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Residential health care facilities that provide developmental services including training and support in life skills such as mobility, socialization, employment and recreation as well as skilled nursing services for children and adults with developmental disabilities (or a developmental disability and one or more secondary impairments) who require a level of medical care, support and supervision not available in group homes or other community care settings or through supported living arrangements, but who do not need full-time intensive medical care or support. Included are Intermediate Care Facilities/DD for people who have a primary need for developmental services and a recurring but intermittent need for skilled nursing services; Intermediate Care Facilities/DD-Habilitative for people who have a primary need for developmental services and an ongoing, predictable but intermittent need for skilled nursing services; and Intermediate Care Facilities/DD-Nursing for people who have a primary need for developmental services and a continuous need for skilled nursing services to monitor medication or medical conditions. These facilities are licensed by the state which also certifies that federal guidelines have been met.