new volunteers is essential to accomplish that overlap across partnership agen- and volunteers. cies to improve cooperation.

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1 OMBUDSMAN OUTLOOK High Expectations for the LongTerm Care Ombudsman Program After a successful Fiscal Year for the Long-Term Care Ombudsman Program, the momentum has not stopped. The program has returned to focusing on its core mission of resident-centered advocacy. This means that all efforts of the program are geared toward protecting the health, safety, welfare, and rights of long-term care residents. Plans for continuing improvements have become steadfast goals. The program is determined to provide the absolute best in advocacy for long-term care residents. Part of the Ombudsman Program s resident-centered advocacy includes performing administrative assessments of each long-term care facility in the state. Every year over 4,000 assisted living facilities, nursing homes, and adult family care homes are visited. During these visits volunteer ombudsmen spend time with residents discussing their experiences at the facility. These discussions provide great insight for ombudsmen to impart to facility administrators and owners as to what improvements can be made. The administrative assessment visit is one of the required quarterly visits that the ombudsman program makes to long-term care facilities in performing its duties mandated by the federal Administration on Aging. Over the course of the next three years, the program is ramping up efforts to increase the number of visits to facilities to THE OFFICIAL NEWSLETTER OF FLORIDA S VOL. 15 fall/winter 2012 LONG-TERM CARE OMBUDSMAN PROGRAM in this issue reach the High Expectations...1 one-visit-pergovernor and Mayor Proclamations...2 quarter goal. With Residents Rights Awareness...3 over 4000 longannual Ombudsman Awards Winners...3 term care facilities Generations Come Together...4 in Florida, the Proposed Legislation...5 recruitment of Residents Rights...6 new volunteers is essential to accomplish this goal. To spearhead this effort, the Baker Act and how it applies to longprogram added a fulltime recruitment term care residents. The program is in manager, Bryan Morgan. Bryan has the process of creating an eight-hour implemented new approaches to re- online course with the Department of cruitment, recognition, and retention Children and Families Mental Health of volunteers to serve in the program. component that addresses that need in With the enhanced recruitment ef- addition to more comprehensive trainforts, standardized training had to be ing in serving residents with mental addressed. The past year included the health diagnoses. The completed prodground-breaking online ombudsman uct will be made available to facilities certification training materials cre- serving residents with a mental health ated by James McFatter, the Ombuds- illness so statutory training requireman Training Administrator. This new ments may be achieved with the hope training adds needed standardization that residents will ultimately benefit. and efficiency in the program. Addi- Other agencies will have access to this tionally, the training administrator is training, and it will be a mandatory charged with creating online modules course for ombudsman program staff that overlap across partnership agen- and volunteers. cies to improve cooperation. Training Continued improvements for acis a continuing discipline in the pro- countability and consistency are also gram, as all staff and volunteers are a goal of the Long-Term Care Omrequired to take additional training be- budsman Program. The program is yond certification courses every year. initiating a plan to improve the reportthis ensures that updated information (continued on page 2) is continually applied to the daily activities of ombudsmen. We re on Facebook! One of the most commonly re Like us at: Florida s Ombudsman Program quested training subjects is the Florida

2 (High Expectations...continued from page 1) ing process for more accurate data. Quality assurance measures are being implemented to ensure quality reporting on all resident complaint investigations, administrative assessments, and facility visitations. To achieve improvement, a grading scale of accuracy will be applied to documentation. In the upcoming year, the expectation is that 45 percent of all documentation passes the level of accuracy established by the program. In , the goal will rise to 65 percent, and to 85 percent by September 2015 as volunteer ombudsmen get more familiar with the high standards. Partnerships with the program continue to grow and improve. That cooperation has yielded better services for those we serve, the residents in longterm care facilities. By September 2016, face-to-face visits are to be established with all law enforcement entities within each ombudsman district where any long-term care facility is located. This is to ensure that officers are aware of the assistance ombudsmen can provide in situations where resident rights have been violated. With the increase of volunteers, higher frequency of visitations, continued completion of assessments in 100 percent of licensed facilities statewide, improved documentation reporting, better training, and continued strengthening of partnerships within the community, the Long-Term Care Ombudsman Program has high expectations for the future. That future ensures better resources and outcomes for longterm care residents. Our residents are the reason the program strives to continually improve, and program staff are honored to do so. Ombudsman Outlook Contributors: Additional Contributor: Bryan Morgan Deputy State Ombudsman for Recruitment and Public Affairs Outlook Layout: Franko Galoso LTCOP, Media Coordinator Jim Crochet State Ombudsman Susan Anderson Deputy State Ombudsman for Legal Affairs Charles T. Corley Department of Elder Affairs Secretary Rick Scott The State of Florida, Governor * NEW Annual Report* Annual Report now available on Ombudsman website! Governor Scott and Mayors across Florida support National Resident Rights Month Last October many proclamations were made to recognize the importance of resident rights statewide. From the Capitol to county and city mayors, the Ombudsman Program was able to stand side by side in a great month of advocacy for Florida s long-term care residents. 2 O

