RELATES TO:
KRS
205.201,
209.030(5),
216.535,
216.540-216.543,
42 U.S.C.
3001 et seq.
NECESSITY, FUNCTION, AND CONFORMITY:
42 U.S.C.
3001 et seq., the Older Americans Act of
1965, as amended, requires states to establish and operate, either directly or
by contract, a long-term care ombudsman program to protect the rights of older
individuals.
KRS
194A.050 requires the secretary for the
Cabinet for Health and Family Services to promulgate administrative regulations
necessary to implement programs mandated by federal law.
KRS
205.204 designates the Cabinet for Health and
Family Services as the state agency to administer the Older Americans Act of
1965, as amended, in Kentucky. This administrative regulation establishes a
statewide Long-term Care Ombudsman Program.
Section
1. Definitions.
(1) "Access"
means the right to enter a long-term care facility, meet with the residents,
and review the records of a resident.
(2) "Administrator" means any person charged
with the general administration or supervision of a long-term care facility
without regard to whether the person has an ownership interest in the facility
or to whether the person's functions and duties are shared with one (1) or more
other persons.
(3) "Case" means
each inquiry brought to, or initiated by, the ombudsman on behalf of a resident
or group of residents involving one (1) or more complaints and includes an
ombudsman investigation or strategy to resolve and follow-up.
(4) "Certification" means the official
notification by the Kentucky long-term care ombudsman that local long-term care
ombudsman individual staff are qualified and acceptable to function in that
capacity.
(5) "Complaint" means an
allegation filed by residents or on behalf of residents relating to the health,
safety, welfare, and rights of a resident.
(6) "Complaint resolution" means either
corrective action taken in regard to an allegation or a determination as to the
validity of the allegation.
(7)
"Complaint verification" means a determination through investigative means that
allegations relating to the health, safety, welfare, and rights of a patient
are generally accurate.
(8) "DAIL"
means the Department for Aging and Independent Living.
(9) "Designation" means formal notification
by the Kentucky long-term care ombudsman that a district program meets
requirements and shall be considered a subdivision of the state
office.
(10) "Designee" means an
individual who is chosen to act on behalf of the KLTCO and who meets the same
qualifications as the KLTCO pursuant to Section 8 of this administrative
regulation.
(11) "District
ombudsman" means that individual certified by the Kentucky long-term care
ombudsman to implement the ombudsman provisions of the approved contract agency
plan.
(12) "Educational or
experiential equivalent" means:
(a) Two (2)
semesters totaling at least twenty-four (24) hours of course work;
and
(b) At least 400 documented
hours of experience assisting aging or disabled individuals through:
1. Practicum placement;
2. Clinicals; or
3. Volunteerism.
(13) "Evaluation" means periodic
analysis and review conducted by the Kentucky long-term care ombudsman of
district, regional, and state ombudsman programs, including quality assurance
and outcome measures pertaining to individual and programmatic
performance.
(14) "Friendly
visitor" means a trained non-certified volunteer who visits residents in
long-term care facilities to assist the district long-term care ombudsman
program.
(15) "Investigation" means
the formal response by a long-term care ombudsman to complaints of issues
involving the health, safety, welfare, and rights of a resident.
(16) "Kentucky long-term care ombudsman" or
"KLTCO" means the individual charged with the administration of the Kentucky
Long-term Care Ombudsman Program under the provisions of the Older Americans
Act of 1965, as amended.
(17) "Long
term care facility" is defined by
KRS
216.510(1).
(18) "Monitoring" means periodic review
measuring ombudsman program's adherence to approved plans, including analysis
of non-client specific data relating to program performance.
(19) "Referral" means the appropriate
channeling of information so as to effect a desired outcome.
(20) "Regional long-term care ombudsman"
means ombudsmen who operate directly from the Kentucky Long-term Care Ombudsman
Program and whose responsibilities include coordination of a multi-area
development district area.
(21)
"Resident representative" is defined by
45
C.F.R
1324.1.
(22) "Volunteer ombudsman" means a certified
unpaid individual serving within a district program to assist a district
ombudsman.
Section 2.
Responsibilities of Kentucky Long-term Care Ombudsman.
