This regulation governs the Montana Mental Health Nursing Care Center, a licensed nursing care facility providing long-term care and treatment for adults (18+) with mental disorders who do not require the acute psychiatric intensity of Montana State Hospital. It establishes admission criteria, application procedures, treatment standards, transfer and discharge criteria, and appeal procedures for the Center. Operators must follow specific eligibility requirements, maintain individualized care plans, and adhere to defined processes for voluntary and involuntary admissions and discharges.
View official source37.66.101 PURPOSE (1) The Montana mental health nursing care center, a licensed nursing care facility, provides long term care and treatment of persons with mental disorders. The primary function of the center is set forth in 53-21-411 , MCA. The center provides a secure unit for persons with alzheimer/dementia. This program provides for persons who do not require the intensity of treatment available at Montana state hospital. Authorizing statute(s): Sec. 53-21-402 and 53-21-411 , MCA Implementing statute(s): Sec. 53-21-411 , MCA History: NEW, 1986 MAR p. 257, Eff. 2/28/86; AMD, 1996 MAR p. 1391, Eff. 5/24/96; TRANS, from DOC, 1998 MAR p. 1505. 37.66.102 DEFINITIONS (1) "Mental disorder" means impairment as defined in 53-21-102 , MCA. (2) "Professional person" means a person as defined in 53-21-102 , MCA. (3) "Center" means the Montana mental health nursing care center. (4) "Superintendent" means the superintendent of the Montana mental health nursing care center. Authorizing statute(s): Sec. 53-21-402 and 53-21-411 , MCA Implementing statute(s): Sec. 53-21-411 , MCA History: NEW, 1986 MAR p. 257, Eff. 2/28/86; AMD, 1996 MAR p. 1391, Eff. 5/24/96; TRANS, from DOC, 1998 MAR p. 1505. 37.66.106 ADMISSION CRITERIA (1) Eligibility for admission to the Montana center is determined without regard to race, color, sex, culture, social origin or condition, political or religious ideas, or ability to pay for the cost of care. (2) To be eligible for admission on a voluntary basis, a person must: (a) be 18 years of age; (b) be diagnosed as having a mental disorder; (c) require long term nursing care; (d) exhibit behaviors rendering the person unable to be served appropriately in the community of residence or in a less restrictive setting; (e) not require acute medical hospital care; (f) not require active psychiatric treatment as provided by Montana state hospital; (g) not require the services of a full time psychiatrist; (h) have received a mental health evaluation and recommendation for admission by a mental health professional person within 60 days prior to application; (i) be admitted on a voluntary basis through application by the person, a legally appointed guardian or durable power of attorney providing for health care decisions; and (j) complete a center application for admission. (3) The following is required for an involuntarily committed person to be admitted to the center from Montana state hospital: (a) meet voluntary criteria for admission in (2) (a) through (g) of this rule; (b) notification of the patient, the patient's next of kin, and the Montana disabilities board of visitors pursuant to 53-21-414 , MCA. (4) The final decision for admission remains with the superintendent of the center. Patients referred from Montana state hospital who meet the above criteria will be given priority for admission to the center. Authorizing statute(s): Sec. 53-21-402 and 53-21-411 , MCA Implementing statute(s): Sec. 53-21-411 and 53-21-414 , MCA History: NEW, 1986 MAR p. 257, Eff. 2/28/86; AMD, 1987 MAR p. 484, Eff. 5/1/87; AMD, 1996 MAR p. 1391, Eff. 5/24/96; TRANS, from DOC, 1998 MAR p. 1505. 37.66.107 APPLICATION PROCEDURES (1) To be considered for admission, the applicant, applicant's guardian, or person who has a power of attorney for the applicant, must submit to the superintendent of the center: (a) a completed admissions packet; and (b) a medical history including the comprehensive medical evaluation and recommendation of a mental health professional. Authorizing statute(s): 53-21-402 , 53-21-411 , MCA Implementing statute(s): 53-21-411 , 53-21-414 , MCA History: NEW, 1986 MAR p. 257, Eff. 2/28/86; AMD, 1996 MAR p. 1391, Eff. 5/24/96; TRANS, from DOC, 1998 MAR p. 1505. 37.66.108 APPLICATION MATERIALS (1) Application packets are available by writing to the superintendent of the Montana Mental Health Nursing Care Center, 800 Casino Creek Drive, Lewistown, Montana 59457. Authorizing statute(s): Sec. 53-21-402 and 53-21-411 , MCA Implementing statute(s): Sec. 53-21-411 and 53-21-414 , MCA History: NEW, 1996 MAR p. 257, Eff. 2/28/86; AMD, 1996 MAR p. 1391, 5/24/96; TRANS, from DOC, 1998 MAR p. 1505. 