Nursing standards of practice and persons with intellectual and developmental disabilities
Nine nurse researchers read all 141 competencies in the national IDD nursing standards and looked for 14 ideas. Holistic Health appears in 78 percent of them. Cultural Competence appears in none. What the 2026 study says about the newer approach to this work, and what a nurse in a six-bed home can do about it.
Victor Ramayrat
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Aug 28, 2026
10 min read →
A surveyor does not read your IPP. They test it.
A surveyor tests four things against each other: the plan, the data, the notes, and the caregiver on shift. Findings live in the gaps. A walk through what the rules actually ask of a 6-bed home, and the ninety-minute check that keeps you ready all year.
Victor Ramayrat
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Aug 28, 2026
11 min read →
Thinking of opening an ICF/DD facility? Here are some insights for starting one in California.
The regional center decides whether the beds are needed. DDS approves the program plan before CDPH issues a licence. Then come 280 direct care hours a week, eight of them licensed, against a per diem that puts a six-bed home at the bottom of its own band.
Victor Ramayrat
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Aug 26, 2026
10 min read →
With all the costs involved, is it worth opening an ICF?
At six occupied beds you earn $67.68 for every hour of direct care the state requires. At five beds you earn $56.40 for the same hours, because the staffing floor does not move. The honest math on a six-bed home, and why people do it anyway.
Victor Ramayrat
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Aug 24, 2026
9 min read →
Your license does not pass to your children. Your plan has to.
Slightly more than half of American employer businesses are owned by someone over 55, and most have no documented plan. In licensed care a handover is also a relicensing event, so the successor has to qualify in their own right.
Victor Ramayrat
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Aug 21, 2026
9 min read →
The evolving landscape of intellectual and developmental disability care.
The federal settings rule turned lockable bedroom doors, roommate choice and access to food at any time into conditions of Medicaid payment. Meanwhile institutional cost per person more than doubled in real terms as the census halved. Four shifts, and what they ask of a six-bed home.
Victor Ramayrat
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Aug 19, 2026
11 min read →
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