(1) The Kentucky Long-term Care Ombudsman
Program shall be administered by a full time ombudsman operated by DAIL or
through a contracted entity.
(2)
The Kentucky Long-term Care Ombudsman shall be responsible for the:
(a) Design, implementation, and management of
a statewide uniform system for receiving, investigating, resolving, and
reporting complaints on behalf of residents in long-term care facilities and
provide ongoing support to assist in the resolution of those
complaints;
(b) Investigation of
complaints made by or on behalf of residents in long-term care facilities from
areas of the state temporarily without local ombudsman programs if a local
backup ombudsman is not available;
(c) Development and implementation of
policies and procedures for operation of the program, including those related
to:
1. Receipt, investigation, verification,
and resolution of complaints;
2.
Protecting confidentiality of records and identity of complainants;
3. Establishing the right of public access to
information regarding conditions in long-term care facilities; and
4. Securing ombudsman access to long-term
care facilities, residents, and residents' personal and medical
records;
(d) Development
and management of a system for the operation of a statewide network of district
programs, including:
1. Designation of
district programs through:
a. Reviewing
applications for designation of district ombudsman contained in their plans for
operating either directly or under subcontract;
b. Providing written confirmation of the
designation; and
c. Administration
of certification and training requirements;
2. Development of district program operating
procedures and reporting requirements; and
3. Establishment of a communications link
between the Kentucky long-term care ombudsman and district programs;
(e) Establishment and maintenance
of program official files and adoption of procedures to protect the
confidentiality of those files;
(f)
Provision of information and education concerning:
1. Program activities;
2. The long-term care system; and
3. The rights and concerns of residents and
potential residents of long-term care facilities;
(g) Provision of assistance to citizen
organizations, consumer groups, and other interested community organizations to
enhance the rights of residents in long-term care facilities;
(h) Promotion of the development of citizen
organizations at the state and local level to participate in the
program;
(i) Use of publicity and
outreach efforts directed at long-term care residents and families, network
staff, and the general public about the availability of the program to receive
and investigate complaints;
(j)
Review of complaint, case, and issue data submitted by the district programs
and analysis for trends, patterns, and issue identification;
(k) Annual National Ombudsman Reporting
System (NORS) report to the Administration on Community Living;
(l) Assistance to the district ombudsman to
establish, develop, and coordinate ombudsman activities;
(m) Development of agreements and working
relationships with relevant agencies to encourage their cooperation and
assistance with the program at the state and local levels;
(n) Development of agreements and working
relationships with legal services programs, particularly those funded by the
Older Americans Act of 1965, as amended;
(o) Development and provision of training on
an ongoing basis for regional and district ombudsman program staff and
volunteers;
(p) Identification and
development of additional funding and staffing resources for the long-term care
ombudsman program;
(q) Support and
promotion of the formation of resident councils in long-term care
facilities;
(r) Development and
provision of testimony and comment on proposed legislation, administrative
regulations, policies, and rule changes affecting the long-term care
residents;
(s) Conduction of other
activities related to the protection and dignity of residents of long-term care
facilities;
(t) Performance of other
activities required by the Administration on Community Living;
(u) Policy that shall require the district
ombudsman program to perform the functions and responsibilities of the
ombudsman pursuant to
45
C.F.R.
1324.13 and adhere to the requirements
of section 712 of the Older Americans Act of 1965, as amended;
(v) Policy and procedure clarifying the local
ombudsman shall have access to the agencies programmatic fiscal information;
and
(w) Policy and procedure for the
receipt and review of grievances received regarding the determination or action
of the ombudsman and representatives.
Section 3. Responsibilities of the Regional
Long-term Care Ombudsman. The regional long-term care ombudsman shall be staff
of, and report directly to, the Kentucky long-term care ombudsman and shall
have the following responsibilities:
(1)
Receive, investigate, and resolve complaints;
(2) Provide technical assistance and
coordination of district programs;
(3) Assist in training of volunteers and
local program personnel;
(4)
Provide information to public agencies regarding problems of long-term care
residents;
(5) Abide by established
policies and procedures related to reporting and confidentiality; and
(6) Perform other job duties as required by
the Kentucky long-term care ombudsman.
