reglab/statecodes huggingface dataset:
Administrative Rules of Montana › Department 37 - PUBLIC HEALTH AND HUMAN SERVICES › Chapter 37.106 - HEALTH CARE FACILITIES › Subchapter 37.106.3 - Construction and Minimum Standards for All Health Care Facilities › Rule 37.106.310 - LICENSING: PROCEDURE FOR OBTAINING A LICENSE: ISSUANCE AND RENEWAL OF A LICENSE

Current through Register Vol. 13, July 5, 2024
(1) A completed
				license application form must be submitted to the department.
(a) The application must be obtained from the
				department.
(b) The administrator or
				designee of the health care facility must sign the completed license
				application form.
Administrative Rules of Montana › Department 37 - PUBLIC HEALTH AND HUMAN SERVICES › Chapter 37.106 - HEALTH CARE FACILITIES › Subchapter 37.106.3 - Construction and Minimum Standards for All Health Care Facilities › Rule 37.106.311 - MINIMUM STANDARDS FOR ALL HEALTH CARE FACILITIES: FOOD SERVICE ESTABLISHMENTS (REPEALED)

Current through Register Vol. 13, July 5, 2024
50-5-103,
					 50-5-404,
					 MCA; IMP,
					 50-5-103,
					 50-5-204,
					 50-5-404,
					 MCA;
Administrative Rules of Montana › Department 37 - PUBLIC HEALTH AND HUMAN SERVICES › Chapter 37.106 - HEALTH CARE FACILITIES › Subchapter 37.106.3 - Construction and Minimum Standards for All Health Care Facilities › Rule 37.106.312 - MINIMUM STANDARDS FOR ALL HEALTH CARE FACILITIES: BLOOD BANK AND TRANSFUSION SERVICES (REPEALED)

Current through Register Vol. 13, July 5, 2024
Sec.
					 50-5-103
					 and
					 50-5-404,
					 MCA; IMP, Sec.
					 50-5-103,
					 50-5-204
					 and
					 50-5-404,
					 MCA;
Administrative Rules of Montana › Department 37 - PUBLIC HEALTH AND HUMAN SERVICES › Chapter 37.106 - HEALTH CARE FACILITIES › Subchapter 37.106.3 - Construction and Minimum Standards for All Health Care Facilities › Rule 37.106.313 - MINIMUM STANDARDS FOR ALL HEALTH CARE FACILITIES: COMMUNICABLE DISEASE CONTROL

Current through Register Vol. 13, July 5, 2024
(1) All health care
				facilities shall develop and implement an infection prevention and control
				program. At a minimum, the facility must develop, implement, and review, at
				least annually, written policies and procedures regarding infection prevention
				and control which must include but are not limited to:
(a) procedures to identify high risk
				individuals; and
(b) the
				identification of methods used to protect, contain, or minimize the risk to
				patients, residents, staff, and visitors.
Administrative Rules of Montana › Department 37 - PUBLIC HEALTH AND HUMAN SERVICES › Chapter 37.106 - HEALTH CARE FACILITIES › Subchapter 37.106.3 - Construction and Minimum Standards for All Health Care Facilities › Rule 37.106.314 - MINIMUM STANDARDS FOR ALL HEALTH CARE FACILITIES: MEDICAL RECORDS

Current through Register Vol. 13, July 5, 2024
(1) A health care facility must initiate and
				maintain a safe, secure, and confidential medical record for each patient,
				resident, or client.
(2) A health
				care facility, excluding a hospital, shall retain a patient's, resident's, or
				client's medical records for no less than six years following the date of the
				patient's, resident's, or client's discharge or death, or upon the closure of
				the facility.
50-5-103,
					 MCA; IMP,
					 50-5-103,
					 50-5-106,
					 50-5-204,
					 MCA;
Administrative Rules of Montana › Department 37 - PUBLIC HEALTH AND HUMAN SERVICES › Chapter 37.106 - HEALTH CARE FACILITIES › Subchapter 37.106.3 - Construction and Minimum Standards for All Health Care Facilities › Rule 37.106.315 - MINIMUM STANDARDS FOR ALL HEALTH CARE FACILITIES: EMPLOYEE FILES

Current through Register Vol. 13, July 5, 2024
(1) The facility is responsible for
				maintaining a file on each employee and substitute personnel. Employee files
				may be inspected by the department at any time. If the file is not maintained
				at the facility it must be available to the department within 24 hours of
				request.
(2) At a minimum, the
				employee file must contain:
(a) the
				employee's name;
(b) a job
				description signed by the employee;
(c) documentation of employee orientation,
				signed by the employee; and
(d) a
				copy of current credentials, certification, or professional licenses required
				to perform the duties described in the job description.
Administrative Rules of Montana › Department 37 - PUBLIC HEALTH AND HUMAN SERVICES › Chapter 37.106 - HEALTH CARE FACILITIES › Subchapter 37.106.3 - Construction and Minimum Standards for All Health Care Facilities › Rule 37.106.316 - MINIMUM STANDARDS FOR ALL HEALTH CARE FACILITIES: SECURED CARE UNIT WITHIN A LICENSED LONG-TERM HEALTH CARE FACILITY

