The Intermediate Care Facilities for the Developmentally Disabled data presented on CalQualityCare.org is the result of efforts by the Department of Social and Behavioral Sciences and the Institute for Health and Aging at the University of California, San Francisco (UCSF SBS/IHA), a nonprofit and public educational institution dedicated to improving health care quality.
UCSF SBS/IHA publishes CalQualityCare.org and oversees the development and maintenance of this website. UCSF SBS/IHA is also responsible for aggregating the data and compiling the ratings.
UCSF SBS/IHA is dedicated to advancing knowledge of health, illness, and medical illness through theory and research that evaluates the organization, financing, and delivery of health care; and to examine the broad dynamics of health policy and health care services. For more information, visit https://nursing.ucsf.edu/about/departments/social-and-behavioral-sciences.
The data on CalQualityCare.org come from the following California state and United States federal government sources, as well as from recognized accrediting organizations. The data have been gathered in various ways — including facility visits, self-reported data, and information submitted by clients or family members — and at different times. The data on CalQualityCare.org are updated quarterly with the most current information available.
Consumers should pay attention to the date data were collected, which can be accessed through the “more information” popup boxes found next to the data on each provider’s profile page (represented by a question mark button). While we make every effort to ensure the data are as current as possible, we are limited by how often the state and federal governments gather the information.
The data sources for Intermediate Care Facilities for the Developmentally Disabled are:
- Program and ownership information: California Department of Public Health’s Licensing and Certification Program, Electronic Licensing Management System (ELMS)
- Facility characteristics, client and staffing information, deficiency and complaint data, and quality of care: the federal CMS Certification and Survey Provider Enhanced Reporting (CMS CASPER) database
About the Ratings
CalQualityCare.org gives performance ratings to Intermediate Care Facilities for the Developmentally Disabled (ICF/DD) in three areas: Overall, Staffing, and Quality of Facility.
The amount of time staff spend with clients is important to the delivery of high quality care. California and federal law requires all ICF/DD facilities to provide enough staff to adequately care for clients. For general and nursing type ICF/DD facilities, direct care staffing requirements are based on the level of mental retardation (MR) and behavioral characteristics for each client. For habilitative type ICF/DD facilities, the staffing is determined by the number of clients served.
While the scores are tabulated differently for these two groups of facilities, all facility scores are combined, resulting in the five-point scale:
- Superior: Facility scored in the best 15%
- Above Average: Facility scored in the 64 – 86% range
- Average: Facility scored in the 43 – 63% range
- Below Average: Facility scored in the 22 – 42% range
- Poor: Facility scored in the worst 21%
The Staffing Performance Rating is based on the sum of registered nurses (RN), licensed practical and vocational nurses (LVN/LPN), and direct care personnel hours per client per day that is reported on the Centers for Medicare and Medicaid ICF/MR Survey Report Form.
Quality of Facility
The Quality of Facility Rating for ICF/DDs is based on the number of deficiencies the facility receives during routine inspections and complaint investigations over the three most recent survey periods. Deficiencies are violations of federal regulations. Complaints are grievances filed with the California Licensing and Certification (L&C) Program.
More serious condition and fundamental deficiencies, such as quality of care and mistreatment, are given a greater weight in these ratings. Also, due to varying facility types and sizes, calculating deficiencies and complaints by the number of beds in each facility standardized the deficiency data and the complaint data.
Finally, more recent survey information received greater weight than earlier surveys in the determining the Quality of Facility Rating.
- Superior: Facility scored in the best 10%
- Above Average: Facility scored in the 66.7 – 90% range
- Average: Facility scored in the 43.4 – 66.6% range
- Below Average: Facility scored in the 20.1 – 43.3% range
- Poor: Facility scored in the worst 20%
For ICF/DD facilities, the Overall Rating is the Quality of Facility Rating adjusted by the Staffing Rating as follows:
- If the Staffing Ratings is 4 or 5, add one point to the Quality of Facility Rating to get the Overall Rating score
- If the Staffing Rating is 2 or 3, then the Quality of Facility Rating equals the Overall Rating score
- If the Staffing Rating is 1, subtract one point from the Quality of Facility Rating to get the Overall Rating score
Resulting scores cannot be less than one or more than five points.
Technical Guide to the ICF/DD Ratings
To read the complete ratings methodology for ICF/DD facilities on CalQualityCare.org, download the PDF, “Technical Guide to the ICF/DD Ratings.”