Section 4. Designation of District Programs.
(1) The Kentucky long-term care ombudsman
shall designate district entities throughout the state to operate the long term
care ombudsman program.
(2) The
district ombudsman program entity shall submit a plan that shall serve as the
application for designation of a district ombudsman. The application shall
include:
(a) Definition of program in terms of
the following personnel:
1. Program
supervisor;
2. Ombudsman advisory
council;
3. District
ombudsman;
4. Friendly visitors;
and
5. Volunteer
ombudsman;
(b) Agency to
conduct the program;
(c) Ability to
receive, investigate, and resolve complaints on behalf of long-term care
residents;
(d) Maintenance of a
complaint documentation system;
(e)
Ability to monitor the development and implementation of laws, policies, and
regulations that apply to residential long-term care;
(f) Ability to recruit and provide
standardized training for volunteers;
(g) Ability to respond in a timely fashion to
requests from the Kentucky Long-term Care Ombudsman Program for statistical
data and other information;
(h)
Ability to receive training and continuing education from the Kentucky
Long-term Care Ombudsman Program;
(i) Ability to assure confidentiality of
files;
(j) Ability to inform and
educate residents, sponsors, organizations, the long-term care industry, and
the general public relative to issues affecting the long-term care system, the
ombudsman program, and resident rights and concerns;
(k) Provision that an individual involved in
the appointment of a subdivision of the office and that an officer, employee,
or other representative of the office is not subject to a conflict of
interest;
(l) Provision that
representatives of the Kentucky Long-term Care Ombudsman Program shall not be
liable under state law for the good faith performance of official duties;
and
(m) Provision of an annual
written statement that the district ombudsman program and contracted entity
shall ensure there is not a conflict of interest for the following:
1. Staff;
2. Volunteers;
3. Governing board members;
4. Advisory board members; or
5. Other parties representing or providing
oversight to the long-term care ombudsman program.
(3) Designated ombudsmen shall be
representatives of the Kentucky Long-term Care Ombudsman Program and shall be
accorded rights and privileges of that office.
(4) The district ombudsman agency shall
coordinate with the Kentucky long-term care ombudsman prior to hiring a
district ombudsman.
Section
5. Responsibilities of the District Ombudsman. The district
ombudsman shall:
(1) Provide services as
follows:
(a) There shall be a staff person,
qualified by training and experience, responsible for administering each
service and supervising assigned staff and volunteers;
(b) There shall be designated staff who are
trained and skilled in assessing and dealing with the needs of older adults and
in the delivery of each service;
(c) Volunteers and paid staff with the same
responsibilities shall meet comparable requirements for training and
skills;
(d) New staff shall receive
an orientation and shall be trained and certified prior to assuming
responsibilities;
(e) Staff shall
attend required training and provide in-service training for staff and
volunteers of local programs;
(f)
Staff and volunteers shall not accept personal gifts or money from participants
or vendors; and
(g) Staff and
volunteers shall not pay bills or cash checks for clients or
participants;
(2) Assure
services are accessible to older persons by telephone, correspondence, or
person-to-person contact;
(3)
Represent residents residing in long-term care facilities within the assigned
geographical areas;
(4) Assure
residents' rights are upheld and promote quality care in long-term care
facilities;
(5) Investigate and
work to resolve complaints on behalf of long-term care residents;
(6) Promote community involvement in the
program by:
(a) Publicizing the existence and
function of the local and state programs;
(b) Advising the public about the
availability of current state, local, and federal inspection reports,
statements of deficiency, and plans for correction for individual long-term
care facilities in the service area;
(c) Organizing and implementing an active
volunteer program;
(d) Assisting in
the development of resident or family and friends councils;
(e) Sponsoring community education and
training programs for long-term care facilities, human service workers,
families, and the general public about long-term care and residents' rights
issues; and
(f) Promoting citizen
involvement in order to ensure regular visitations, especially for those
residents without available family or friends; and
(7) Implement accurate recordkeeping
procedures to assure that:
(a) An accurate
record shall be maintained on each participant that documents:
1. Participant identification data;
2. Requests for assistance;
3. Eligibility for services
provided;
4. Follow-up;
and
5. Closure;
(b) Reports for the Kentucky
long-term care ombudsman are prepared and submitted in a format and time frame
as directed;
(c) Procedures are
followed to protect the identity, confidentiality, and privacy of clients;
and
(d) Nonclient-specific
statistical and financial data is submitted as required.
Section 6. Responsibilities of the
Volunteer Ombudsman. The volunteer ombudsman shall:
(1) Complete required training, including
training and certification requirements for those involved in complaint
investigation;
(2) Provide regular
visitation of residents in long-term care facilities;
(3) Adhere to guidelines provided by the
Kentucky long-term care ombudsman and district ombudsmen; and
(4) Complete required paperwork.
Section 7. Ombudsman Advisory
Council.
(1) The designated district ombudsman
program shall have an advisory council whose functions are to:
(a) Review and advise programs on policies
and procedures;
(b) Provide ongoing
support and leadership; and
(c)
Identify and generate funding resources for program viability.
(2) The advisory council shall be
comprised as follows:
(a) Members shall be
persons with a strong interest in improving the quality of life for the
long-term care residents and for protecting their rights;
(b) Group size and composition shall be
individualized to the needs of the local program but shall not be less than
seven (7); and
(c) One-third (1/3)
of the members shall be consumers or family members of consumers.
(3) Advisory council members shall
not:
(a) Be responsible for certifying or
licensing long-term care facilities;
(b) Be a provider of long-term care services
or part of an association of providers;
(c) Have any interest or association that may
impair the ability of the ombudsman to objectively and independently
investigate and resolve complaints;
(d) Gain economically or receive any
compensation from a long-term care facility or association;
(e) Be on the Adult Protective Services
Caregiver Misconduct Registry or the Kentucky Nurse Aide registry; or
(f) Have been found guilty of the following:
1. A violent crime as defined by
KRS
439.3401;
2. Abuse, neglect, or exploitation of another
person, including assault;
3.
Felony theft offense; or
4. Felony
drug offense.
Section 8. Qualifications, Certification, and
Training of Long-Term Care Ombudsmen.
(1) The
Kentucky long-term care ombudsman, regional long-term care ombudsman, and
district long-term care ombudsman shall:
(a)
Possess a minimum of a bachelor's degree in a health or human services
profession from an accredited college or university with:
1. One (1) year experience in health or human
services; or
2. The educational or
experiential equivalent in the field of aging or physical disabilities;
or
(b) Be a certified
regional or district ombudsman with no lapse in certification prior to October
19, 2016.
(2) The
Kentucky long-term care ombudsman shall meet the qualifications of subsection
(1)(a) or (b) of this section and have expertise in:
(a) Long-term services and supports or other
direct services for older persons or individuals with disabilities;
(b) Consumer-oriented public policy
advocacy;
(c) Leadership and
program management skills; and
(d)
Negotiation and problem solving skills.
(3) The Kentucky long-term care ombudsman, a
district, regional, or volunteer ombudsman, and a friendly visitor shall have a
completed background check conducted prior to hire using the following:
(a) The Adult Protective Services Caregiver
Misconduct Registry;
(b) The
Kentucky Nurse Aide registry; and
(c) A criminal record check utilizing the
Kentucky Administrative Office of the Courts or the Kentucky Justice Cabinet
and not have been found guilty of the following:
1. A violent crime as defined by
KRS
439.3401;
2. Abuse, neglect, or exploitation of another
person, including assault;
3.
Felony theft offense; or
4. Felony
drug offense.
(4) Program sponsors, sub-contract agency
directors, and directors of other sponsoring agencies shall receive basic
training whenever possible.
(5) The
long-term care ombudsman, program staff, and volunteers shall receive a minimum
of twenty-four (24) hours of training in order to be eligible for certification
as a long-term care ombudsman, including at least the following areas:
(a) The Older Americans Act of 1965, as
amended, and the aging network;
(b)
Characteristics, special needs, and problems of the long-term care
resident;
(c) Characteristics of
long-term care facilities including:
1.
