What to Expect from the Informal Dispute Resolution (IDR) Process: A Guide for Assisted Living Operators
Recent changes to Colorado’s assisted living regulations, specifically 6CCR 1011-1, Chapter 7, have made the Informal Dispute Resolution (IDR) process more appealing as a first option in challenging deficiency findings. These changes, coupled with increased penalties imposed by the Colorado Department of Public Health and Environment (CDPHE), make it crucial to understand what to expect from the IDR process.
The IDR Process: What to Expect
Firstly, the process in not actually a “dispute resolution process.” In an earlier article we discuss that is an informal review panel composed of five members. The panel includes:
Two representatives from assisted living providers.
One representative from the Division (CDPHE).
One Ombudsman.
One representative from the Colorado Department of Health Care Policy and Financing (HCPF).
The IDR process provides a limited opportunity for assisted living operators to contest deficiencies cited by the CDPHE. While the IDR Panel can only make recommendations to the Health Facilities and Emergency Services Division Director, their recommendations carry are significant and can impact the final decision. Here’s what the IDR committee can recommend:
1. Sustain the Deficiency as Written: The deficiency remains unchanged.
2. Delete the Deficiency Entirely: The deficiency is removed from the record.
3. Amend the Deficiency: Specific examples within the deficiency may be deleted, especially in cases involving federal nursing facility (NF) surveys where the deficiency was cited at Immediate Jeopardy (IJ) or Substandard Quality of Care (SQOC).
4. Move the Deficiency: The deficiency may be reassigned to another category or given a new classification.
5. Reduce the Scope and Severity: The severity and scope of the deficiency may be lessened.
The panel cannot and will not evaluate the behavior or competency of the surveyors, and will generally restrict their review to the accuracy of the facts presented in the Department’s Deficiency Letter, and where or not they believe there was a “potential for harm.”
The more serious penalties being imposed by the Department, along with the reputational stigma that can attend a level C, D, or E deficiency, elevate the importance of the IDR process as a necessary step prior to filing an administrative appeal. By effectively challenging unjust deficiencies, you can mitigate penalties and avoid the adverse impacts associated with higher-level deficiencies.
For more detailed information on the IDR process and recent regulatory changes, you can visit our blog [here].
The content here is provided for your general education and is not legal advice specific to your situation. The IDR is an important step but does not require an attorney. Indeed, a licensee is not permitted to use an attorney for the presentation. However, involvement of an attorney may be helpful at this stage if there is a possibility of an appeal to the administrative courts. You should discuss this with your attorney or contact us if you want a discussion more specific to your situation.
We can be reached at info@pinkowskilaw.com if you have comments or questions about this topic.