[Federal Register Volume 67, Number 40 (Thursday, February 28, 2002)]
[Notices]
[Pages 9279-9281]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 02-4800]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Administration on Aging
Agency Information Collection Activities: Proposed Submission to
the Office of Management and Budget (OMB) for Clearance: Comment
Request; Revision of Information Collection
AGENCY: Administration on Aging, HHS.
The Administration of Aging (AoA), Department of Health and Human
Services, is submitting the following proposal for the collection of
information in compliance with the Paperwork Reduction Act (Pub. L. 96-
511): State Annual Long-Term Care Ombudsman Report and Instructions for
Older Americans Act Title VII.
Type of Request: Revision of a currently approved collection.
Use: To continue an existing information collection, State Annual
Long-Term Care Ombudsman Report (and Instructions), from Older
Americans Act Title VII grantees. Under section 712(c), section
712(h)(1) and section 712(h)(2)(B) of the Older Americans Act, as
amended, states are required to provide information on ombudsman
activities to AoA, which AoA is then required to present to Congress.
The information on complaints and conditions in long-term care
facilities and the ombudsman program is also used by the states, other
federal agencies, researchers and consumer groups for a variety of
purposes.
Frequency: Annually.
Respondent: State Long-Term Care Ombudsman Programs.
Estimated number of responses: 53.
Estimated Burden Hours: Approximately 3 hours per state program.
Additional Information or Comments: The reporting system, the
National Ombudsman Reporting System (NORS), was developed in response
to needs identified and directives in the Older Americans Act and
approved by the Office of Management and Budget for use in FY 1995-96.
It was twice extended, with slight modifications, for use through
August 2004. Although the NORS is approved through August 2004, we are
planning to revise the form and instructions for use by the states in
FY 2003 (beginning October 2002), with the first report using the
revised form due to AoA in January 2004.
The proposed revisions, provided in the attached table, were
developed by state and local ombudsmen and have been reviewed by all
state ombudsmen. The revised NORS form, with instructions, and a
proposed expenditure certification form are posted on the AoA Web site,
www.aoa.gov/notices/2002/LTCO-01.html.
Written comments and recommendations for the proposed information
collection should be sent by Internet or postal mail to the following
address within 60 days of the publication of this notice, via e-mail to
sue.wheaton@aoa.gov or regular mail at the following address:
Administration on Aging, ATTN: Sue Wheaton, Cohen Building, Room 4737,
Washington, DC 20101.
Josefina G. Carbonell,
Assistant Secretary for Aging.
Proposed Changes in National Ombudsman Reporting System (NORS)
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Current Proposed change
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Cases, complainants and complaints by No change.
type of facility; action taken on the
complaints; a summary of long-term
care issues; a detailed profile of the
program and its activities, including
the number and type of facilities
licensed and operating in the state
(and the number beds this represents);
a description of geographic program
coverage, by type of facility; the
staffing and funding of local
programs; and an overview of other
ombudsman activities (including:
training, technical assistance,
resident visitation, community
education, and all other items in Part
III F of the current form).
The current NORS instructions provide Direction on which codes to use
general guidance but no specific for which types of problems is
direction on how to code specific provided in an attachment to
complaints. the NORS instructions.
The current form has nine categories Retain the same number of case
for types of complainants (cases) and and complaint fields currently
133 categories for types of problems in use and the alphabetical
(complaints). The specific complaint order within the major groups,
categories are organized by major but adjust the wording on some
types of complaints (Residents Rights, of the categories to capture
Resident Care, etc.) and the specific problems not specified in the
categories are listed alphabetically current complaint codes (see
within each major group. italicized words in this
column below). (If they wish,
states may add additional
categories in their own
systems and ``fold'' these
back into the NORS categories
for the report to AoA.).
[[Page 9280]]
For cases and complaints, the current Add ``ALF'' (for assisted
form has a type of facility heading living facility) and RCF
which reads ``Board & Care (or (residential care facility) to
similar)''. the board and care case and
complaint column heading so
the heading reads: ``B&C, ALF,
RCF, etc.,'' with a footnote
explaining the types of
facilities that are included.
