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https://doi.org/10.1016/j.gerinurse.2012.12.005
Copy DOIJournal: Geriatric Nursing | Publication Date: Jan 1, 2013 |
In the July 2011 issue of this Journal, we advised you about a number of changes made by one section of the Patient Protection and Affordable Care Act (the ACA)whichwas passed by Congress on March 23, 2010. Our column last year discussed a final regulation, published by the Centers for Medicare & Medicaid Services (CMS) on March 18, 2011, which amended the Social Security Act (the Act) by adding specific provisions related to the imposition and collection of civil money penalties (CMPs) when nursing facilities are found, following a survey, to be out of compliance with Medicare and Medicaid participation requirements. Those changes were effective as of January 1, 2012. One of the changes to the nursing facility enforcement process was the creation of a new independent informal dispute resolution (IIDR) process to be completed within 60 days of the imposition of a civil money penalty, so long as the IIDR is timely requested by the facility. Clearly, the IIDR process is new and many states have yet to receive requests from nursing facilities to conduct a review of survey deficiencies using this new option. This author recently worked with a nursing facility that decided to dispute survey findings using the IIDR process, and we are providing an overview of our experience with the process in this column, as well as take away points learned from the experience. A nursing facility underwent its annual recertification survey. At the conclusion of the inspection, the survey team advised the administrator that there were a few instances of noncompliance, but nothing was identified as being of any concern to the survey team. About a week after the exit conference, the survey team leader called the administrator to advise her that the survey agency supervisor had reviewed the inspection notes and determined that
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