42 CFR § 483.120

§ 483.120 Specialized services.

This federal regulation defines 'specialized services' for nursing facility (NF) residents with serious mental illness (MI) or intellectual/developmental disabilities (IDD), and establishes State obligations to provide or arrange those services. For MI residents, specialized services require an interdisciplinary team-developed plan targeting acute episodes, symptom reduction, and improved independent functioning. For IDD residents, specialized services must meet the requirements of 42 CFR § 483.440(a)(1). Nursing facilities must also provide lower-intensity mental health or IDD services to residents who need them but do not require the full specialized services level.

§ 483.120 Specialized services.

(a) 
Definition
—(1) For mental illness, specialized services means the services specified by the State which, combined with services provided by the NF, results in the continuous and aggressive implementation of an individualized plan of care that—

(i) Is developed and supervised by an interdisciplinary team, which includes a physician, qualified mental health professionals and, as appropriate, other professionals.

(ii) Prescribes specific therapies and activities for the treatment of persons experiencing an acute episode of serious mental illness, which necessitates supervision by trained mental health personnel; and

(iii) Is directed toward diagnosing and reducing the resident's behavioral symptoms that necessitated institutionalization, improving his or her level of independent functioning, and achieving a functioning level that permits reduction in the intensity of mental health services to below the level of specialized services at the earliest possible time.

(2) For intellectual disability, specialized services means the services specified by the State which, combined with services provided by the NF or other service providers, results in treatment which meets the requirements of § 483.440(a)(1).

(b) 
Who must receive specialized services.
 The State must provide or arrange for the provision of specialized services, in accordance with this subpart, to all NF residents with MI or IID whose needs are such that continuous supervision, treatment and training by qualified mental health or intellectual disability personnel is necessary, as identified by the screening provided in § 483.130 or §§ 483.134 and 483.136.

(c) 
Services of lesser intensity than specialized services.
 The NF must provide mental health or intellectual disability services which are of a lesser intensity than specialized services to all residents who need such services.