Current through Register Vol. 13, July 5, 2024
(1) All rules in this subchapter apply to
				secured care units.
(2) Special
				locking arrangements as specified in the "NFPA 101: Life Safety Code Handbook",
				2012 Edition must be utilized, or an acceptable alternative is based on an
				equivalency for the automatically releasing, panic hardware required by section
				7.2.1.6.1 of the "NFPA 101: Life Safety Code Handbook", 2012 Edition. Where
				local authorities having jurisdiction allow, the following conditions apply to
				this alternative:
(a) All locks must be
				electromagnetic. The use of mechanical locks, such as a deadbolt is not
				permitted;
(b) All of the secured
				doors must have a manual electronic keypad release. The keypad must release the
				lock(s) on the door(s) after entry of the proper code sequence;
(c) The code sequence must be posted in the
				vicinity of each keypad and may be inconspicuous;
(d) Provisions must be made for the rapid
				removal of occupants by such reliable means as the remote control of the locks.
				Typically this is done by placing a staff-accessible switch at the nurse's
				station which is capable of releasing all doors; and
(e) All the locks on all secured doors must
				automatically release upon any of the following conditions:
(i) the actuation of the approved supervised
				automatic fire alarm system;
(ii)
				the actuation of an approved supervised automatic sprinkler system;
				and
(iii) upon the loss of power
				controlling the lock(s) or locking mechanism.
Administrative Rules of Montana › Department 37 - PUBLIC HEALTH AND HUMAN SERVICES › Chapter 37.106 - HEALTH CARE FACILITIES › Subchapter 37.106.3 - Construction and Minimum Standards for All Health Care Facilities › Rule 37.106.320 - MINIMUM STANDARDS FOR ALL HEALTH CARE FACILITIES: PHYSICAL PLANT AND EQUIPMENT MAINTENANCE

Current through Register Vol. 13, July 5, 2024
(1) Each facility
				must have a written maintenance program describing the procedures to keep the
				building, grounds, and equipment in good repair and free from
				hazards.
(2) A health care facility
				must provide housekeeping services on a daily basis.
(3) All electrical, mechanical, plumbing,
				fire protection, heating, and sewage disposal systems must be kept in
				operational condition.
(4) Floors
				must be kept clean and in good repair at all times.
(5) Walls and ceilings must be kept in good
				repair and be of a finish that can be easily cleaned.
(6) Every facility must be kept clean and
				free of odors. Deodorants may not be used for odor control in lieu of proper
				ventilation.
(7) The temperature of
				hot water supplied to handwashing and bathing facilities must not exceed
				120°F.
50-5-103,
					 MCA; IMP,
					 50-5-103,
					 50-5-204,
					 MCA;
Administrative Rules of Montana › Department 37 - PUBLIC HEALTH AND HUMAN SERVICES › Chapter 37.106 - HEALTH CARE FACILITIES › Subchapter 37.106.3 - Construction and Minimum Standards for All Health Care Facilities › Rule 37.106.321 - MINIMUM STANDARDS FOR ALL HEALTH CARE FACILITIES: ENVIRONMENTAL CONTROL

Current through Register Vol. 13, July 5, 2024
(1) A health care facility must be
				constructed and maintained so as to prevent entrance and harborage of rats,
				mice, insects, flies, or other vermin.
(2) Hand cleansing soap or detergent and
				individual towels must be available at each lavatory in the facility. A waste
				receptacle must be located near each lavatory.
(3) Cleaners used to clean bathtubs, showers,
				lavatories, urinals, toilet bowls, toilet seats, and floors must contain
				fungicides or germicides with current EPA registration for that
				purpose.
(4) Cleaning devices used
				for lavatories, toilet bowls, showers, or bathtubs may not be used for other
				purposes. Those tools used to clean toilets or urinals must not be allowed to
				contact other cleaning devices.
(5)
				A minimum of 10 foot-candles of light must be available in all rooms and
				hallways, with the following exceptions:
(a)
				all reading lamps must have a capacity to provide a minimum of 30 foot-candles
				of light;
(b) all toilet and
				bathing areas must be provided with a minimum of 30 foot-candles of
				light;
(c) general lighting in food
				preparation areas must be a minimum of 50 foot-candles of light; and
(d) hallways must be illuminated at all times
				by at least a minimum of five foot-candles of light at the floor.
Administrative Rules of Montana › Department 37 - PUBLIC HEALTH AND HUMAN SERVICES › Chapter 37.106 - HEALTH CARE FACILITIES › Subchapter 37.106.3 - Construction and Minimum Standards for All Health Care Facilities › Rule 37.106.322 - MINIMUM STANDARDS FOR ALL HEALTH CARE FACILITIES: DISASTER PLAN

Current through Register Vol. 13, July 5, 2024
(1) All health care facilities must develop a
				written disaster plan as follows:
(a) skilled
				nursing facilities (long-term care), outpatient centers for primary care,
				outpatient centers for surgical services, critical access hospitals, hospitals,
				residential hospice facilities, inpatient hospice facilities, and infirmaries
				must develop a written disaster plan in conjunction with other emergency
				services in the community;
(b)
				these procedures must be developed such that they can be followed in the event
				of a natural or man-caused disaster.
Administrative Rules of Montana › Department 37 - PUBLIC HEALTH AND HUMAN SERVICES › Chapter 37.106 - HEALTH CARE FACILITIES › Subchapter 37.106.3 - Construction and Minimum Standards for All Health Care Facilities › Rule 37.106.330 - MINIMUM STANDARDS FOR ALL HEALTH CARE FACILITIES: WRITTEN POLICY AND PROCEDURE

Current through Register Vol. 13, July 5, 2024
(1) A current
				written policy and procedure manual that describes all services provided in the
				health care facility must be developed, implemented, and maintained at the
				facility. The manual must be available to staff, residents, resident family
				members, resident legal representatives, and the department and must be
				complied with by all facility personnel and its agents. Policies and procedures
				must be reviewed at least annually by either the administrator or the medical
				director with written documentation of the review.
50-5-103,
					 MCA; IMP,
					 50-5-103,
					 MCA;
Administrative Rules of Montana › Department 37 - PUBLIC HEALTH AND HUMAN SERVICES › Chapter 37.106 - HEALTH CARE FACILITIES › Subchapter 37.106.3 - Construction and Minimum Standards for All Health Care Facilities › Rule 37.106.331 - MINIMUM STANDARDS FOR ALL HEALTH CARE FACILITIES: LAUNDRY AND BEDDING