3 Ombudsmen visit facilities statewide to raise awareness of resident rights Interaction with the long-term care population is the most rewarding experience for volunteers in the ombudsman program. One of the easiest ways to do this is simply explaining the rights residents have living in their homes. In the Pasco-North Pinellas district, District Manager Lynn Penley held a regional resident council meeting. Resident councils are formed in facilities to empower residents to address grievances with facility administration. This self advocacy is very important. Penley states, We are proud to announce that over 20 residents attended the Inaugural Resident Council meeting at Wellspring Assisted Living Facility in Zephyrhills on October 24. Residents are looking forward to making positive changes through the resident council. Withlacoochee District Manager Helen Anderson and her ombudsmen continued resident interaction in Central Florida, giving resident rights presentations to 22 area longterm care facilities. In the Southwest Florida district, District Manager DeLois Williams and The Don Hering Excellence in Advocacy award is presented to one of the Ombudsman of the Year recipiants who represents the best of the best in the Ombudsman Program. The award was named after twoher ombudsmen provided resident rights training to nursing staff in area facilities. Ombudsmen across Florida reached out to educate residents and staff of the basic rights of all residents throughout October. The focus continues all year long and the advocacy continues to touch lives. Annual Ombudsman Award Winners To thank our outstanding citizen volunteers, Florida s Long-Term Care Ombudsman Program recognizes its volunteers with the following awards: Ombudsman of the Year and Don Hering Excellence in Advocacy award winners. The Ombudsman of the Year award is given to an ombudsman volunteer who is selected by the members of each of the 18 councils in the State. These individuals demonstrate exceptional efforts, going above and beyond the call of duty in advocating for longterm care facility residents. term State Council Chairman, Donald Hering, for his advocacy, leadership, compassion and tireless work for long-term care facility residents. This award is voted upon by both the Executive Committee and the State District Ombudsman Manager, Lynn V. Penley, Award winner, Gayle Mountain, and State Ombudsman, Jim Crochet 3 O Council and is based on both objective and subjective criteria. This year the Don Hering Excellence in Advocacy award was presented to Gayle Mountain. Gayle is an Ombudsman for the Pasco and North Pinellas District. When asked if she had a memorable case, Gayle said, I did so many but they are all memorable, because I was able to help the residents. Congratulation to all the Ombudsman award winners! Ombudsman of the Year Ray Sykes Alan Tudor Robert Mills Marie Brand James Jen Cynthia Floyd Gayle Mountain Constance Faison Maritza Ramos-Pratt Joanne Crain Rita Steinback Arlyne Lewis Shirlee Leifert Leonard Dills Ruth Battle-Hall Janice Johnson Jeanne Anastasi Don Hering Excellence in Advocacy Gayle Mountain

4 Generations come together for long-term care residents Over the last year the Long-Term Care Ombudsman Program has increased the efforts to recruit volunteers. Traditional avenues such as newspapers, radio and television broadcasting, and making presentations are often successful in attracting professional and retired citizens. To attract younger volunteers, Deputy State Ombudsman for Recruitment and Public Relations, Bryan Morgan, began approaching universities with health care administration curriculums. The appeal was to combine the experience of our seasoned ombudsmen with the eagerness to learn of students. The intergenerational combination would create a dynamic exchange of new methods being taught in the universities with years of service of ombudsmen. The first universities approached included the University of Miami, Florida International University, University of South Florida, and the University of Central Florida. The Orlando campus of UCF realized the opportunity and became the pilot of the program. In the summer semester of 2012, five health care administration major students began the process of becoming certified ombudsmen. As a requirement of participating the student candidates must complete the necessary level-two background check and the certification training expected of all volunteers prior to the internship. After certification training, student ombudsmen are paired with traditional ombudsmen to visit long-term care facilities for annual resident centered assessments. While participating, the students learn how to communicate with residents as well as learn about administration of nursing homes, assisted living facilities, and adult family care homes. Dr. Jennifer Sumner, a Director of Internship Programs at UCF describes the experience, In the spring of 2012, I was approached about our internship programs. Internships are a required part of the curriculum for three of our majors; further, internships are an integral part of the learning experience for our students. In order for internships to be successful, we must have engaged and willing partners to serve as hosts and mentors; the partnership that we have developed 4 O with the Long-Term Care Ombudsman Program has been exceptional. Mr. Morgan, and the other mentors of the program, have enhanced the knowledge of our students and have helped to guide them for success in their future careers. An added benefit for our students as interns with the Long-Term Care Ombudsman