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(1) Each facility where moderate sedation or deep sedation/general anesthesia is to be provided shall be initially inspected by a team appointed by the board, prior to the initial issuance of the appropriate permit to administer anesthesia on the premises, and at intervals not to exceed five years. Adequacy of the facility and competency of the anesthesia team will be evaluated by the inspection team. The inspection team shall consist of at least two individuals. One member must hold a deep sedation/general anesthesia permit. Any dentist whose facility is to be inspected shall be notified at least 30 days prior to the inspection, and the names of the inspection team shall be provided to the dentist.

(2) The onsite inspection shall include a test of the applicant and the applicant's staff on their abilities to recognize and manage complications likely to occur, considering the techniques being used. Early recognition of complications will be emphasized. The facility must be inspected for the presence of drugs and equipment appropriate for the level of sedation or anesthesia to be provided. Monitoring assistants shall be examined for their knowledge of their respective roles in normal operating procedures and in various emergency situations. The inspection team shall evaluate office staff in proficiency in handling emergency procedures. The inspection team shall evaluate the accuracy of anesthesia record-keeping.

(3) If the onsite inspection team finds deficiencies present in the inspected office, the facility shall be given 30 days to address the deficiencies. If, at the completion of this 30-day period, the deficiencies have not adequately been rectified, the board will limit the practitioner's permit to apply moderate sedation or deep sedation/general anesthesia only in qualifying facilities.

(4) If serious life-threatening deficiencies are found by the onsite inspection team, the board will immediately limit the practitioner's permit by refusing to permit the administration of moderate sedation or deep sedation/general anesthesia on the premises.

(5) An individual who provides anesthesia at multiple facilities must be inspected at one facility only. The individual must state all facilities are compliant for the equipment requirements.

(6) Five-year reinspections may be performed by one inspector, unless the dentist being inspected, or board, requests two inspectors. Reinspections for moderate sedation permits may be performed by dentists holding a moderate sedation permit or a deep sedation/general anesthesia permit. For deep sedation/general anesthesia permits, reinspections must be performed by another dentist holding a deep sedation/general anesthesia permit.

History: 37-1-131, 37-4-205, MCA; IMP, 37-1-131, 37-4-101, 37-4-511, MCA; NEW, 1985 MAR p. 1994, Eff. 12/27/85; AMD, 1994 MAR p. 1130, Eff. 4/29/94; TRANS, from Commerce, & AMD, 2003 MAR p. 2435, Eff. 10/31/03; AMD, 2007 MAR p. 43, Eff. 1/12/07; AMD and TRANS, from 24.138.3206, 2011 MAR p. 2629, Eff. 12/9/11.

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