Current through Register Vol. 13, July 5, 2024
(1) If a health care facility processes its
				laundry on the facility site, it must:
(a)
				use rooms solely for laundry purposes;
(b) equip the laundry room with at least one
				mechanical washer and hot air tumble dryer, handwashing facilities, mechanical
				ventilation to the outside, a fresh air supply, and a hot water supply system
				which supplies the washer with water of at least 160°F (71°C) during
				each use. If the laundry water temperature is less than 160°F, chemicals
				and detergent suitable to the water temperature and the manufacturer's
				recommended product time of exposure must be utilized.
(c) sort and store soiled laundry in an area
				separate from that used to sort and store clean laundry;
(d) provide well maintained carts or other
				containers impervious to moisture to transport laundry, keeping those used for
				soiled laundry separate from those used for clean laundry;
(e) dry all bed linen, towels, and washcloths
				in a manner that protects against contamination;
(f) protect clean laundry from contamination;
				and
(g) ensure that facility staff
				handling laundry cover their clothes while working with soiled laundry, use
				separate clean covering for their clothes while handling clean laundry, and
				wash their hands both after working with soiled laundry and before they handle
				clean laundry.
Administrative Rules of Montana › Department 37 - PUBLIC HEALTH AND HUMAN SERVICES › Chapter 37.106 - HEALTH CARE FACILITIES › Subchapter 37.106.4 - Minimum Standards for a Hospital › Rule 37.106.401 - MINIMUM STANDARDS FOR A HOSPITAL: GENERAL REQUIREMENTS

Current through Register Vol. 13, July 5, 2024
(1) A hospital shall comply with the
				Conditions of Participation for Hospitals in 42 CFR subchapter G part
				482.
(2) If a hospital provides
				skilled nursing care or intermediate nursing care, as those levels of care are
				defined in
				50-5-101,
				MCA, the hospital shall comply with the skilled nursing facility requirements
				listed in 42 CFR subchapter G part 483.
(3) The department adopts and incorporates by
				reference 42 CFR subchapter G part 482 and 42 CFR subchapter G part 483. 42 CFR
				subchapter G part 482 sets forth the conditions of participation a hospital
				must meet to participate in the Medicare Program. 42 CFR subchapter G part 483
				sets forth the skilled nursing facility requirements a hospital provider of
				long term care services must meet to participate in the Medicare Program. A
				copy of the regulations may be obtained from the Department of Public Health
				and Human Services, Office of Inspector General, 2401 Colonial Drive, P.O. Box
				202953, Helena, MT 59620-2953.
AUTH:
					 50-5-103,
					 50-5-404,
					 MCA; IMP:
					 50-5-103,
					 50-5-204,
					 50-5-404,
					 MCA
Administrative Rules of Montana › Department 37 - PUBLIC HEALTH AND HUMAN SERVICES › Chapter 37.106 - HEALTH CARE FACILITIES › Subchapter 37.106.4 - Minimum Standards for a Hospital › Rule 37.106.402 - MINIMUM STANDARDS FOR A HOSPITAL: MEDICAL RECORDS

Current through Register Vol. 13, July 5, 2024
Medical records shall comply with the following
				  requirements:
(1) A patient's entire
				medical record must be maintained, in either its original form or that allowed
				by ARM 37.106.314(3),
				for not less than 10 years following the date of a patient's discharge or
				death, or, in the case of a patient who is a minor, for not less than 10 years
				following the date the patient either attains the age of majority or dies, if
				earlier.
(2) An obstetrical record
				shall be developed for each maternity patient and must include the prenatal
				record, labor notes, obstetrical anesthesia notes and delivery
				record.
(3) A record must be
				developed for each newborn, and shall include, in addition to the information
				in (2), the following information:
(a)
				observations of newborn after birth;
(b) delivery room care of newborn;
(c) physical examinations performed on
				newborn;
(d) temperature of
				newborn;
(e) weight of
				newborn;
(f) time of newborn's
				first urination;
(g) number,
				character and consistency of newborn's stool;
(h) type of feeding administered to
				newborn;
(i) phenylketonuria report
				for newborn;
(j) name of person to
				whom newborn is released.
Administrative Rules of Montana › Department 37 - PUBLIC HEALTH AND HUMAN SERVICES › Chapter 37.106 - HEALTH CARE FACILITIES › Subchapter 37.106.4 - Minimum Standards for a Hospital › Rule 37.106.403 - MINIMUM STANDARDS FOR A HOSPITAL: HOSPITAL RECORDS

Current through Register Vol. 13, July 5, 2024
(1) Hospital records must be
				maintained.
Sec.
					 50-5-103
					 and
					 50-5-404,
					 MCA; IMP, Sec.
					 50-5-103,
					 50-5-106
					 and
					 50-5-404,
					 MCA;
Administrative Rules of Montana › Department 37 - PUBLIC HEALTH AND HUMAN SERVICES › Chapter 37.106 - HEALTH CARE FACILITIES › Subchapter 37.106.4 - Minimum Standards for a Hospital › Rule 37.106.404 - MINIMUM STANDARDS FOR A HOSPITAL: LABORATORIES

Current through Register Vol. 13, July 5, 2024
(1) A hospital laboratory shall comply with
				the Conditions for Coverage of Services of Independent Laboratories as set
				forth in 42 CFR 405.1310, 405.1311, 405.1314, 405.1316, and 405.1317. A copy of
				the cited rules is available at the Department of Public Health and Human
				Services, Quality Assurance Division, 2401 Colonial Drive, P.O. Box 202953,
				Helena, MT 59620-2953.
Sec.
					 50-5-103
					 and
					 50-5-404,
					 MCA; IMP, Sec.
					 50-5-103,
					 50-5-204
					 and
					 50-5-404,
					 MCA;
Administrative Rules of Montana › Department 37 - PUBLIC HEALTH AND HUMAN SERVICES › Chapter 37.106 - HEALTH CARE FACILITIES › Subchapter 37.106.4 - Minimum Standards for a Hospital › Rule 37.106.405 - MINIMUM STANDARDS FOR A HOSPITAL: ORGAN DONATION REQUESTS AND PROTOCOLS

