Intermediate care facility (ICF/IID) services.

(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]