303 State Long-Term Care Ombudsman

How to use this Section: This section addresses the responsibilities of the State Long-Term Care Ombudsman according to the party which is being served: 1) in general, 2) to long-term care residents, 3) to Long-Term Care Ombudsman Representatives, 4) to AAAs and (5) to provider agencies also known as local Ombudsman entities.

Policy

The State Long-Term Care Ombudsman (SLTCO) is responsible for providing leadership for the statewide Long-Term Care Ombudsman Program (LTCOP).

Procedures

303.1 General responsibilities of the State Ombudsman

The SLTCO is responsible for:

  1. Leadership and management of the statewide LTCOP

    1. Providing leadership, planning, and direction for the statewide LTCOP.

    2. Providing program management and development, including coordination with the State agency which may include participation on its Leadership Team.

    3. Evaluating statewide LTCOP performance.

    4. Developing policies, procedures, and standards for administration of the LTCOP and Ombudsman Representative practice.

    5. Providing support to and accepting counsel from the Advisory Council.

    6. Adhering to the Ombudsman Code of Ethics (Appendix A).

  2. Designation of Ombudsman Representatives and LTCOPs

    1. Providing standards for designation of Ombudsman Representatives and provider agencies through issuing policies, providing guidance on requests for proposals, and providing for training and certification of Ombudsman Representatives.

    2. Prohibiting any individual from acting as a representative of the Office or processing complaints on behalf of residents without being certified to do so.

    3. Prohibiting any entity from providing services of the LTCOP without being designated to do so.

  3. Long-term care issues advocacy

    1. Advocating for policy, regulatory, and/or legislative changes to benefit long-term care residents.

      Georgia law was revised in 2013 to exempt executive branch employees from lobbyist registration. However, the SLTCO has discretion to register as a lobbyist for state-level legislative and regulatory advocacy purposes.

    2. Coordinating with statewide and national advocacy organizations involved in advocating for resident interests and long-term care issues.

    3. Providing leadership to statewide advocacy efforts on behalf of long-term care facility residents.

    4. Maintaining awareness of current issues and trends in long-term care.

    5. Recommending public policy changes through:

      1. Publication of an annual report.

      2. Legislative and administrative advocacy.

      3. Work with media.

      4. Collaboration with other agencies and advocates.

      5. Other appropriate means.

    6. Providing training and technical assistance to provider agencies, and others in the aging network regarding the LTCOP role in issues advocacy.

  4. Interagency coordination

    1. Coordinating LTCOP services with adult protective services, state agencies licensing and certifying long-term care facilities, legal assistance provided under the Older Americans Act (OAA), law enforcement, protection and advocacy systems, and other appropriate agencies.

  5. Maintaining record management and the LTCO reporting system

    1. Maintaining case records, both at the Office and through LTCOPs. Such records are the property of the SLTCO and may not be released, disclosed, duplicated, or removed without the written permission of the SLTCO or designee (see II-500).

    2. Maintaining, in collaboration with the State agency, a statewide uniform reporting system to collect and analyze data relating to complaints and conditions in long-term care facilities and to residents, for the purpose of identifying and resolving significant problems.

    3. Submitting such data to appropriate entities as required by the OAA.

    4. Preparing and distributing the LTCOP annual report as required by the OAA.

  6. Information and consultation

    1. Providing information and consultation regarding long-term care issues and the LTCOP to the general public, residents, community organizations, and other agencies.

  7. Technical assistance

    1. Providing specialized technical assistance, consultation, training, and resources to Ombudsman Representatives, provider agencies, and the State agency related to the operation of the LTCOP.

References

OAA § 712; O.C.G.A. § 31-8-53; O.C.G.A. § 21-5-70; O.C.G.A. § 21-5-71(i)(6.1); 45 C.F.R. § 1234.13(a)(7)(vii)

303.2 State Ombudsman responsibilities to long-term care residents

The SLTCO shall, personally or through representatives of the Office:

  1. Identify, investigate, and resolve complaints made by or on behalf of residents that may adversely affect the health, safety, welfare, or rights of residents, and relating to action, inaction, or decisions of:

    1. Providers, or representatives of providers, of long-term care services.

    2. Public agencies.

    3. Health and social service agencies.

  2. Identify, investigate, and resolve complaints related to the welfare and rights of the residents with respect to the appointment and activities of guardians, conservators, and representative payees.

  3. Provide services to assist residents in protecting their health, safety, welfare, and rights.

  4. Inform residents about the means of obtaining services provided by long-term care service providers, public agencies, or health and social service agencies or other services to assist residents in protecting their health, safety, welfare, and rights.

  5. Provide regular and timely access to LTCOP services for residents and timely responses to complaints.

  6. Represent the interests of residents before governmental agencies and pursue administrative, legal, and other remedies to protect the health, safety, welfare, and rights of residents.

  7. Analyze, comment on, and monitor the development and implementation of federal, state, and local laws, regulations, and other governmental policies and actions pertaining to the health, safety, welfare, and rights of residents, with respect to the adequacy of long-term care facilities and services in the state.

  8. Recommend changes in such laws, regulations, policies, and actions as the Office determines appropriate.

  9. Facilitate public comment on laws, regulations, policies, and actions.

  10. Provide technical support for the development of resident and family councils to protect the well-being and rights of residents.

  11. Prohibit inappropriate disclosure of the identity of any complainant or resident with respect to LTCOP files, records, or other information.

  12. Serve as the Patient Care Ombudsman pursuant to federal bankruptcy law where the debtor is a health care business that provides long-term care and where:

    1. The SLTCO is appointed by the United States trustee.

    2. The patients involved are otherwise within the jurisdiction of the Office.

    3. The SLTCO determines that serving as a Patient Care Ombudsman will not significantly impact the ability of the LTCOP to perform its other duties.

References

OAA § 712(a)(3),(d); O.C.G.A. § 31-8-58; 11 USC § 333(a)(2)(B)

303.3 State Ombudsman responsibilities to Ombudsman Representatives

The SLTCO shall provide to Ombudsman Representatives:

  1. Certification training and ongoing training in accordance with the Certification Requirements for Ombudsman Representatives (Appendix B).

  2. Program management and development to enable the local Ombudsman entity to fulfill the Program Components (III-100).

  3. Technical assistance and supervision as needed related to complaint handling, issues advocacy, and other LTCOP services.

  4. Timely review, comment, and approval of the local Ombudsman entity Annual Plan (III-100.1, b, i).

  5. Monitoring and evaluation of the statewide LTCOP.

References

OAA § 712(a)(3)(F); O.C.G.A. § 31-8-52

303.4 State Ombudsman responsibilities to the provider agency

The SLTCO shall provide to the provider agency:

  1. Administrative and technical assistance to assist the provider agency in its support of the LTCOP, including:

    1. Information and resources to assist the provider agency in supporting and promoting the LTCOP.

    2. Statewide LTCOP data and data analysis.

    3. Assistance with monitoring the Ombudsman Representatives.

  2. Assistance with screening Ombudsman Representative applicants, including:

    1. Providing a conflict of interest screening tool.

    2. Timely response to requests for review of applications and for minimum qualification substitutions.

    3. Participation in interviews of applicants as members of an interviewing team at the provider agency’s request.

  3. Assistance with job performance review as requested by the provider agency.

  4. Assistance with arrangements for temporary provision of LTCO services when Ombudsman Representatives of the provider agency are unavailable, or an Ombudsman Representative staff position is vacant.

References

OAA § 712(a)(3)(F)