Mississippi Administrative Code › Title 18 - HUMAN SERVICES › Part 26 - Policies and Procedures Manual for the MS Ombudsman Program › Part II - Administration of the Long-Term Ombudsman Program › Section 18-26-2-B - Designation and Withdrawal of Designation of Ombudsman Programs and Ombudsmen

Current through June 25, 2024
*
Designation of Ombudsman
				  Programs
The State Long-Term Care Facilities Ombudsman shall designate
				  provider agencies to provide Ombudsman throughout Mississippi.
* In order to be eligible for designation by the Office of
				  the State Long-Term Care Ombudsman (SLTCO) as a provider agency, an entity
				  must:
a) Be a public or nonprofit
				entity;
b) Not be an agency or
				organization responsible for licensing or certifying long-term care
				services;
c) Not be an association
				of providers of long-term care or residential services for older
				persons;
d) Have no financial
				interest in a long-term care facility;
e) Have demonstrated capability to carry out
				the responsibilities of the provider agency;
f) Have no un-remedied conflict of interest;
				AND
g) Meet all contractual
				requirements of the Mississippi Department of Human Services.
* Where an AAA contracts with a provider agency, the
				  designation of a new provider agency shall occur as follows:
a) The AAA shall issue a request for proposal
				(RFP) seeking an entity to provide LTCO services within its service area. The
				AAA shall request, at a minimum, the following:
* Assurance that the entity meets all the criteria for
				  designation as a provider agency;
* The goals and objectives of such entity in providing LTCO
				  services;
* A description of how such entity will comply with the
				  Program Components (as outlined in Part IV of this manual).
* The staffing plan for the local long-term care ombudsman
				  program, AND
* A description of the resources of the entity which will be
				  provided to assist in the operation of the local LTCOP.
b) The AAA shall forward copies of all the
				proposals received in response to the RFP to DAAS and the State Long-Term Care
				Ombudsman shall review such in coordination with DAAS.
c) The AAA shall recommend an entity for
				designation as a provider agency to DAAS and to the SLTCO and shall provide the
				SLTCO with information supporting its recommendation.
d) The SLTCO shall review and consider all
				proposals and the recommendation of the AAA in coordination with DAAS, and
				shall determine the entity most appropriate to designate as the provider
				agency.
e) The SLTCO shall notify
				the AAA of the determination within thirty (30) days of receiving the AAA's
				recommendation.
f) The AAA shall
				notify the responding entities of the SLTCO decision within fifteen (15) days
				of receiving such notification.
g)
				Upon designation by the SLTCO, the AAA may enter into a contract with the
				provider agency for the provision of LTCO services in the relevant service
				area. Such contract must:
* Specify the service area;
* Require the provider agency to adhere to all applicable
				  federal and state laws, regulations and policies, AND
* Provide that designation by the SLTCO continues for the
				  duration of the contract and subsequently renewed contracts within the period
				  specified within the RFP unless the provider agency is de-designated or the
				  contract terminated for cause.
h) The execution date of the provider
				agency's contract with the AAA to provide LTCO services shall constitute the
				effective date of the designation.
i) Should the contract between the service
				provider and the AAA to provide LTCO services not be renewed or be terminated
				for any reason, the AAA shall:
* Immediately notify the SLTCO;
* Follow the steps above to designate a new provider agency
				  as soon as possible; AND
* Follow the steps below to provide continuation of ombudsman
				  services.
* Where the AAA seeks to serve as the provider agency, the
				  designation of a new provider agency shall occur as follows:
a) Designation of the AAA as the provider
				agency where the SLTCO determines that either:
* Designation of the AAA as the provider agency is necessary
				  to assure an adequate supply of ombudsman services; or
* Services of comparable quality can be provided more
				  economically by the AAA.
b)
				The AAA shall request consideration to be designated as a provider agency and
				submit a proposal to the SLTCO setting forth, at a minimum, the following:
* Assurance that the entity meets all criteria for
				  designation as a provider agency;
* The goals and objectives of such entity in providing LTCO
				  services;
* A description of how each Program Component shall be met by
				  such entity;
* The staffing plan for the district long-term care ombudsman
				  program; AND
* A description of the resources of the entity which will be
				  provided to assist in the operation of the district LTCOP.
c) The SLTCO may designate the AAA as the
				provider agency where:
* The AAA meets the criteria for designation;
* The AAA submits an acceptable proposal; AND
* The AAA is not otherwise prohibited from fulfilling the
				  duties of the provider agency.
d) The SLTCO shall notify the AAA within
				thirty (30) days of the receipt of the proposal of its decision. If the SLTCO
				refuses to designate the AAA as the provider agency, the notification shall
				include notice of the right of the AAA to request a hearing to appeal the
				SLTCO's determination with the DAAS Division Director.
e) The execution of the AAA's contract with
				the DAAS to provide LTCO services shall be the effective date of the
				designation.
