For purposes of this Part, the following terms shall be
defined as follows:
"IMD" means a nursing facility that is considered to be an
Institution for Mental Diseases (IMD) under Section 1905(i) of the Social
Security Act (
42 USC
1396 d(i)). Federal regulations provide that:
An IMD is primarily engaged in providing diagnosis, treatment, or care of
persons with mental diseases, including medical attention, nursing care, and
related services. An IMD has an overall character of a facility established and
maintained primarily for the care and treatment of individuals with mental
diseases. An institution for the mentally retarded (ICF/MR) is not an IMD (see
42 CFR
435.1009) .
"Class I IMD" means a nursing facility determined to be an
IMD during the initial review conducted pursuant to Section
145.40.
"Class II IMD" means a nursing facility determined to be an
IMD in a subsequent review conducted pursuant to Section
145.50.
"IMD Guidelines" means the Guidelines in Section 4390 of the
CMMS State Medicaid Manual relating to Institutions for Mental Diseases
(Centers for Medicare and Medicaid Services, 7500 Security Boulevard, Baltimore
MD 21244-1850 (1994, no later amendments or editions included)). Criteria used
in determining whether the overall character of a facility is that of an IMD
include whether the current need for institutionalization for more than 50
percent of all the patients in the facility results from mental diseases and
whether the facility specializes in providing psychiatric/psychological care
and treatment.
"Mental Disease" means mental disease or mental illness as
defined in the IMD Guidelines. Mental disease includes those diseases listed as
mental disorders in the International Classification of Diseases, 9th Revision,
Clinical Modification (ICD-9-CM) until implementation of the International
Classification of Diseases, 10th Revision, Clinical
Modification (ICD-10-CM) and its classifications for mental disorders, with the
exception of mental retardation, senility and organic brain syndrome.
"Current need for nursing facility care results from mental
disease" means that a review of the resident's diagnoses, the character and
nature of his or her problems, functional status, and his or her care needs
indicates that the resident's need for nursing facility care results from his
or her mental disease and not a physical or medical reason.
