Long Term Care

Get Free Quotes

/ /

Intermediate Care Insurance Plan Types and Rates

What Goes on in an Intermediate Care Facility?

An intermediate care facility is a health care center for the elderly, disabled, and the non-acutely ill. These facilities offer less intensive health care than a skilled care facility or a hospital. It is the place for people with different emotional or physical conditions that require institutional care minus the degree of care offered by a hospital or a nursing home. These facilities can be categorized according to the type of care they provide. For example, there is an intermediate care facility specifically for the mentally-retarded or a facility that caters only to developmentally-disabled residents.

Another way to describe an intermediate care facility is a place for people suffering from chronic conditions and not able to live independently, while not needing constant monitoring or care. These facilities give nursing supervision and supportive care under doctor’s orders round the clock, but they do not provide continuous nursing care. The emphasis is on rehabilitation therapy in these facilities. They focus on enabling individuals to go back to a home environment or to retain or regain as many activities of daily living as possible. Intermediate care facilities offer a wide range of medical, recreational, social, and support services. Sometimes there are facilities that offer both skilled care and intermediate care.

Intermediate Care Facilities for Individuals with Mental Retardation

There are intermediate care facilities that cater especially for individuals with intellectual disability or the mentally retarded. These facilities offer individualized and comprehensive rehabilitation and health care services with the aim of promoting the patient’s independence and functional status. This type of care is also offered as an optional benefit under the Medicaid and is offered across the country in every state.

Medicaid Eligibility for ICF/MR Benefit

This optional Medicaid benefit is available for people in need of, and are already, receiving active treatment services. Active treatment means the consistent and aggressive application of a medical care program of both generic and specialized treatment, health services and training. This type of treatment does not cover services aimed at maintaining independent individuals who can function and who do not need a continuous health care program or rehabilitation service. By law, states cannot limit people’s access to this type of service or make people wait in line to obtain it. This is why ICF/MR services may sometimes be more readily available than other care options like long term care. The individuals who are in need of these services are assumed to have already established their disability status and their Medicaid eligibility.

Included Services

Intermediate care facilities give active treatment, aggressive, continuous, and consistent implementation of a medical program of generic or specialized treatment, training, and health services. The service is focused on helping the enrollee move and function with as much independence and self-determination as possible. Federal regulations offer a wide range of facility and services requirements for implementing services. All the services being offered including nutrition and health care services are part of the aggressive treatment plan. The determination of the required services is based on an individualized program plan after an evaluation. This treatment plan is set in place by an interdisciplinary team of qualified professionals. The survey and certification of an intermediate care facility lays out all the facility requirements, which include staffing, management, governing body, client behavior, client protections, and the physical environment.

The Day Program

A lot of intermediate care facilities are run by residents who work within the community. They support and participate in vocational activities or other activities outside the resident. They get involved in community interests of their own choosing. These activities are collectively known as day programs. The intermediate care facility in a certain community will be responsible for all the activities, particularly the day programs. This is because the idea of aggressive treatment suggests that all aspects of service and support to the enrollee should be coordinated and focused on specific individualized goals.

Where Are These Services Provided?

The Medicaid optional coverage for intermediate care facilities can only be availed of in a licensed residential facility that has been certified by the survey agency of the state as an official intermediate care facility. Intermediate care facilities are provided only when there are no other available payment options for the individual and if the individual is eligible for Medicaid.