Numbers of beds;
2. Levels of
care;
3. Services; and
4. Costs;
(d) The long-term care reimbursement system
including:
1. Medicaid;
2. Medicare;
3. SSI; and
4. State supplementation;
(e) The regulation of facilities
and the enforcement of regulations;
(f) Complaint investigation and
resolution;
(g)
Guardianship;
(h) Residents'
rights;
(i) Development of resident
and family councils;
(j) Recruiting,
screening, selecting, training, placing, and supporting volunteers;
and
(k) Use of public
funds.
(6) District
ombudsmen shall attend training meetings as established by the Kentucky
long-term care ombudsman.
(7) All
long-term care ombudsmen and volunteers shall be:
(a) Certified within thirty (30) days of hire
or prior to providing services; and
(b) Re-certified every two (2) years prior to
the expiration of the current certification.
(8) Certification shall be awarded after
submitting certification documentation of:
(a)
Verification of completion of minimum training requirements; and
(b) A score of at least eighty (80) percent
on the certification examination.
Section 9. Confidentiality. Investigatory
files, complaints, responses to complaints, and other information related to
complaints or investigations maintained by the ombudsman program shall be
considered confidential information in accordance with the Older Americans Act
of 1965,
42
U.S.C.
3027(a)(12)(C).
Confidentiality shall be maintained using the criteria established in this
section.
(1) Persons who gain access to a
resident's records shall not discuss or disclose information in the records or
disclose a resident's identity outside of the program.
(2) The Kentucky long-term care ombudsman
shall release information only with:
(a)
Written consent of the resident; or
(b) A court order to disclose.
(3) Information shall be secured
as follows:
(a) Complaint files shall be
contained in a locked file cabinet;
(b) Computerized systems shall have secured
access codes; and
(c) Computer
software containing confidential information shall be stored in a locked file.
(4) The confidentiality
and disclosure criteria shall not preclude the ombudsman's use of otherwise
confidential information in the files for preparation and disclosure of
statistical, case study, and other data if the ombudsman does not disclose the
identity of persons otherwise protected in this section.
Section 10. Rights of Access.
(1) Kentucky, regional, volunteer, and
district ombudsmen shall have unrestricted access to long-term care facilities:
(a) Without prior notice;
(b) To meet with one (1) or more residents;
and
(c) To observe the operation of
the facility as it affects the patient.
(2) Volunteer ombudsmen shall have access to
the:
(a) Residents' dining area;
(b) Residents' living area;
(c) Residents' recreational area;
(d) Lounges; and
(e) Areas open to the general
public.
(3) Certified
representatives of the Kentucky Long-term Care Ombudsman Program shall have
access to a resident's medical and social records with permission of the
resident or his legal guardian, except as provided for under
KRS
209.030(7).
(4) Access shall not include the right to
examine the financial records of the facility without the consent of the
administrator.
(5) If the ombudsman
is denied entry to a long-term care facility, or denied upon a request for
copies of all licensing and certification records maintained by the state with
respect to long-term care facilities, the ombudsman shall inform the:
(a) Administrator or operator of the
statutory authority for access. If access is still denied, the ombudsman shall
inform the
(b) Kentucky long-term
care ombudsman;
(c) Office of
Inspector General, Division of Health Care; and
(d) Local law enforcement officials to secure
assistance for entry if entry into a facility is denied.
(6)
(a)
Willful interference, as governed by
KRS
216.541(3), with
representatives of the Kentucky Long-term Care Ombudsman Program in the
performance of official duties shall be unlawful and result in a fine of $100
to $500 for each violation.
(b)
Each day the violation continues shall constitute a separate offense.
Section 11. Referrals.
(1) Representatives of the long-term care
ombudsman program shall be exempt from making reports of abuse, neglect,
exploitation, or spouse abuse to the Department for Community Based Services,
Division of Protection and Permanency, and, if appropriate, the Office of
Inspector General, Division of Health Care, for investigation without
appropriate consent or court order pursuant to 45 C.F.R Parts
1321 and
1324.
