Section 164.422 - Provision of Services(A)Admission. Prior to admission, the Licensed or Approved Provider shall verify the resident is 18 years old or older and that the residential rehabilitation services are appropriate for the resident based upon a determination the resident: (1) has a substance use disorder or a mental or behavioral disorder due to psychoactive substance use and is not intoxicated and is not currently at risk of experiencing withdrawal; (2) is mentally and physically stable and does not pose a risk to self or others;(3) is open to recovery and can understand relapse;(4) requires a 24-hour per day structured and supportive environment in order to maintain gains; and(5) is capable of recognizing physical danger, including when such danger requires immediate egress from the residence, and is able to follow a prescribed procedure for egress, as demonstrated by completion of a self-preservation test.(B)Duration of Services. Length of stay may vary depending upon the needs of the resident.(C)Assessment. The Licensed or Approved Provider shall ensure that the assessment required by 105 CMR 164.072 shall be completed within the first week of treatment. Pursuant to 105 CMR 164.072(B), the Licensed or Approved Provider may initiate resident treatment prior to completion of the assessment required by 105 CMR 164.072 upon obtaining sufficient information to initiate treatment for the acute problem at the time of presentation and that the assessment is subsequently completed in a reasonable timeframe, provided that a Qualified Healthcare Professional must see such a resident prior to initiating an FDA-approved medication for treatment of addiction. Providers of Residential Rehabilitation for Adults are exempt from the requirement in 105 CMR 164.072(D) that the assessment be completed by a Senior Clinician or Clinician.(D)Treatment. The Licensed or Approved Provider shall provide treatment services as required by 105 CMR 164.074, in accordance with program components specified in 105 CMR 164.423.(E)Medical Services. Notwithstanding the assessment required by 105 CMR 164.072, the Licensed or Approved Provider shall refer the resident for a complete physical examination within 30 calendar days of admission unless medical reports document a comparable examination within 12 months prior to admission. Referrals shall be documented in the resident's record.(F) Licensed or Approved Providers providing services to pregnant and postpartum residents and their infants shall establish QSOAs with early intervention programs to provide developmental assessments and services to infants. Licensed or Approved Providers shall also comply with requirements of 105 CMR 164.082(A) governing services to pregnant patients and residents.(G)Exemptions: (1) Residential rehabilitation programs for adults are exempt from the requirement in 105 CMR 164.072(G) that the initial assessment be completed by Senior Clinician or Clinician.(2) Residential rehabilitation programs for adults are exempt from the requirements set forth in 105 CMR 164.048(B).(3) Social Model Recovery Homes are exempt from the provisions contained in 105 CMR 164.073: Individual Treatment Plan and 105 CMR 164.074: Minimum Treatment Requirements, to provide individual counseling.Amended by Mass Register Issue 1482, eff. 11/11/2022.