Nursing Home Deficiency Dispute Process
Pursuant to Minnesota Statute 144A.10, Subd. 16., independent informal dispute resolution, (a) Notwithstanding subdivision 15, a facility certified under the federal Medicare or Medicaid programs may request from the commissioner, in writing, an independent informal dispute resolution process regarding any deficiency citation issued to the facility. The facility must specify in its written request each deficiency citation that it disputes. The commissioner shall provide a hearing under sections 14.57 to 14.62. Upon the written request of the facility, the parties must submit the issues raised to arbitration by an administrative law judge.
(b) Upon receipt of a written request for an arbitration proceeding, the commissioner shall file with the Office of Administrative Hearings a request for the appointment of an arbitrator and simultaneously serve the facility with notice of the request. The arbitrator for the dispute shall be an administrative law judge appointed by the Office of Administrative Hearings. The disclosure provisions of section 572B.12 and the notice provisions of section 572B.15, subsection (c), apply. The facility and the commissioner have the right to be represented by an attorney.
(c) The commissioner and the facility may present written evidence, depositions, and oral statements and arguments at the arbitration proceeding. Oral statements and arguments may be made by telephone.
Timing for Response to Dispute of Deficiencies
(d) Within ten working days of the close of the arbitration proceeding, the administrative law judge shall issue findings regarding each of the deficiencies in dispute. The findings shall be one or more of the following:
(1) Supported in full. The citation is supported in full, with no deletion of findings and no change in the scope or severity assigned to the deficiency citation.
(2) Supported in substance. The citation is supported, but one or more findings are deleted without any change in the scope or severity assigned to the deficiency.
(3) Deficient practice cited under wrong requirement of participation. The citation is amended by moving it to the correct requirement of participation.
(4) Scope not supported. The citation is amended through a change in the scope assigned to the citation.
(5) Severity not supported. The citation is amended through a change in the severity assigned to the citation.
(6) No deficient practice. The citation is deleted because the findings did not support the citation or the negative resident outcome was unavoidable. The findings of the arbitrator are not binding on the commissioner.
(e) The commissioner shall reimburse the Office of Administrative Hearings for the costs incurred by that office for the arbitration proceeding. The facility shall reimburse the commissioner for the proportion of the costs that represent the sum of deficiency citations supported in full under paragraph (d), clause (1), or in substance under paragraph (d), clause (2), divided by the total number of deficiencies disputed. A deficiency citation for which the administrative law judge’s sole finding is that the deficient practice was cited under the wrong requirements of participation shall not be counted in the numerator or denominator in the calculation of the proportion of costs.
Nursing Home Abuse and Neglect Attorney Kenneth LaBore has decades of experience and handles the following types of elder abuse claims and others:
Violation of Resident Rights
For a Free Consultation to obtain information on how to hold negligent wrongdoers accountable from an experienced attorney contact Minneapolis Elder Abuse Neglect Attorney Kenneth LaBore at 612-743-9048 or Toll Free at 1-888-452-6589, email: KLaBore@MNnursinghomeneglect.com.