Administrative Rules of Montana
Department 37 - PUBLIC HEALTH AND HUMAN SERVICES
Chapter 37.40 - SENIOR AND LONG TERM CARE SERVICES
Subchapter 37.40.2 - Screening for Skilled Nursing and Intermediate Care Services
Rule 37.40.205 - PREADMISSION SCREENING, NURSING FACILITY SERVICES
Universal Citation: MT Admin Rules 37.40.205
Current through Register Vol. 18, September 20, 2024
(1) For elderly persons and physically disabled persons, the need for nursing facility service will be determined based upon the following criteria:
(a) The
services of a skilled nursing facility (SNF) are needed when a person meets the
criteria for skilled care as defined by Title XVIII of the Social Security
Act.
(b) The services of an
intermediate care facility (ICF) are needed when a person:
(i) does not qualify for skilled nursing
facility care; and
(ii) is
determined by the department or its designee to need care at a level higher
than personal care;
(c)
In order to receive home and community services, an applicant must be
determined to be at risk of or require care at the intermediate level as
determined by the department or its designee through a functional rating of the
person. The need for such care is indicated when the person:
(i) is able to ambulate (walk or wheel) to a
dining room or equivalent;
(ii) is
capable of self care with minimal assistance;
(iii) has four or fewer problems determined
to be low level by the department or its designee; and
(iv) requires no more than one-hour of
nursing care per 24 hours.
(d) A candidate for discharge is a person who
has two or less problems. This criteria does not apply to persons with a
diagnosis of mental illness or mental retardation.
(2) For mentally retarded persons applying for the home and community services program, the appropriate nursing facility services will be determined based upon the following criteria:
(a) The services of an intermediate care
facility for the mentally retarded (ICF/MR) are needed when a mentally retarded
person:
(i) has severe medical problems
requiring substantial care, but not to the extent that habilitation is
impossible;
(ii) has extreme
deficits in self-care and daily living skills which require intensive training;
or
(iii) has significant
maladaptive social and/or interpersonal behavior patterns which require an
on-going, supervised program of intervention.
(b) Skilled nursing facility (SNF) level of
care is needed when a person with mental retardation meets the requirements for
SNF services as found in (1) (a) of this rule.
Sec. 53-2-201, 53-6-113 and 53-6-402, MCA; IMP, Sec. 53-2-201, 53-6-101, 53-6-111 and 53-6-402, MCA;
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