Regulatory Compliance

70th AHCA/NCAL Convention and Expo

RC-3 - Informal Dispute Resolution: Finding Your Seat at the Table

Speaker(s)

• 

  William Vaughan, RN, BSN

  Vice President, Education and Clinical Affairs
  Remedi SeniorCare

  Disclosure: Remedi SeniorCare: Employee (Status: Ongoing)

In 2018, surveyors cited over 100,000 federal deficiencies in nursing centers nationwide. Recognizing that not every deficiency is either factually accurate or a sign of noncompliance with regulations, CMS requires each state survey agency to have a process in place that permits nursing centers to challenge reports of deficiencies. Understanding the informal dispute resolution (IDR) process empowers leaders in nursing centers to effectively advocate for their facilities.

In this session, we will highlight various aspects of the IDR process, focusing on fact pattern analysis, regulatory requirements, and standards of care, and explore the rights and responsibilities of facilities in the IDR process. We’ll look at case studies from actual IDRs and discuss recommendations to improve IDR outcomes.

Learning Objectives:

• Describe how regulatory language, guidance to surveyors, policies and procedures and standards of practice impact compliance decisions.
• Identify what aspects of a deficiency should be critically analyzed to determine if it should be disputed.
• Describe two approaches to demonstrate compliance by augmenting documentation.