Development of Intermediate Care Facilities for Individuals with Intellectual Disabilities

PURPOSE: This rule prescribes procedures on development of intermediate care facilities for persons with mental retardation. (1) As used in this rule, a provider that owns, operates, or has interest in only one (1) intermediate care facility for individuals with intellectual disabilities (ICF/IID) is— (A) A sole proprietor that owns no interest in another ICF/IID; (B) A partnership or a majority of the partnership that owns no interest in another ICF/IID; or (C) A corporation that has neither any officers nor a majority of board members in common with another corporation which has any interest in an ICF/IID. (2) Any entity intending to operate a Medicaid-reimbursed ICF/IID in excess of those beds in existence on May 29, 1991, shall give written notice of that intent to the Department of Mental Health’s Division of Developmental Disabilities (Division of DD) between July 1 and October 1 of the fiscal year preceding the fiscal year in which the provider intends to operate the ICF/IID. (3) No provider may be reimbursed under Medicaid to operate an ICF/IID without a provider agreement issued by the Department of Social Services’ MO HealthNet Division (MHD). The MHD shall not issue a provider agreement without receiving either a certificate of authorization or an acknowledgment of exemption from the Division of DD. (4) After May 29, 1991, the Division of DD shall issue an acknowledgment of exemption to permit the MHD to issue a provider agreement to a certified ICF/IID if— (A) The ICF/IID will have six (6) or fewer beds; (B) The provider does not own, operate, or have any interest in any other ICF/IID; and (C) The provider has notified the Division of DD between July 1 and October 1 of its intent to operate the ICF/IID during the next fiscal year. (5) Any provider that has received an exemption under section (4) and then either obtains, operates, or acquires an interest in any other Medicaid-enrolled ICF/IID, or seeks to enroll an additional ICF/IID in the Medicaid program, shall forfeit the exemption granted under section (4). As soon as the ICF/IID for which exemption was originally granted can be accommodated in the Medicaid Home and Community-Based Waiver Program, the Division of DD shall notify the MHD to that effect, and MHD shall terminate the ICF/IID provider agreement within thirty (30) days after receipt of the notification from the Division of DD. (6) After May 29, 1991, the Division of DD may issue a certificate of authorization to permit the MHD to issue a provider agreement for a provider to operate an ICF/IID of seven (7) or more beds if— (A) The proposed ICF/IID is to be a freestanding facility and not attached to any other existing ICF/IID; (B) The provider has notified the Division of DD between July 1 and October 1 of its intent to operate the ICF/IID during the next fiscal year; and (C) The ICF/IID cannot be accommodated within the federal Home and CommunityBased Waiver Program for persons with developmental disabilities as determined by the Division of DD. AUTHORITY: section 630.050, RSMo Supp. 2013, and section 660.075, RSMo Supp. 2014.* This rule originally filed as 9 CSR 305.060. Original rule filed Sept. 1, 1993, effective April 9, 1994. Amended: Filed May 25, 1995, effective Dec. 30, 1995. Amended: Filed May 13, 2016, effective Nov. 30, 2016. *Original authority: 630.050, RSMo 1980, amended 1993, 1995, 2008 and 660.075, RSMo 1991, amended 2014.