(2) The ombudsman shall seek
consent of the resident:
(a) To work to
resolve complaints and make referrals to agencies; or
(b) When the ombudsman personally witnesses
abuse, gross neglect, or exploitation of the resident.
(3) Communication of consent to reveal the
identity of the resident or complainant may be made in writing, orally, or
visually.
(4) When the resident is
unable to communicate consent and has no resident representative, the ombudsman
shall:
(a) Take steps to investigate
complaints that adversely affect the health, safety, welfare, or rights of the
resident; and
(b) Refer the matter
and disclose identifying information of the resident to the management of the
facility in which the resident resides or the appropriate agencies in the
following circumstances:
1. The ombudsman
personally witnesses suspected abuse, gross neglect, or exploitation of a
resident and has no evidence indicating that the resident would not wish a
referral to be made; and
2. The
ombudsman has reasonable cause to believe that disclosure would be in the best
interest of the resident.
(5) If the resident is unable to communicate
consent and has a resident representative, the ombudsman shall contact the
resident representative for consent.
(6) If there is reasonable cause to believe
the resident representative through their action, inaction, or decision making
may adversely affect the health, safety, welfare, or rights of the resident,
the ombudsman shall:
(a) Seek permission of
the KLTCO or designee during an investigation if a resident is unable to give
consent and the resident representative is not acting in the best interest of
the resident; and
(b) Make a
referral to the appropriate agencies upon approval of the KLTCO or
designee.
(7) Referrals
under this section shall not affect the continuing duty, full freedom, and
independence of the ombudsman to:
(a) Ensure
the continued adequacy and responsiveness of complaint investigation and
resolution, monitoring, and data collection systems consistent with the Older
Americans Act of 1965, as amended;
(b) Maintain an independent capacity to
investigate and resolve complaints as governed by Section 13 of this
administrative regulation;
(c)
Receive and process, on a regular basis, information related to the number,
type, and source of complaints, facilities involved, and the manner of
complaint resolution; and
(d)
Maintain by specific agreement the power, ability, and right to monitor the
agency's complaint processing performance and take action necessary to correct
and improve deficiencies.
(8) District ombudsmen shall address concerns
regarding the investigation or resolution of complaints to the Kentucky
long-term care ombudsman or designee.
(9) District ombudsmen shall make referrals
to county attorneys, legal aid agencies, and legal assistance
offices.
(10) District ombudsman
shall report to the Kentucky long-term care ombudsman a referral to the Office
of the Attorney General or any federal agency.
Section 12. Receiving Reports.
(1) The Kentucky long-term care ombudsman,
regional ombudsmen, district ombudsmen, and persons identified and approved by
these ombudsmen shall have the authority to provide intake of a
complaint.
(2) The person receiving
a report shall obtain as much information as possible, making a reasonable
effort to obtain the:
(a) Name and location of
the long-term care facility involved;
(b) Name and location of the
resident;
(c) Name, address, and
telephone number of the person responsible for the resident;
(d) Nature of the complaint as specifically
as possible;
(e) Name and location
of the alleged perpetrator; and
(f)
Identity of the reporting source, though reports may be made
anonymously.
(3) The
person receiving the report may contact other agencies or individuals to secure
additional information relevant to the investigation.
Section 13. Complaint Investigation.
(1) A long-term care facility resident shall
have the right to:
(a) Voice grievances and
recommend changes in policies and services to facility staff and outside
representatives of the resident's choice, free from restraint, interference,
coercion, discrimination, or reprisal;
(b) Associate and communicate privately with
persons of the resident's choice; and
(c) Private meetings with the appropriate
long-term care facility inspectors from the Cabinet for Health and Family
Services.
(2) A
long-term care ombudsman shall investigate and resolve complaints:
(a) Made by or on behalf of an older
individual who is a resident of a long-term care facility relating to action
that may adversely affect the health, safety, welfare, and rights of the
resident; and
(b) Made by or on
behalf of a younger long-term care facility resident if actions will:
1.
a.
Benefit an older individual residing in the long-term care facility or older
individuals residing in long-term care facilities generally; or
b. Be the only viable avenue of assistance
available to the resident; and
2. Not significantly diminish the Long-term
Care Ombudsman Program's efforts on behalf of long-term care
residents.
