARE FACILITIES › Subchapter 37.106.21 - Intermediate Care Facilities for the Developmental Disabled ( ICF /DD) › Rule 37.106.2161 - PHYSICAL ENVIRONMENT

Current through Register Vol. 13, July 5, 2024
(1) The facility
				must not:
(a) 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
(b) segregate the client solely on the basis
				of their physical disabilities. It must integrate the client who has ambulation
				deficits or who is deaf, blind, or has a seizure disorder, etc., with others of
				comparable social and intellectual development.
Administrative Rules of Montana › Department 37 - PUBLIC HEALTH AND HUMAN SERVICES › Chapter 37.106 - HEALTH CARE FACILITIES › Subchapter 37.106.21 - Intermediate Care Facilities for the Developmental Disabled ( ICF /DD) › Rule 37.106.2162 - EMERGENCY PLAN AND PROCEDURES

Current through Register Vol. 13, July 5, 2024
(1) 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.
(2) The facility
				must communicate, periodically review, make the plan available and provide
				training to the staff.
(3) The
				facility must hold evacuation drills at least quarterly for each shift of
				personnel and under varied conditions to:
(a)
				ensure that all personnel on all shifts are trained to perform assigned
				tasks;
(b) ensure that all
				personnel on all shifts are familiar with the use of the facility's fire
				protection features; and
(c)
				evaluate the effectiveness of emergency and disaster plans and
				procedures.
Administrative Rules of Montana › Department 37 - PUBLIC HEALTH AND HUMAN SERVICES › Chapter 37.106 - HEALTH CARE FACILITIES › Subchapter 37.106.21 - Intermediate Care Facilities for the Developmental Disabled ( ICF /DD) › Rule 37.106.2163 - SECURED UNITS

Current through Register Vol. 13, July 5, 2024
(1) A secured unit
				within a facility shall have a written policy outlining resident admission
				criteria, transfer criteria and discharge criteria for the secured
				unit.
(2) Provisions should be made
				for secured unit residents to access large group activities when provided by
				the facility, e.g., holiday activities, etc. except as contraindicated by
				factors identified within their individual treatment plans.
(3) A secured unit within a facility is
				considered a separate unit. A staff station shall be located within the secured
				unit. The station shall provide at a minimum the following:
(a) provisions for charting;
(b) provisions for hand washing;
(c) provisions for medication storage and
				preparation;
(d) telephone access;
				and
(e) a nurse/staff call system
				as required by the "Guidelines for the Construction and Equipment of Hospital
				and Medical Facilities", as adopted in ARM
				37.106.302.
Administrative Rules of Montana › Department 37 - PUBLIC HEALTH AND HUMAN SERVICES › Chapter 37.106 - HEALTH CARE FACILITIES › Subchapter 37.106.21 - Intermediate Care Facilities for the Developmental Disabled ( ICF /DD) › Rule 37.106.2164 - FIRE PROTECTION

Current through Register Vol. 13, July 5, 2024
(1) 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 ), 2000 edition, which is incorporated by reference. A copy of the LSC,
				2000 edition, may be obtained from the National Fire Protection Association,
				Batterymarch Park, Quincy, MA 02269.
(a) The
				department may apply a single chapter of the LSC to the entire facility or may
				apply different chapters to different buildings or parts of buildings as
				permitted by the LSC.
(b) A
				facility that meets the LSC definition of a residential board and care
				occupancy and that has 16 or fewer beds must have its evacuation capability
				evaluated in accordance with the Evacuation Difficulty Index of the LSC
				(Appendix F).
Administrative Rules of Montana › Department 37 - PUBLIC HEALTH AND HUMAN SERVICES › Chapter 37.106 - HEALTH CARE FACILITIES › Subchapter 37.106.21 - Intermediate Care Facilities for the Developmental Disabled ( ICF /DD) › Rule 37.106.2170 - INFECTION CONTROL

Current through Register Vol. 13, July 5, 2024
(1) 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.
(2) The facility must implement successful
				corrective action in affected problem areas.
(3) The facility must maintain a record of
				incidents and corrective actions related to infections.
(4) The facility must prohibit employees with
				symptoms or signs of a communicable disease from direct contact with the client
				and their food.
(5) All staff shall
				use the proper hand washing techniques after providing direct care to a
				resident.
Sec.
					 50-5-103
					 and
					 50-5-238,
					 MCA; IMP, Sec.
					 53-5-103,
					 50-5-201 and
					 50-5-238,
					 MCA;
Administrative Rules of Montana › Department 37 - PUBLIC HEALTH AND HUMAN SERVICES › Chapter 37.106 - HEALTH CARE FACILITIES › Subchapter 37.106.21 - Intermediate Care Facilities for the Developmental Disabled ( ICF /DD) › Rule 37.106.2171 - DIETETIC SERVICES

