Administrative Rules of Montana › Department 37 - PUBLIC HEALTH AND HUMAN SERVICES › Chapter 37.5 - FAIR HEARINGS AND CONTESTED CASE PROCEEDINGS › Subchapter 37.5.6 - Certification of Long Term Care Facilities Informal Dispute Resolution › Rule 37.5.603 - OPPORTUNITY FOR INFORMAL DISPUTE RESOLUTION

Current through Register Vol. 13, July 5, 2024
(1)
				A facility may request an informal dispute resolution to refute a deficiency
				citation made by the state survey agency.
(2) An informal dispute resolution is a
				different and separate form of procedure from an administrative review and/or
				fair hearing. A facility is not entitled to an administrative review, fair
				hearing or other process in addition to an informal dispute resolution unless
				specifically provided for by department rule or otherwise required by
				law.
(3) Informal dispute
				resolution is an informal opportunity for the facility to dispute deficiency
				citations. Informal dispute resolutions conducted under this chapter are
				subject to neither the provisions of the Montana Administrative Procedure Act,
				Title 2, chapter 4, MCA, nor to statutory rules or provisions regarding civil
				procedure or evidence.
(4) This
				rule does not require that the informal dispute resolution be conducted prior
				to the state survey agency making a recommendation to the CMS.
(5) Nothing in this chapter shall be
				construed to impede, prevent or delay any enforcement action or proceedings by
				the CMS or the department, acting as the State Medicaid Agency.
(6) The determination of the presiding
				official who conducts the informal dispute resolution is not binding upon CMS
				nor does it affect any right the facility may have to pursue any available
				federal administrative hearings or appeals processes.
(7) Only one informal dispute resolution to
				dispute deficiencies cited is available for either a standard survey or a
				complaint investigation survey.
(8)
				Regardless of whether a facility has used the opportunity for informal dispute
				resolution at the standard or complaint investigation survey, a facility may
				request an additional informal dispute resolution under the following
				circumstances:
(a) if a deficiency cited as a
				result of a standard or complaint survey continues at a survey revisit (that
				is, the facility has failed to correct a deficiency cited as a result of the
				standard or complaint survey prior to the revisit), the facility may request
				informal dispute resolution to dispute citation of the deficiency at the survey
				revisit;
(b) if a new deficiency is
				cited as a result of a survey revisit or as the result of an informal dispute
				resolution, the facility may request informal dispute resolution to dispute
				citation of the deficiency at the survey revisit or following informal dispute
				resolution; or
(c) if, on the basis
				of new facts discovered at the survey revisit, or as the result of an informal
				dispute resolution, a new example of a deficiency cited as a result of a
				standard or complaint survey is added following the survey revisit, or
				following informal dispute resolution, the facility may request informal
				dispute resolution to dispute the new example of the deficiency
				citation.