1. CMS Update October 6, 2013 Steven Chickering
Associate Regional Administrator, WDSC
October 6, 2013

2. Objectives Review ICF/IID Demographics
Learn about what’s new with the ICF/IID Program
Identify the top 10 W Tags/Citations

3. CMS Central Office ICF/IID Team
Peggye Wilkerson – Deputy Director, Division of Continuing Care Providers
Adrienne Rogers – Team Lead
Melissa Rice
Vacant

4. ICF/IID Demographics Total number of individuals served: 420,613
Under 22 years of age: 31,992
22-45 years of age: 160,993
46-65 years of age: 191,013
Over 65 years of age: 36,615

5. ICF/IID Demographics
Total number of ICF/IIDs: 5723

6. Where Individuals Reside
Large (>100 beds) 43%
Medium (17-99 beds) 16%
Small (4-16 beds) 41%

7. What’s Happening

8. Interpretive Guidance
ICF/IID Interpretive Guidelines
Updated
Internal review of draft revisions
Public comment of draft revisions
Final clearance hopefully by end of 2013

9. Survey & Certification Letters
S&C: ICF/IID – Intermediate Care Facilities for the Intellectually Disabled (ICF/IID) No Longer Certified Under Time-Limited Agreements, Published: February 8, 2013

10. S&C: ICF/IID (cont)
The Burden Reduction Rule I removed the time limited agreement for certification of ICF/IID’s – The regulation at § was changed to provide that provider agreements for ICF/IID’s would remain in effect as long as the facility remains in compliance with the Conditions Of Participation (COP’s). Regulations at § through § are also changed to reflect this change.

11. Survey & Certification Letters (cont)
S&C: ICF/IID-QIDP – Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICF/IID) – Nomenclature Change (Qualified Intellectual Disabilities Professional (QIDP), Published: May 3, 2013

12. S&C 13-28-ICF/IID-QIDP (cont)
Rosa’s Law: The enactment of Rosa’s Law on October 5, 2010 changed all references to “mental retardation” in Federal law to “intellectual disability” and changed all references to a “mentally retarded individual” to “an individual with an intellectual disability.” These changes were codified in regulation by the Centers for Medicare & Medicaid Services (CMS) on May 16, 2012.

13. S&C Letters - Future Locked Areas Prone Restraints
Undergoing clearance process
Prone Restraints
Reviewing literature and data

14. ICF/IID Nomenclature
Continue to update forms with correct nomenclature
Form CMS-3070 G will be revised in 2013
Updating State Operations Manual (SOM) as well
Training materials have been updated
Reviewing website references

15. Elderly Individuals
Guidelines to assist surveyors in evaluating IPPs for elderly individuals under development

16. Survey Process No Changes at this time
Anticipate a review within next months

17. Top 10 Deficient Practice Citations

18. Top 10 W-Tags W249 – IPP Program Implementation
W104 – Governing Body Oversight
W331 – Nursing Services
W369 – Medication Administration
W149 – Prevention of Abuse, Neglect and Mistreatment

19. Top 10 W-Tags (continued)
W189 – Staff Training Program
W322 – Preventive and General Health Care
W159 – QIDP
W120 – Outside Services
W154 – Thorough Investigations

20. Other Frequently Cited W-Tags
W368 – Medications administered in accordance with physician orders
W263 – Restrictive programs implemented only with informed consent
W153 – All allegations of abuse, neglect, mistreatment & injuries of unknown origin are reported immediately to administrator and/or others according to state law
W436 – Furnish adaptive equipment

21. Other Frequently Cited W-Tags (cont)
W227 – IPP states specific objectives
W262 – Specially constituted committee reviews, approves and monitors all restrictive programs
W312 – Medications used to manage inappropriate behavior may be used only when its an integral part of IPP

22. Training Basic Surveyor Training Web-based Basic Courses – pilot
Two courses per year
Includes onsite experience
Web-based Basic Courses – pilot
Post-training evaluations

23. CMS ICF/IID Surveyor Contract
Augment Regional Offices and State Survey Agencies
Will complete 77 surveys during FY 2013
Assist with CMS training activities

24. Questions ?

25. Thank You for the Opportunity
Contact Information: