Standing Up for Fairness in Colorado’s Nursing Home Oversight
Advocating for Balanced Oversight in Long-Term Care
At Pinkowski Law, we believe that fairness and due process are essential to maintaining quality care for Colorado’s most vulnerable residents. Recently, our firm reached out to the Colorado Department of Public Health and Environment (CDPHE) to recommend a simple but meaningful improvement: allow Skilled Nursing Facilities (SNFs) the same opportunity for oral presentation during Informal Dispute Resolution (IDR) proceedings that Assisted Living Residences (ALRs) already enjoy.
A Clear Disparity in Review Rights
Under current CDPHE policy, ALR providers disputing deficiencies that involve enforcement action may appear before a review committee to present their case directly—helping ensure that any misunderstandings can be clarified before decisions are finalized.
By contrast, SNFs may only submit written materials for review. Even when facing significant civil money penalties or enforcement actions, their IDR process is limited to a “desk review,” without the opportunity to explain or respond to committee questions in person.
We believe this imbalance limits transparency and consistency. Federal regulations already require that SNFs receive fair, impartial, and meaningful IDR opportunities. An oral presentation option would bring Colorado’s process closer to those federal standards.
The Department’s Response
The Department’s leadership responded thoughtfully, emphasizing its intent to maintain independence and efficiency in the current IDR process. The Division noted that public committee reviews include diverse perspectives—three from the SNF community, two from CDPHE, one from the Ombudsman’s office, and one from another state agency—and that the current written process helps avoid undue pressure on committee members.
They also cited logistical and funding constraints, as well as prior experiences suggesting that face-to-face reviews could feel too formal or adversarial.
We appreciate their careful consideration and the professionalism of the response. Regulatory reform is always complex, and good faith dialogue is the first step toward meaningful progress.
A Path Toward Modernization and Trust
That said, we remain convinced that oral presentation opportunities would enhance fairness, transparency, and accountability - not undermine them. Allowing both sides to clarify the record directly supports accuracy and reduces the risk of decisions based on incomplete or misunderstood information.
In a sector as heavily regulated as long-term care, even modest procedural improvements can make a real difference. A fair process benefits not only providers, but also residents, families, and the public’s confidence in the integrity of the oversight system.
Our Commitment
At Pinkowski Law, we don’t simply defend care providers - we work to improve the systems that govern them. We’ll continue engaging with state agencies and lawmakers to ensure Colorado’s long-term care framework evolves in ways that balance accountability with fairness.
Progress may be slow, but it comes through persistence, collaboration, and respect for the institutions that serve our communities.
We welcome topic suggestions! Write to brian@pinkowskilaw.com if you are curious to learn more about a certain topic impacting nursing homes, assisted living residences, or other group housing concerns.