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Administrative Code

Virginia Administrative Code
12/2/2024

Part V. Long-Term Care Ombudsman Program

Article 12
Record Management

22VAC30-60-570. Office of the State Long-Term Care Ombudsman.

A. When handling complaints, the Office of the State Long-Term Care Ombudsman shall take the following steps:

1. Staff of the Office of the State Long-Term Care Ombudsman shall provide complaint counseling to an appropriate person alleging a reasonably specified complaint to assist such person in resolving the complaint himself.

2. If the person alleging a reasonably specified complaint is unable or unwilling to resolve the complaint himself, staff of the Office of the State Long-Term Care Ombudsman will attempt to obtain reasonably specific information from the complainant, in accordance with which staff of the Office of the State Long-Term Care Ombudsman shall assess the complaint to determine the most appropriate means of investigating and resolving the complaint.

a. Staff of the Office of the State Long-Term Care Ombudsman shall investigate reasonably specified complaints reported to the office which allege action, inaction, or decisions of providers of long-term care services (or their representatives) which may adversely affect the rights, health, welfare, or safety of the person complaining or the recipient of services.

b. Staff of the Office of the State Long-Term Care Ombudsman shall initiate the investigation of a complaint within two working days of the date on which the complaint is received.

c. Staff of the Office of the State Long-Term Care Ombudsman shall refer complaints concerning long-term care regulatory issues and allegations of abuse, neglect, and exploitation to the appropriate agency for investigation, pursuant to §§ 51.5-139 through 51.5-142 of the Code of Virginia.

d. When the complaint alleges abuse, neglect, or exploitation, staff of the Office of the State Long-Term Care Ombudsman shall make a referral by telephone immediately to the appropriate Adult Protective Services staff in the appropriate local Department of Social Services. "Appropriate local Department of Social Services" means the Department of Social Services (i) in the locality where the alleging person resides, or (ii) in the locality where the abuse, neglect, or exploitation is alleged to have occurred, or (iii) in the locality where the complaint is discovered.

e. Staff of the Office of the State Long-Term Care Ombudsman shall forward a reasonably specified complaint to the appropriate regulatory agency or to the Adult Protective Services unit within three working days of the date on which the complaint is received.

f. Staff of the Office of the State Long-Term Care Ombudsman shall complete their investigation of a complaint handled by the office within 45 working days of the date on which the complaint is received.

g. No action shall be taken or threatened by any long-term care provider or facility for the purpose of punishing or retaliating against any resident, ombudsman, employee, or other interested person for presenting a complaint under this regulation or for providing assistance to the complaining party.

B. Staff of the Office of the State Long-Term Care Ombudsman shall comply with the provisions of confidentiality required by § 51.5-141 of the Code of Virginia and the Government Data Collection and Dissemination Practices Act (§ 2.2-3800 et seq. of the Code of Virginia) concerning confidentiality with respect to the identity of the alleging person or the service recipient and the records maintained by the office.

C. Staff of the Office of the State Long-Term Care Ombudsman shall provide identifying information to the Adult Protective Services unit of the Department of Social Services concerning the affected person or service recipient alleged to be a victim of abuse, neglect, or exploitation.

D. Staff of the Office of the State Long-Term Care Ombudsman may provide identifying information to appropriate agencies involved in the investigation of complaints, at the discretion of the State Ombudsman.

E. All substate ombudsman representatives, when acting for or on behalf of the Office of the State Long-Term Care Ombudsman pursuant to a duly executed contract between the substate ombudsman program in the Area Agency on Aging and the Office of the State Long-Term Care Ombudsman in the Virginia Department for Aging and Rehabilitative Services, shall be bound by the provisions of subsections A through C of this section.

F. Section 51.5-140 of the Code of Virginia provides to the staff of the Office of the State Long-Term Care Ombudsman the right of access to long-term care facilities and to the residents and records of such facilities.

