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attestation of compliance to EOHHS on December 1, 2020, and bi- annually on May 1st and December 1st thereafter. 3. Providers must allow EOHHS to sample attestations for lookbacks and validation by paid claims reviews and/or conduct on-site reviews and record reviews. The self-assessment and reporting tools shall be available on the EOHHS website. D. At the conclusion of each bi-annual IMD review, EOHHS shall make one (1) of the following determinations: 1. The facility is not at risk of becoming an IMD; 2. The facility is an At-Risk Facility, as defined herein; 3. The facility is determined to be an IMD. E. In determining whether a facility with over sixteen (16) beds is considered an IMD, EOHHS reviews and considers the overall character of the facility. EOHHS consideration shall include, but is not limited to, the following criteria: 1. Whether the facility is designated and/or licensed as a psychiatric or behavioral health facility by the State of Rhode Island Department of Behavioral Healthcare, Developmental Disabilities and Hospitals pursuant to R.I. Gen. Laws Chapters 40.1-5, 40.1-24 and 40.1-24.5; 2. Whether the facility is accredited as a psychiatric or behavioral health facility by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO), or another similarly nationally-recognized accreditation entity, which accredits and certifies health care organizations and programs in the United States; 3. Whether the facility specializes in providing psychiatric and/or psychological care and treatment, as evidenced by consideration of the following indicators: a. Fifty percent (50%) or more of individuals residing in the facility have medical records indicating that they are at the facility because of a mental disease; b. Fifty percent (50%) or more of the facility’s staff have specialized psychiatric/psychological training; c. Fifty percent (50%) or more of individuals residing in the facility are receiving psychopharmacological drugs; and d. Whether the current need for institutionalization for more than fifty percent (50%) of all the individuals at the facility results from mental