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Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICF-IID)

Intermediate Care Facility (ICF) for individuals with developmental disabilities is licensed by the Ohio Department of Developmental Disabilities (DODD), to be operated by a specific provider at a specific location. The Department of Health (DOH) certifies the licensed facility as meeting the Federal requirements for funding as an ICF-IID. The provider is responsible for all aspects of care for the individual, including financial matters, transportation, habilitation, and medical needs.​ 


As this program has recently transferred to DODD from the Ohio Department of Job & Family Services (ODJFS), DODD is reviewing the program.  A policy workgroup, made up of state staff and industry stakeholders, will lead the review of several aspects of the program including the vision for the future of the program, the current Individual Assessment Form (IAF) and the reimbursement structure.  Updates from those groups, as well as other program updates will be posted here as they occur.

Updated 6/10/14 – The department has issued the following communication regarding changes to ICF-IID licensure terms.

Updated 2/12/14 – The department has issued the following communication regarding changes to the Resident Assessment Classification (RAC) system used with the IAF beginning with FY15 rate setting. 

Updated 11/5/13 – The department has issued the following memo regarding FY15 rate methodology changes for LARGE (9 beds or more) ICFs.

Updated 10/17/13 – The department has issued the following memo regarding ICF cost reports and the BWC payout for 2013.

*Updated 5/2/13 – The department is keeping a list of frequently asked questions regarding the IAF.  These are being updated as trainings take place and providers have questions related to the IAF.  Please continue to check back here for updates to the FAQs.  If you have questions related to the IAF, please email 

*Updated 12/4/12 – Department communication regarding Individual Assessment Forms.

*Update 8/6/12 – DODD releases “White Paper” outlining the future of the ICF Program

ICF Voluntary Conversion

ICF Providers have the opportunity to participate in a voluntary conversion initiative for individuals who would prefer to receive Home and Community Based Services (HCBS) through a waiver.  The individual would have the opportunity to use the funding they currently receive in the ICF to fund a HCBS waiver.  Since the funding will be used for the waiver, the provider will surrender the ICF certification for the bed that the individual is currently occupying.  This effort will not only assist the state in our long-term care rebalancing efforts, but will provide individuals with the opportunity to receive services in their preferred setting. 

DC Downsizing

DODD Developmental Centers (DCs) are continuing their efforts to allow individuals to move into Home and Community Based waiver settings or private ICFs.  There are several options available to individuals in our DCs, including the option to move to a non-state operated ICF.  In this case, the ICF provider may either have the individual from the DC fill a current vacancy or if there is an individual currently residing in that ICF who would like to be served o​n a waiver, the individual from the ICF can move to a waiver setting, creating a vacancy for the individual from the DC.  In this effort, the funding from the DC individual will be used to fund the waiver of the individual leaving the ICF.  Since the ICF will be serving the individual from the DC, they will not need to surrender their ICF certification for the bed.

​Intermediate care facilities - definitions
​Intermediate care facilities - provider agreements
​Intermediate care facilities - institutions eligible to participate in medicaid
Intermediate care facilities - payment during the Ohio office of medical assistance administrative appeals process for termination of a provider agreement
Intermediate care facilities - payment during the state survey agency's administrative appeals process for termination or non-renewal of medicaid certification
Intermediate care facilities - level of care review process
Intermediate care facilities - resource assessment notice
Intermediate care facilities - coverage of bed-hold days for medical necessity and other limited absences
Intermediate care facilities - personal needs allowance accounts and other resident funds
Intermediate care facilities - outlier services for behavioral redirection and medical monitoring
Intermediate care facilities - relationship of other covered medicaid services
Intermediate care facilities - medicaid cost report, record retention, and disclosure requirements
Intermediate care facilities - rate recalculations, interest on overpayments, penalties, repayment of overpayments, and deposit of repayment of overpayments
Intermediate care facilities - debt estimation, debt summary report, and successor liability agreements for change of operator, facility closure, voluntary termination, involuntary termination, or voluntary withdrawal
Intermediate care facilities - payment and adjustment process
Intermediate care facilities - chart of accounts
Appendix - Chart of Accounts
Intermediate care facilities - leased staff services
Intermediate care facilities - capital asset and depreciation guidelines
Appendix - Estimated Useful Lives of Capital Assets
Intermediate care facilities - nonreimbursable costs
Intermediate care facilities - resident assessment classification and case mix payment system
Intermediate care facilities - compensation cost limits, reasonable costs for compensation, and compensation disallowances if any for owners and relatives of owners
Intermediate care facilities - compensation cost limits, reasonable costs for compensation, and compensation disallowances if any for administrators
Intermediate care facilities - method for establishing the other protected costs component of the prospective rate
Intermediate care facilities - cost of ownership, efficiency incentive, and reporting of accumulated depreciation
Intermediate care facilities - nonextensive renovation
Intermediate care facilities - active treatment day programming
Intermediate care facilities - prospective rate reconsideration on the basis of possible calculation errors
Intermediate care facilities - prospective rate reconsideration on the basis of extreme hardship upon admission of a resident from a state-operated developmental center
Intermediate care facilities - outlier services for pediatric
ventilator services.
Intermediate care facilities - exception review process.
ICF Forms  
ICF Resources  
ICF Communications
DODD periodically has information to communicate regarding ICFs and has created an email distribution list.  If you would like to receive periodic updates on the ICF program, please subscribe by:
Sending an email to and request to be added. 
ICF Related Articles
Link to Assistant Attorney General Perez testimony before Senate HELP Committee summarizing Olmstead enforcement activity: 
Link to Hilltop Institute report on Rebalancing Long-term Services and Supports: