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Dispute Resolution


This page is designed to help nursing homes understand the Informal Dispute Resolution (IDR) and Independent Informal Dispute Resolution (IIDR) processes.

iMPROve Health is contracted by the Bureau of Community and Health Systems to provide independent reviews of disputed Centers for Medicare and Medicaid Services (CMS) citations if requested, by a nursing home provider. The Bureau however, makes the final determination to uphold or revise any citation, after review of iMPROve Health’s recommendation.

Informal Dispute Resolution (IDR)

CMS offers providers the opportunity to dispute cited deficiencies on the CMS 2567. Submissions for dispute must be received by iMPROve Health within 10 calendar days of receipt of the CMS 2567. 

Providers should complete the LARA-BCHS-108 form and upload all supporting documents to iMPROve Health’s portal at

Once the dispute has been received, iMPROve Health will complete the review and make their independent determination. These findings will be sent to the Bureau for review. The provider will be notified of the Bureau's decision in a letter that will accompany the final CMS 2567.

IDR Conference Calls with MPRO Reviewer


Independent Informal Dispute Resolution (IIDR)

CMS offers providers the opportunity to IIDR imposed Civil Monetary Penalty (CMP) recommendations. The timeframe for completion of the IIDR process is 60 calendar days from the facility’s request, which is strictly enforced by CMS.

Once the provider has received notification from CMS of their opportunity to IIDR survey findings, a provider must complete the LARA/BCHS-111 and upload all IIDR supporting documentation on iMPROve Health’s portal at Submissions must be received by iMPROve Health within 10 calendar days of the provider’s receipt of the CMS 2567.

iMPROve Health will respond to the Bureau within 20 days of their findings. The Bureau will review iMPROve Health's recommendations and make a determination to uphold or revise the CMS 2567. The Bureau’s recommendation will be forwarded to CMS, who will make the final decision.


iMPROve Health
IDR/IIDR Department

Please submit this completed form and IDR supporting documents electronically via the iMPROve Health’s Portal. The web address for instructions and a link to the portal is Please note that the link to the Secure File Exchange was replaced by the new link, effective September 1st, 2017. For questions, please contact Charlene Kawchak-Belitsky at 248-465-1038 or Aris Rhodes-Bond at 248-465-7405.

Other questions can be sent to the Bureau by emailing