37.40.1435 HOME AND COMMUNITY-BASED SERVICES FOR ELDERLY AND PHYSICALLY DISABLED PERSONS: ADULT RESIDENTIAL CARE, REQUIREMENTS
(1) Adult residential care is a residential habilitation option for consumers residing in an adult foster home, a residential hospice, or an assisted living facility.
(2) Adult residential care is a bundled service that may include:
(a) personal care services;
(c) social activities;
(d) recreational activities;
(e) medication oversight; and
(f) assistance in arranging transportation for medical care.
(3) Adult residential care must provide for 24-hour onsite response staff to meet scheduled or unpredictable needs of consumers and to provide supervision of consumers for safety and security.
(4) A consumer of adult residential care may not receive the following services through the program:
(a) personal assistance as specified at ARM 37.40.1447;
(b) homemaking services as specified at ARM 37.40.1450;
(c) environmental accessibility adaptation services as specified at ARM 37.40.1485;
(d) respite care as specified at ARM 37.40.1451; and
(e) nutrition as specified in ARM 37.40.1476.
(5) Adult residential care facilities must be licensed by the state of Montana.
(6) A provider of adult residential care must report serious occurrences to the department in accordance with serious occurrence policy requirements.
(7) An assisted living facility providing adult residential services must have the following features:
(a) Provide a home-like environment in either:
(i) an apartment style living unit with a bedroom, easy access to a bath, and cooking areas; or
(ii) a home style living unit with a bedroom, easy access to a bath, and reasonable access to food and beverages, unless against medical advice.
(b) Small dining areas or ability to eat with a private party.
(c) Residents must have control of lockable access to living unit and egress from the facility (unless Category C). The facility may have a master key for emergencies.
(d) Residents must have the ability to furnish and decorate living unit.
(e) Access to private areas for telephone and visitors.
(f) Provide reasonable assistance coordinating and arranging for the resident's choice of community pursuits outside the residence. This is in addition to the regular outings provided by the facility.
(g) Residents must have reasonable access to unscheduled activities and resources in the community.
(h) Policies and practices allow resident risk, through family and resident education, risk assessment, and negotiated risk agreement.
(i) Aging in place must be a common practice of the assisted living facility, within scope of license.
(j) The facility should make concerted efforts to allow consumers to remain in the facility when changing from private pay to waiver funding.
(k) Education and documentation of the facility policies around room changes needs to have been given and explained to the consumer prior to admission and reviewed as financial status changes.
(8) Providing waiver funding for adult residential services in assisted living facilities that do not meet the above criteria is not allowed.
(9) Effective September 1, 2011, Medicaid funding will no longer be available for newly admitted home and community services consumers in an assisted living facility, unless the facility meets the above criteria.