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Arkansas General Assembly· HB 1784Notification that HB1784 is now Act 864

An act TO MODIFY THE INFORMAL DISPUTE RESOLUTION 10 PROCESS FOR LONG-TERM CARE FACILITIES, the official text

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Stricken language would be deleted from and underlined language would be added to present law.

1 State of Arkansas            As Engrossed: S4/3/25
2 95th General Assembly
                                    A Bill

3 Regular Session, 2025                                           HOUSE BILL 1784

4

5 By: Representative Wardlaw

6 By: Senator Irvin

7

8                             For An Act To Be Entitled

9               AN ACT TO MODIFY THE INFORMAL DISPUTE RESOLUTION

10              PROCESS FOR LONG-TERM CARE FACILITIES; AND FOR OTHER

11              PURPOSES.

12

13

14                                    Subtitle

15                       TO MODIFY THE INFORMAL DISPUTE

16                       RESOLUTION PROCESS FOR LONG-TERM CARE

17                       FACILITIES.

18

19 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF ARKANSAS:

20

21  SECTION 1. Arkansas Code � 20-10-1907 - 20-10-1909 are amended to read

22 as follows:

23  20-10-1907. Informal dispute resolution hearing -- Conduct.

24  (a) Unless the long-term care facility chooses another order of

25 presentation of arguments:

26              (1)(A) The Department of Human Services shall present the

27 initial arguments at the hearing.

28                       (B) Initial arguments shall be detailed and not limited to

29 a recitation of the statement of deficiencies; and

30              (2) After the Department of Human Services department completes

31 its arguments, the long-term care facility shall present its arguments.

32  (b)(1) As a matter of fairness to all parties, the impartial decision

33 maker shall determine in conjunction with all parties:

34                       (A) The appropriate time needed for each presentation of

35 information and argument; and

36                       (B) The sequence and appropriate time for each rebuttal

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    As Engrossed: S4/3/25                                                HB1784

1 argument.

2            (2) However, the impartial decision maker may grant each party

3 additional equal time for good cause as determined by the impartial decision

4 maker in conjunction with all parties.

5   (c)(1) Rules of evidence or procedure shall not apply except as

6 provided in this section.

7            (2) The impartial decision maker may:

8            (A) Accept any information that the impartial decision

9 maker deems material to the issue being presented; and

10           (B) Reject any information that the impartial decision

11 maker deems immaterial to the issue being presented.

12  (d)(1) The hearing may not be recorded.

13           (2) However In addition, the impartial decision maker may make

14 written or recorded notes of the arguments.

15  (e) Only employees Employees of the long-term care facility, attending

16 physicians, other medical care providers of residents of the long-term care

17 facility at the time of the deficiency, pharmacists providing medications to

18 residents of the long-term care facility at the time of the deficiency, and

19 any consultant pharmacists or nurse consultants utilized by the long-term

20 care facility, and or by the medical director of the long-term care facility

21 may appear or participate at the hearing for or on the behalf of the long-

22 term care facility.

23  (f) Only employees of the Department of Human Services department may

24 appear or participate at the hearing for or on behalf of the Department of

25 Human Services department.

26  (g) A party may be represented by an attorney.

27  (h) A person authorized under subsection (e) or subsection (f)

28 subsections (e)-(g) of this section to participate in the hearing may present

29 direct questions to an opposing participant during the rebuttal argument.

30  (h)(1) Within fourteen (14) days of a final decision concerning the

31 issues presented in the hearing and any related matters, the Department of

32 Health shall provide the parties with a report concerning the hearing, all

33 decisions made on the basis of the hearing, and any related matters.

34           (2) The report required under subdivision (h)(1) of this section

35 shall include without limitation:

36           (A) Information concerning any change to the disputed

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    As Engrossed: S4/3/25                                                   HB1784

1 deficiency; and

2                   (B) A listing of each specific item of the deficiency and

3 all changes made to the deficiency.

4   (i)(1) The Department of Human Services shall compile and make

5 available to all long-term care facilities subject to this section a

6 quarterly report that shall include without limitation the number of informal

7 dispute resolutions during the previous quarter that were:

8                   (A) Heard;

9                   (B) Decided in favor of the state agency; and

10                  (C) Decided in favor of the long-term care facility.

11  (2) The Department of Human Services shall review the reports

12 under subdivision (i)(1) of this section and shall:

13                  (A) Determine what patterns of sustained and overturned

14 deficiencies exist; and

15                  (B) Evaluate the training process to address the

16 identified patterns.

17  (j) A party shall not be represented by an attorney.

18

19  20-10-1908. Determination of impartial decision maker and Office of

20 Long-Term Care.

21  (a)(1) Upon the conclusion of all arguments by the parties, the The

22 impartial decision maker shall issue a written statement of findings that

23 shall be entitled "Determinations" no later than seven (7) calendar days

24 after the informal dispute resolution hearing.

