Mississippi Administrative Code › Title 18 - HUMAN SERVICES › Part 26 - Policies and Procedures Manual for the MS Ombudsman Program › Part I - Introduction to the Long-Term Ombudsman Program › Section 18-26-1-B - Definitions

Current through June 25, 2024
Abuse:
Negligent or willful
				  infliction of injury, unreasonable confinement, intimidation, or cruel
				  punishment with resulting physical harm, pain, or mental anguish; or
				  deprivation by a person, including a caregiver, of goods or services that are
				  necessary to avoid physical harm, mental anguish, or mental illness or sexual
				  abuse.
ADL:
Activities of Daily Living,
				  including but not limited to, bathing, walking, excretory functions, feeding,
				  personal grooming, and dressing. These have been revised to:
				  mobility/ambulation; community mobility; transferring; eating and meal
				  preparation.
Advanced Health-Care Directive
				  (AHCD):
Designating an agent to make health-care decisions. MS has
				  the Uniform Health-Care Decisions Act in §
									41-41-201 through §
									41-41-229 of the MS Code which
				  combines the power of attorney for health care along with a living will. An
				  example is provided in §
									41-41-209.
Advisory Council:
This group
				  provides guidance and advice to the SLTCO in order to enhance the effectiveness
				  of the statewide LTCOP. Each AAA has an Advisory Council.
Area Agency on Aging (AAA):
An
				  agency designated by the DAAS to arrange for providing the aging services in
				  its planning and service area (PSA). There are 10 AAAs in Mississippi that
				  contract with DAAS to provide services under Title III and Title VII of the
				  OAA.
Area Plan:
A plan developed by AAA
				  for its relevant planning and service area as required by the Older Americans
				  Act (OAA) §306.
Assisted Living Facility (ALF):
Facility that provides personal care and the addition of supplemental services
				  to include, but not be limited to, the provision of medical services (i.e.,
				  medication procedures and medication administration) and emergency response
				  services. These are for individuals who want to maintain some level of
				  independence, but require support with activities of daily living
				  (ADLs).
Case:
Each inquiry brought to, or
				  initiated by, the ombudsman on behalf of a resident or group of residents
				  involving one or more complaints relating to the health, safety, welfare, or
				  rights of residents which requires opening a case and includes ombudsman
				  investigation, strategy to resolve, and follow-up. One or more complaints
				  constitutes a case. You cannot have a case without a complaint.
Certification:
The designation
				  provided by the State Long-Term Care Facilities Ombudsman to an individual who
				  meets minimum qualifications, is free of conflicts of interest, and has
				  successfully completed training and other criteria stipulated in the
				  Certification Requirements for the Mississippi Ombudsman Program. Designation
				  authorizes such individual to act as a representative of the Long-Term Care
				  Ombudsman Program. An ombudsman (even a volunteer) shall not be authorized to
				  investigate a complaint without being certified by the State Long-Term Care
				  Facilities Ombudsman.
Closed Case
: A case is where none
				  of the complaints within the case require any further action on the part of the
				  ombudsman and every complaint has been assigned the appropriate disposition
				  code.
Community Education:
Presentations
				  to community groups, other agencies or professionals or to groups of residents
				  or families (other than resident & family councils) on long-term care
				  issues. Each Ombudsman district is required to do two community education
				  events each federal fiscal year.
Complaint
: A concern brought to, or
				  initiated by, the ombudsman for investigation and action by or on behalf of one
				  or more residents of a long-term care facility relating to the health, safety,
				  welfare or rights of a resident. One or more complaints constitutes a case. You
				  cannot have a case without a complaint.
Complainant
: An individual who
				  lodges a complaint. This could be a resident, family member, facility staff,
				  ombudsman, banker, police officer, social worker, etc.
Conservator:
An individual
				  appointed by the Court to make
financial
decisions for and
				  exercise the legal rights and powers of an adult where the adult lacks
				  sufficient capacity to make or communicate significant responsible decisions
concerning the management of his or her property
. A
				  conservator has priority over the power of attorney agent. See §
									93-13-251 through §
									93-13-267 of the MS Code.
Consultation:
Means providing
				  information and technical assistance to facilities and individuals regarding
				  long-term care issues. It is often by telephone. It does not involve
				  investigating and working to resolve a complaint (a consultation is not a case,
				  therefore, isn't a complaint). If you refer someone to another agency and are
				  not actively involved in investigating and working to resolve the problem, it
				  is not a case or complaint. However, it is counted as a consultation.
Designation:
Status which
				  authorizes an individual (whether a district or local ombudsman or volunteer)
				  to act as a Representative of the Office. Said individual has successfully
				  completed the training requirements and is also free of conflicts of
				  interest.
District Ombudsman:
An ombudsman
				  who acts in a supervisory position over local ombudsman in their respective AAA
				  region. There are currently 10 district ombudsmen in the Mississippi Long-Term
				  Care Facilities Ombudsman Program.
Exploitation:
The illegal or
				  improper act or process of an individual, including a caregiver, using the
				  resources (money, assets, property) of an older or vulnerable individual for
				  monetary or personal benefit, profit or gain without the informed consent of
				  the resident.
Family Council:
Family members of
				  residents and/or facility staff that meet regularly where the ombudsman can
				  provide technical assistance, information, training and support.
Guardian:
An individual or entity
				  appointed by the Court to make
personal and/or property
decisions for and exercise the legal rights and powers of an adult where the
				  court finds the adult lacking sufficient capacity to make or communicate
				  significant responsible decisions
concerning his or her health or
				  safety
. Even residents who have been adjudicated incapacitated and to
				  whom a guardian has been appointed retain some rights. These residents need to
				  have their desires and preferences considered even if the guardian has the
				  legal responsibility over that decision.
