Office of the State Long Term Care Ombudsman

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1 Office of the State Long Term Care Ombudsman Office of Elder Rights Team SLTCO Local Long Term Care Ombudsmen Volunteer Ombudsman Program Policy & Discharges Support Services 1

2 State Long Term Care Ombudsman Deanna Clingan Fischer FYI and Updates 2

3 The Advocate monthly newsletter The Advocate Sent monthly Covers various topics in long term care Provides fact sheets To subscribe 3

4 Poster of agencies who provide assistance to residents/tenants in long term care MDS Section Q 4

5 Section Q: a snapshot Through Section Q, NF residents are identified who wish to learn about available community supports and services along with the possibility of returning to the community. The goal of Section Q is to meaningful engage residents in their discharge planning goals. Information exchange is promoted between residents, NF s, local contact agencies and community resources. Returning to the Community brochures The LLTCO are circulating copies of the brochure titled Returning to the Community. Facilities are including these in their admission packets. These brochures supplement Section Q of the MDS. The number for Lifelong Links is listed in the brochures. This is to encourage residents to reach out to the Lifelong Links Center for information on community services and supports at any time. 5

6 Section Q referrals If a resident triggers for a Section Q referral, the facility should: Contact the Iowa Medicaid Enterprise (IME) at: , or IME will start the Section Q referral process, and if criteria is met, they will send the referral to the local Lifelong Links Center. Section Q referrals After the Lifelong Links Center receives the referral, they will be in touch with the contact person listed on the referral to discuss community supports and options. This follow up typically occurs within two business days of receiving the referral from IME. It s important to note that Section Q referrals can be made ANY TIME, not just when the MDS assessment is due. 6

7 Section Q referral Through this process, the Lifelong Links Center, resident, caregiver, and facility can work together to develop and implement a successful discharge plan. Not all referrals through Section Q result in a discharge to the community. Residents have the right to change their mind about discharging to the community after information is obtained. Section Q questions? For Section Q questions, go to our website: Under the Long Term Care Ombudsman tab, click on MDS Section Q Education for more information. 7

8 Civil Money Penalty (CMP) CMP Grant Purpose of the CMP grant is to provide residents in nursing facilities and their family members information on topics they have requested: Resident Rights Involuntary Discharge from a Long Term Care Facility Financial Power of Attorney Living Wills Resident and Family Councils The Volunteer Ombudsman Program The Long Term Care Ombudsman Program Medicaid and HCBS Elderly Waiver Program Long Term Care Payment Options Long Term Care Choices Financial Exploitation Health Care Power Of Attorney 8

9 CMP GRANT Information is provided in the form of brochures and webinars which are located at under the Long Term Care Ombudsman tab Pre and Post Surveys will be completed through the grant cycle by Nursing Facility Staff Additional brochures can be requested by calling Feel free to contact Julie Pollock, Local Long Term Ombudsman, with any questions or comments at Local Long Term Care Ombudsman 9

10 Local Long Term Care Ombudsmen (LLTCO) Kim Weaver Melanie Kempf Stacia Timmer Jennifer Golle Julie Pollock Tonya Amos Pam Railsback Kim Cooper What LLTCO actually do: Investigate complaints Provide information to families Provide consultation to facilities Provide training to facility staff Ensure adequate facility coverage Coordinate with outside agencies 10

11 An average day: A day in the life of a LLTCO can vary greatly Facility numbers range from Number of counties range from 7 17 Beds covered range from 5,073 to >8,000 Provide orientation to volunteer ombudsman Volunteer Ombudsman Program 11

12 Volunteer Ombudsman Program Volunteer Ombudsman Program (VOP) Coordinators Merea Bentrott & Sarah Hinzman AmeriCorps VISTA Members Cairn Reisch & Meredith Funke What is the VOP? The Certified Volunteer Long Term Care Ombudsman Program (VOP): Is a newer program (2013) Places trained and certified volunteers in long term care facilities to promote residents rights Only NF, SNF, HNF, RCF and EGH at this time Assists Local Long Term Care Ombudsmen (LLTCO) to carry out duties described in the Older Americans Act (e.g. monitoring visits) 12

13 Who are the VOP volunteers? Community members over 18 years of age (currently includes college students through retirees). Some with professional experience in areas of health, human services or long term care. Some with experience as family members or caregivers of a long term care resident. Who are the VOP volunteers? Have a strong appreciation for older adults. Are good listeners and objective problem solvers. Are able to demonstrate an understanding of program practices. Do not have a conflict of interest, as defined by the Older Americans Act (OAA). 13

14 VOP An average day A trained, certified Volunteer Ombudsman: Advocates for residents rights in an assigned care facility Makes unannounced monitoring visits to facility (3 hrs/mo minimum) Observes physical and cultural conditions of facility VOP An average day Receives complaints from residents and visitors about quality of life and care Communicates complaints to facility staff on behalf of resident with his/her permission Monitors progress to resolution Reports findings to program 14

15 Policy Coordinator and Legislative Liaison Paige Thorson Discharge Specialist Cynthia Pederson

16 Discharges an average day Receives and reviews involuntary discharge notices Discusses involuntary discharge with facilities Discusses involuntary discharge with resident/resident s decision makers Attempts to resolve involuntary discharge to satisfaction of resident Discharges an average day Assists resident/resident s decision maker with alternate placement Attends involuntary discharge appeal hearings Closures 16

17 Involuntary Discharge Notice 30 Day Nursing Facilities Needs to comply with IAC Chapter 481 Chapter 58 and Chapter 441 Chapter 81 Must state reason for discharge Must state the effective date of the discharge Location to which resident will be discharged Must contain statutory statement explaining appeal rights in 12 point type Involuntary Discharge Notice 30 Day Nursing Facilities Office of the State Long Term Care Ombudsman contact information Contact information for Disability Rights Iowa the agency responsible for protection and advocacy for persons with developmental disabilities and for persons who are mentally ill 17

18 Involuntary Discharge Notice 30 Day Nursing Facilities Must be personally delivered to resident and the responsible party Also must be transmitted to: DIA, resident s responsible party, resident s primary care provider, person/agency responsible for resident s placement, State Long Term Care Ombudsman s office All parties receiving the notice shall be shown in a CC line on the notice Administrative Law Judges pay attention to: Full 30 days from delivery of notice to discharge date Language of notice meeting legal requirements Documentation of required counseling regarding discharge 18

19 Involuntary Discharge Notice Assisted Living Program & Elder Group Home 30 Day Notice needs to be given to tenant or tenant s legal representative If tenant or tenant s legal representative contests the notice must immediately be sent certified mail to our office Internal appeal of discharge determination If tenant holds over must proceed under landlord/tenant law Support Team Administrative Assistant Katie Mulford Other Support Members: Pat, Danika, Janet, Janny Fiscal Staff: Tammy, Dixie, Jeff Publicity and Training: Erin, Nichole 19

20 Hot Topics Visitation Rights Powers of Attorney Agents making inappropriate decisions Legal Issues guardianship, conservatorship Court Committals Challenging family members Top Five Complaints Issues related to resident/tenant care (205) Issues related to autonomy, choice, exercise of rights, privacy (185) Issues related to admission, transfer, discharge and eviction (157) Issues related to the system and concerns apart from the facility (113) Issues related to financial concerns or property lost, missing or stolen (67) 20

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