C.F.R. » Title 42 » CHAPTER IV—CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES › SUBCHAPTER G—STANDARDS AND CERTIFICATION › PART 483—REQUIREMENTS FOR STATES AND LONG TERM CARE FACILITIES › Subpart I—Conditions of Participation for Intermediate Care Facilities for Individuals with Intellectual Disabilities

42 C.F.R. § 483.410

Condition of participation: Governing body and management

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(a) Standard: Governing body. The facility must identify an individual or individuals to constitute the governing body of the facility. The governing body must—

(1) Exercise general policy, budget, and operating direction over the facility;

(2) Set the qualifications (in addition to those already set by State law, if any) for the administrator of the facility; and

(3) Appoint the administrator of the facility.

(b) Standard: Compliance with Federal, State, and local laws. The facility must be in compliance with all applicable provisions of Federal, State and local laws, regulations and codes pertaining to health, safety, and sanitation.

(c) Standard: Client records. (1) The facility must develop and maintain a recordkeeping system that includes a separate record for each client and that documents the client's health care, active treatment, social information, and protection of the client's rights.

(2) The facility must keep confidential all information contained in the clients' records, regardless of the form or storage method of the records.

(3) The facility must develop and implement policies and procedures governing the release of any client information, including consents necessary from the client, or parents (if the client is a minor) or legal guardian.

(4) Any individual who makes an entry in a client's record must make it legibly, date it, and sign it.

(5) The facility must provide a legend to explain any symbol or abbreviation used in a client's record.

(6) The facility must provide each identified residential living unit with appropriate aspects of each client's record.

(d) Standard: Services provided under agreements with outside sources. (1) If a service required under this subpart is not provided directly, the facility must have a written agreement with an outside program, resource, or service to furnish the necessary service, including emergency and other health care.

(2) The agreement must—

(i) Contain the responsibilities, functions, objectives, and other terms agreed to by both parties; and

(ii) Provide that the facility is responsible for assuring that the outside services meet the standards for quality of services contained in this subpart.

(3) The facility must assure that outside services meet the needs of each client.

(4) If living quarters are not provided in a facility owned by the ICF/IID, the ICF/IID remains directly responsible for the standards relating to physical environment that are specified in § 483.470 (a) through (g), (j) and (k).

(e) Standard: Licensure. The facility must be licensed under applicable State and local law.

[53 FR 20496, June 3, 1988. Redesignated at 56 FR 48918, Sept. 26, 1991, and amended at 57 FR 43925, Sept. 23, 1992]
Notes of Decisions
Cited in 7 cases, 1990–2020 · leading case: Texas Home Mgmt., Inc. v. Peavy, 89 S.W.3d 30 (Tex. 2002).
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Texas Home Mgmt., Inc. v. Peavy, 89 S.W.3d 30 (Tex. 2002). · cites it 2× “See 42 C.F.R. §§ 483.410 -.480; 25 Tex. Admin.”
JL ex rel. Thompson v. New Mexico Dep't of Health, 165 F. Supp. 3d 1048 (D.N.M. 2016). “102 ¶ 430f]; (3) “[flailing to ensure that outside agencies that provided services to Plaintiffs while committed to the Training School, such as ENMRSH, had a written agreement with the Training School that required the outside agency to provide all necessary medi *1069 cal care…”
Legacy Healthcare, Inc. v. Barnes & Thornburg, 837 N.E.2d 619 (Ind. Ct. App. 2005). “, 42 C.F.R. § 483.410 (condition of participation regarding governing body and management of ICF/MR contains five component standards of participation); see also 42 C.”
Texas Home Mgmt., Inc. v. Texas Dep't of Mental Health & Mental Retardation, 953 S.W.2d 1 (Tex. App. 1997). · cites it 2× “See 42 C.F.R. § 483.410 -.480 (1995). To ensure compliance with the Conditions of Participation, the Texas Department of Human Services conducts periodic surveys to investigate facility and client records, observe facility practices and procedures, and interview facility…”
Oakwood Cmty. Ctr. icf/mr v. Sebelius, 723 F. Supp. 2d 937 (E.D. Ky. 2010). “] See 42 C.F.R. §§ 483.410 & 483.440. Additionally, OIG found immediate jeopardy to exist.”
Neeta Gayakwad v. RSCR California, Inc. (C.D. Cal. 2020). “See 42 C.F.R. § 483.410 (e) (“The facility must be licensed under applicable State and local law.”
Soc'y for Good Will to Retarded Child. v. Cuomo, 745 F. Supp. 879 (E.D.N.Y 1990). “(a) The defendants shall maintain substantial compliance with the Federal Medicaid regulations (42 C.F.R. 483.410 et seq) at Long Island Developmental Center (LIDC), including the Sagtikos, Sagamore and the small residential units, and shall maintain the facility’s certification…”
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