* Where the contract for LTCO services is not with or through
				  the AAA, the designation of a new provider agency shall occur as
				  follows:
a) DAAS will use a competitive
				bid process to seek an entity to provide LTCO services within a particular
				service area. The competitive bid process will identify the criteria for
				designation as a provider agency and shall request submission of documents
				supporting the entity's claim to meet these criteria.
b) DAAS will require that all of the
				responding entities which meet the criteria for designation develop a proposal
				setting forth, at a minimum, the following:
* Assurance that the entity meets all criteria for
				  designation as a provider agency;
* The goals and objectives of such entity in providing LTCO
				  services;
* A description of how each Program Component shall be met by
				  such entity;
* The staffing plan for the local long-term care ombudsman
				  program, AND
* A description of the resources of the entity which will be
				  provided to assist in the operation of the local LTCOP.
c) SLTCO shall review each submitted proposal
				and shall choose the entity most appropriate to serve as the provider agency
				based on the submitted proposals and on the criteria for designation. The SLTCO
				may consult with the AAA serving the relevant service area.
d) The SLTCO shall notify the responding
				entities of this determination within forty-five (45) days. The notification
				shall be consistent with DAAS policy and procedures for entities that apply and
				are not chosen due to the SLTCO's determination.
e) DAAS will contract with the provider
				agency to provide LTCO services when appropriate. Such contract must:
* Specify the service area;
* Require the provider agency to adhere to all applicable
				  federal and state laws, regulations and policies; AND
* Provide that designation by the SLTCO continues for the
				  duration of the contract and subsequently renewed contracts within the period
				  specified with the RFP unless the provider agency is de-designated by the SLTCO
				  or the contract is terminated for cause.
f) The execution date of the provider
				agency's contract with DAAS to provide ombudsman services shall be the
				effective date of the designation.
*
Withdrawal of Designation Ombudsman
				  Program
The State Ombudsman may de-designate an entity as a provider
				  agency for cause.
* The SLTCO may refuse to designate or may de-designate an
				  entity as a provider agency for one of more of the following reasons:
a) Failure of the entity to continue to meet
				the criteria for designation;
b)
				Existence in the entity of an un-remedied conflict of interest with the
				LTCOP;
c) Deliberate failure of the
				entity to disclose any conflict of interest;
d) Violation of LTCO confidentiality
				requirements by any person employed by, supervised by, or otherwise acting as
				an agent of the entity;
e) Failure
				of the entity to provide adequate LTCO services, including but not limited to
				failure to perform enumerated responsibilities, failure to fill a vacant
				ombudsman staff position within a reasonable time, failure to submit a Local
				LTCOP Annual Plan for approval by the SLTCO, or failure to use funds designated
				for the LTCOP for LTCO services;
f)
				Failure of the entity to adhere to the provisions of the contract for the
				provision of ombudsman services, OR
g) Failure of the entity to adhere to
				applicable federal and state laws, regulations and policies.
* Process for withdrawal of designation of a LTCO provider
				  agency:
a) Where an AAA contracts with
				a provider agency, the process to de-designate the provider agency shall be as
				follows:
* The SLTCO shall send notice of intent to de-designate at a
				  specified date to the AAA and the provider agency. The notice shall include the
				  reasons for withdrawal of designation and notice of hearing procedures of the
				  DAAS.
* Withdrawal of designation of a provider agency shall not
				  become effective until all appeals are exhausted.
* The AAA and SLTCO shall provide for the continuation of
				  ombudsman services.
* The AAA shall terminate its contract for LTCO services with
				  the provider agency.
b)
				Where an AAA serves as a provider agency, the process to de-designate the
				provider agency shall be as follows:
* The SLTCO shall send notice to de-designate at a specified
				  date to the AAA. The notice shall include the reasons for withdrawal of
				  designation and notice of hearing procedures of the DAAS.
* Withdrawal of designation of the AAA as a provider agency
				  shall not become effective until all appeals are exhausted.
* The AAA and the SLTCO shall provide for the continuation of
				  ombudsman services until designation of another entity is effective.
* DAAS will terminate the portion of the contract between the
				  AAA and the DAAS which provides for ombudsman services.
c) Where a provider agency contracts directly
				with the DAAS, the process to de-designate the provider agency shall be as
				follows:
* SLTCO shall send notice of the intent to de-designate at a
				  specified date to the provider agency and to the applicable AAA. The notice
				  shall include the reasons for withdrawal of designation and notice of the
				  hearing procedures of the DAAS.
* Withdrawal of designation of a provider agency shall not
				  become effective until all appeals are exhausted.