25  (2) The statement shall include:

26                  (A) A recitation of the deficiency tag numbers;

27                  (B) A statement of whether a disputed deficiency should

28 remain, be removed, or be modified on the statement of deficiencies; and

29                  (C) The facts and persuasive arguments that support the

30 impartial decision maker's finding for each deficiency tag number.

31  (b)(1) The determination of the impartial decision maker shall be

32 provided to the parties.

33  (2)(A) The Office of Long-Term Care shall review the

34 determination and shall issue a written document entitled "State Survey

35 Agency Determination" within seven (7) calendar days after the issuance of

36 the "Determinations" statement required under subsection (a) of this section.

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    As Engrossed: S4/3/25                                                   HB1784

1                     (B) The state survey agency determination shall state:

2                          (i) Whether, for each disputed deficiency mentioned

3 in the impartial decision maker's determination, the finding of the impartial

4 decision maker is accepted, rejected, or accepted as modified by the state

5 survey agency;

6                          (ii) For each deficiency finding by the impartial

7 decision maker that the office does not accept the finding of the impartial

8 decision maker, a statement explaining the reasons that the finding was not

9 accepted along with the facts, circumstances, or reasons for not accepting

10 the finding; and

11                         (iii) For each disputed deficiency finding of the

12 impartial decision maker that the office accepts the finding with

13 modification, a recitation of the modification and the reason or reasons for

14 the modification.

15         (c) A state survey agency determination is not subject to appeal,

16 reargument, or reconsideration.

17         (d) The office shall deliver a copy of the state survey agency

18 determination to the long-term care facility and to the impartial decision

19 maker.

20         (e)(1) In accordance with the state survey agency determination, the

21 office shall issue an amended statement of deficiencies if the state survey

22 agency determination results in modification to any deficiencies cited in the

23 original statement of deficiencies.

24         (2) If the office determines that amendments to the statement of

25 deficiencies should result in changes to the scope or severity assigned to

26 any deficiency, the amended statement of deficiencies shall reflect the

27 changes to the scope or severity of any cited deficiency.

28         (f) The amended statement of deficiencies shall be provided to the

29 long-term care facility.

30         (g) The "Determinations" statement required under subsection (a) of

31 this section and the "State Survey Agency Determination" document required

32 under subdivision (b)(2) of this section shall be provided to the long-term

33 care facility no later than ten (10) days before the deadline for the long-

34 term care facility to request a hearing before an administrative law judge of

35 the United States Department of Health and Human Services Departmental

36 Appeals Board, as outlined in the notice letter issued to the long-term care

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    As Engrossed: S4/3/25                                                 HB1784

1 facility by the Centers for Medicare & Medicaid Services, after the survey

2 that is the basis for the informal dispute resolution hearing.

3   (h)(1) The Department of Human Services shall compile and make

4 available to all long-term care facilities subject to this section a

5 quarterly report that shall include without limitation and identify by

6 deficiency, scope, and severity rating the number of informal dispute

7 resolutions during the previous quarter that were:

8            (A) Heard;

9            (B) Decided in favor of the state agency; and

10           (C) Decided in favor of the long-term care facility.

11           (2) The Department of Human Services shall:

12           (A) Review the reports under subdivision (h)(1) of this

13 section;

14           (B) Determine what patterns of sustained and overturned

15 deficiencies exist; and

16           (C) Evaluate the training process to address the

17 identified patterns.

18           (3) The Department of Human Services shall use the result from

19 the report under subsection (h) of this section to evaluate employee

20 performance and to determine whether individuals or groups of employees need

21 remedial training.

22

23  20-10-1909. Matters not subject to informal dispute resolution.

24  (a)(1) The informal dispute resolution hearing is limited to

25 deficiencies cited on a statement of deficiencies.

26           (2) No other issues may be addressed at an informal dispute

27 resolution hearing, including, but not limited to:

28           (A) Scope and severity assessments of deficiencies unless

29 the scope and severity assessments allege substandard quality of care or

30 immediate jeopardy;

31           (B) Any remedies imposed;

32           (C) Any alleged failure of the survey team to comply with

33 a requirement of the survey process;

34           (D) Any alleged inconsistency of the survey team in citing

35 deficiencies among long-term care facilities; and

36           (E) Any alleged inadequacy or inaccuracy of the informal

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    As Engrossed: S4/3/25                                           HB1784

1 dispute resolution process.

2   (b) If the impartial decision maker finds that matters not subject to

3 informal dispute resolution are presented, the impartial decision maker shall

4 strike all documentary evidence related to or presented for the purpose of

5 disputing the matter not subject to informal dispute resolution.

6   (c) The impartial decision maker may not include in the determination

7 any matter not subject to informal dispute resolution.

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