Library: Policy

340:105-11-237. Complaint investigation

Revised 9-15-17

The State Long-Term Care Ombudsman Program (Program) complaint mechanism functions at all levels with procedures for receipt, investigation, and resolution of problems and complaints.

(1) The Office of the State Long-Term Care Ombudsman (Office) staff:

(A) receive complaints from all sources, including referrals from enforcement agencies and complaints from area ombudsman programs;

(B) refer complaints to area ombudsman supervisors when appropriate;

(C) investigate complaints directly or with ombudsman supervisors;

(D) refer unresolved formal complaints to a regulatory or law enforcement agency, when appropriate;

(E) assist other agencies in complaint resolution;

(F) follow-up on complaint resolution and closure; and

(G) may decline to investigate any complaint when:

(i) the complaint is frivolous or not made in good faith;

(ii) the complaint was made so long after the incident that it is no longer reasonable to conduct an investigation;

(iii) an adequate investigation cannot be conducted because of insufficient funds, insufficient staff, lack of staff expertise, or any other reasonable factor that would result in an inadequate investigation despite a good faith effort; or

(iv) an investigation by the Office would create a real or apparent conflict of interest.

(2) Area ombudsman supervisors:

(A) receive complaints from all sources;

(B) investigate complaints through on-site, unannounced visits to the facility or refer the complaints to ombudsman volunteers;

(C) resolve complaints or refer the complaint in writing to State Long-Term Care Ombudsman (Ombudsman) staff when correction cannot be achieved at the area level, or when a regulatory or law enforcement agency's assistance is needed; and

(D) follow-up on conditions identified through the complaint process.

(3) Ombudsman volunteers:

(A) receive complaints and learn of problems from all sources;

(B) investigate complaints through on-site, unannounced, routine weekly visitation to the assigned facility or refer complaints to an ombudsman supervisor for investigation;

(C) resolve problems or complaints within the facility or refer to an ombudsman supervisor for resolution; and

(D) follow-up on conditions through routine, weekly visitation with residents in the assigned facility.