Chapter 02. Nursing Home Ombudsman Program

“Legal representative” means a person acting under a power of attorney, as a representative payee (unless the facility is the representative payee), or as a guardian of the person or property.

“Local ombudsman” means the Director of the local Nursing Home Ombudsman Program.

“Patient advocate” means the director of the local Nursing Home Ombudsman Program, the Director of the State Nursing Home Ombudsman Program, or the professional staff and volunteers working in those programs.

“Related Institution”.

“Secretary” means the Secretary of Aging.

“State ombudsman” means the Director of the State Nursing Home Ombudsman Program.

The local office on aging has established a local nursing home ombudsman program within the agency or by grant, or contract; and

The local nursing home ombudsman program complies with these regulations.

At least 14 hours of orientation to provide a working knowledge of the long-term care system and the Statewide Ombudsman Program;

At least quarterly in-service meetings, each at least 1 day in duration;

Technical assistance on a continuing, as-needed basis.

At least 20 hours of initial training to provide a working knowledge of the long-term care system and the Statewide Ombudsman Program;

At least quarterly in-service meetings, each at least 3 hours in duration;

Technical assistance on a continuing, as-needed basis.

Physical, mental, and emotional aspects of aging;

History, purpose, objectives of local ombudsman program, and relationship to State Ombudsman Program;

Volunteer policies, procedures, and skills for handling complaints;

Confidentiality;

Overview of nursing home system;

Patients' Bill of Rights—State and federal;

Regulatory system—federal/State/local laws and regulations;

Health care system profile and interrelationships between agencies;

Family/resident council;

Reading and understanding medical records.

Personal contact with the resident who has made the complaint or on whose behalf the complaint was made;

Interviews with appropriate officials and staff of the related institution and other appropriate resource people;

Visits with residents other than the resident who has complained or on whose behalf the complaint has been made if it is necessary to verify the complaint or to protect the confidentiality of the complaint or resident;

Documentation of the complaint and investigation;

Periodic communication with the complainant and resident to keep them informed of the status of the investigation.

The complainant or resident, or a legal representative of either, consents in writing to the disclosure and specifies to whom the identity may be disclosed; or

A court orders the disclosure.

Development of a plan for corrective action through discussions with the complainant, resident, and appropriate officials and staff of the related institution;

Establishment of a timetable for resolution;

Follow-up within 30 days to determine if the problem giving rise to the complaint has been resolved.

Name, address, and phone number of the complainant;

Name of the resident;

Relationship of the complainant to the resident;

Name of the facility;

Nature of the complaint;

Steps taken to investigate the complaint;

Outcome of the investigation;

Resolution and follow-up.

The patient advocate presents written authorization from the resident on whom the record is kept;

In the event that the resident has been adjudicated a disabled person, the patient advocate presents written authorization from the court appointed guardian; or

In the event that the resident has not been adjudicated disabled but is unable to communicate with others or is found to be medically incompetent by the attending physician of the resident, the patient advocate presents written authorization from the next of kin of the resident, the sponsoring agency of the resident, or, unless the facility is the representative payee, the representative payee that the Social Security Administration designates for the resident.

The Ombudsman Program shall promote the development of family and resident councils in nursing homes in their local jurisdictions.

If a nursing home does not have a resident council, the local ombudsman shall provide assistance to the residents and the facility in developing an active resident council.

If a nursing home does not have an active family council, the local ombudsman shall provide assistance and make recommendations to the family members and facility in developing an active family council.

Local ombudsman involvement in the development of resident or family councils may include:

The local ombudsman shall inform the head of each resident and family council in the service area of:

The local ombudsman shall make every effort to attend a resident or family council meeting to which the ombudsman has been invited.