Current through Register Vol. 13, July 5, 2024
(1) This rule is adopted to implement Chapter
				219, Laws of 1987, which amended both the Uniform Anatomical Gift Act, Title
				72, chapter 17, MCA, and the Montana Health Care Facility Licensing Act, Title
				50, chapter 5, part 2, MCA. Sections (2) through (5) of this rule paraphrase
				72-17-211,
				MCA of the Uniform Anatomical Gift Act and are included here to clarify the
				requirements for hospitals in cases of patients who are suitable organ donors.
				For a full text of the Uniform Anatomical Gift Act, reference should be made to
				Title 72, chapter 17, MCA.
(2)
				When, according to generally accepted medical standards, a patient is a
				suitable candidate for donation of body parts as defined in
				72-17-102(8),
				MCA, the hospital administrator or his/her designated representative shall
				communicate to the next-of-kin (as defined in (3) below) the option of donating
				all or any part of the patient's body and of the next-of-kin's option to
				decline. In addition to communicating such options, the hospital administrator
				or his/her designee must also request the next-of-kin to consent to an
				anatomical gift. The foregoing obligations of the administrator must be carried
				out unless the administrator or his/her designee:
(a) has actual notice of opposition to the
				gift by the decedent or the next-of-kin as defined in (3) below; or
(b) has reason to believe that an anatomical
				gift is contrary to the decedent's religious beliefs; or
(c) is aware of medical or emotional
				conditions under which the request would contribute to severe emotional
				distress.
Administrative Rules of Montana › Department 37 - PUBLIC HEALTH AND HUMAN SERVICES › Chapter 37.106 - HEALTH CARE FACILITIES › Subchapter 37.106.4 - Minimum Standards for a Hospital › Rule 37.106.410 - MINIMUM STANDARDS FOR A HOSPITAL: CORONARY CARE UNIT

Current through Register Vol. 13, July 5, 2024
If a hospital provides a coronary care unit, the unit shall
				  comply with the following requirements:
(1) When a patient is cared for in a coronary
				care unit, a licensed registered nurse shall be on duty.
(2) At a minimum, the following equipment and
				supplies must be available in a coronary care unit:
(a) oxygen, oxygen and suction
				apparatus;
(b) defibrillator,
				resuscitator and respirator;
(c)
				emergency drugs;
(d)
				oscilloscope;
(e) heart-rate meter
				with an alarm system;
(f) an
				electrocardiograph which is activated simultaneously with the alarm system and
				which may also be activated manually or at predetermined intervals;
(g) external pacemaker.
Administrative Rules of Montana › Department 37 - PUBLIC HEALTH AND HUMAN SERVICES › Chapter 37.106 - HEALTH CARE FACILITIES › Subchapter 37.106.4 - Minimum Standards for a Hospital › Rule 37.106.411 - MINIMUM STANDARDS FOR A HOSPITAL: INTENSIVE CARE UNIT

Current through Register Vol. 13, July 5, 2024
If a hospital provides an intensive care unit, the unit shall
				  comply with the following requirements:
(1) When a patient is cared for in an
				intensive care unit, a licensed registered nurse shall be on duty.
(2) At a minimum, the following equipment and
				supplies must be available in an intensive care unit:
(a) oxygen, oxygen and suction
				apparatus;
(b) defibrillator,
				resuscitator and respirator;
(c)
				emergency drugs.
Administrative Rules of Montana › Department 37 - PUBLIC HEALTH AND HUMAN SERVICES › Chapter 37.106 - HEALTH CARE FACILITIES › Subchapter 37.106.4 - Minimum Standards for a Hospital › Rule 37.106.420 - MINIMUM STANDARDS FOR A HOSPITAL: OBSTETRICAL SERVICES

Current through Register Vol. 13, July 5, 2024
If a hospital provides obstetrical services, the hospital
				  shall comply with the following requirements:
(1) Obstetrical services must be under the
				supervision of a licensed registered nurse on a 24-hour basis.
(2) A maternity patient shall only be placed
				in a room with other maternity patients. The use of maternity rooms for other
				than maternity patients shall be restricted to noninfected gynecological and
				surgical patients. A maternity patient with infection shall be isolated in a
				separate room outside of the obstetrical service.
(3) An equipped room must be provided for
				each patient in labor.
(4) At least
				one delivery room must be provided.
(5) A delivery record shall be made for a
				maternity patient delivering and include, but not be limited to, the following
				information:
(a) starting time of patient's
				labor;
(b) time of birth of
				patient's newborn;
(c) anesthesia
				used on patient;
(d) whether an
				episiotomy was performed on patient;
(e) whether forceps were used in
				delivery;
(f) names of attending
				physicians;
(g) names of attending
				nurses;
(h) names of all other
				persons attending delivery;
(i) sex
				of the newborn;
(j) time of eye
				prophylactic treatment and name of drug used.
Administrative Rules of Montana › Department 37 - PUBLIC HEALTH AND HUMAN SERVICES › Chapter 37.106 - HEALTH CARE FACILITIES › Subchapter 37.106.4 - Minimum Standards for a Hospital › Rule 37.106.421 - MINIMUM STANDARDS FOR A HOSPITAL: NEWBORN NURSERY

Current through Register Vol. 13, July 5, 2024
If a hospital provides a newborn nursery, the nursery shall
				  comply with the following requirements:
(1) The newborn nursery must be under the
				supervision of a licensed registered nurse on a 24-hour basis.
(2) An individual bassinet must be provided
				for each newborn.
(3) Each newborn
				must have separate equipment and supplies for bathing, dressing and other
				handling.
(4) At least one
				incubator must be provided in the nursery.
(5) Oxygen, oxygen and suction equipment must
				be available and adapted to the size of newborns. When oxygen is administered,
				the concentration within the incubatory and near the newborn's head shall be
				determined by means of a reliable oxygen analyzer. These measurements shall be
				recorded on the newborn's chart.
(6) Formula prepared in the hospital shall be
				prepared by terminal heat method using separate equipment furnished for formula
				preparation.
Sec.
					 50-5-103
					 and
					 50-5-404,
					 MCA; IMP, Sec.
					 50-5-103,
					 50-5-204
					 and
					 50-5-404,
					 MCA;
Administrative Rules of Montana › Department 37 - PUBLIC HEALTH AND HUMAN SERVICES › Chapter 37.106 - HEALTH CARE FACILITIES › Subchapter 37.106.4 - Minimum Standards for a Hospital › Rule 37.106.422 - MINIMUM STANDARDS FOR A HOSPITAL: PEDIATRIC AND ADOLESCENT SERVICES