Program, not routinely seen with other internships, is that they receive the opportunity to become certified ombudsmen; this unique certification adds value to the students education and makes them more marketable in the industry upon graduation. We are delighted to have this partnership in place with the Long-Term Care Ombudsman Program, and are grateful for the wonderful experiences offered to our student interns. I can give this partnership a very heart felt thumbs-up said Lowie Brannan, District Ombudsman Manager for the Orlando area. The students commitment to our program has been outstanding overall. They are eager, smart, energetic, and a burst of fresh air to all of us. They have been instrumental to the district s ability to exceed expectations and enhance our responsiveness to residents issues. The decision to recruit students in this particular field was inspired by the vision of an ongoing learning cycle. I envisioned students beginning their careers in health care administration coming in at the ground level and understanding the rights of residents, said Morgan. As they gain experience in talking to residents and listening to their concerns they learn to apply the resident s needs to the rights they are entitled to. When they are interviewing for a job after graduation they can provide invaluable experience of working with residents to resolve complaints. This makes them more attractive to a company who is looking for quality administrators to (continued on page 5)

5 (Generations...continued from page 4) better their business. After the inaugural success of the internship program, Jim Crochet, State Ombudsman, is eager to see what advances the expansion of the effort will bring in the second year. Mr. Crochet explained, The advantages are shared across the board, Proposed Legislation to Retarget Ombudsman Focus and Resources experience for students, assistance for residents, more volunteers for the program, and a pool of knowledgeable graduates facility owners can be confident in hiring. With the intership program expanding across the state and into more universities, the sucess of the program will be a definite asset and fullfilling venture. -Susan Anderson The State Long-Term Care Ombudsman Program is proposing new legislation this year to revise the internal operating structure and procedures of the Long-Term Care Ombudsman Program (LTCOP). The new legislation attempts to bring some efficiencies to the program and proposes to conform Florida s ombudsman statute to the requirements of the federal Older Americans Act, 42 U.S.C. 3001, et seq. Realignment of the internal structure of the program will allow the LTCOP to move in a direction more suited to effect meaningful quality of life enhancements for Florida s residents in long-term care facilities. Ombudsmen are in a unique position to ensure the dignity and quality of life of long-term care residents in a culturally appropriate manner and should make these concerns a primary objective of the program. The proposed legislative changes will help in efforts to retarget ombudsman resources to investigations and training that emphasize the quality of life of residents. Such statutory updates that reallocate ombudsman resources should ensure that the ombudsmen remain qualified and informed advocates to address the unmet resident quality of life complaints. Specifically, the proposal will provide the following: Conform terminology and programmatic requirements to the Older Americans Act (in part, as directed by the Administration on Aging s Compliance Review of 2011); Allow the State Ombudsman to have final authority to make appointments of individuals serving as ombudsmen; Clarify that the term representatives of the office includes the state ombudsman, ombudsman program staff, and certified ombudsman volunteers; delineates the activities and duties of the state ombudsman in relation to ombudsmen in general; Remove limitations on access to resident records in conformance with s. 712(b) of the Older Americans Act; Create the opportunity for consultative problem solving by restructuring the state council into a state advisory council by expanding membership to include representatives of stakeholder groups as directed by s. 712(e) of the Older Americans Act. Specifically, the Act requires the views of area agencies on aging, old- 5O er individuals, and providers of longterm care in planning and operating the LTCOP; Revise and clarify the application, background screening, and training requirements needed to become a certified ombudsman; Provide needed flexibility in the operation of the program within districts to eliminate strict geographical boundaries which prevent individuals from volunteering as ombudsmen; and Revise the terminology describing local councils to conform to s. 712(a) (5) of the Older Americans Act and to relieve the state of the unnecessary resource burdens when performing internal staffing activities. Support of Governor Scott s ALF Workgroup Recommendations In addition to a revision of its own program, the LTCOP supports the recommendations of Governor Scott s Assisted Living Workgroup that strengthen regulatory oversight and provide enhanced protection of individual rights for persons residing in assisted living facilities. The recommendations for statutory revision that the LTCOP supports, in brief, include: Eliminate unethical or incompetent providers from the system; Improve coordination between the various federal, state and local agencies with any role in long-term care facility oversight ; Create a professional board with regulatory responsibility for assisted living facility administrators; Enact more stringent requirements for hospital accountability in discharge planning; Enact legislation that provides ALF residents an appeal process for disputed discharges; and Increase funding for assistive care services, optional state supplementation, and other budget categories that support the cost of care for residents.

