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2 TITLE 16 HEALTH AND SAFETY DELAWARE ADMINISTRATIVE CODE that remain clinically valid. Exception: The resource test will be waived at annual renewal. If the case worker receives asset information after a renewal has been completed, the receipt of new information will be treated as a change in circumstances. See Section 14820.1 How Changes in Circumstances affect Continuous Eligibility. 29 DE Reg. 610 (01/01/26) 25200 CAREGIVER QUALIFICATIONS The primary person in charge of the care of a child, usually a family member or a designated health care professional meeting the following qualifications: The individual must be willing to accept the responsibility of the care of the child. The individual must be trained and/or display competence in the medical skill required by the child. 25250 GENERAL LEVEL OF CARE FACTORS 1. The assessment of whether a child’s profile is consistent with a qualifying level of care is influenced by multiple considerations. Material criteria include the following mental, physical, familial, and environmental factors: a. Chronological and developmental age of child; b. Nature and severity of disease or medical condition(s); c. Symptomatology or functional limitations attributable to disease or medical condition (s); d. Stability of disease process or medical condition(s); e. Physical environment; f. Availability and profile of primary caregiver(s); g. Potential for harm, regression, or developmental delay in absence of services; h. Extent of assistance necessary for child to engage in activities of daily living ("ADLs") i. Extent of monitoring or supervision necessary to minimize potential for harm due to mental or physical health risks (e.g. suicide; elopement; self injurious behaviors; seizure); and j. Extent to which professional or specialized personnel (e.g. nurse; therapist) are necessary to provide monitoring, assistance, or services. 2. Since some debilitating diseases and medical conditions (quadriplegia; profound mental retardation) are highly correlated with a qualifying level of care, the Division may adopt presumptive eligibility guidelines to expedite processing of such applications. 25300 SPECIFIC LEVEL OF CARE STANDARDS 25300.1 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: