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Requirements for Intermediate Care Facilities (ICFs) authorized under 1135 Waivers

Issued: September 30, 2020 


Intermediate Care Facilities for Persons with an Intellectual Disability (ICF/ID), Intermediate Care Facilities for Persons with Other Related Conditions (ICF/ORC)


During emergencies, the Centers for Medicare and Medicaid Services (CMS) has the authority to temporarily modify or waive some Federal requirements. These types of waivers are authorized under section 1135 of the Social Security Act (SSA) and are commonly referred to as “1135 waivers.” In response to the COVID-19 pandemic, CMS has issued blanket waivers for many provisions, which means that a waiver or modification to the specified requirement does not require individualized approval.

The Office of Developmental Programs (ODP) submitted a request for an 1135 waiver of certain requirements under 42 CFR §§ 483.400 – 483.480 (relating to Conditions of Participation for Intermediate Care Facilities for Individuals with Intellectual Disabilities) that are not covered under the blanket waivers approved by CMS. On July 26, 2020, ODP received notification from CMS of the provisions for which ODP’s requests for an 1135 waiver were approved. In their response, CMS included clarification to some requirements, regardless if they were waived or modified. Attached is a document that outlines requirements that have been modified, waived, or clarified by CMS.

Blanket waivers as of August 20, 2020 are included in the document attached below and labeled as such. They are updated periodically by CMS and can be found on the CMS website. ODP recommends providers review the blanket waivers on the CMS website often to remain updated.

The section 1135 waivers described in this attachment are effective March 1, 2020 and will terminate upon termination of the Federal Public Health Emergency, including any extensions. In no case will any of these waivers extend past the last day of the Federal Public Health Emergency (or any extension thereof).

Questions about these waivers can be directed to Kevin Dressler, Director of the Bureau of State Operated Facilities at

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