Current through Register Vol. 13, July 5, 2024
(1) Each client
				must receive a nourishing, well-balanced diet including modified and
				specially-prescribed diets.
(2) A
				qualified dietitian must be employed either full-time, part-time or on a
				consultant basis at the facility's discretion.
(3) If a qualified dietitian is not employed
				full-time, the facility must designate a person to serve as the director of
				food services.
(4) The client's
				interdisciplinary team, including a qualified dietitian and physician, must
				prescribe all modified and special diets including those used as a part of a
				treatment to manage inappropriate client behavior.
(5) Foods proposed for use as a primary
				reinforcement of adaptive behavior are evaluated in light of the client's
				nutritional status and needs.
(6)
				Unless otherwise specified by medical needs, the diet must be prepared at least
				in accordance with the "Nutrition and Your Health: Dietary Guidelines for
				Americans", 2000, 5th edition of the recommended dietary allowances published
				by the Food and Nutrition Board of the National Research Council, National
				Academy of Sciences, adjusted for age, sex, disability and activity.
(7) Each client must receive at least three
				meals daily, at regular times comparable to normal mealtimes in the community
				with:
(a) not more than 14 hours between a
				substantial evening meal and breakfast of the following day, except on weekends
				and holidays when a nourishing snack is provided at bedtime, 16 hours may
				elapse between a substantial evening meal and breakfast; and
(b) not less than 10 hours between breakfast
				and the evening meal of the same day.
Administrative Rules of Montana › Department 37 - PUBLIC HEALTH AND HUMAN SERVICES › Chapter 37.106 - HEALTH CARE FACILITIES › Subchapter 37.106.21 - Intermediate Care Facilities for the Developmental Disabled ( ICF /DD) › Rule 37.106.2180 - FACILITY FAIR HEARING

Current through Register Vol. 13, July 5, 2024
(1) A facility has
				the right to appeal licensure decisions as outlined in
				50-5-208,
				MCA.
(2) The department shall
				follow the hearing procedure for fair hearings as outlined at ARM
				37.5.117.
Sec.
					 50-5-103
					 and
					 50-5-238,
					 MCA; IMP, Sec.
					 53-5-103,
					 50-5-201 and
					 50-5-238,
					 MCA;
Administrative Rules of Montana › Department 37 - PUBLIC HEALTH AND HUMAN SERVICES › Chapter 37.106 - HEALTH CARE FACILITIES › Subchapter 37.106.22 - Residential Treatment Facilities › Rule 37.106.2201 - RESIDENTIAL TREATMENT FACILITY: APPLICATION OF OTHER RULES

Current through Register Vol. 13, July 5, 2024
(1) 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.
AND HUMAN SERVICES
Sec.
					 50-5-103,
					 MCA; IMP, Sec.
					 50-5-103
					 and
					 50-5-201,
					 MCA;
Administrative Rules of Montana › Department 37 - PUBLIC HEALTH AND HUMAN SERVICES › Chapter 37.106 - HEALTH CARE FACILITIES › Subchapter 37.106.22 - Residential Treatment Facilities › Rule 37.106.2202 - RESIDENTIAL TREATMENT FACILITY: LICENSURE STANDARDS

Current through Register Vol. 13, July 5, 2024
(1) A residential treatment facility must
				meet the requirements of the following:
(a)
				the standards for the following categories, contained in the Joint Commission
				on Accreditation of Health Care Organizations' 2017 Comprehensive Accreditation
				Manual for Behavioral Health Care:
(i) Care,
				Treatment, and Services (CTS);
(ii)
				Environment of Care (EC);
(iii)
				Emergency Management (EM);
(iv)
				Human Resource Management (HRM);
(v) Infection, Prevention and Control
				(IC);
(vi) Leadership
				(LD);
(vii) Life Safety
				(LS);
(viii) Medication Management
				(MM);
(ix) National Patient Safety
				Goals (NPSG);
(x) Performance
				Improvement (PI);
(xi) Record of
				Care, Treatment, and Services (RC);
(xii) Rights and Responsibility of the
				Individual (RI); and
(xiii) Waived
				Testing (WT).