(3) District and volunteer ombudsmen shall
not investigate complaints unless certified by the Kentucky Long-term Care
Ombudsman Program.
(4) The Kentucky
and regional ombudsmen shall inform the district ombudsmen of on-site
investigations conducted in their districts.
(5) The investigation shall be conducted
according to the criteria established in this subsection.
(a) Investigation shall include contact with
the resident, staff of the long-term care facility, and collateral
contacts.
(b) A representative of
the program shall, upon entering the facility, promptly notify the
administrator or his designated representative of his presence.
(c) A representative of the program shall not
enter the living area of a resident without identifying himself to the
resident.
(6) The
investigating ombudsman, with permission of the resident or resident
representative, shall take steps to investigate a complaint and attempt to
resolve the complaint to the resident's satisfaction. Resolution may include:
(a) Collaborating or negotiating at the
nursing home administrative level to change particular nursing home behavior,
pattern, or practice affecting the resident;
(b) Consulting with a resident, relative, or
nursing home staff member to resolve a problem;
(c) Effecting positive enforcement action by
a regulatory agency;
(d) Proposing
regulatory or statutory changes or additions;
(e) Communicating with community groups and
professional organizations; and
(f)
Encouraging the utilization of legal services assistance.
(7) Documentation shall be completed on
complaint investigations and incorporated into the ombudsman data system as
follows:
(a) The documentation entered into
the data system shall be entered by the 15th of the month for all cases
completed the prior month; and
(b)
Documentation of the investigation shall include the:
1. Identity of the resident on whom the
report is made;
2. Date the
face-to-face visit with the resident was completed;
3. Identity of the long-term care
facility;
4. Complaint;
5. Identity of persons interviewed and
records or documents reviewed during the course of the investigation;
6. Factual information used to support
findings and conclusions; and
7.
Actions taken and services provided.
(8) Resolution shall include documented
follow-up and ongoing monitoring of the situation for a reasonable period of
time, depending on the complexity of the situation, through contact with the
complainant or resident or, if appropriate, for the purpose of determining that
the causes giving rise to the complaint have not been repeated and have not
recurred.
(9)
(a) In accordance with
KRS
216.541(2) and (3),
retaliation and reprisals by a long-term care facility or other entity against
an employee or resident for having filed a complaint or having provided
information to the Kentucky Long-term Care Ombudsman Program shall be unlawful
and shall result in a fine of $100 to $500 for each violation.
(b) Each day a violation continues shall
constitute a separate offense.
Section 14. Reporting Requirements. The
Kentucky long-term care ombudsman program shall maintain a statewide uniform
reporting system to collect and analyze information on complaints and
conditions in long-term care facilities for the purpose of identifying and
resolving significant problems.
(1) The
contracted agency providing the district long-term care program shall submit
quarterly reports to the Kentucky long-term care ombudsman according to the
contractual agreement.
(2) The
district ombudsman shall submit an annual report to the Kentucky long-term care
ombudsman no later than determined in the contractual agreement for inclusion
in the annual state ombudsman report.
Section 15. Monitoring and Evaluation.
(1) District long-term care ombudsman
programs shall be monitored annually by the contract agency or the Kentucky
long-term care ombudsman according to contract or, if services are provided
directly by the Kentucky long-term care ombudsman, by the DAIL.
(2) Formal evaluations of the district
ombudsman program shall be conducted at regular intervals, at least annually,
by the Kentucky long-term care ombudsman.
(3) The results of the evaluation, omitting
client identifying information, shall be made available to the district
long-term care ombudsman contracting agency to be used to plan and implement
program changes to meet participant needs.
(4) The Kentucky long-term care ombudsman and
district long-term care ombudsman contracting agency shall permit staff of the
Cabinet for Health and Family Services, persons acting for the Cabinet for
Health and Family Services, or staff designated by appropriate federal agencies
to:
(a) Monitor and evaluate programs and
activities initiated under the Older Americans Act of 1965, as amended, and
other programs for which the department has administrative responsibility;
and
(b) Interview clients by
persons and agencies listed in this subsection, except if confidentiality
requirements are applicable.