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UNOFFICIAL 1737-39 C.F.R. §§456.350, 456.351, 456.360, 456.370, 456.380, 456.381, 456.400, 456.401, 456.405 - 456.407, 456.411 - 456.413, 456.431 - 456.438)

§17-1737-36 Inspection of care (IOC) reviews in ICF-MR facilities. The department shall be responsible for conducting periodic inspection of care review in ICF-MRs to evaluate the utilization of care and services provided to the client: (1) Inspection of care team members shall be employees of the department, and may consist of a physician or a registered nurse, and a social worker. One of the team members shall be a QMRP. If a physician is not on the team, a physician shall be available to provide consultation to the team; (2) Frequency of inspection shall be based on the quality of care and services provided by the facility, and on the condition of clients in the facility. However, at the minimum, each client shall be evaluated once annually; (3) No facility shall be notified of the time of inspection more than forty-eight hours before the scheduled arrival of the team; (4) Method of inspection shall be by personal contact with and observation of each client, and review of each client's medical record to determine the following: (A) Whether the facility services are adequate to meet the health needs of each client, the rehabilitative and social needs of each client and to promote maximum physical, mental, and psychosocial functioning; (B) Whether continued stay in the facility is necessary and desirable; (C) Whether it is feasible to meet the client's health needs, and in an ICF-MR the client's rehabilitative needs through alternative institutional or noninstitutional services; and (D) Whether each client is receiving active treatment in accordance with the provisions of section 17-1737-30; (5) The determinations on adequacy of services and related matters stipulated in paragraph (4) shall be based on, but not limited to, such items as whether: