Section 15-6-007 - PLAN OF OPERATION An Agency Plan of Operation for a local long-term care ombudsman program, must provide the following information.
(A) A description of the area to be served within a planning and service area. No local program will include within its service area any facility being served by another designated program;(B) A statement of philosophy and goals and objectives of the program;(C) A statement of the procedures to be used to recruit and support volunteer ombudsman advocates;(D) A statement of methods to evaluate the attainment of program goals and objectives for the program;(E) If more than one local long-term care ombudsman program is to be established in the planning and service area, a statement detailing how the programs will coordinate services and avoid duplication of effort;(F) An annual budget of income and expenses for the program coincident with the state fiscal year;(G) A statement of procedures that ensure the program must comply with all requirements of the Office, including training of all representatives of the Office, confidentiality of records and reporting;(H) A statement of procedures that ensure that no person will investigate any complaint filed with the Office unless such person is certified by the Office; and(I) A statement of procedures that ensure the program has the ability to pursue appropriate remedies to resolve complaints, including but not limited to: (i) Representing residents in administrative hearings and appeals before state and federal agencies, including the Nebraska Department of Health and Human Services and the United States Department of Health and Human Services;(ii) Making referrals and recommending specific courses of action, referring situations to public and private agencies, such as the Nebraska Department of Health and Human Services Adult Protective Services Program, Legal Services Corporations, county attorneys' offices, the Nebraska Attorney General's office, state and federal courts and other agencies; and(J) Serving as an agent for residents in negotiations with long-term care facilities, public and private agencies, family members, and other individuals and agencies to the extent permitted by state and federal law.007.01MINIMUM STANDARDS. Written policies and procedures for the administrative and programmatic operation of the program must be based upon the following minimum standards. (A) The program must have a job description for each position, as well as written personnel policies and procedures for hiring and selection, compensation, evaluation, disciplinary action and grievance and supervision and training of employees, contractors, volunteers, students and interns. The personnel policies and procedures must include: (i) The following minimum requirements qualifications for individuals serving in the capacity of local long-term care ombudsman or ombudsman advocates for the State or local long-term care ombudsman programs: (1) An understanding of long-term care issues;(2) Experience in the fields of aging and health care;(3) Worked with and been involved in volunteer programs;(4) Good verbal, listening and writing skills;(5) Commitment to serve a minimum of three hours per week in the performance of their duties facility;(6) No known conflict of interest which would interfere with their objective performance as an ombudsman advocate;(7) Not been employed by or affiliated with a long-term care facility within the previous 12 months;(8) Understanding of, and agreement to follow, the ombudsman rules of confidentiality;(9) Agreement to follow the policies and procedures of the State and local long term care ombudsman program and accept the direction of the Ombudsman Advocate Coordinator;(10) Compliance with the Office's reporting needs to collect and analyze data relating to complaints and conditions in long-term care facilities; and(11) Certification by the Office of the Long-Term Care Ombudsman;(B) An Equal Opportunity Policy that includes nondiscrimination on the basis of race, disability, color, sex, affiliation, or age and an Affirmative Action statement;(C) An organizational chart which identifies the responsibility of each position in the program;(D) Means to ensure that no individual or organizational conflict of interest exists in accordance with 45 CFR 1324.21; and(E) A local long-term care ombudsman program staff must include at least one individual available to conduct ombudsman advocate activities, manage the program on a day-to-day basis and coordinate and supervise ombudsman advocates and adequate support staff.007.02FISCAL ACCOUNTABILITY. An agency must maintain accounting records as necessary for preparation of financial statements in accordance with generally accepted accounting principles.007.03COMPLAINT INVESTIGATION AND RESOLUTION. A local program will investigate and resolve to the best of its ability all complaints received by or on behalf of individuals who reside in long-term care facilities. 007.03(A)INDIVIDUAL INTEREST. The Office and designated local programs will represent the interests and wishes of individuals who are residents of long-term care facilities, even if they are contrary to the interests and wishes of any person who files a complaint with the Office or local program on behalf of such individuals.007.04ACCESS TO RESIDENT MEDICAL RECORDS. The Office and local programs must obtain the consent of the resident in order to have access to the medical and personal records retained by the facility of any individual who is a resident, or client of a long-term care facility. The Health Insurance Portability and Accountability Act of 1996 does not preclude release by covered entities of resident private health information or other resident identifying information to the Office and local programs, including but not limited to residents' medical social or other records, a list of resident names and room numbers, or information collected in the course of a State or Federal survey or inspection process. 007.04(A)CONSENT. If consent is given by a resident of a long-term facility to allow a representative of the Office access to medical and personal records retained by a long term care facility, such consent must be in writing, including through the use of auxiliary aids and services, unless. (i) The resident is unable or unwilling to consent in writing, but is willing and able to give oral consent, in which case consent may be granted orally by the resident;(ii) The resident is under legal guardianship or conservatorship that provides the guardian or conservator with the authority to approve review of records. In such case the representative of the Office must obtain the permission of the guardian or conservator for review of the records in the same manner as required if the resident was not under conservatorship or guardianship; or(iii) The consent of the legal guardian or conservator will not be required if: (1) The existence of the legal guardianship or conservatorship is unknown to the Office or the facility;(2) The legal guardian or conservator cannot be reached within five working days;(3) The subject of the complaint is the guardian or the conservator; or(4) In case of an emergency.007.04(B)REASONABLE CAUSE. If the resident is unable to express written or oral consent and in order to investigate a complaint, the resident representative refuses to consent to the access, a representative of the Office has reasonable cause to believe that the resident representative is not acting in the best interests of the resident the Office will have access to the medical and personal records of the resident without prior consent.007.04(C)PERMANENT FILE. If authorized in writing by the resident, legal guardian or conservator of the resident, or any other person having legal authority to inspect records, such authorization will be made a part of the permanent file of the resident.15 Neb. Admin. Code, ch. 6, § 007
Adopted effective 9/21/2020