Current through Register Vol. 13, July 5, 2024
If a hospital provides pediatric and adolescent services, the
				  hospital shall comply with the following requirements:
(1) Pediatric and adolescent services must be
				under the supervision of a licensed registered nurse.
(2) At a minimum pediatric and adolescent
				services shall provide the following:
(a) an
				examination and treatment room with equipment and supplies designed for the
				care of children;
(b) oxygen and
				suction equipment designed for children.
Administrative Rules of Montana › Department 37 - PUBLIC HEALTH AND HUMAN SERVICES › Chapter 37.106 - HEALTH CARE FACILITIES › Subchapter 37.106.4 - Minimum Standards for a Hospital › Rule 37.106.430 - MINIMUM STANDARDS FOR A HOSPITAL: PSYCHIATRIC SERVICES

Current through Register Vol. 13, July 5, 2024
If a hospital provides psychiatric services, the hospital
				  shall comply with the following requirements:
(1) Psychiatric services must be under the
				supervision of a licensed psychiatrist on a 24-hour basis.
(2) Psychiatric service staff must include a
				sufficient number of adjunctive therapists to provide restorative and
				rehabilitation services for the number of patients accommodated.
(3) A licensed registered nurse or a licensed
				practical nurse under the supervision of a registered nurse shall be in charge
				24 hours a day.
Sec.
					 50-5-103
					 and
					 50-5-404,
					 MCA; IMP, Sec.
					 50-5-103,
					 50-5-204
					 and
					 50-5-404,
					 MCA;
Administrative Rules of Montana › Department 37 - PUBLIC HEALTH AND HUMAN SERVICES › Chapter 37.106 - HEALTH CARE FACILITIES › Subchapter 37.106.4 - Minimum Standards for a Hospital › Rule 37.106.440 - MINIMUM STANDARDS FOR A HOSPITAL: RESPIRATORY THERAPY

Current through Register Vol. 13, July 5, 2024
If a hospital provides respiratory therapy, the hospital
				  shall comply with the following requirements:
(1) Respiratory therapy services must be
				under the supervision of a licensed physician appointed from the active medical
				staff.
(2) An internal and external
				quality control program must be provided for all parameters of acid-base
				testing.
(3) Written policies and
				procedures must be developed describing the control measures to be followed in
				order to eliminate the transfer of infection from the use of respiratory
				equipment.
Sec.
					 50-5-103
					 and
					 50-5-404,
					 MCA; IMP, Sec.
					 50-5-103,
					 50-5-204
					 and
					 50-5-404,
					 MCA;
Administrative Rules of Montana › Department 37 - PUBLIC HEALTH AND HUMAN SERVICES › Chapter 37.106 - HEALTH CARE FACILITIES › Subchapter 37.106.5 - Minimum Standards for Outpatient Centers for Surgical Services › Rule 37.106.501 - PURPOSE

Current through Register Vol. 13, July 5, 2024
(1) The purpose of these rules is to
				establish the minimum licensing requirements for the licensure of outpatient
				centers for surgical services.
50-5-103,
					 MCA; IMP,
					 50-5-103,
					 MCA;
Administrative Rules of Montana › Department 37 - PUBLIC HEALTH AND HUMAN SERVICES › Chapter 37.106 - HEALTH CARE FACILITIES › Subchapter 37.106.5 - Minimum Standards for Outpatient Centers for Surgical Services › Rule 37.106.502 - SCOPE

Current through Register Vol. 13, July 5, 2024
(1) For purposes of this subchapter,
				outpatient centers for surgical services include facilities described at
				50-5-101(42),
				MCA.
50-5-103,
					 MCA; IMP,
					 50-5-103,
					 MCA;
Administrative Rules of Montana › Department 37 - PUBLIC HEALTH AND HUMAN SERVICES › Chapter 37.106 - HEALTH CARE FACILITIES › Subchapter 37.106.5 - Minimum Standards for Outpatient Centers for Surgical Services › Rule 37.106.503 - DEFINITIONS

Current through Register Vol. 13, July 5, 2024
(1) "Medical director" means a physician
				licensed under Title 37, chapter 3 MCA, who oversees the services provided in
				an outpatient center for surgical services. The medical director may also serve
				in the outpatient center as a licensed health care professional. The medical
				director can also serve as the outpatient center administrator.
(2) "Outpatient center" for purposes of this
				subchapter, refers to an outpatient center for surgical services. Outpatient
				centers are limited to provide care for periods of less than 24
				hours.
(3) "Safe manner" means that
				physicians and other clinical staff must follow acceptable surgical standards
				of practice in all phases of a surgical procedure, beginning with the
				preoperative preparation of the patient, through to the postoperative recovery
				and discharge.
AUTH:
					 50-5-103, MCA; IMP:
					 50-5-103,
					 MCA
Administrative Rules of Montana › Department 37 - PUBLIC HEALTH AND HUMAN SERVICES › Chapter 37.106 - HEALTH CARE FACILITIES › Subchapter 37.106.5 - Minimum Standards for Outpatient Centers for Surgical Services › Rule 37.106.506 - MINIMUM STANDARDS FOR OUTPATIENT CENTERS FOR SURGICAL SERVICES

