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State of California—Health and Human Services Agency
California Department of Public Health

AFL 13-06
April 15, 2013

Intermediate Care Facilities for the Intellectually Disabled

No Longer Certified Under Time-Limited Agreements

AUTHORITY:      Title 42 Code of Federal Regulations (CFR) Section 442.15, 442.109; Section 3012 of the State Operations Manual

This All Facility Letter (AFL) outlines the Survey and Certification Letter 13-11, issued by the Centers for Medicare and Medicaid Services (CMS) on February 8, 2013, which announced that Title 42 CFR Section 442.15 was amended to eliminate time-limited agreements for providers of Intermediate Care Facilities for the Intellectually Disabled (ICF/IID), previously referred to as Intermediate Care Facilities for the Mentally Retarded.

Effective, May 16, 2012, ICF/IID’s are no longer subject to time-limited agreements. Provider agreements will now remain effective for as long as the facility complies with the Conditions of Participation.

Recertification surveys are required an average of every 12 months and at least once every 15 months (Title 42 Code of Federal Regulations Sections 442.109(a) and (b)).

If during a survey, a facility is found not to meet the standards for participation the facility may maintain its certification if no Immediate Jeopardy exists and if the facility provides an acceptable plan of correction to the survey agency (the Licensing and Certification Program).

The ICF/IID may become decertified if an Immediate Jeopardy remains unabated after 23 days or it fails to regain compliance with Conditions of Participation within 90 days. Please consult Section 3012 of the State Operations Manual for the decertification procedures.

CMS’s Survey and Certification Letter 13-11 is attached for your review.

Facilities are responsible for following all applicable laws. The California Department of Public Health’s failure to expressly notify facilities of statutory or regulatory requirements does not relieve facilities of their responsibility for following all California and federal laws and regulations.

If you have any questions, please contact your local District Office.



Original signed by Pamela Dickoss for

Debby Rogers, RN, MS, FAEN
Deputy Director


Attachment: CMS S&C Letter 13-11

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