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UNOFFICIAL 1700.1-4 “Acuity level or level of medical care” means one of the following types of inpatient services: NF or ICF-ID. “Acuity level A” means that the department has applied its standards of medical necessity and determined that an individual requires a level of medical care from a nursing facility relatively lower than acuity level C. Prior to October 1, 1990, that level of care was appropriately obtained from an ICF. “Acuity level B” means that the department has applied its standards of medical necessity and determined that an individual requires the level of medical care and special services that are appropriately obtained from an ICF/MR. “Acuity level C” means that the department has applied its standards of medical necessity and determined that an individual requires a level of medical care from a nursing facility relatively higher than acuity level A. Prior to October 1, 1990, that level of care was appropriately obtained from an SNF. “Acuity level D” means that the department has applied its standards of medical necessity and determined that an individual requires a level of medical care that is relatively higher than acuity level C, but less than acute. “Acuity ratio” means the estimated average acuity level A direct nursing costs divided by the estimated average acuity level C direct nursing costs, as determined by the department. For the FY 98 rebasing, the department has determined the ratio to be 1.00:0.8012. “Acute care services” means the short term medical treatment, usually in an acute care hospital, for individuals having an acute illness or injury. “Adequate notice” means a notice sent to an individual no later than the date of the action affecting medical eligibility that includes: (1) A statement of the action the department has taken or intends to take; (2) The reason for the intended action; (3) The specific departmental rule supporting the action;