Library: Policy

340:105-11-242. Access

Revised 9-15-17

(a) Access to facilities and residents.The Office of the State Long-Term Care Ombudsman (Office) procedures for access to long-term care facilities and facility residents are in Sections 1-829-F, 1-1902, 1-1919, and 1-2213-D, Title 63 of the Oklahoma Statutes.An Office or local ombudsman, as that term is defined by Oklahoma Department of Human Services Aging Services, is authorized to enter any facility licensed per the Oklahoma Nursing Home Care Act, the Oklahoma Residential Care Act, and the Continuum of Care and Assisted Living Act to communicate privately and without unreasonable restriction with any resident who consents to the communication, to seek consent to communicate, and to observe all areas of the facility that directly pertain to the care of the resident, without infringing upon the privacy of other residents without their consent.

(1) Area ombudsman staff and trained, designated ombudsman volunteers have the same right of access to licensed long-term care facilities and residents as Office staff.

(2) Any ombudsman staff or volunteer asked to leave the premises of any licensed facility for any reason does so and immediately reports the incident to the Office.

(b) Access to resident's records.The State Long-Term Care Ombudsman (Ombudsman) and Office staff have access to:

(1) review the resident's medical and social records when the:

(A) Office representative has the resident's or the resident's legal representative's permission; or

(B) resident is unable to consent to the review, has no legal representative, and the Office representative obtains Ombudsman approval;

(2) the records as necessary to investigate a complaint when:

(A) a resident's legal guardian refuses to give permission;

(B) an Office representative has reasonable cause to believe the guardian is not acting in the resident's best interests; and

(3) the administrative records, policies, and documents of long-term care facilities, to which the residents or the general public have access; and

(4) copies of all licensing and certification records maintained by the Oklahoma State Department of Health or any state agency with respect to long-term care facilities.Ombudsman volunteers must obtain a resident's legal representative's, ombudsman supervisor's, Ombudsman's, or deputy ombudsman's consent before accessing medical or social records of a resident who does not have the capacity to grant informed consent.

(5) The Health Insurance Portability and Accountability Act of 1996 (HIPAA) Privacy Rule,Part 160 of Title 45 of the Code of Federal Regulations (C.F.R.) and 45 C.F.R. Part 164 Subparts A and E does not preclude release by covered entities of resident private health information or other resident identifying information to the State Long-Term Care Ombudsman Program 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 federal or state survey or inspection process.