Informal Dispute Resolution Process

The Informal Dispute Resolution (IDR) process gives nursing facilities, assisted living facilities, intermediate care facilities, Home and Community-based Service and Texas Home Living waiver providers the opportunity to informally dispute regulatory survey findings. (Texas Government Code §531.058 and Human Resources Code §161.0892).

In accordance with Senate Bill 304, 84th Texas Legislature, 2015, and House Bill 2590, 85th Legislature, 2017, the Texas Health and Human Services Commission has contracted with Michigan Peer Review Organization (MPRO) to perform IDR reviews and make a recommendation of compliance or non-compliance.

To request an IDR, facilities/providers must submit via email a fully executed IDR Request Form to the HHSC IDR Department within 10 calendar days of receiving the official Statement of Deficiencies (Forms 2567/3724). If a timely request is made for an IDR, HHSC will forward the request to MPRO. Facilities/providers are then required to submit a rebuttal letter and supporting documentation directly to MPRO within the required timeframes.

Request Forms

Due Dates

Supporting documentation due dates are as follows:

  • For NFs, ICF and the HCS/TxHML waiver providers the due date is the 5th calendar day after submitting the IDR Request form to HHSC on time.
  • For ALFs the due date is the 15th calendar day after submitting the IDR Request Form to HHSC on time.

Note: If the due date falls on a Saturday, Sunday or legal holiday, the due date becomes the next business day.

As indicated by House Bill 2205, 86th Texas Legislature 2019, the facility may ask clarifying questions of the surveyor during an IDR conference. The facility must first submit an IDR Request Form with a conference selected as the IDR type. Subsequently, the facility must submit a completed IDR Conference Questionnaire (PDF) to MPRO with its supporting documentation.

Where to Submit Your Supporting Documentation

All rebuttal information and the IDR Conference Questionnaire (if indicated) may be submitted via MPROs IDR Secure Application. Read instructions and find the IDR portal link.

For questions or problems with submitting supporting documentation, contact MPRO:

Aris Rhodes-Bond, IDR Project Specialist
248-465-7405

Charlene Kawchak-Belitsky, IDR Senior Manager
248-465-1038

Email: iidrgroup@mpro.org

Texas Administrative Code rules for IDR

For questions or problems with submitting the IDR Request Form, contact IDR:

HHSC IDR Department
IDR@hhsc.state.tx.us
737-867-7795

Other Options for Nursing Facilities and Assisted Living Facilities

In addition to the IDR, nursing facilities may be able to use the independent IDR or informal reconsideration process. Assisted Living facilities also may be able to use the informal reconsideration process.

Independent IDR (IIDR) for Nursing Facilities

The IIDR is an informal administrative procedure intended to provide nursing facilities an opportunity to refute cited deficiencies after any survey in which federal civil monetary penalties (CMP) are imposed, and that CMP is to be collected or placed in an escrow account under 42 CFR §488.431. If notified of the opportunity for an IIDR by the Centers for Medicare and Medicaid Services (CMS), nursing facilities may submit a request for the IIDR process.

The IIDR Request Form (PDF) and offer letter from CMS must be received by IDR within 10 calendar days of receipt of the notification from CMS. The facility’s rebuttal letter and supporting documentation must be received by the 10th calendar day from the facility’s request for an IIDR. The IIDR Request Form and rebuttal information should be emailed to IDR@hhsc.state.tx.us.

If a phone conference is selected, it must be conducted by the 30th calendar day. The IIDR process must be completed by the 60th calendar day from when the request was received.

Note: If a designated due date falls on a Saturday, Sunday or legal holiday, the due date becomes the next business day.

For additional information regarding the IIDR process, see the federal policy/procedure for IIDR (PDF).

Contact Us

HHSC - Informal Dispute Resolution
1106 Clayton Lane, Suite 300W
Mail Code: H970
Austin, Texas 78723
Phone: 512-706-7268
Email: IDR@hhsc.state.tx.us

Informal Reconsideration for Nursing Facilitates and Assisted Living Facilities

HHSC provides NFs and ALFs an informal opportunity to dispute a licensure action taken by the regulatory agency. Facilities must submit a fully executed IR Request Form (PDF) by email to HHSC within 10 calendar days of receiving written notification of the licensure action.

Note: If a designated due date falls on a Saturday, Sunday or legal holiday, the due date becomes the next business day.

Contact Us

HHSC - Informal Dispute Resolution
1106 Clayton Lane, Suite 300W
Mail Code: H970
Austin, Texas 78723
Phone: 512-706-7268
Email: IDR@hhsc.state.tx.us