16 Del. Admin. Code § 25000-25300
Current through Register Vol. 28, No. 7, January 1, 2025
Section 25000-25300 - SPECIFIC LEVEL OF CARE STANDARDS25300.1 DEFINITION OF INSTITUTIONAL SETTING An institutional setting is a residential placement that provides room board and health related services, which are supervised by a licensed practitioner. The setting has the necessary professional personnel, equipment and facilities to meet the health and functional needs of the child on a continuing or repetitive basis and is authorized under State law to provide such care.
25300.2 DEFINITION OF HOSPITAL LEVEL OF CARE A hospital is an institutional setting that provides medical, nursing and allied health care for acute or chronic illnesses. Such a setting includes at least daily physician intervention and the availability of around the clock professional nursing care. A hospital may provide general medical care or specialized care (e.g. psychiatric or rehabilitative).
25300.3 DEFINITION OF SKILLED NURSING FACILITY LEVEL OF CARE Skilled nursing facility (SNF) is an institutional setting, which provides skilled nursing or rehabilitation, services for mental or physical conditions. Such a setting includes availability of around the clock professional nursing observation, assessment or intervention.
25300.4 DEFINITION OF INTERMEDIATE NURSING FACILITY LEVEL OF CARE Intermediate care nursing facility (ICF) is an institutional setting in which nursing and allied health care and support services are provided. Such services are supervised by but not necessarily given by a licensed nurse.
25300.5 DEFINITION OF ICF/IMD LEVEL OF CARE An intermediate care facility for mental disease (ICF/IMD) is a residential setting which offers comprehensive clinical and support services to persons with significant behavioral health disorders. Children who qualify for an ICF/IMD level of care exhibit a severe, complex, or chronic behavioral health disorder. Such disorder must compromise age-appropriate functioning in multiple areas and require frequent or intensive medical or behavioral interventions (e.g. drug therapy; professional counseling; behavior management techniques). Subject to full consideration of factors itemized in Section DSSM 25250), the presence of the following disability-related personal characteristics supports qualifications under an ICF/IMD level of care:
| a. | impaired judgment or insight |
| b. | disorientation to time, place, or person |
| d. | perceptual or thinking disturbance |
| e. | lack of self-regulation or impulse control |
| f. | diminished capacity to focus, concentrate, or maintain attention |
| g. | propensity to engage in verbal or physical aggression towards others |
| h. | marked changes in mood or affect |
| i. | marked withdrawal, isolation, or depression |
| k. | appetite disturbance with change in weight |
| l. | marked difficulty in maintaining interpersonal relationships |
25300.6 DEFINITION OF ICF/MR LEVEL OF CARE An intermediate care facility for the mentally retarded (ICF/MR) is a residential setting which offers comprehensive habilitative and support services to persons with mental retardation or related conditions. Children who qualify for an ICF/MR level of care exhibit significant deficits in age-appropriate functioning in multiple domains. As a consequence, they require frequent assistance or supervision to competently or safely engage in activities of daily living (ADLs). Subject to full consideration of factors itemized in Section DSSM 25200, the presence of adaptive behavior deficits in the following contexts supports qualification under an ICF/MR level of care:
| g. | receptive and expressive communication |
| i. | co-occurrence of physical or behavioral health disorder |
| j. | co-occurrence of alcohol or substance addiction or misuse |
16 Del. Admin. Code § 25000-25300