Current through Register Vol. 13, July 5, 2024
(1) An outpatient center must:
(a) meet the requirements of ARM Title 37,
				chapter 106, subchapter 3 relating to the minimum standards for all health care
				facilities;
(b) to the extent that
				other licensure rules in ARM Title 37, chapter 106, subchapter 3 conflict with
				the terms of this subchapter, the rules in this subchapter will
				apply;
(c) have a written policy
				and procedure manual as described in ARM
				37.106.507 available to, and
				followed by, all personnel;
(d)
				establish a coordinated transfer of care for patients who require services
				longer than 24 hours or for patients requiring care beyond the capabilities of
				the outpatient center. This coordinated transfer of care must include one of
				the following:
(i) a written transfer
				agreement with the receiving hospital;
(ii) one or more physicians with surgical
				privileges in the outpatient center must have admitting privileges at the
				receiving hospital and are present in the outpatient center during any surgical
				procedure; or
(iii) the receiving
				hospital writes a coordinated transfer policy and specifies the respective
				roles and responsibilities of the outpatient center upon arrival at the
				receiving hospital; and
(e) in transferring patients, the outpatient
				center must:
(i) coordinate and provide
				notice to the receiving hospital, including the reason for the transfer prior
				to the patient's transfer; and
(ii)
				provide the patient's medical records to the receiving hospital during the
				transfer.
Administrative Rules of Montana › Department 37 - PUBLIC HEALTH AND HUMAN SERVICES › Chapter 37.106 - HEALTH CARE FACILITIES › Subchapter 37.106.5 - Minimum Standards for Outpatient Centers for Surgical Services › Rule 37.106.507 - WRITTEN POLICIES AND PROCEDURES

Current through Register Vol. 13, July 5, 2024
(1) Each
				outpatient center must maintain a policy and procedure manual. The policy and
				procedure manual must be reviewed by the medical director or administrator and
				updated as necessary, but at least annually. The manual must contain policies
				and procedures for:
(a)
				preadmission;
(b) patient
				education;
(c) preoperative
				assessment;
(d) postoperative
				assessment;
(e) observation and
				recovery;
(f) discharge
				planning;
(g) emergency procedures
				of the outpatient center to include information on the transfer agreement with
				the receiving hospital;
(h)
				anesthesia policies as described in ARM
				37.106.514;
(i) business practices; and
(j) patient and staff security.
Administrative Rules of Montana › Department 37 - PUBLIC HEALTH AND HUMAN SERVICES › Chapter 37.106 - HEALTH CARE FACILITIES › Subchapter 37.106.5 - Minimum Standards for Outpatient Centers for Surgical Services › Rule 37.106.508 - OPERATIONAL STANDARDS FOR OUTPATIENT CENTERS FOR SURGICAL SERVICES

Current through Register Vol. 13, July 5, 2024
(1) An outpatient center is organized under a
				governing body that sets policy and is responsible for the organization. This
				governing body must meet regularly, but at least quarterly.
(2) The outpatient center administration
				must:
(a) operate under clearly defined
				mission, goals, and objectives for the organization;
(b) employ qualified personnel, both medical
				and managerial;
(c) adopt policies
				and procedures necessary for the orderly conduct of the organization, including
				the scope of clinical and surgical activities;
(d) ensure that the quality of care is
				evaluated and that identified problems are appropriately addressed;
(e) maintain effective communication
				throughout the organization, including ensuring a correlation between quality
				management and improvement activities and other management functions of the
				organization; and
(f) follow
				generally accepted accounting principles.
Administrative Rules of Montana › Department 37 - PUBLIC HEALTH AND HUMAN SERVICES › Chapter 37.106 - HEALTH CARE FACILITIES › Subchapter 37.106.5 - Minimum Standards for Outpatient Centers for Surgical Services › Rule 37.106.511 - STAFFING AND PERSONNEL REQUIREMENTS

Current through Register Vol. 13, July 5, 2024
(1)
				Staffing and personnel requirements for an outpatient center for surgical
				services include:
(a) professional staff who
				are licensed under Title 37, MCA, to practice in their profession and have the
				knowledge and skills required to provide the services offered by the outpatient
				center;
(b) all personnel assisting
				in the provision of health care services are appropriately trained, qualified,
				and supervised according to the policies and procedures of the outpatient
				center; and
(c) the outpatient
				center must keep a schedule for clinical staff, to make sure all shifts are
				adequately covered.
Administrative Rules of Montana › Department 37 - PUBLIC HEALTH AND HUMAN SERVICES › Chapter 37.106 - HEALTH CARE FACILITIES › Subchapter 37.106.5 - Minimum Standards for Outpatient Centers for Surgical Services › Rule 37.106.512 - MEDICAL, CLINICAL, AND HEALTH RECORD INFORMATION

Current through Register Vol. 13, July 5, 2024
(1) An individual clinical record must be
				established for each person receiving care. Each record must be accurate,
				legible, and promptly completed. The record must include at least the
				following:
(a) patient
				identification;
(b) significant
				medical history and results of physical examination;
(c) preoperative diagnostic studies, if
				performed;
(d) findings and
				techniques of the operation including a pathologist's report on all tissues
				removed during surgery, except those exempted by the governing body;
(e) any allergies and abnormal drug
				reactions;
(f) entries related to
				anesthesia administration;
(g)
				documentation of properly executed informed patient consent which includes
				notice of transfer when deemed appropriate;
(h) discharge diagnosis; and
(i) discharge recommendations and
				instructions given to the patient.
Administrative Rules of Montana › Department 37 - PUBLIC HEALTH AND HUMAN SERVICES › Chapter 37.106 - HEALTH CARE FACILITIES › Subchapter 37.106.5 - Minimum Standards for Outpatient Centers for Surgical Services › Rule 37.106.513 - INFECTION PREVENTION, CONTROL, AND SAFETY

Current through Register Vol. 13, July 5, 2024
(1) The outpatient center must maintain an
				infection control program that seeks to minimize infections and communicable
				diseases. The outpatient center is responsible for providing a plan of action
				for preventing, identifying, and managing infections and communicable diseases,
				and for immediately implementing corrective and preventive measures that result
				in improvement.
(a) The infection prevention
				and control program must include documentation that the outpatient center has
				considered, selected, and implemented nationally recognized infection control
				guidelines.
(b) The infection
				prevention and control program is under the direction of a designated and
				qualified infection control officer who is a licensed health care professional
				and has training in infection control.
Administrative Rules of Montana › Department 37 - PUBLIC HEALTH AND HUMAN SERVICES › Chapter 37.106 - HEALTH CARE FACILITIES › Subchapter 37.106.5 - Minimum Standards for Outpatient Centers for Surgical Services › Rule 37.106.514 - ANESTHESIA RISK AND EVALUATION

