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LONG TERM CARE OMBUDSMAN

 

DIVISION 5

ACCESS, INVESTIGATION AND REPORTING

PROCEDURES

114-005-0000

Access to Long Term Care Facilities

(1) Upon entering a long term care facility, the Ombudsman or designee shall present identification provided by the Ombudsman Program to the specified staff person and request that the Ombudsman or designee be directed to the person in charge. The Ombudsman or designee shall show I.D. to the person in charge. If the person in charge is not available, the Ombudsman or designee may proceed to fulfill the Ombudsman or designee's duties.

(2) The Ombudsman or designee is not required to inform the long term care facility of the specific nature of the visit. The Ombudsman or designee may generally inform the long term care facility as to whether or not the visit is a routine visit or complaint investigation, but shall not offer any information that would enable a person to determine the name of the complainant, witness or witnesses or alleged victims.

(3) The Ombudsman or designee is not required to give prior notification before visiting a long term care facility.

(4) The Ombudsman or designee is not required to conform to any policy of a long term care facility that in any way limits access rights established by ORS 441.117 and this rule.

(5) During any visit to a long term care facility, the Ombudsman or designee shall have access, without accompaniment of long term care facility staff, to all public or common areas and to resident rooms with the consent of the resident or the resident's legal guardian. For the purpose of investigating or resolving complaints, the Ombudsman or designee shall have access to laundry rooms, kitchens, linen closets, shower rooms and other service areas of a long term care facility that are relevant to any matter under investigation.

(6) The Ombudsman or designee may obtain access to a long term care facility at any time considered necessary and reasonable by the Ombudsman or designee for the purpose of performing the duties of the Ombudsman or designee.

Stat. Auth.: ORS 441
Stats. Implemented:
Hist.: LTCO 1-1989, f. 1-19-89, cert. ef. 2-1-89

114-005-0010

Access to Resident

(1) The Ombudsman or designee may communicate privately with any consenting resident. The Ombudsman and designee shall have access to each resident in private to determine if the resident wishes to communicate with the Ombudsman or designee. The resident's refusal to communicate with the Ombudsman or designee shall not be relayed by an intermediary. In a multi-bed room, a resident's refusal to communicate with the Ombudsman or designee shall not keep the Ombudsman or designee from entering or communicating with other residents. If the resident's room does not permit private consultation to occur between the Ombudsman or designee and resident, or if such consultation infringes upon the rights of roommates, then the facility shall provide an appropriate private place for such meetings. The resident(s) and the Ombudsman or designee may also meet in any common area of the facility unless their presence there would infringe upon the privacy or other rights of other residents.

(2) When encountering a closed door the Ombudsman or designee shall knock and listen for a response. If there is no response, the Ombudsman or designee may open the door and announce his/her presence as entering. If residents are observed in a situation or condition requiring privacy, the Ombudsman or designee shall excuse themselves and close the door upon exiting.

(3) When encountering a closed privacy curtain, the Ombudsman or designee shall request permission from the resident to enter the curtained area. If the resident does not respond, the Ombudsman or designee shall request that staff of the long term care facility determine if the resident is asleep or receiving treatment or services. If the resident is sleeping or receiving treatment or services, the Ombudsman or designee may not enter the curtained area. If the resident is not sleeping or receiving treatment or services, the Ombudsman or designee may enter the curtained area to determine if the resident wishes to communicate with the Ombudsman or designee.

Stat. Auth.: ORS 441
Stats. Implemented:
Hist.: LTCO 1-1989, f. 1-19-89, cert. ef. 2-1-89

114-005-0020

Reporting the Investigation

Upon completion of an investigation, the Ombudsman or designee shall report, either verbally or in writing, opinions or recommendations to the administrator or other staff in charge, his/her designated representative, and affected parties. Findings and conclusions from the investigation may be reported, verbally or in writing, provided the report complies with all confidentiality requirements and does not jeopardize the integrity of any related investigation.

Stat. Auth.: ORS 441
Stats. Implemented:
Hist.: LTCO 1-1989, f. 1-19-89, cert. ef. 2-1-89

114-005-0030

Access to Records

(1) The Ombudsman or designees shall have access to any resident's records with the written authorization of the resident or the resident's legal guardian. If the resident has no legal guardian and is unable to consent, the Office of the Long Term Care Ombudsman may subpoena the resident's records for the purpose of complaint investigation and resolution.

(2) The Ombudsman and designee shall have access to long term care facility records that relate to an investigation. Such records include:

(a) Incident reports;

(b) Staff plans;

(c) Survey inspection reports;

(d) Time Cards;

(e) Facility licenses;

(f) Staff licenses; and

(g) Employee schedules.

(3) When the Ombudsman or designee is investigating a complaint and is refused access to records authorized by this rule, the Office of the Long Term Care Ombudsman may issue a subpoena which requires a person to appear to give testimony or to produce documents. If a person fails to comply with the subpoena, the Office of the Long Term Care Ombudsman may request a court to take appropriate action.

Stat. Auth.: ORS 441
Stats. Implemented:
Hist.: LTCO 1-1989, f. 1-19-89, cert. ef. 2-1-89

114-005-0040

Confidentiality of Records

(1) The identity of residents, complaints or person providing information on behalf of the resident or complainant shall be confidential and shall not be disclosed unless:

(a) The resident or resident's legal representative gives written consent that the resident's identity may be disclosed and specifies to whom the disclosure may be made;

(b) The complainant or the complainant's legal representative gives written consent that the complainant's identity may be disclosed and specifies to whom the disclosure may be made;

(c) The person providing information on behalf of the resident or complainant gives written consent which states that the person's identity may be disclosed and specifies to whom the disclosure may be made; or

(d) A court orders disclosure.

(2) No Ombudsman or designee who gains access to a resident's records shall discuss or disclose information in the records or disclose the identity of a resident, a complainant or a person providing information on behalf of a resident to any person not associated with the Ombudsman Program unless the conditions of section (1) of this rule are met.

(3) Information obtained by the Ombudsman Program may be used by the Ombudsman Program for the preparation and disclosure of statistical, case study, or other data provided that the identities of specific individuals are not disclosed.

Stat. Auth.: ORS 441
Stats. Implemented:
Hist.: LTCO 1-1989, f. 1-19-89, cert. ef. 2-1-89

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