This Montana Administrative Rule subchapter establishes minimum operating standards for skilled nursing care facilities and skilled/intermediate care facilities, incorporating federal Conditions of Participation under 42 CFR Part 483. It covers drug services requirements (medication release, self-administration, deviation reporting, and reference materials), staffing and medical records standards for infirmaries, and compliance requirements for kidney treatment centers. Facility operators must adhere to both state standards and the incorporated federal regulations.
View official sourceADMINISTRATIVE RULE OF MONTANA HEALTHCARE FACILITIES 37.106 Subchapter 6 Long Term Care RULE 37.106.601 MINIMUM STANDARDS FOR A SKILLED AND SKILLED/ INTERMEDIATE CARE FACILITY: GENERAL REQUIREMENTS RULES 37.106.602 THROUGH 37.106.604 RESERVED 37.106.606 MINIMUM STANDARDS FOR A SKILLED AND SKILLED/ INTERMEDIATE CARE FACILITY: DRUG SERVICES RULES 37.106.607 THROUGH 37.106.639 RESERVED 37.106.640 MINIMUM STANDARDS FOR AN INFIRMARY RULES 37.106.641 THROUGH 37.106.644 RESERVED RULES 37.106.646 THROUGH 37.106.649 RESERVED 37.106.650 MINIMUM STANDARDS FOR A KIDNEY TREATMENT CENTER 37.106.601 MINIMUM STANDARDS FOR A SKILLED AND SKILLED/ INTERMEDIATE CARE FACILITY: GENERAL REQUIREMENTS (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. Authorizing statute(s): 50-5-103, 50-5-404, MCA Implementing statute(s): 50-5-103, 50-5-204, 50-5-404, MCA History: NEW, 1980 MAR p. 1587, Eff. 6/13/80; TRANS, from DHES, 2002 MAR p. 185; AMD, 2022 MAR p. 1876, Eff. 9/24/22. 37.106.605 MINIMUM STANDARDS FOR A SKILLED NURSING CARE FACILITY FOR EACH 24 HOUR PERIOD: STAFFING (REPEALED) Authorizing statute(s): 50-5-103, 50-5-404, MCA Implementing statute(s): 50-5-103, 50-5-204, 50-5-404, MCA History: Eff. 12/31/72; TRANS, from DHES, 2002 MAR p. 185; REP, 2022 MAR p. 1876, Eff. 9/24/22. 37.106.606 MINIMUM STANDARDS FOR A SKILLED AND SKILLED/ INTERMEDIATE CARE FACILITY: DRUG SERVICES (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. Authorizing statute(s): Sec. 50-5-103 and 50-5-404, MCA Implementing statute(s): Sec. 50-5-103, 50-5-204 and 50-5-404, MCA History: NEW, 1980 MAR p. 1587, Eff. 6/13/80; TRANS, from DHES, 2002 MAR p. 185. 37.106.640 MINIMUM STANDARDS FOR AN INFIRMARY (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. (5) If a modified diet is ordered by a physician for a patient, facilities must be available for its preparation and service. Authorizing statute(s): Sec. 50-5-103 and 50-5-404, MCA Implementing statute(s): Sec. 50-5-103, 50-5-204 and 50-5-404, MCA History: NEW, 1980 MAR p. 1587, Eff. 6/13/80; TRANS, from DHES, 2002 MAR p. 185. 37.106.645 MINIMUM STANDARDS FOR AN INTERMEDIATE DEVELOPMENTAL DISABILITY CARE FACILITY (REPEALED) Authorizing statute(s): 50-5-103, MCA Implementing statute(s): 50-5-103, 50-5-201, 50-5-204, MCA History: NEW, 1984 MAR p. 973, Eff. 6/29/84; TRANS, from DHES, 2002 MAR p. 185; REP, 2022 MAR p. 1876, Eff. 9/24/22. 37.106.650 MINIMUM STANDARDS FOR A KIDNEY TREATMENT CENTER (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. Authorizing statute(s): Sec. 50-5-103, MCA Implementing statute(s): Sec. 50-5-103, MCA History: NEW, 1980 MAR p. 1587, Eff. 6/13/80; AMD, 1994 MAR p. 3192, Eff. 12/23/94; TRANS, from DHES, 2002 MAR p. 185.