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Informal Dispute Resolution Information Center

Program Overview

Comprehensive Care Facility (Nursing Home) Informal Dispute Resolution

The Indiana State Department of Health (ISDH) serves as the state licensing and federal certification survey agency for health care facilities.  Upon completion of a survey of a nursing home, the ISDH issues a survey report detailing survey findings. Pursuant to federal regulations, a health care facility is offered the opportunity for an informal dispute resolution (IDR) to refute the findings of a survey conducted by the ISDH Division of Long Term Care.  The ISDH Health Care Quality & Regulatory Commission IDR Program is responsible for overseeing and conducting all IDR and independent informal dispute resolution (IIDR) processes.

Pursuant to the Patient Protection and Affordable Care Act (2010), a nursing home may request an independent informal dispute resolution (IIDR) if the Centers for Medicare and Medicaid Services (CMS) imposes a civil money penalty against the facility and the civil money penalty amounts are subject to being collected and placed in an escrow account. 

Residential Care Facility Informal Dispute Resolution

The informal dispute resolution process is available to facilities for state rule citations cited at 410 IAC 16.2-5.  The state rule citations do not qualify for independent informal dispute resolution.

Contact the Program

Indiana State Department of Health
Division of Long Term Care
2 North Meridian Street, 4B
Indianapolis, IN 46204
(317) 233-7442 (Long Term Care Receptionist)
(317) 233-1325 (ISDH Main Switchboard)

Director of Informal Dispute Resolution Program
Suzanne Williams, RN
(317) 233-7651
(317) 233-8761 Lisa Hensley, IDR Administrative Assistant, lhensley@isdh.in.gov
(317) 233-7154 [Fax]

Program Policies and Advisories

Instructions for Requesting Informal Dispute Resolution​
Instructions for Requesting Independent Informal Dispute Resolution

Federal Laws and Regulations

Centers for Medicare and Medicaid Services (CMS)

Code of Federal Regulations (CFR)

State Rules

Federal Policies and Guidance

  • CMS S&C 12-08-NH Federal Requirements for Independent Informal Dispute Resolution Process for Nursing Homes  [December 2, 2011]
  • CMS S&C 13-57-NH Escrow and Independent Informal Dispute Resolution (Independent IDR) Process for Nursing Homes – Applicable to All Civil Money Penalties (CMPs)
  • CMS S&C 14-18-NH Advance Copy: Update of State Operations Manual (SOM) Chapter 7 and Survey Process Timeframe Reminder



Federal Government

Centers for Medicare and Medicaid Services (CMS)