Code of Federal Regulations (Last Updated: May 6, 2024) |
Title 42 - Public Health |
Chapter IV - Centers for Medicare & Medicaid Services, Department of Health and Human Services |
SubChapter C - Medical Assistance Programs |
Part 456 - Utilization Control |
Subpart I - Inspections of Care in Intermediate Care Facilities and Institutions for Mental Diseases |
§ 456.609 - Determinations by team.
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§ 456.609 Determinations by team.
The team must determine in its inspection whether -
(a) The services available in the facility are adequate to -
(1) Meet the health needs of each beneficiary, and the rehabilitative and social needs of each beneficiary in an ICF; and
(2) Promote his maximum physical, mental, and psychosocial functioning.
(b) It is necessary and desirable for the beneficiary to remain in the facility;
(c) It is feasible to meet the beneficiary's health needs and, in an ICF, the beneficiary's rehabilitative needs, through alternative institutional or noninstitutional services; and
(d) Each beneficiary under age 21 in a psychiatric facility and each beneficiary in an institution for Individuals with Intellectual Disabilities or persons with related conditions is receiving active treatment as defined in § 441.154 of this subchapter.