Review of Montana Medicaid Program - Nursing Homes as Institutions for Mental Diseases

EXECUTIVE SUMMARY:

The objectives of this review were this determine whether:  (1) Montana was monitoring nursing homes to ensure compliance with institutions for mental disease (IMD) criteria; and (2) nursing homes participating in the Montana Medicaid program were IMDs.  We reviewed nursing homes participating in the Medicaid program during Federal fiscal year 2003.  Montana needs to establish specific controls to monitor nursing homes for compliance with IMD criteria.  We also recommended that Montana monitor and evaluate, with qualified medical personnel, two nursing homes that may be IMDs.  Montana responded that it did have several controls in place to assist in monitoring for compliance, and provided further analysis to show that the nursing homes identified in our report are not IMDs.  They also agreed to institute procedures to routinely monitor for compliance with IMD criteria.