37.5.606    INFORMAL DISPUTE RESOLUTION FACILITY REQUIREMENTS

(1) A request for informal dispute resolution must be in writing and either received by the department or postmarked within ten calendar days of the facility's receipt of the state survey agency's written deficiency citations. The department will accept timely applications by fax.

(2) A facility's failure to submit a timely request for informal dispute resolution shall be deemed a waiver of the facility's right to request informal dispute resolution, and the department shall be entitled to deny any request for informal dispute resolution which is not either received by the department or postmarked within ten calendar days following the facility's receipt of the state survey agency's written deficiency citations.

(3) Requests for an informal dispute resolution must be mailed or delivered to the Office of Fair Hearings, 2401 Colonial Drive, P.O. Box 202953, Helena, MT 59620-2953 or faxed to the attention of the Office of Fair Hearings at (406) 444-3980.

(4) The written request for an informal dispute resolution must:

(a) list the specific survey deficiency citation(s) being disputed and briefly summarize the facility's objections to each survey deficiency citation;

(b) specify whether the facility desires:

(i) a record review;

(ii) a telephone conference; or

(iii) an in-person conference;

(c) provide the name, address, and telephone number of the person who is coordinating the informal dispute resolution for the facility; and

(d) specify whether legal counsel will represent the facility at the informal dispute resolution, so that the department may arrange for legal representation as well. The informal dispute resolution will be cancelled and rescheduled if the facility does not notify the presiding official in its request for informal dispute resolution that it will be represented by legal counsel, but subsequently appears at the informal dispute resolution with legal counsel.

(5) Any substantiating materials the facility wishes to have considered as part of the informal dispute resolution process must be mailed to the presiding official and must be received or postmarked no later than seven calendar days prior to the time of any scheduled telephone or in-person conference, or prior to the deadline set by the presiding official for receipt of substantiating materials in the case of a record review. The facility shall clearly:

(a) identify and describe the relevance of any material submitted;

(b) label and cross reference all attachments to the disputed citation;

(c) highlight or otherwise notate relevant facts; and

(d) indicate the desired outcome for each disputed citation.

(6) The facility shall provide to the state survey agency a duplicate copy of all substantiating materials submitted to the presiding official.

(7) The facility may request in writing, at the same time the informal dispute resolution is requested, supporting documentation for a disputed deficiency citation from the state survey agency as specified in ARM 37.5.607(3).

(8) Prior to the commencement of any informal dispute resolution conducted via in-person or telephone conference, a facility representative with authority to act on the facility's behalf must present to the presiding official a signed statement listing all of the participants who will be present on the facility's behalf. This statement:

(a) must specify that the facility feels the named persons are necessary to present the facility's case;

(b) must state that the facility takes responsibility to ensure that any person appearing on the facility's behalf will comply with all applicable federal and state health information security, privacy, and confidentiality regulations; and

(c) may list as participants staff members of a professional association(s) or legal counsel who are advising or representing the facility in the informal dispute resolution.

(9) Any observer who is not representing or advising the state survey agency or the facility must leave the informal dispute resolution during any portion of the proceedings where protected health information will be disclosed.

(10) Any person who is the subject of protected health care information discussed during an informal dispute resolution shall be entitled to receive, upon written request, a list of the names of anyone that participated in the informal dispute resolution.

History: 53-6-109, 53-6-113, MCA; IMP, 53-6-109, 53-6-113, MCA; NEW, 2004 MAR p. 736, Eff. 4/9/04.