18 Miss. Code. R. 26-4-A

Current through December 10, 2024

Section 18-26-4-A - Facility Visits

The Federal Older Americans Act (OAA) requires that "the residents have regular, timely, private, and unimpeded access" to the services provided through the Ombudsman Program. Section 712(3)(D) By doing so, the ombudsman will be able to identify concerns of residents, establish trust and develop relationships between the residents and explain the Ombudsman Program to both residents, their families and the facility staff and provide consistent statewide coverage of the long-term care facilities in Mississippi.

Facility Visits

1) Regular and timely access is considered to be a minimum of quarterly visits to each long-term care facility in each service district (January-March; April-June; July-September; October-December). These would be considered routine visits for the purpose of monitoring and assessing the general condition of residents and the physical plant of the facility. However, the Mississippi Ombudsman Program requires monthly visits to the long-term care facilities. Additional visits during the month shall be conducted by district and local ombudsman in the following situations:

a) To investigate a complaint;

b) A history of serious or frequent complaints;

c) Number and types of referrals made to other agencies (Licensing & Certification and the AG's office);

d) A change in ownership or administration;

e) Implementation of a serious state or federal plan of correction (# of citations and deficiencies from a survey);

f) An imminent closure;

g) Facilities licensed for 120+ residents; or

h) By request of the SLTCO in the interest of protecting residents' rights.

2) Visits shall be unannounced so that the facilities have no advanced knowledge of the visit. The timing of the visits should also be staggered so the facility does not have a basis to predict the timing of the visit.

3) Working with resident or family council, presenting an in-service for facility staff or participating in an annual survey may be combined with the monthly non-complaint related visit.

4) The purpose of the visits is to:

a) Observe the condition of the residents and the facility and make recommendations as needed.

b) Meet new residents and familiarize them and any family members to the Ombudsman Program.

c) The Ombudsman shall ensure their posters are in a visible location at each facility and there is a copy of Resident's Rights posted in clear view so the residents, family members or resident representatives can observe. Depending on the size of the facility, there may be a need for more than one poster in each facility.

5) Facilities with continued patterns of non-responsiveness to complaints or non-compliance with citations or deficiencies require a more frequent Ombudsman presence.

6) The Ombudsman should have supply of business cards and/or brochures/book marks available so as to provide to residents.

7) Prior to leaving the facility, the Ombudsman may meet with the administrator and/or department heads to provide information or recommendations based on his/her observations. Information regarding specific complaints shall be disclosed only with resident consent.

Ombudsman should, at a minimum, quarterly monitor to see if the survey results are posted where residents are able to view the results and that the ombudsman poster is prominently displayed and contains the current ombudsman's name, address and phone number. Complaint-related visits need to take place when responding to a complaint. The resident needs to be visited. The ombudsman shall have access to all long-term care facilities for regular visits and to investigate complaints. The ombudsman should have access to have a private conversation with each resident. Once consent is obtained and documented (written or oral), the ombudsman may be able to resolve the concern to the resident's satisfaction before leaving the facility. A concern may be a case with one or more complaints or simply a consultation. All complaints are tracked in WellSky. Consultations are only tracked for purposes of the annual NORS report.

The most important part of complaint intake is listening. Always ask the complainant if he/she has spoken with anyone at the facility to have the issue resolved. Let the caller know that an Ombudsman will be in contact with them within 2-3 days. The breakdown in communication and lack of trust is the root cause of conflict in institutions. We can help by bringing people together instead of continuing their adversarial positions. Ombudsman use their skill in communication and mediation to advocate for a process that enables the resident's voice to be heard regarding what is most important to him/her. We take all complaints except those that involve complaints against residents, unless the concern is due to failure on the facility's part to resolve the matter, or those complaints requiring private legal counsel. If an issue of abuse, neglect, or exploitation is suspected during the intake, the ombudsman must use their discretion in referring the complainant to another agency. The Health Department will handle the regulatory issues and the Medicaid Control Fraud Unit will handle criminal abuse issues in nursing homes or personal care homes. A case may have more than one type of complaint code. However, only use one category for each type of problem. Complaints received at the Office of the State Long-Term Care Ombudsman will be assigned to the appropriate Representative of the Office to handle.

18 Miss. Code. R. 26-4-A

Adopted 4/12/2019