Code of Massachusetts Regulations › 101 CMR - EXECUTIVE OFFICE FOR HEALTH AND HUMAN SERVICES › Title 101 CMR 30.00 - Statewide Long-term Care Ombudsman Program › Section 30.12 - Complaint and Problem Resolution Procedures for the Ombudsman Program

Current through Register 1525, July 5, 2024
(1)
Receipt of a
			 Complaint(s)
. The State Ombudsman Program or local ombudsman
			 programs will receive complaints, both oral and written, made by or on behalf
			 of residents, and may also initiate a complaint on their own accord.
(a) The State Ombudsman Program and local
			 ombudsman programs will receive complaints during regular business hours,
			 Monday through Friday, excluding holidays.
(b) All complaints initiated or received by
			 the State Ombudsman Program or local ombudsman programs will be reduced to
			 writing and become part of a case file.
(c) Upon receipt of a complaint, an ombudsman
			 representative will discuss the complaint with the resident (and, if the
			 resident is unable to communicate informed consent, the resident's
			 representative) to:
1. determine the
			 perspective of the resident (or resident representative, where applicable)
			 regarding the complaint;
2. request
			 that the resident (or resident representative, where applicable) communicate
			 informed consent in order to investigate the complaint;
3. determine the resident's wishes with
			 respect to resolution of the complaint, including whether the allegations are
			 to be reported and, if so, whether the ombudsman representative may disclose
			 resident identifying information or other relevant information to the facility
			 and/or appropriate agencies;
4.
			 advise the resident (and the resident's representative, where applicable) that
			 the resident's identity will not be disclosed without the resident's
			 permission, and specify to whom the resident's identity may be disclosed if the
			 resident consents. Such disclosure will be made without the resident's consent
			 if ordered by a court of competent jurisdiction;
5. work with the resident (or resident's
			 representative, where applicable) to develop a plan of action for resolution of
			 the complaint;
6. investigate and
			 contact those who may be involved in a resolution to attempt to verify the
			 facts alleged in the complaint; and
7. determine whether the complaint is
			 resolved to the satisfaction of the resident (or resident representative, where
			 applicable).
(d) If
			 informed consent is not provided to the ombudsman representative to discuss or
			 proceed with the complaint, the resident or the resident representative will be
			 provided with information and/or referral sources appropriate to enable the
			 resident to advocate on their own behalf.
(e) Where the ombudsman representative
			 determines the resident is unable to give informed consent and has no resident
			 representative, the ombudsman representative will take appropriate steps to
			 investigate and work to resolve the complaint to protect the health, welfare,
			 safety, or rights of the resident.
(f) If the ombudsman representative has
			 reasonable cause to believe the resident representative is not acting in the
			 best interest of the resident, the ombudsman representative will work to
			 protect the health, welfare, safety, or rights of the resident.
(g) Where a complaint is found to be
			 unsupported, the ombudsman representative will inform the resident or resident
			 representative, where applicable, of this finding as soon as possible after
			 making such determination.
(h) If
			 an ombudsman representative observes a practice in a facility which affects the
			 resident or a number of residents in the facility, and such practice
			 constitutes grounds for a complaint, the ombudsman representative may
			 investigate and attempt to resolve such complaint without the consent of
			 individual residents.