MDH creates new form for appeals & reconsideration requests

By Michaun Shetler  |  January 12, 2024  |  Assisted living providers

Assisted living providers are afforded the right to request an appeal or reconsideration. Members have shared concerns with us regarding the major delays they are experiencing with getting a timely response to these types of requests. Some providers have shared that they have waited over a year for a response. These concerns have been shared with Minnesota Department Health (MDH) and they acknowledge this issue and are actively working to improve their response time to meet statutory requirements.

One change that was shared with us this month is that a new form has been created called, “HDR Appeals Submission Form.” The new form has already been implemented by MDH. The form is not available on the MDH website. A link to the new form is being provided in all enforcement letters and will be included in all maltreatment letters.

After being made aware of the new form and once we were given the ability to access the link/form we reached out to several members and attorney business partners to get some feedback. That feedback was shared with MDH and has resulted in MDH making some changes to the form and prompted them to add some additional fields soon. One additional field being added is to identify the orders being appealed. 

This form is intended to be broadly applicable to a variety of appeals and reconsideration requests. Based on what is selected for “Appellant Identity, “the “Type of Appeal” options change. If someone chooses “Other Interested Party,” the appeals options are limited to the maltreatment reconsideration options. The below examples show the differences when “Other Interested Party” is selected vs. “Facility Licensee.”

The form was built to apply to all types of state appeals, therefore getting more specific with the title would have been more problematic than the broad term “appeal.” If this causes confusion or concern, MDH is happy to field calls and provide guidance or reassurance.
 
The form will ask the submitter to distinguish between hearing or reconsideration. Hearing rights only exist for fines or other license sanctions, so the form also distinguishes between the two. MDH does not issue fines if it is also imposing a licensing sanction. 

The form will require providers to submit all the information MDH needs. The “upload file(s)” box allows providers to attach up to 2GB of additional information. Submitting protected health information (PHI) to MDH is specifically permitted by Health Insurance Portability and Accountability Act (HIPAA). The web portal is owned by MDH, and the submission is relayed securely to an MDH mailbox. 

MDH believes this new form option will provide numerous advantages over previous email/paper submissions including the following:
  • Consistency/completeness of information provided. MDH has experienced numerous issues with unclear requests from a variety of appellants that created work from their administrative staff and analysts. Establishing some required fields and forcing a choice of appeal type will help resolve many of these issues. 
  • Submission of the form automatically creates a PDF of the form and attachments available for capturing into MDH workflow and records management programs. Soon, the additional step of loading the PDFs into those programs will be automated as well, creating even more administrative efficiency. 
  • The form produces a standard document, MDH can utilize machine learning and document recognition programs to automate additional administrative tasks.
  • The submissions are stored on an MDH server, so they cannot be inadvertently deleted, misplaced, lost, etc. like email or paper. The date and time of submission is recorded with every form. 
  • Having a single form allows some of those automated processes to look into single source area and extract data, rather than the variety of tracking mechanisms used to monitor the various appeal types. 

MDH will still allow providers to send in appeal and reconsideration requests via email or by mail but indicated that the new form will be the preferred method of making these types of requests going forward. 

Resources
  • Click here to review information from MDH on requesting reconsideration of correction orders for licensed AL providers
  • Click here to review information from MDH on requesting reconsideration of license denial for provisional assisted living providers
  • Click here to review information on how to challenge a finding of the MDH Office of Health Facility Complaints
  • Click here to review information from MDH FAQs about reconsiderations and appeals

If you have questions about the new form and/or process, contact MDH directly at: health.HRD.appeals@state.mn.us.  


Michaun Shetler
Michaun Shetler  |  Director of Assisted Living  |   mshetler@careproviders.org  |  952-851-2484