For several years I was under the impression that the Intermediate Care Facility (ICF/ID) and Residential Habilitation Center (RHC) where my son lived was also a healthcare facility. We were led to believe that the medical and nursing providers had oversight by the Department of Health which also provided oversight to what was referred to as “the healthcare clinic.”
The ICF/ID and RHCs are NOT healthcare facilities. There is no professional peer review or oversight by the Department of Health. I have learned this lesson after years of frustration trying to get appropriate medical and nursing care for my son who was a resident of the RHC.
While these facilities in Washington State employ Physicians, Nurses, Physical, Occupational and Speech Therapists to provide care to the residents, there is no state oversight of this care to ensure it meets the community standard of care that everyone should be entitled to. The residents and their families/guardians are led to believe that appropriate medical and nursing care is provided but in some cases, I believe this is not happening.
This is a systems problem that no one seems to be able to address. The Department of Health has no oversight, the Department of Social and Health Services does not look at healthcare standards, the Long Term Care Ombudsman does not oversee anything having to to with the Intermediate Care Facility or RHC, Disability Rights Washington (the Protection and Advocacy Agency) has not addressed this problem.
I fully support the idea of an intermediate care facility and a campus community that can provide full service health and behavioral care but the system in place in our state does not meet this standard. It is shameful that the agency which oversees the RHC cannot see that there are major problems ensuring the healthcare for the residents is provided for.
It appears to me that our state is not meeting the Federal Regulations and the so-called “investigations” that have been done have been a waste of time and energy. This is so frustrating – when they can not even see the problem, there is no opportunity to fix it. The whole system is in denial and it is only hurting the very people who are supposed to be helped.
The investigator I spoke with today made it very clear by her repeated statement of “the RHC is not a healthcare facility” and by the regulations she had there were no deficiencies to cite.
I read the Code of Federal Regulations differently though – Below is the exact text from the Code of Federal Regulations – am I reading this incorrectly?
- 440.150 Intermediate care facility (ICF/IID) services.
(a) “ICF/IID services” means those items and services furnished in an intermediate care facility for Individuals with Intellectual Disabilities if the following conditions are met:
(1) The facility fully meets the requirements for a State license to provide services that are above the level of room and board;
(2) The primary purpose of the ICF/IID is to furnish health or rehabilitative services to persons with Intellectual Disability or persons with related conditions;
(3) The ICF/IID meets the standards specified in subpart I of part 483 of this chapter.
(4) The beneficiary with Intellectual Disability for whom payment is requested is receiving active treatment, as specified in §483.440 of this chapter.
(5) The ICF/IID has been certified to meet the requirements of subpart C of part 442 of this chapter, as evidenced by a valid agreement between the Medicaid agency and the facility for furnishing ICF/IID services and making payments for these services under the plan
So, my questions are is our state our of compliance by the ICF/ID or RHC not being a healthcare facility?
If so, how is this remedied?