(1) The presiding official shall make a written recommendation to CMS, the facility and the state survey agency following the informal dispute resolution.

(2) CMS shall have the final authority to make a determination in the informal dispute resolution process. CMS may accept, reject or amend the recommendation of the presiding official.

(3) If CMS notifies the state survey agency that CMS is making the final determination following informal dispute resolution, the state survey agency will not issue the deficiency citation form until CMS instructs the state to do so.

(4) The deficiency citation form shall be amended as specified in ARM 37.5.607 based on the written determination of CMS. If any amendments are made based on the CMS determination, the amended deficiency citation form will be sent by the state survey agency to CMS and the facility.