Administrative Rules of Montana › Department 37 - PUBLIC HEALTH AND HUMAN SERVICES › Chapter 37.106 - HEALTH CARE FACILITIES › Subchapter 37.106.18 - Licensure of Specialty Mental Health Facilities › Rule 37.106.1851 - SPECIALTY MENTAL HEALTH FACILITY: ADMISSION PROCEDURES

Current through Register Vol. 13, July 5, 2024
(1) A specialty mental health facility must
				develop, maintain, and implement admission procedures designed to ensure that
				no client is admitted prior to the facility's documented determination of its
				ability to meet the needs of the client based on a documented appraisal of the
				client's individual service needs.
(2) The facility must assign a psychiatrist
				licensed in Montana to admit all patients according to a defined set of
				admission criteria based upon the Diagnostic and Statistical Manual III-R (DSM
				III-R) of the American Psychiatric Association and may admit only those
				patients whose mental health conditions are associated with addictions related
				to eating disorders (codes 307.10, 307.50, 307.51, 307.52, and 307.53 in the
				DSM III-R), pathological gambling (code 312.31 in the DSM III-R), or sexual
				disorders (codes 302.20, 302.30, 302.40, 302.71, 302.72, 302.79, 302.81,
				302.82, 302.83, 302.84, 302.89, and 302.90 in the DSM III-R).
(3) Whenever a patient is admitted to the
				facility by a physician other than a psychiatrist, the facility must assure
				that the physician consults with the facility psychiatrist, by phone or
				otherwise, within 12 hours after admission, that a written notation of that
				consultation and the psychiatrist approval of the admission for a mental health
				condition or suspected mental health condition is made and kept in the
				patient's records, and that a psychiatric evaluation is conducted in accordance
				with the standards in (4) below prior to admission.
(4) Each patient must receive a psychiatric
				evaluation that must be completed by a psychiatrist licensed in Montana prior
				to admission unless (5) below applies; include a medical history; contain a
				record of mental status; note the onset of illness and the circumstances
				leading to admission; describe attitudes and behavior; estimate intellectual
				functioning, and orientation; and include an inventory of the patient's assets
				in descriptive rather than interpretive fashion.
(5) If an individual seeks admission or is
				referred to the facility outside of the hours of 6:00 a.m. to 7:00 p.m., Monday
				through Friday, or during national holidays, then the facility may allow that
				person temporary occupancy under the direction of a Montana licensed physician
				or Montana licensed psychiatrist until the psychiatric evaluation can be
				conducted during the facility's next regularly scheduled business
				day.
(6) If an individual is
				referred to the facility by a licensed psychiatrist or licensed physician who
				is not affiliated with the facility, the psychiatric evaluation must still be
				completed by the facility's staff psychiatrist within the time frame otherwise
				prescribed for such an evaluation. If a psychiatric evaluation has been
				conducted by a Montana-licensed psychiatrist not affiliated with the facility,
				the staff psychiatrist must review and approve the evaluation and note such
				review and approval in the patient's records.
(7) When indicated, a complete neurological
				examination must be conducted within 72 hours of admission.
(8) A licensed physician must conduct a
				physical examination of each patient within 24 hours after or seven days prior
				to that patient's admission.
(9)
				The department hereby incorporates by reference codes 302.20, 302.30, 302.40,
				302.71, 302.72, 302.79, 302.81, 302.82, 302.83, 302.84, 302.89, 302.90, 307.10,
				307.50, 307.51, 307.52, 307.53, and 312.31 of the DSM III-R of the American
				Psychiatric Association, which contain descriptions of various diagnoses of
				mental disorders associated with eating disorders, pathological gambling, and
				sexual disorders. A copy of the manual may be obtained from the American
				Psychiatric Association, 1700 18th Street NW, Washington, D.C. 20009.
Sec.
					 50-5-103,
					 MCA; IMP, Sec.
					 50-5-103,
					 MCA;