C.F.R. » Title 42 » CHAPTER IV—CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES › SUBCHAPTER C—MEDICAL ASSISTANCE PROGRAMS › PART 440—SERVICES: GENERAL PROVISIONS › Subpart A—Definitions

42 C.F.R. § 440.150

Intermediate care facility (ICF/IID) services

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(a) “ICF/IID services” means those items and services furnished in an intermediate care facility for Individuals with Intellectual Disabilities if the following conditions are met:

(1) The facility fully meets the requirements for a State license to provide services that are above the level of room and board;

(2) The primary purpose of the ICF/IID is to furnish health or rehabilitative services to persons with Intellectual Disability or persons with related conditions;

(3) The ICF/IID meets the standards specified in subpart I of part 483 of this chapter.

(4) The beneficiary with Intellectual Disability for whom payment is requested is receiving active treatment, as specified in § 483.440 of this chapter.

(5) The ICF/IID has been certified to meet the requirements of subpart C of part 442 of this chapter, as evidenced by a valid agreement between the Medicaid agency and the facility for furnishing ICF/IID services and making payments for these services under the plan.

(b) ICF/IID services may be furnished in a distinct part of a facility other than an ICF/IID if the distinct part—

(1) Meets all requirements for an ICF/IID, as specified in subpart I of part 483 of this chapter;

(2) Is clearly an identifiable living unit, such as an entire ward, wing, floor or building;

(3) Consists of all beds and related services in the unit;

(4) Houses all beneficiaries for whom payment is being made for ICF/IID services; and

(5) Is approved in writing by the survey agency.

[59 FR 56234, Nov. 10, 1994]
Notes of Decisions
Cited in 14 cases, 1981–2011 · leading case: Biekert v. Maram
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Biekert v. Maram (2009) illappct · cites it 3× “§1396d(d) (2006); 42 C.F.R. §440.150 (a)(2) (2007); 89 Ill.”
Snelling v. South Dakota Department of Social Services (2010) sd · cites it 2× “The Medicaid FS Waiver program is limited to individuals in need of and *475 eligible for institutionalized services in an Intermediate Care Facility for People with Mental Retardation (ICF/MR) as provided by 42 C.F.R. § 440.150 , but who could remain in their homes or in the…”
Linton Ex Rel. Arnold v. Carney Ex Rel. Kimble (1990) tnmd · cites it 2× “See also 42 C.F.R. § 440.150 . SNF care consists of institutional care above the level of ICF services but below the level of a hospital.”
State of Wisconsin, Department of Health and Social Services, Plaintiff v. Otis R. Bowen, Secretary of Health and Human (1986) ca7 “§ 1396d(c); 42 C.F.R. § 440.150 . Both sorts of facilities must be licensed by the state and certified by the state Medicaid *393 agency as conforming to federal requirements.”
Rennich Ex Rel. Rennich v. North Dakota Department of Human Services (2008) nd “” 42 C.F.R. § 440.150 (a)(2) (2007). The parties agree Rennich does not haye mental retardation.”
Lind v. Wells County Social Service Board (1981) nd · cites it 2× “432 (1980); (3) Whether or not consideration was given to the attending physician’s opinion as required by 42 C.F.R. §§ 440.150 (e) and 456.436 (1980); and (4) Whether or not the Social Service Board’s decision was supported by a preponderance of the evidence.”
Weisenborn Ex Rel. Shoemaker v. MISSOURI DEPT. OF MENTAL HEA. (2011) moctapp “1010), have a need for the level of care provided in an ICF/MR (42 C.F.R. section 440.150), and a determination that but for the waiver, the applicant would be institutionalized in such an institution (42 C.”
Weisenborn v. Missouri Department of Mental Health (2011) moctapp “1010), have a need for the level of care provided in an ICF/MR (42 C.F.R. section 440.150), and a determination that but for the waiver, the applicant would be institutionalized in such an institution (42 C.”
Hawaii v. Heckler (1985) ca9 “Intermediate care facilities are defined in 42 C.F.R. § 440.150 (a)(1) (1984) as facilities that "[fjully [meet] the requirements for a State license to provide, on a regular basis, health-related services to individuals who do not require hospital or skilled nursing facility…”
John/Jane Doe v. Jeb Bush (2001) ca11 “225 ("Any of the services defined in subpart A of this part [which includes the definition of ICF services found at 42 C.F.R. § 440.150 ] that are not required under § 440.”
KING BY KING v. Fallon (1992) rid “See 42 C.F.R. § 440.150 (a)(1)(ii) (1991). Other options include community-based "waiver" and "rehabilitation" services.”
Ass'n of Residential Resources in Minnesota, Inc. v. Gomez (1994) mnd “While it is true that direct care employees at both state and private facilities perform essentially the same function, and federal law, itself, categorizes both types of facilities as ICFs/MR, see 42 C.F.R. § 440.150 (1992), differences in management style, wage negotiation and…”
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