Current through Register Vol. 47, No. 6, September 18, 2024
An informal conference will be held concurrently with any
informal dispute resolution held pursuant to 42 CFR Section 488.331 for those
health care facilities certified under Medicare or the medical assistance
program.
(1)
Definition. For purposes of these rules, "independent
reviewer" means an attorney licensed in the state of Iowa who is not currently
employed by the department, has not been employed by the department in the past
eight years, and has not appeared in front of the department on behalf of a
health care facility in the past eight years. Preference shall be given to an
attorney with background knowledge, experience or training in long-term
care.
(2)
Request for
informal conference. The request for an informal conference must be in
writing, addressed to the compliance officer and include the following:
a. Identification of the citation(s) being
disputed;
b. The type of informal
conference requested: face-to-face or telephone conference; and
c. A request for surveyor worksheets for the
citation(s) being disputed, if desired.
(3)
Submission of
documentation. Within the same ten-day period required for submission
of a plan of correction pursuant to 481-subrule 50.10(7), the facility shall
submit the following:
a. The names of those
who will be attending the informal conference, including legal counsel;
and
b. Documentation supporting the
facility's position. The facility must highlight or use some other means to
identify written information pertinent to the disputed deficiency(ies).
Supporting documentation that is not submitted within the required time frame
will not be considered, except as otherwise permitted by the independent
reviewer upon good cause shown. "Good cause" means substantial or adequate
grounds for failing to submit documentation in a timely manner. In determining
whether the facility has shown good cause, the independent reviewer shall
consider what circumstances kept the facility from submitting the supporting
documentation within the required time frame.
(4)
Face-to-face or telephone
conference. A face-to-face or telephone conference, if requested, will
be scheduled to occur within ten business days of the receipt by the department
of the written request, all supporting documentation, and the plan of
correction required by 481-subrule 50.10(7).
a. Failure to submit supporting documentation
will not delay scheduling.
b. The
conference will be scheduled for one hour to allow the facility to informally
present information and explanation concerning the contested deficiencies. Due
to the confidential nature of the conference, attendance may be
limited.
c. If additional
information is requested during the informal conference, the facility will have
two business days to deliver the additional materials to the
department.
d. When extenuating
circumstances preclude a face-to-face conference, a telephone conference will
be held or the facility may be given one opportunity to reschedule the
face-to-face conference.
(5)
Results. The results of
the informal conference will generally be sent to the facility within ten
business days after the date of the informal conference or, if additional
information is requested, within ten business days after the department's
receipt of the additional information.
a. The
independent reviewer may affirm or may modify or dismiss the citation. The
independent reviewer shall state in writing the specific reasons for the
affirmation, modification or dismissal of the citation.
b. The department will issue an amended
(changes in factual content) or corrected (correction of typographical/data
errors) citation if changes result from the informal conference.
c. The facility must submit to the department
a new plan of correction for the amended or corrected citation within ten
calendar days from the date of the letter conveying the results of the informal
conference.