G. All substate ombudsman representatives, when acting for or on behalf of the Office of the State Long-Term Care Ombudsman pursuant to a duly executed contract between the substate ombudsman program in the Area Agency on Aging and the Office of the State Long-Term Care Ombudsman in the Virginia Department for Aging and Rehabilitative Services, shall be provided the same rights of access as those set forth in subsection F of this section.

Statutory Authority

§ 51.5-131 of the Code of Virginia; 42 USC § 3001 et seq.

Historical Notes

Derived from Virginia Register Volume 29, Issue 2, eff. October 24, 2012.

22VAC30-60-580. Substate long-term care ombudsman programs.

A. An Area Agency on Aging shall obtain approval of its Area Plan for Aging Services from, and shall execute a contract with, the Virginia Department for Aging and Rehabilitative Services before it operates a substate ombudsman program. Such contract shall be in the form of an agreement incorporating as the scope of services the approved Area Plan for Aging Services or approved amendments thereto, signed by both parties. The contract shall provide assurances by the Area Agency that adequate legal representation, should any be necessary, shall be supplied on behalf of representatives of the substate ombudsman program acting in the scope of their services.

B. The actions of the representatives of the substate ombudsman program when acting on behalf of the Office of the State Long-Term Care Ombudsman pursuant to the duly executed contract, shall be governed, with regard to confidentiality requirements and rights of access, by the provisions of 22VAC30-60-570 B through 22VAC30-60-570 D.

C. The authority of the substate ombudsman program shall be limited to the geographic area specified in the approved Area Plan for Aging Services or in an approved area plan amendment, recognized as the scope of services of the contract.

D. The following steps will be observed under the circumstances described:

1. Staff of the substate ombudsman program shall comply with the complaint handling and reporting procedures established by the Office of the State Long-Term Care Ombudsman, in accordance with 22VAC30-60-570 A and instructions provided by the Office of the State Long-Term Care Ombudsman.

2. Staff of the substate ombudsman program shall forward all complaints to the Office of the State Long-Term Care Ombudsman within three working days of the date on which the complaint is received by the substate ombudsman program.

3. Staff of the substate ombudsman program shall forward all complaints regarding long-term care services provided directly by or under contract by the Area Agency on Aging to the Office of the State Long-Term Care Ombudsman within one working day of the date on which the complaint is received by the substate ombudsman program.

4. Staff of the substate ombudsman program shall forward all complaints regarding the Office of the State Long-Term Care Ombudsman to the Virginia Department for Aging and Rehabilitative Services within one working day of the date on which the complaint is received by the substate ombudsman program.

E. If the substate ombudsman program utilizes volunteers to visit long-term care facilities, such utilization must be indicated in the Area Plan for Aging Services and specified in the contract. Such volunteers shall be screened and trained by the substate ombudsman program prior to their assuming their responsibilities.

F. Each volunteer in a substate ombudsman program shall sign an agreement with the program which specifies the responsibilities of the volunteer, in accordance with the Area Plan for Aging Services, as approved, and the executed contract.

G. The substate ombudsman program shall assure that each volunteer has fulfilled the minimum training requirements established by the Office of the State Long-Term Care Ombudsman Program and has signed the agreement required by 22VAC30-60-580 F.

H. The substate ombudsman program shall submit accurate and timely reports in accordance with instructions provided by the Office of the State Long-Term Care Ombudsman.

Statutory Authority

§ 51.5-131 of the Code of Virginia; 42 USC § 3001 et seq.

Historical Notes

Derived from Virginia Register Volume 29, Issue 2, eff. October 24, 2012.

22VAC30-60-590. Conflict of interest.

Staff and representatives of the Office of the State Long-Term Care Ombudsman and staff and representatives of the substate ombudsman program shall have no conflicts of interest with regard to long-term care facilities, long-term care providers, and long-term care issues, pursuant to the State and Local Government Conflict of Interests Act (§ 2.2-3100 et seq. of the Code of Virginia).

Statutory Authority

§ 51.5-131 of the Code of Virginia; 42 USC § 3001 et seq.

Historical Notes

Derived from Virginia Register Volume 29, Issue 2, eff. October 24, 2012.

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