Subcommittee approves licensing changes for intermediate-care facilities to reflect statutory medication rules and need-based staffing

The subcommittee approved regulation document 53-47, which updates licensing standards for intermediate-care facilities for individuals with intellectual disabilities (ICF-IID) to reflect statutory changes allowing certain unlicensed persons to administer medications and to align state licensing standards with applicable federal rules.

DPH staff told the committee the amendments follow a 2022 statutory change (Act 179) that amended the Nurse Practice Act to permit some unlicensed persons to give medications in correctional and intermediate-care settings when appropriate. The regulation package provides the regulatory underpinning for that statutory change, and staff said they are not aware of reported adverse outcomes tied to those statutory, authorized practices.

The proposal also replaces fixed shift-based staffing language (first, second, third shift) with a need-specific regimen tied to individual resident needs and federal compliance and reimbursement requirements. Committee members said the need-based approach appears to match federal Medicare/Medicaid expectations and could reduce conflict between overlapping regulatory requirements.

The subcommittee approved the regulation by voice vote and asked no substantive amendments at the hearing. DPH staff noted that regional federal standards (CFR references) were used to align state licensing with reimbursement and quality requirements.