TX HHS Form 3648. DAHS Informal Dispute Resolution (IDR) Request

The TX HHS Form 3648, DAHS Informal Dispute Resolution (IDR) Request, is a crucial document for Day Activity and Health Services (DAHS) facilities to request an IDR. This form helps facilities dispute survey findings and violations, ensuring that any issues are addressed promptly.

To complete the form, facilities must provide required information such as their facility owner's name, administrator's name, area code, phone number, fax number, and date received of the official written notification of survey findings. The form also outlines specific conditions for submitting the request, including a 10-calendar-day deadline from receipt of the notification. Facilities must submit two copies of the completed form, rebuttal letter, and supporting documentation to the relevant offices.

The DAHS IDR Request Form is used in situations where facilities disagree with survey findings or wish to dispute violations cited during an inspection. Key features of the form include the requirement for facilities to provide a plan of correction in response to official written notifications of survey findings, even if they disagree with the results. By using this form, facilities can initiate the IDR process and work towards resolving any issues identified during a survey.

• The DAHS IDR Request Form is used by Day Activity and Health Services (DAHS) facilities to request an Informal Dispute Resolution (IDR).
• The form must be completed within 10 calendar days of receipt of the official written notification of survey findings.
• Facilities must submit two copies of the completed form, rebuttal letter, and supporting documentation to the relevant offices.