37.66.109 ADMISSIONS PROCEDURES (1) The superintendent will review all application materials and determine the applicant's eligibility for admission. (2) The superintendent will notify the applicant, in writing, of the decision regarding eligibility. (3) The eligible applicant will be admitted when an appropriate bed is available. (4) If there is no bed immediately available, the applicant will be placed on a waiting list. (5) Except for priority admissions as described in ARM 37.66.106 , the center will admit applicants from the waiting list on the basis of the date of determination of eligibility for admission as beds become available. (6) The superintendent may waive the use of the waiting list if: (a) the location of an available bed requires that the next person admitted be of a particular sex; or (b) there is an applicant whose current living conditions require that he or she be admitted immediately. (7) When two or more applicants have equal priority on the waiting list, the person with the longest documented Montana residence will be admitted first. Authorizing statute(s): Sec. 53-21-402 and 53-21-411 , MCA Implementing statute(s): Sec. 53-21-411 and 53-21-414 , MCA History: NEW, 1986 MAR p. 257, Eff. 2/28/86; AMD, 1996 MAR p. 1391, Eff. 5/24/96; TRANS, from DOC, 1998 MAR p. 1505. 37.66.115 TREATMENT (1) Treatment provided at the center focuses on maintaining the resident's physical and mental functioning to the extent possible. Residents will be provided medical, nursing, dietary, recreation and social services through an individualized care plan for each resident. The center may utilize the services of the regional mental health center when individual residents might benefit from such services. Authorizing statute(s): Sec. 53-21-411 , MCA Implementing statute(s): Sec. 53-21-411 , MCA History: NEW, 1986 MAR p. 257, Eff. 2/28/86; TRANS, from DOC, 1998 MAR p. 1505. 37.66.120 TRANSFER AND DISCHARGE CRITERIA (1) The superintendent may authorize the transfer of a center resident to a licensed hospital in a medical emergency without the resident's consent. (2) The director of the department of public health and human services, may authorize the transfer of a center resident to Montana state hospital for a period not to exceed 10 days. (3) Residents of the center may be voluntarily admitted to Montana state hospital pursuant to 53-21-111 , MCA, or involuntarily committed pursuant to 53-21-128 , MCA. (4) If the patient is currently the subject of an involuntary commitment, the patient may be transferred to Montana state hospital after notification pursuant to 53-21-413 , MCA. (5) A legally competent voluntary resident will be discharged from the center within 5 days following a written request from the resident. If guardianship or durable power of attorney for the health care of the resident has been established, the written request must be made by the guardian or power of attorney. (6) The superintendent may also discharge a resident after making proper arrangements if: (a) the resident consistently displays behavior which violates other residents= rights; (b) the resident=s behavior poses a consistent and/or serious danger to other residents, staff or visitors; (c) the resident requires specialized care or treatment not available at the center; (d) the resident is able to function in a setting requiring greater independence; (e) the resident may be served in a less restrictive environment such as a non-specialized nursing home; or (f) the resident poses a health danger to other residents. Authorizing statute(s): Sec. 53-21-402 , 53-21-411 and 53-21-413 , MCA Implementing statute(s): Sec. 53-21-112 , 53-21-113 , 53-21-412 and 53-21-413 , MCA History: NEW, 1986 MAR p. 257, Eff. 2/28/86; AMD, 1996 MAR p. 1391, Eff. 5/24/96; TRANS, from DOC, 1998 MAR p. 1505. 37.66.130 APPEAL PROCEDURE (1) Applicants who are denied admission, or residents who are involuntarily discharged may appeal by submitting, in writing, their reasons for appealing the decision to the director of the Department of Public Health and Human Services, 111 N. Sanders, P.O. Box 4210, Helena, MT 59604-4210 prior to discharge or within 30 days of the denial of admission. (2) The director will respond to the appeal, in writing, within 30 days of receipt of the appeal. (3) Pending appeal of an involuntary discharge, the patient may be transferred pursuant to ARM 37.66.120 or allowed to remain at the center until the final decision of the director. Authorizing statute(s): 53-21-402 , 53-21-411 , MCA Implementing statute(s): 53-21-411 , MCA History: NEW, 1986 MAR p. 257, Eff. 2/28/86; AMD, 1996 MAR p. 1391, Eff. 5/24/96; TRANS, from DOC, 1998 MAR p. 1505.