Current through Register Vol. 13, July 5, 2024
(1) The
				outpatient center must:
(a) prohibit the use
				of flammable anesthesia;
(b) have
				a policy which defines the types of anesthesia that will be used within the
				facility. Similarly, the outpatient center must address in this policy the
				level of American Society of Anesthesiologists (ASA) Physical Status
				Classification System level appropriate to receive surgical services in these
				types of facilities;
(c) conduct
				an assessment prior to the patient's admission as well as prior to surgery to
				evaluate the risk of anesthesia and of the procedure to be performed; and
(d) have policies that address the
				basis or criteria used in conducting the assessments.
Administrative Rules of Montana › Department 37 - PUBLIC HEALTH AND HUMAN SERVICES › Chapter 37.106 - HEALTH CARE FACILITIES › Subchapter 37.106.5 - Minimum Standards for Outpatient Centers for Surgical Services › Rule 37.106.515 - SURGICAL AND RELATED SERVICES

Current through Register Vol. 13, July 5, 2024
(1) Surgical
				procedures must be performed in a safe manner by qualified physicians
				functioning within their scope of practice and who limit the surgical
				procedures to those that are approved by the governing body in accordance to
				the facility policies and procedures.
(2) The outpatient center uses acceptable
				standards of practice to ensure proper identification of the patient and the
				surgical site in order to avoid wrong site/wrong person/wrong procedure errors.
				Generally accepted procedures to avoid such errors include:
(a) a preprocedure verification process to
				make sure all relevant documents and related information are available, are
				correctly identified, match the patient, and are consistent with the procedure
				the patient and the surgical staff are expecting to perform;
(b) marking of the intended procedure site by
				the physician who will be performing the procedure so that is it is clear where
				the procedure is to be performed on the patient's body;
(c) verification that a current health
				history is complete which includes a list of current prescription and
				nonprescription medications and dosages, physical examination, and pertinent
				preoperative diagnostic studies have been completed; and
(d) a recheck of the procedures listed in (a)
				through (c).
Administrative Rules of Montana › Department 37 - PUBLIC HEALTH AND HUMAN SERVICES › Chapter 37.106 - HEALTH CARE FACILITIES › Subchapter 37.106.6 - Minimum Standards for Nursing Facilities › Rule 37.106.601 - MINIMUM STANDARDS FOR A SKILLED AND SKILLED/ INTERMEDIATE CARE FACILITY: GENERAL REQUIREMENTS

Current through Register Vol. 13, July 5, 2024
(1) A skilled
				nursing care facility shall comply with the Conditions of Participation for
				Skilled Nursing Facilities as set forth in 42 CFR subchapter G part 483. An
				intermediate care facility shall comply with the requirements set forth in 42
				CFR subchapter G subpart I. A copy of the cited requirements may be obtained
				from the Department of Public Health and Human Services, Office of Inspector
				General, 2401 Colonial Drive, P.O. Box 202953, Helena, MT 59620-2953.
AUTH:
					 50-5-103,
					 50-5-404,
					 MCA; IMP:
					 50-5-103,
					 50-5-204,
					 50-5-404,
					 MCA
Administrative Rules of Montana › Department 37 - PUBLIC HEALTH AND HUMAN SERVICES › Chapter 37.106 - HEALTH CARE FACILITIES › Subchapter 37.106.6 - Minimum Standards for Nursing Facilities › Rule 37.106.605 - MINIMUM STANDARDS FOR A SKILLED NURSING CARE FACILITY FOR EACH 24 HOUR PERIOD: STAFFING (REPEALED)

Current through Register Vol. 13, July 5, 2024
AUTH:
					 50-5-103,
					 50-5-404, MCA
					 IMP:
					 50-5-103,
					 50-5-204,
					 50-5-404,
					 MCA
Administrative Rules of Montana › Department 37 - PUBLIC HEALTH AND HUMAN SERVICES › Chapter 37.106 - HEALTH CARE FACILITIES › Subchapter 37.106.6 - Minimum Standards for Nursing Facilities › Rule 37.106.606 - MINIMUM STANDARDS FOR A SKILLED AND SKILLED/INTERMEDIATE CARE FACILITY: DRUG SERVICES

Current through Register Vol. 13, July 5, 2024
(1) Medication
				shall be released to a patient at discharge only on the written authorization
				of his licensed physician.
(2)
				Self-administration of medication by a patient is not permitted except on order
				of his licensed physician.
(3) Any
				deviation from the prescribed drug dosage, route or frequency of administration
				and unexpected drug reactions shall be reported immediately to the patient's
				licensed physician with an entry made on the patient's medical record and on an
				incident report.
(4) A current
				medication reference book must be provided at each nurses station.
Sec.
					 50-5-103
					 and
					 50-5-404,
					 MCA; IMP, Sec.
					 50-5-103,
					 50-5-204
					 and
					 50-5-404,
					 MCA;
Administrative Rules of Montana › Department 37 - PUBLIC HEALTH AND HUMAN SERVICES › Chapter 37.106 - HEALTH CARE FACILITIES › Subchapter 37.106.6 - Minimum Standards for Nursing Facilities › Rule 37.106.640 - MINIMUM STANDARDS FOR AN INFIRMARY

Current through Register Vol. 13, July 5, 2024
(1)
				The infirmary shall provide patients with licensed physician care.
(2) The infirmary shall provide skilled
				nursing services. A licensed registered nurse shall serve as charge nurse on
				the day shift; and a licensed registered or practical nurse shall serve as
				charge nurse on evening and night shifts.
(3) Nurse staffing schedules must be
				maintained on file in the infirmary for the preceding six months.
(4) The infirmary shall maintain a medical
				record for each patient which includes, but is not limited to the following
				information:
(a) identification
				data;
(b) chief
				complaint;
(c) present
				illness;
(d) medical
				history;
(e) physical
				examination;
(f) laboratory and
				x-ray reports;
(g) treatment
				administered;
(h) tissue
				report;
(i) progress
				reports;
(j) discharge
				summary.
Administrative Rules of Montana › Department 37 - PUBLIC HEALTH AND HUMAN SERVICES › Chapter 37.106 - HEALTH CARE FACILITIES › Subchapter 37.106.6 - Minimum Standards for Nursing Facilities › Rule 37.106.645 - MINIMUM STANDARDS FOR AN INTERMEDIATE DEVELOPMENTAL DISABILITY CARE FACILITY (REPEALED)

