An intermediate care facility for individuals with intellectual disabilities (ICF/IID) is designed and functions to meet the needs of four or more individuals with developmental disabilities or related conditions, who require 24-hour active treatment services, and who are unrelated to the proprietor.
The primary purpose of an ICF/IID facility is to provide for the health and rehabilitative needs of the individuals living at the facility in an effort to maximize their independence and maintain functioning to the maximum extent possible in the presence of degenerative conditions. These services are provided under a contract with the Medicaid program.
Application Process
To begin the application process, contact the Bureau of Facility Standards at (208) 334-6626, option 2 or fsb@dhw.idaho.gov to set up an initial meeting. Applicants seeking Medicaid Certification and state licensure as an ICF/IID must complete and submit an application packet. Application packet materials (items #1 and #3) are located below or can be requested through the Bureau of Facility Standards at (208) 334-6626, option 2.
All items must be submitted to the Bureau of Facility Standards for review and approval.
Additionally, all building construction plans must be submitted for review and approval by the Fire Safety and Construction Program Supervisor. For additional information regarding these requirements, please refer to the Fire Safety and Construction website.
The application packet (items #1 and #3) must be submitted and approved prior to an initial certification survey. Items #5 - #8 are regulatory appendices and additional information resources related to ICFs/IID.
1. Initial Application Form
2. Required Facility Information Sheet
3. The facility’s Emergency Preparedness Plan as required per Appendix Z.
4. ICF/IID Application Process Information
5. Appendix J: Guidance to Surveyors: Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICFs/IID).
6. Exhibit 355: Probes and Procedures for Appendix J
7. Appendix Q - Guidelines For Determining Immediate Jeopardy.
8. Appendix Z - Emergency Preparedness (EP) requirements.
Submit all required application packet materials (items #1 - #3 above). All applications materials must be legible and easily readable. Information may be submitted on a flash drive. KEEP A COPY FOR YOUR RECORDS.
Mail a completed application to:
Department of Health and Welfare
Bureau of Facility Standards
Attn: ICF/IID Program
P.O. BOX 83720
BOISE, ID 83720-0009
For additional information and document assistance refer to CMS Exhibit 63 and the Centers for Medicare & Medicaid Services Intermediate Care Facility for People with Intellectual Disabilities (ICF/IID) website.
Become a Medicaid Provider
To become an Idaho Medicaid provider, you must submit an Idaho Medicaid provider enrollment application to Gainwell Technology, Idaho’s Medicaid Management Information Systems (MMIS) Vendor. To submit an Idaho Medicaid provider enrollment application, go to Idaho Gainwell Technology's Online Portal for Medicaid Providers and register for a trading partner account, or call 866-686-4272 for more information. A step-by-step user guide can be found by selecting Reference Material, User Guides, New Provider Enrollment Guide. Additional provider enrollment help is available by contacting your Provider Relations Consultant or Provider Services.
