Administrative Rules of Montana › Department 37 - PUBLIC HEALTH AND HUMAN SERVICES › Chapter 37.40 - SENIOR AND LONG TERM CARE SERVICES › Subchapter 37.40.3 - Reimbursement for Skilled Nursing and Intermediate Care Services › Rule 37.40.306 - PROVIDER PARTICIPATION AND TERMINATION REQUIREMENTS

Current through Register Vol. 13, July 5, 2024
(1) Nursing facility service providers, as a
				condition of participation in the Montana Medicaid program must meet the
				following requirements:
(a) comply with and
				agree to be bound by all laws, rules, regulations and policies generally
				applicable to Medicaid providers, including but not limited to the provisions
				of ARM 37.85.401,
				37.85.402,
				37.85.406,
				37.85.407,
				37.85.410,
				37.85.414, and
				37.85.415;
(b) maintain a current license issued by the
				department of public health and human services under Montana law for the
				category and level of care being provided, or, if the facility is located
				outside the state of Montana, maintain a current license under the laws of the
				state in which the facility is located for the category and level of nursing
				facility care being provided;
(c)
				maintain a current certification for Montana Medicaid issued by the Department
				of Public Health and Human Services under applicable state and federal laws,
				rules, regulations and policies for the category and level of care being
				provided, or, if the facility is located outside the state of Montana, maintain
				current Medicaid certification in the state in which the facility is located
				for the category and level of nursing facility care being provided;
(d) maintain a current agreement with the
				department to provide the level of care for which payment is being made, or, if
				the facility is located outside the state of Montana, comply with the
				provisions of ARM
				37.40.337;
(e) operate under the direction of a licensed
				nursing home administrator, or other qualified supervisor for the facility, as
				applicable laws, regulations, rules, or policies may require;
(f) for providers maintaining resident trust
				accounts, insure that any funds maintained in such accounts are used only for
				those purposes for which the resident, legal guardian, or personal
				representative of the resident has given written authorization. The provider
				must maintain personal funds in excess of $50 in an interest bearing account
				and must credit all interest earned to the resident's account. Resident's
				personal funds in amounts up to $50 must be maintained in such a manner that
				the resident has convenient access to such funds within a reasonable time upon
				request. A provider may not borrow funds from such accounts or commingle
				resident and facility funds for any purpose;
(g) A provider holding personal funds of a
				deceased nursing facility resident who received Medicaid benefits at any time
				shall, within 30 days following the resident's death, pay those funds as
				provided by law and regulation.
(h)
				maintain admission policies which do not discriminate on the basis of diagnosis
				or handicap, and which meet the requirements of all federal and state laws
				prohibiting discrimination against the handicapped, including persons infected
				with acquired immunity deficiency syndrome/human immunodeficiency virus
				(AIDS/HIV) ;
(i) comply with ARM
				37.40.101,
				37.40.105,
				37.40.106,
				37.40.110,
				37.40.120, and
				37.40.201 through
				37.40.207, regarding screening for
				nursing facility services;
(j)
				comply with all applicable federal and state laws, rules, regulations, and
				policies regarding nursing facilities at the times and in the manner required
				therein, including but not limited to
				42 USC
				1396 r(b) (5) and 1396r(c) (1994 supp.) and
				implementing regulations, which contain federal requirements relating to
				nursing home reform. The department hereby adopts and incorporates herein by
				reference
				42 USC
				1396 r(b) (5) and 1396r(c). A copy of these
				statutes may be obtained from the Department of Public Health and Human
				Services, Senior and Long Term Care Division, 111 N. Sanders, P.O. Box 4210,
				Helena, MT 59604-4210.