* SLTCO shall provide for continuation of ombudsman services
				  until designation of another entity is effective. The SLTCO may consult with
				  the applicable AAA regarding the provision of services in the service
				  area.
* DAAS will terminate its contract with the provider
				  agency.
* Voluntary withdrawal of a provider agency:
A LTCO provider agency may voluntarily relinquish its
				  designation by providing notice to the SLTCO and to the AAA in the relevant
				  service area. Such notice shall be provided sixty (60) days in advance of the
				  date of relinquishment of designation.
* Continuation of Ombudsman Services:
Where a provider agency is in the process of appealing its
				  withdrawal of designation or has relinquished designation:
a) The provider agency, the AAA if
				applicable, and the SLTCO shall arrange for the provision of ombudsman services
				until a new provider agency is designated;
b) The provider agency shall surrender intact
				to the SLTCO or the SLTCO designee all LTCO case records, documentation of all
				LTCO activities and complaint processing as required by the ombudsman reporting
				system, and identification cards of all local LTCOs associated with the
				provider agency;
c) The provider
				agency shall, at the discretion of the DAAS, surrender any equipment purchased
				with funds designated for LTCO services; AND
d) The provider agency shall surrender the
				balance of any advanced state or federal monies to the AAA, or to the DAAS
				where the AAA serves as the provider agency.
*
Designation of Long-Term Care
				  Ombudsmen
The State Ombudsman designates individuals as ombudsmen to
				  participate in the Long-Term Care Ombudsman Program and to represent the Office
				  of the State Long-Term Care Ombudsman.
* Criteria for designation as an ombudsman
To be designated as a LTCO, an individual must:
a) Have demonstrated capability to carry out
				the responsibilities of a LTCO;
b)
				Be free of un-remedied conflicts of interest;
c) Meet the minimum qualifications for the
				applicable LTCO position;
d)
				Satisfactorily complete the applicable designation/certification training
				required as specified in said policies and procedures manual;
e) Be awarded a current designation
				certificate by the SLTCO; AND
f)
				Satisfactorily fulfill LTCO Program Components as outlined in said policies and
				procedures manual.
* Minimum qualifications for staff ombudsmen
a) In order to qualify for a LTCO staff
				position, an individual must have:
* An undergraduate degree from a four-year college or
				  university;
* Two years of professional experience with at least one year
				  in aging, long-term care, or related fields; AND
* A criminal background check by a local law enforcement
				  agency. The individual shall not be hired if he or she has been convicted of
				  any of the crimes listed under the laws related to nursing home or personal
				  care home employees.
b)
				Relevant and comparable education and/or experience may be substituted at the
				discretion of the SLTCO. Experience may be substituted for undergraduate
				education on a one-to-one basis; however, the same experience cannot be used to
				meet both the education and experience requirements.
* Values and Skills that an Ombudsman Should Possess
Regardless of the discipline from which an ombudsman comes or
				  the level of education and training, those working with the elderly in
				  long-term care facilities should possess certain basic values and attitudes as
				  well as fundamental interpersonal relationship and intervention skills.
				  Additionally, there should be a basic set of principles which guide an
				  ombudsman decision when providing advocacy services.
Values and Attitudes
* A genuine liking and respect for older adults, especially
				  the frail and impaired;
* A belief in the resident's right to self-determination,
				  privacy, confidentiality, and consent to services;
* A belief in quality of care and life;
* An ability to demonstrate commitment and take action on
				  behalf of the frail and elderly;
* A belief and willingness to allow for the individuality of
				  the resident unrestricted by personal belief or opinion;
* A mature attitude towards the use of power and
				  authority;
* An understanding and acceptance of death and dying, and the
				  ability to cope.
Skills (Ability/Aptitude)
* Develop trust and confidence between residents and their
				  families;
* Provide personal understanding and empathy;
* Conduct active listening techniques, effective
				  communication;
* Draw the client out, asking his preferences and actively
				  involving him/her in the complaint investigation/resolution process;
* Mobilize interaction among many different
				  individuals;
* Form resident and family councils;
* Mediate conflicts;
* Use support and reinforcement techniques;
* Offer professional opinions and remain impartial;
* Find resources, negotiate services, make referrals;
* Educate the resident and his family, and the community
				  about long-term care; and
* Ability to professionally and personally bring about case
				  closure.
* Minimum qualifications for volunteers
a) There are no minimum education or
				experience requirements for volunteers prior to screening and acceptance into
				the LTCOP. The LTCOP shall clarify responsibilities and providing training for
				volunteers.
b) Volunteers undergo
				the same training and designation process as employed Representatives of the
				Office.
