Library: Policy

340:105-11-237.2. Complaint investigation timeframes

Isssued 9-15-17

(a) All complaints investigated by a designated ombudsman require a face-to-face visit with the resident the complaint involves.The time frames for the initial attempt at a face-to-face visit must occur within five business days of the receipt of the complaint unless:

(1) the complaint includes an allegation of abuse, neglect, or exploitation; then the time frame for initial face-to-face contact with resident occurs within three business days; or

(2) the complaint involves an actual or threatened discharge from a facility, the time frame for initial face-to-face contact with resident is no later than the last day the resident has a right to appeal the discharge or within five business days, whichever comes first.

(b) There is no time frame for the determination of the final disposition of a complaint but it is determined when the ombudsman has enough evidence to complete the investigation.In the event the final disposition of a complaint exceeds 90 days, the Ombudsman representative assigned to investigate the complaint submits the case to the Ombudsman or Deputy Ombudsman for review and the reason the case will remain open is documented in the case record.

(c) In rare instances weather, illness, or other unforeseen, serious circumstances may delay on-site investigation.When a delay occurs, the ombudsman representative consults with and seeks consent from the State Long-Term Care Ombudsman or deputy ombudsman to:

(1) initiate a phone response.

(A) Contact with the resident and/or the complainant is attempted.

(B) Resolution of the complaint may be sought, in accordance with the resident's wishes, through phone calls to persons that may be able to resolve or mitigate the situation, such as the facility administrator, facility staff, or another agency;

(2) complete comprehensive documentation regarding the cause(s) for delay and the response to the complaint in:

(A) hard copy case notes, when used;

(B) electronic documentation, such as a journal entry titled, "Delayed Response" documenting the:

(i) follow-up date;

(II) delaying factor(s); and

(iii) steps taken to resolve the complaint;

(3) an on-site visit follow-up with the resident is required even when the complaint was resolved by phone.The follow-up visit occurs immediately following the unforeseen circumstance; and

(4) complete the follow-up visit with comprehensive documentation in:

(A) hard copy case notes, when used; or

(B) electronic documentation, such as a journal entry titled, "Delayed Response" documenting the;

(i) follow-up date;

(ii) any remaining issues or additional complaints to be resolved; and

(iii) resident's satisfaction with the resolution.