Intermediate-Care Facilities (ICFS)

Intermediate-care facilities (ICFs) are a type of care facility for individuals such as the elderly, not acutely ill, mentally ill, or disabled, who are not able to live independently but do not require constant care. Thus, ICFs provide services to patients with health conditions that do not necessarily require hospitalization or skilled nursing care but present a need for subacute care. Intermediate care is generally provided to patients who are medically stable but are not stable enough to be treated in other healthcare settings such as in a long-term care facility, at home, or on an outpatient basis. ICFs are generally a location for patient recuperation or [Page 649]rehabilitation following an acute episode or a place for the chronically ill to receive care to avoid inappropriate hospitalizations.

The term intermediate care implies that the care is provided on a transitional basis, as if moving from one level of care to another. Therefore, intermediate care may refer to the services provided to the patient during the transition stage between hospitalization and home and from needing acute medical attention to being functionally independent. Patients of ICFs generally receive 24-hour care from a multidisciplinary team of health professionals. Some ICFs may resemble nursing homes, providing services in a residential setting, while others may also care for the elderly. ICFs may offer medical, social, and support services to patients; however, the focus of these facilities is on rehabilitating individuals so that they are able to regain the functions of independent daily living and return to a home setting.

Although there are ICFs that treat people with various health conditions, including the acutely and chronically ill, this entry focuses on ICFs for people with mental illness and developmental delays. ICFs for the Mentally Retarded (ICF/MR) in the United States are certified by the Centers for Medicare and Medicaid Services (CMS) and state Medicaid programs. The care provided at these facilities is an optional benefit for Medicaid clients who qualify. The program was originally established in 1971 as a result of federal legislation.