Dispute Process

Overview

Transparency means accountability. Any healthcare facility, patient, family member, researcher, or member of the public can contest any score, data point, or enforcement action published on ForThePatient.org. We commit to investigating every dispute within 30 calendar days and publishing our resolution.

Our dispute process is designed to be accessible, transparent, and fair. Disputes are tracked in a public log so that anyone can see how we respond to challenges and whether patterns of error exist in our data or methodology.

Who Can File a Dispute

Anyone may file a dispute. You do not need to prove standing, identify yourself as a facility representative, or demonstrate harm. Common dispute filers include:

• Healthcare facilities that believe their score does not accurately reflect their quality of care, or that factual information (name, address, type) is incorrect.
• Patients and family members who have direct experience that contradicts published data — for example, a facility listed as having an ER that does not, or a recent closure not yet reflected.
• Researchers and journalists who identify methodological concerns, data anomalies, or inconsistencies across facility types.
• Government agencies that identify errors in how we interpret or display CMS data.

Dispute Categories

1. Factual Data Error

A data point displayed on ForThePatient.org is factually incorrect — wrong address, wrong facility type, incorrect CMS Certification Number (CCN), facility listed as open when it has closed, or similar. These are typically the fastest disputes to resolve because they can be verified against public records.

2. Score Calculation Error

The composite score or a component score was calculated incorrectly — the wrong data was used, a formula was misapplied, a measure was incorrectly mapped, or a percentile rank is demonstrably wrong. Resolving these requires examining our scoring engine against the underlying CMS data.

3. Enforcement Action Error

An enforcement action (fine, payment denial, abuse citation, Special Focus Facility designation) is attributed to the wrong facility, listed with an incorrect amount, or is no longer current. We take enforcement data accuracy especially seriously because of its impact on public perception.

4. Methodological Challenge

A dispute not about factual accuracy but about the appropriateness of our methodology — for example, challenging a component weight, disputing whether a measure should be included, or arguing that a scoring approach disadvantages a particular facility type. These require the most careful review and may result in methodology updates.

5. Missing or Outdated Information

A facility that should appear but does not, a recent CMS data update we have not yet incorporated, or contextual information (specialties, services) that is missing or outdated.

How to File a Dispute

Send an email to disputes@forthepatient.org with the following information:

Review Process

When we receive a dispute, we follow a structured review process:

1. Acknowledgment (within 3 business days). We confirm receipt and assign a dispute tracking number (format: DSP-YYYY-NNNN).
2. Classification. We categorize the dispute by type and severity. Factual data errors and enforcement inaccuracies are prioritized.
3. Investigation. We verify the claim against our source data (CMS datasets, state records, or other public sources). For methodological challenges, we may consult external reviewers with relevant expertise.
4. Resolution. We determine whether the dispute warrants a correction, a methodology update, or no change. We document our reasoning regardless of outcome.
5. Notification. We email the filer (if contact was provided) with our resolution, including a detailed explanation of our findings.
6. Public posting. The dispute and its resolution are added to our public audit trail.

Timeline & Service Level Agreement

Possible Outcomes

Correction Applied

If we confirm a data error or scoring mistake, we correct the affected facility's score, update our database, and note the correction in the public audit trail. Corrections are typically applied within 24 hours of resolution.

Methodology Updated

If a methodological challenge reveals a legitimate flaw or improvement opportunity, we may update our scoring methodology. Methodology changes affect all facilities of the relevant type and are documented in a versioned update to our methodology page.

No Change (with explanation)

If we determine the dispute does not warrant a correction, we provide a detailed explanation of why. Common reasons include: the data matches CMS source data (the issue is upstream, not in our analysis), the methodology has been deliberately designed as described, or the dispute reflects a misunderstanding of how a measure is calculated. We never dismiss disputes without explanation.

Referred to CMS

If a dispute reveals an error in the underlying CMS data rather than in our analysis, we notify CMS through their data feedback channels and document the referral in our audit trail. We cannot correct upstream CMS data, but we will note the discrepancy on the affected facility's page if appropriate.

Public Audit Trail

Every dispute and its resolution is recorded in our public audit trail. The audit trail includes:

• Dispute tracking number
• Date received and date resolved
• Dispute category
• Affected facility (by CCN and name)
• Summary of the dispute
• Summary of our investigation
• Outcome (correction applied, methodology updated, no change, or referred to CMS)
• Whether the 30-day SLA was met

The audit trail does not include the filer's identity or contact information unless they explicitly request to be credited.

We publish the audit trail because transparency is a core principle. If we make mistakes, those mistakes — and our corrections — should be visible to everyone. A rating system that is not willing to be held accountable for its own accuracy has no business holding healthcare facilities accountable for theirs.

Appeals

If you disagree with our resolution, you may file an appeal by replying to your resolution email or sending a new email to disputes@forthepatient.org referencing your dispute tracking number. Appeals are reviewed by a different team member than the original investigator.

Appeals must be filed within 60 calendar days of the original resolution. We commit to resolving appeals within an additional 30 calendar days.

Appeal resolutions are also published in the public audit trail.

Good Faith Policy

We investigate all disputes in good faith, regardless of who files them. We do not retaliate against facilities that dispute their scores. We do not penalize patients who report data errors. We do not adjust scores in response to legal threats, public pressure, or political influence.

Our only criterion for action is accuracy. If a dispute demonstrates that our data or methodology is wrong, we fix it. If it does not, we explain why. The process is the same whether the filer is a large hospital system or an individual patient.