6 Ombudsmen Recognize Residents Rights Month The month of October recognizes a handful of observations such as Columbus Day, National Boss Day and Halloween. However, for the Long- Term Care Ombudsman Program the most important recognition is Residents Rights Month. For a full month the rights of residents in long-term care are on display across the nation. These rights are the cornerstones of the Ombudsman Program. This issue of the Ombudsman Outlook recaps the successful month of Resident Rights awareness. Residents in long-term care facilities such as adult family care homes, assisted living facilities, and nursing homes retain their rights as citizens of this great country and in some cases, gain some. Throughout the year, Florida s 18 ombudsman councils are busy educating residents and facility staff through visitations, resident council meetings or in-service trainings for staff. In October however, the emphisis is strongest. This is not only a great way to celebrate the month but also to make contact with the residents who may need the assistance of an ombudsman. In the fiscal year the Long-Term Care Ombudsman Program assisted residents with various complaints. In assisted living facili -ties and adult family care homes the top five concerns were: 1. Medication administration and organization 2. Menu 3. Cleanliness, pests, general housekeeping 4. Equipment/Buildings 5. Dignity, respect, staff attitudes These issues are in violation of residents rights to have adequate and appropriate health care, live in a safe and decent living environment, and be treated with consideration, respect and with due recognition of personal dignity. In that same year the Long-Term Care Ombudsman Program found the following complaints most prevalent in nursing homes: 1. Discharge/Eviction 2. Dignity, respect, staff attitudes 3. Medications-administration, organization 4. Failure to respond to requests for assistance 5. Personal property The rights in violation were, the right to being treated with respect and dignity, receiving appropriate health care, a right to personal possessions, and the right to receive a thirty-day written notice of discharge or relocation. For someone who does not live in long-term care these rights are taken 6O for granted every day. Imagine being in your own home and someone talking down to you Would you accept that? If you are told in your own home that you will have to accept what is given to you for dinner, would you not complain? What if you were told that you could not have personal items like pictures of your family in your room? How could that not upset you? How would you feel if you were not able to have visitors? We must remember that long-term care facilities are homes for those who live there. Staff and ombudsman have the opportunity to leave after their job is done but the residents will remain. These are but a few of the rights that are extended to those in longterm care. Others include the right to civil and religious liberties such as voting and worshiping how they choose. Residents in nursing homes have the right to choose their physician and pharmacy as well as the right to refuse medications and to know the consequences. Those in assisted living facilities have the right to share a room with a spouse if they both live at the facility, and be free of physical and chemical restraints. Again, imagine being in your own home and in a situation where such rights were not observed. The long-term care ombudsmen who visit facilities year round are citizen volunteers who are trained to be experts in resident rights. Each volunteer shares the same compassion for others and realize that long-term care is in the future for most of us. The simple gesture of helping those who receive services now will improve the treatment for others in the future. It is not lost on ombudsmen that those who need their rights protected are the ones that have made everyday rights for all of us possible. The full list of rights can be found on our website: ombdusman.myflorida.com.