Immediate Family:
A member of the
				  household or adult relative with whom there is a close personal or significant
				  relationship. Examples include father, mother, son, daughter, brother, sister,
				  aunt, uncle, first cousin, nephew, niece, wife, husband, father-in-law,
				  mother-in-law, son-in-law, daughter-in-law, brother-in-law, sister-in-law,
				  stepparent, stepbrother, stepsister, stepchild, half-sister, half-brother,
				  grandparent or grandchild. This definition is limited to conflict of interest
				  only.
Information & Assistance:
Services which provide information to individuals on long-term care or the
				  needs/rights of long-term care residents.
In-Service Education to a Facility:
Presentations to long-term facility staff on long-term care issues. Each
				  Ombudsman district is required to do five (5) In-Service Education seminars per
				  federal fiscal year.
Legal Representative:
An agent
				  under a valid power of attorney, provided that the agent is acting within the
				  scope of his or her agency; an agent under a durable power of attorney for
				  health care or health care agent under an advance health care directive; or an
				  executor or administrator of the estate of a deceased resident. Residents who
				  have a legal representative with decision-making power retain their ability to
				  participate in their own care and to exercise their rights.
Local Long-Term Care Ombudsman
: An
				  individual designated by the SLTCO to be an advocate for residents in long-term
				  care facilities to protect their health, safety, welfare and rights.
Long-Term Care:
Refers to extended
				  medical and social services required by people with chronic conditions to help
				  them live as independently as possible despite significant challenges. It may
				  be delivered in community settings (adult day care), institutionalized settings
				  (nursing homes) or informal settings (home of friends or family).
Long-Term Care Facility:
Any
				  skilled nursing facility, extended care home, intermediate care facility,
				  personal care home or boarding home which is subject to regulation or licensure
				  by the State Department of Health (Mississippi Code §
									43-7-55).
Neglect:
It is the failure to care
				  for a person in a manner which would avoid physical or emotional harm or pain,
				  or the failure to react to a situation which may be harmful. It may or may not
				  be intentional.
Not Verified:
It is determined
				  after work (interviews, record inspection, observations, etc.) that the
				  circumstances described in the complaint are not accurate.
Office of State Long-Term Care Facilities
				  Ombudsman:
Organizational unit in MS which is led by the State
				  Long-Term Care Ombudsman. The organizational unit consists of the SLTCO
				  only.
PNA (Personal Needs Allowance):
After an applicant is determined eligible for Medicaid in a nursing facility,
				  the individual is required to pay toward the cost of their care if income
				  allows. This is referred to as Medicaid Income. It is total income less
				  allowable deductions. PNA is one such deduction. It is currently $44 per month.
				  Veterans and surviving spouses who receive a $90 VA pension get a $90 PNA.
				  Medicaid Income is not paid by a HCBS participant.
Representatives of the Office:
District, local or volunteer ombudsmen selected by an area agency on aging who
				  have been designated by the State Ombudsman to act as resident advocates on
				  behalf of the state.
Resident:
Any resident, prospective
				  resident, prior resident or deceased resident of any long-term care facility,
				  regardless of age.
Resident Council:
Residents of
				  long-term care facilities and/or facility staff that meet regularly to discuss
				  issues relating to their care and quality of life. Assisted living facilities
				  are not required by federal law to facilitate meetings, unlike nursing
				  homes.
Resident Representative:
means
				  either:
(1) an individual chosen by the
				resident to act on his or her behalf concerning decisions, accessing medical or
				other personal information, managing financial affairs and receiving
				notifications;
(2) a person
				authorized by State or Federal law (including agents under a power of attorney)
				to act on the resident's behalf concerning decisions, accessing medical or
				other personal information, managing financial affairs and receiving
				notifications;
(3) Legal
				representative; or
(4)
				Court-appointed guardian or conservator of the resident.
Resolved:
This is how the complaint
				  has been resolved depending on the resident's satisfaction. It can either be
				  partially resolved, not resolved or resolved to the satisfaction of the
				  resident.
Skilled Nursing Facility (SNF):
Facility in which medical care must be provided 24-hours by trained
				  individuals, such as a registered nurse and physical, speech and occupational
				  therapists. Examples of skilled nursing services include wound care,
				  intravenous (IV) therapy, injections, physical therapy, and monitoring of vital
				  signs & medical equipment.
State Long-Term Care Ombudsman
				  (SLTCO)
: An individual who is the head of the Ombudsman Program
				  for the State of Mississippi on a full-time basis to fulfill the duties and
				  responsibilities of Older Americans Act. Said individual is responsible for
				  ensuring that all residents of long-term care facilities in Mississippi have
				  adequate access to the services of the LTCOP and that each AAA has at least one
				  designated ombudsman.
Systems Advocacy:
Activities which
				  support and promote issues which benefit a group of long-term care
				  residents.
Volunteer Ombudsman
:
An individual over 18 years old who has completed a Certification Training
				  prescribed by the State Ombudsman Program and is designated to act as a
				  representative to participate in the ombudsman program.
Willful Interference
: means the
				  actions or inactions taken by an individual in an attempt to intentionally
				  prevent or interfere with the State Ombudsman Program from performing any of
				  their functions or duties.
WellSky
: The statewide reporting
				  system used to collect data relating to complaints, consultations, training
				  provided, and other activities of the ombudsman program. This data is used when
				  submitting the NORS annual report to the AOA. It is due by January 31st of each
				  year and represents information from the previous federal fiscal year (Oct.
				  1st-Sept.
				  30th).