(1) A medical assistance facility must have a governing body that is legally responsible for the conduct of the facility and that:

(a) Ensures that the medical staff of the facility:

(i) are appointed by the governing body to the medical staff after the governing body considers the recommendations of the existing members of the medical staff;

(ii) have bylaws and written policies that are approved by the governing body and meet the requirements of (3) below and ARM 37.106.1104;

(iii) are accountable to the governing body for the quality of care provided to patients; and

(iv) are selected on the basis of individual character, competence, training, experience, and judgment.

(b) Appoints a chief executive officer who is responsible for managing the facility.

(c) In accordance with a written policy, ensures that:

(i) Every patient is either under the care of a physician or under the care of a nurse practitioner or physician's assistant supervised by a physician;

(ii) Whenever a patient is admitted to the facility by a physician's assistant or nurse practitioner, the facility's sponsoring physician is notified of that fact, by phone or otherwise, within 24 hours after the admission, and that a written notation of that consultation and of the physician's approval or disapproval is kept in the patient's record;

(iii) A physician, nurse practitioner, or physician's assistant is on duty or on call and physically available at the facility within one hour at all times, unless the procedure described in (iv) is adopted and implemented;

(iv) If the facility cannot ensure that a practitioner is available within one hour after a patient first contacts the facility, within that hour, the director of nursing or alternate:

(A) evaluates the condition of the patient;

(B) determines whether a practitioner can reach the facility before the hour is up; and

(C) if the practitioner will not be available, arranges for the transport of the patient to another facility capable of providing the appropriate level of care; and

(v) No patient is cared for in the facility for more than 96 hours.

(d) Prepares, adopts, and reviews and updates annually an overall institutional plan which includes the following:

(i) An annual operating budget that is prepared according to generally accepted accounting principles and includes all anticipated income and expense; and

(ii) Projected capital expenditures, if any, for at least a three-year period.

(e) Maintains a list of all contracted services, including the scope and nature of the services provided, and ensures that a contractor providing services to the facility:

(i) furnishes services that permit the facility, including the contracted services, to comply with all applicable licensure standards; and

(ii) provides the services in a safe and effective manner.

(f) Ensures that the medical and nursing staff of the facility are licensed, certified, or registered in accordance with Montana law and rules and that each such staff member provides health services within the scope of his or her license, certification, or registration.

History: Sec. 50-5-103, MCA; IMP, Sec. 50-5-101, 50-5-103 and 50-5-204, MCA; NEW, 1989 MAR p. 663, Eff. 4/28/89; TRANS, from DHES, 2002 MAR p. 185.