* A volunteer shall have a criminal background check by the
				  local law enforcement agency. The individual shall not serve as a volunteer if
				  he or she has been convicted of any of the crimes listed under the laws related
				  to nursing home or personal care home employees.
* Provider agency process for hiring LTCO staff
a) Prior to providing an offer of employment
				to an individual for the purpose of serving as an LTCO, the provider agency
				shall:
* Indicate to the SLTCO that the individual has a
				  satisfactory criminal background check, AND
* Provide the SLTCO with a completed Individual Conflict of
				  Interest Reporting Form and an opportunity to review the resume of the
				  candidate(s) being considered for employment.
b) The SLTCO shall promptly notify the
				provider agency of any concerns related to the candidate's ability to meet
				minimum qualifications or other designation requirements.
c) If the SLTCO has concerns about the future
				designation of any candidate, the SLTCO may request an interview of the
				candidate and shall inform the provider agency of any concerns that the
				provider agency should consider prior to hiring the candidate(s).
* Requests for substitutions or variances
Requests for substitutions or variances related to minimum
				  requirements must be made in writing and approved prior to the hiring or
				  promotion of the employee in question.
* Designation of formerly designated ombudsman from
				  Mississippi or from another state
When an individual has been designated as an LTCO previously
				  in Mississippi but is not currently designated, or when an individual has been
				  designated as a LTCO in another state, the SLTCO shall determine what steps are
				  needed to qualify as a designated LTCO, by reviewing the circumstances on an
				  individual basis and considering, at a minimum, the following criteria:
a) Context and extent of LTCO training
				completed, which must meet or exceed current designation/certification training
				requirements for Mississippi; AND
b) Need for updated and/or
				Mississippi-specific training;
c)
				Need to demonstrate competencies for the position by completing written or oral
				examinations; AND
d) Quality of
				performance of individual as an LTCO, including checking references.
* Notification of designation
The SLTCO shall send written notification of an individual's
				  designation as a LTCO to the individual being designated, as well as to the
				  AAA, and the provider agency in the relevant service area within thirty (30)
				  days of the determination.
*
Refusal to Designate, Suspension of
				  Designation, or Withdrawal of Designation of an Individual as a Long-Term Care
				  Ombudsman
The State Ombudsman may refuse to designate, may suspend
				  designation, or may withdraw designation of an individual as an
				  ombudsman.
* The SLTCO may refuse to designate, may suspend designation,
				  or may de-designate an individual as an LTCO for any of the following
				  reasons:
a) Failure of the individual
				to meet and/or maintain the criteria for designation;
b) Existence of an un-remedied conflict of
				interest;
c) Deliberate failure of
				the individual to disclose any conflict of interest;
d) Violation of the confidentiality
				requirements;
e) Failure to provide
				adequate and appropriate services to long-term care residents;
f) Falsifying records and/or
				reports;
g) Failure to adhere to
				the Ombudsman Code of Ethics (See Appendix A);
h) Failure to follow LTCO policies and
				procedures or the direction of the SLTCO (which includes failure to submit
				reports);
i) A change in employment
				duties which are incompatible with LTCO duties;
j) Separation from the LTCOP. Examples
				include: removal from employment by the designated provider agency, an extended
				absence of the LTCO preventing fulfillment of job responsibilities, provider
				agency's contract for the provision of LTCO services is not renewed;
				OR
k) Failure to act in accordance
				with applicable federal or state laws, regulations, and policies.
* Process for refusal to designate, suspension of
				  designation, or withdrawal of designation of an individual as an
				  ombudsman:
a) Prior to refusing to
				designate, suspending designation, or withdrawing designation an individual as
				a LTCO, the SLTCO shall consult with the relevant AAA and the provider agency
				to consider remedial actions which could be taken to avoid the refusal to
				designate or the withdrawal of designation.
b) The SLTCO shall provide written notice of
				the decision to refuse to designate, suspend designation, or de-designate an
				individual as a LTCO to the provider agency, the AAA if applicable, and to the
				Division Director of DAAS. Such notice shall:
* Specify the reasons for and the effective date of the
				  decision, AND
* In the case of a suspension, indicate the circumstances
				  under which the suspension will end or be reconsidered.
c) The SLTCO or the deputy SLTCO shall
				promptly notify the administrator of facilities which had been regularly
				visited by such individual of the refusal to designate, suspension of
				designation, or withdrawal of designation.
d) If the decision to refuse to designate,
				suspend designation, or de-designate an individual as a LTCO results in the
				absence of ombudsman services in the relevant service area, the provider
				agency, the AAA, and the SLTCO shall arrange for the provision of ombudsman
				services until a LTCO is designated.
The State Ombudsman may de-designate or issue sanctions on an
				  AAA for failure to comply with Ombudsman Program
				  Components.