CMS Issues Changes to ICF Program

CMS Issues Changes to ICF Program – More than a Name Change

On May 11, 2012 CMS issued a letter regarding the Publication of Final Rule “Medicare and Medicaid Program; Regulatory Provisions to Promote Program Efficiency, Transparency, and Burden Reduction CMS-9070-F”.  These rules will take effect on July 16, 2012 and have a direct impact for ICF/IID (formerly ICF/MR) providers.

Name Change: Based on Rosa’s Law (2010), Intermediate Care Facilities for Persons with Mental Retardation (ICF/MR) will now reflect nationwide changes and be referred to as Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICF/IID).

Elimination of 12 month Time Limited Agreement: The rule eliminates the mandatory 12 month ICF/IID annual survey and replaces the requirement with an open ended agreement which, consistent with nursing facilities (NFs), would remain in effect until the Secretary or a State determines that the ICF/IID no longer meets the conditions of participation for ICF/IIDs. Instead ICFs/IID must be surveyed, on average, every 12 months with a maximum 15-month survey interval.

Complaint Surveys Can be Combined with Annual before the end of 12 months: Complaint surveys that result in an abbreviated survey 10 or 11 months into the facility’s certification period, can now be expanded for the purpose of completing the requirements of annual certification at the same time.

Some ICFs/IDD may be surveyed more frequently: The proposed change allows states greater latitude to survey poor performing facilities more frequently and high quality facilities less frequently, as long as the overall time-frames are observed. Each ICF/IDD will be surveyed at least once every 15 months, and facilities must be surveyed an average of every 12 months. This means that if some facilities are surveyed only after 12 months but before the end of 15 months from the last survey, other facilities in the state must be surveyed more frequently than 12 months.

For further information, download the letter which includes links to the rules and additional information.

Link: CMS Letter SC12-29