C.F.R. » Title 42 » CHAPTER IV—CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES › SUBCHAPTER G—STANDARDS AND CERTIFICATION › PART 488—SURVEY, CERTIFICATION, AND ENFORCEMENT PROCEDURES › Subpart E—Survey and Certification of Long-Term Care Facilities

42 C.F.R. § 488.331

Informal dispute resolution

Read at: eCFRecfr.gov CornellLII GovInfogovinfo.gov CasesGoogle Scholar

(a) Opportunity to refute survey findings. (1) For non-Federal surveys, the State must offer a facility an informal opportunity, at the facility's request, to dispute survey findings upon the facility's receipt of the official statement of deficiencies.

(2) For Federal surveys, CMS offers a facility an informal opportunity, at the facility's request, to dispute survey findings upon the facility's receipt of the official statement of deficiencies.

(3) For SNFs, dually-participating SNF/NFs, and NF-only facilities that have civil money penalties imposed by CMS that will be placed in a CMS escrow account, CMS also offers the facility an opportunity for independent informal dispute resolution, subject to the terms of paragraphs (b), (c), and (d) of this section and of § 488.431. The facility must request independent informal dispute resolution in writing within 10 days of receipt of CMS's offer. However, a facility may not use the dispute resolution processes at both §§ 488.331 and 488.431 for the same deficiency citation arising from the same survey unless the informal dispute resolution process at § 488.331 was completed prior to the imposition of the civil money penalty.

(b)(1) Failure of the State or CMS, as appropriate, to complete informal dispute resolution timely cannot delay the effective date of any enforcement action against the facility.

(2) A facility may not seek a delay of any enforcement action against it on the grounds that informal dispute resolution has not been completed before the effective date of the enforcement action.

(c) If a provider is subsequently successful, during the informal dispute resolution process, at demonstrating that deficiencies should not have been cited, the deficiencies are removed from the statement of deficiencies and any enforcement actions imposed solely as a result of those cited deficiencies are rescinded.

(d) Notification. Upon request, CMS does and the State must provide the facility with written notification of the informal dispute resolution process.

[59 FR 56238, Nov. 10, 1994, as amended at 76 FR 15126, Mar. 18, 2011]
Notes of Decisions
Cited in 9 cases (5 in the last 5 years), 1999–2023 · leading case: CT Ohio Portsmouth, L.L.C. v. Ohio Dept. of Medicaid, 2020 Ohio 5091 (Ohio Ct. App. 2020).
Sort: Relevance Newest Treatment
CT Ohio Portsmouth, L.L.C. v. Ohio Dept. of Medicaid, 2020 Ohio 5091 (Ohio Ct. App. 2020). · cites it 3× “42 C.F.R. 488.331; Ohio Adm.Code 3701-63-02.”
Pervaiz Chaudhry v. Tomas Aragon, 68 F.4th 1161 (9th Cir. 2023). “Health & Safety Code § 1280 (c)(1); 42 C.F.R. § 488.331 (a)(2). 4 “PA 1” represents physician assistant Albakova.”
Whispering Oaks RCF Mgmt. Co. Inc. v. Missouri Dep't of Health & Senior Servs., 444 S.W.3d 492 (Mo. Ct. App. 2014). · cites it 2× “” As the source of its right to IDR, Appellant cites to 42 C.F.R. § 488.331 (a)(1), which provides: “For non-Federal [inspections], the State must offer a facility an informal opportunity, at the facility’s request, to dispute survey findings upon the facility’s receipt of the…”
Bryn Mawr Care, Inc. v. Kathleen Sebelius, 749 F.3d 592 (7th Cir. 2014). “See 42 C.F.R. § 488.331 (requiring state agencies to offer an informal process to challenge deficiency findings).”
Ivy Hall Geriatric & Rehab. Ctr., Inc. v. Shalala, 50 F. Supp. 2d 447 (D. Maryland 1999). “” 42 C.F.R. § 488.331 (a)(1). Thus, a facility’s sole means of redress for a revocation of a NATCEP (if that is the only remedy imposed) is by resort to the informal dispute resolution process (“IDR”).”
Adkins v. S. Health Partners (E.D. Ky. 2021). · cites it 2× “301 , 42 C.F.R. § 488.331 , and 21 C.F.R. § 1321.”
Pervaiz Chaudhry v. Tomas Aragon (9th Cir. 2023). “Health & Safety Code § 1280 (c)(1); 42 C.F.R. § 488.331 (a)(2). 4 “PA 1” represents physician assistant Albakova.”
Chaudhry v. Smith (E.D. Cal. 2021). “42 C.F.R. § 488.331 (a)(2) (“For 14 Federal surveys, CMS offers a facility an informal opportunity, at the facility’s request, to 15 dispute survey findings upon the facility’s receipt of the official statement of deficiencies.”
Oakwood Ventures, LLC v. Cochran (D. Neb. 2021). “" 42 C.F.R. § 488.331 (a)(1). Under State law, that means notifying NDHHS that the facility "desires to contest the notice and request an informal conference with a representative of the department in person or by other means at the request of the applicant or licensee[.”
Annotations are extracted automatically from the opinions in the Syfert caselaw corpus and ranked by authority, recency, and treatment. Dots show Syfertize treatment of the citing case itself.