Montana Administrative Register Notice 37-637 No. 17   09/05/2013    
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 BEFORE THE Department of Public

 health and human services of the



In the matter of the adoption of New Rules I through XI pertaining to licensure requirements for outpatient centers for surgical services







            TO: All Concerned Persons


1. On June 6, 2013, the Department of Public Health and Human Services published MAR Notice No. 37-637 pertaining to the public hearing on the proposed adoption of the above-stated rules at page 945 of the 2013 Montana Administrative Register, Issue Number 11.


2. The department has adopted New Rule I (37.106.501), II (37.106.502), III (37.106.503), IV (37.106.506), V (37.106.507), VI (37.106.508), VII (37.106.511), VIII (37.106.512), IX (37.106.513), X (37.106.514), and XI (37.106.515), as proposed.


3. The department has thoroughly considered the comments and testimony received. A summary of the comments received and the department's responses are as follows:


COMMENT #1: One comment was received advising the department that under the Statement of Reasonable Necessity (SRN), the name of the accrediting organization was indicated as the "American Association for Ambulatory Health Care."  The commenter requests that this be amended to read, "Accreditation Association for Ambulatory Health Care" in this section and in any others in which it may be incorrectly indicated.


RESPONSE #1: The department agrees.  The department checked the rule text and the term is used correctly in the rule itself.  It is used incorrectly in one spot of the SRN. Since the term is used correctly in the rule, the department does not need to correct the SRN.


COMMENT #2: One comment was received urging the department to add language to the proposed rule requiring the facility to have a circulating registered nurse present in any and each separate operating room and in any and each separate invasive procedure room for the duration of the procedure.


RESPONSE #2: The department agrees that the presence of a circulating nurse is an important characteristic of quality patient care. It is the department's opinion that facilities in Montana must define circulating nurse procedures based on an assessment of case complexity and patient acuity. Therefore, this rule is written such that it allows facilities to define the level of such involvement through their written facility policy and procedures.



/s/ Kurt R. Moser                                           /s/ Richard H. Opper                                   

Kurt R. Moser                                                Richard H. Opper, Director

Rule Reviewer                                             Public Health and Human Services



Certified to the Secretary of State August 26, 2013.



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