Current through Register Vol. 13, July 5, 2024
AUTH:
					 50-5-103,
					 MCA IMP:
					 50-5-103,
					 50-5-201,
					 50-5-204,
					 MCA
Administrative Rules of Montana › Department 37 - PUBLIC HEALTH AND HUMAN SERVICES › Chapter 37.106 - HEALTH CARE FACILITIES › Subchapter 37.106.6 - Minimum Standards for Nursing Facilities › Rule 37.106.650 - MINIMUM STANDARDS FOR A KIDNEY TREATMENT CENTER

Current through Register Vol. 13, July 5, 2024
(1) A kidney treatment center shall comply
				with the requirements set forth in 42 CFR 405, Subpart U.
(2) The department hereby adopts and
				incorporates by reference 42 CFR 405, Subpart U, which sets standards that
				suppliers of end-stage renal disease services must meet in order to be
				certified for reimbursement from the federal medicare or medicaid programs. A
				copy of 42 CFR 405, Subpart U, is available from the Department of Public
				Health and Human Services, Quality Assurance Division, 2401 Colonial Drive,
				P.O. Box 202953, Helena, MT 59620-2953.
Sec.
					 50-5-103,
					 MCA; IMP, Sec.
					 50-5-103,
					 MCA;
Administrative Rules of Montana › Department 37 - PUBLIC HEALTH AND HUMAN SERVICES › Chapter 37.106 - HEALTH CARE FACILITIES › Subchapter 37.106.7 - Critical Access Hospital › Rule 37.106.704 - MINIMUM STANDARDS FOR A CRITICAL ACCESS HOSPITAL (CAH)

Current through Register Vol. 13, July 5, 2024
(1) A critical access hospital must comply
				with the conditions of participation for critical access hospitals under 42 CFR
				485 Subpart F. The department adopts and incorporates by reference 42 CFR 485
				Subpart F. A copy of the cited requirements may be obtained from the Department
				of Public Health and Human Services, Office of Inspector General, 2401 Colonial
				Drive, P.O. Box 202953, Helena, MT 59620-2953.
(2) A critical access hospital may maintain
				up to 25 inpatient beds that can be used interchangeably for acute care or
				swing-bed services. A critical access hospital granted a waiver under Section
				123(i) of the Medicare Improvements for Patients and Providers Act of 2008
				(MIPPA) may maintain an additional ten beds to be used only for skilled nursing
				facility or nursing facility level services. A critical access hospital may not
				add the additional beds granted under a waiver through capital expenditure for
				new construction.
(3) A facility
				qualifies as a necessary provider of health care services to residents of the
				area where the facility is located if the facility:
(a) is located in a county with fewer than
				six residents per square mile;
(b)
				is a state licensed facility located within the boundaries of an Indian
				reservation;
(c) is located in a
				county where the percentage of the population age 65 or older exceeds the
				statewide average; or
(d) has
				combined inpatient days for Medicare and Medicaid beneficiaries that account
				for at least 50% of its total acute inpatient days in the last full year for
				which data is available.
Administrative Rules of Montana › Department 37 - PUBLIC HEALTH AND HUMAN SERVICES › Chapter 37.106 - HEALTH CARE FACILITIES › Subchapter 37.106.8 - Licensing of Specialty Hospitals › Rule 37.106.801 - PURPOSE

Current through Register Vol. 13, July 5, 2024
(1) The purpose of these rules is to
				establish the general requirements for the licensure of specialty hospitals.
				These rules outline the process for application, including the submission of
				results of an impact study; and the development and implementation of charity
				care policies for the nondiscrimination of persons who are unable to pay for
				health care services provided in specialty hospitals.
50-5-103,
					 50-5-245,
					 MCA; IMP,
					 50-5-121,
					 50-5-245,
					 50-5-246,
					 MCA;
Administrative Rules of Montana › Department 37 - PUBLIC HEALTH AND HUMAN SERVICES › Chapter 37.106 - HEALTH CARE FACILITIES › Subchapter 37.106.8 - Licensing of Specialty Hospitals › Rule 37.106.802 - SCOPE

Current through Register Vol. 13, July 5, 2024
(1) A specialty hospital is a subclass of a
				hospital that is intended to diagnose, care, or treat patients with:
(a) cardiac conditions;
(b) orthopedic conditions;
(c) patients undergoing surgery; or
(d) patients being treated for cancer-related
				diseases and receiving oncology services.
Administrative Rules of Montana › Department 37 - PUBLIC HEALTH AND HUMAN SERVICES › Chapter 37.106 - HEALTH CARE FACILITIES › Subchapter 37.106.8 - Licensing of Specialty Hospitals › Rule 37.106.803 - DEFINITIONS

Current through Register Vol. 13, July 5, 2024
(1) "Administrator" means the individual
				responsible for the day-to-day operations of a specialty hospital. This
				individual may also be known as, but not limited to, "chief executive officer,"
				"executive director," or "president."
(2) "Charity care" or financial assistance"
				means free or discounted health services provided to persons who meet the
				organization's criteria for financial assistance and are unable to pay for all
				or a portion of the services.
(3)
				"Emergency care services" means health care items and services furnished or
				required to evaluate and treat an emergency medical condition.
(4) "Emergency medical condition" means a
				condition manifesting itself by symptoms of sufficient severity, including
				severe pain, that the absence of immediate medical attention could reasonably
				be expected to result in any of the following:
(a) the person's health would be in serious
				jeopardy;
(b) the person's bodily
				functions would be seriously impaired; or
(c) a bodily organ or part would be seriously
				damaged.