IDR Introduction & Purpose

10002.1 – IDR Introduction & Purpose (Rev. 221; Issued: 05-10-24; Effective: 05-10-24; Implemetation:05-10-24) Section 488.745 and 488.1130 offers HHAs and hospice programs the option to request an informal opportunity to dispute condition-level survey findings warranting an alternative sanction following a facility’s receipt of the official statement of deficiencies (Form CMS-2567). Whenever possible, we want to provide every opportunity to settle disagreements at the earliest stage, prior to a formal hearing, conserving time and money potentially spent by the facility, the SA, and CMS. The goal of IDR is to offer the facility an opportunity to refute one or more condition-level deficiencies cited on the statement of deficiencies. An IDR between an HHA or hospice program and the SA or CMS Location, as appropriate, will allow the facility an opportunity to provide an explanation of any material submitted to the SA and respond to the reviewer's questions (77 FR 67141). This IDR will occur with the agency who conducted the survey. The IDR process, as established by the State or CMS Location, must be in writing so that it is available for review upon request. If the survey is conducted by the CMS Location, the CMS Location may conduct the IDR. CMS has adopted the following elements to be incorporated in all cases involving deficiencies cited as a result of Federal surveys. They are designed to clarify and expedite the resolution process. States are free to incorporate these elements into their procedures. 1. Notice to the facility will indicate that the IDR, including any face-to-face meetings, constitutes an informal administrative process that in no way is to be construed as a formal evidentiary hearing. 2. Notice to the facility will indicate that counsel may accompany the HHA or hospice program. If the facility chooses to be accompanied by counsel, then it must indicate that in its request for IDR, so that CMS may also have counsel present. 3. CMS will verbally advise the facility of CMS’s decision relative to the informal dispute, with written confirmation to follow.