In response to an ombudsman
recommendation, the footnote
clarifies that complaints may
be from unregulated as well as
regulated facilities.
Complaint Category F. 40 reads Change to ``Accidental or
``Accidents, improper handling''. injury of unknown origin;
falls; improper handling.''
Category 41 reads ``Call lights, Change to ``Call lights,
requests for assistance''. response to requests for
assistance.''
Category F.47 reads ``Pressure sores''. Change to ``Pressure sores, not
turned.''
Category F.49 reads ``Toileting''...... Change to ``Toileting,
incontinent care.''
Category P. 117 reads ``Abuse/ Change to ``Abuse/neglect/
abandonment by family member/friend/ abandonment by family member/
guardian or, while on visit out of friend/guardian or, while on
facility, any other person''. visit out of facility, any
other person.''
Category P. 121 reads ``Financial Change to read: ``Financial
exploitation by family or other not exploitation or neglect by
affiliated with facility''. family or other not facility''
and emphasize in the
instructions this addition and
how to use this complaint
category.
Major Category Q. reads ``Complaints in Strike ``Shelters'' from Q.132
Other Than Nursing or Board and Care/ and use Q.132 to capture
Similar Settings'' and Q. 132 reads ``Services from outside
``Shelters''. provider'' (i.e., personal
care, transportation or other
service provided to a facility
resident by an outside
provider). Change the heading
of Q to read ``Complaints
About Services in Settings
Other Than Long-Term Care
Facilities or By Outside
Provider'' and emphasize/
clarify in the instructions
how to use the new Q.132.
NORS instructions providegeneral Emphasize in the NORS
guidance but emphasis and increased instructions that category A.6
clarity are required on some items. ``Resident-to-resident
physical or sexual abuse'' is
for willful abuse of one
resident by another resident,
not for unintentional harm or
altercations between residents
who require staff supervision,
which should be coded in
category I.66. (For example, a
confused resident who strikes
out is categorized at I.66 and
an alert resident who strikes
out is A.6.)
Add to the instructions that
resident requests for
assistance in moving out of
the facility should be coded
under P. (System/Others) 128
``Other.''
Part I E.2.(a) under ``Disposition'' Change the verb tense so it
reads (number of complaints) ``for reads ``for which government
which government policy or regulatory policy or regulatory change or
change or legislative action was legislative action is required
required to resolve * * *''. to resolve * * *''.
For Part III F. ``Other
Ombudsman Activities,'' item
6, the instructions define
more prominently and
specifically that resident
visitation on a ``regular
basis'' means no less
frequently than quarterly.
(Note: ``Regular visitation''
is not a federal ombudsman
program requirement, but it is
an activity in the NORS which
requires definition.)
The instructions clarify Part
III F.7., ``Participation in
Facility Surveys,'' means
participating in any aspect of
both regular surveys and
surveys held in response to
complaints. This may include
conferring with the
certification agency prior to
or following a survey. It is
not limited to actually going
with the team on the survey.
The instructions emphasize that
under Part I A and B, a
``case'' means ``opening of a
case file and includes
ombudsman investigation, fact
gathering, setting of
objectives and/or strategy to
resolve, and follow-up''
(which is the definition of
``case'' on the NORS form).
Other calls reporting
incidents or seeking advice
but not requiring ombudsman
involvement to the degree
specified in this definition
should be counted as
consultations to individuals
or facilities in Part III F.4.
or documented in some way
specific to the state's needs
but not included in the NORS
system. For example, in those
few states where state law
requires reporting instances
of nursing home abuse to the
ombudsman program, the reports
should not be counted as a
case and as an abuse complaint
unless the ombudsman program
investigates and is actively
involved in working out a
resolution. Unless the
ombudsman program is actively
engaged in investigating and
working to resolve the
problems reported, the program
should keep its own list of
such reports and not include
them in the data submitted in
the NORS system.
The instructions, at the bottom of page This direction is deleted from
3, direct ombudsmen to document the instructions. (The effect
primary complaints in Part I D but not will be to leave such
to document problems which are documenting decisions up to
incidental to, or even causal to, the the states. One state
primary complaint. ombudsman staff member
strongly objected to this
change because it could lead
to inconsistent documentation
among the states, but the
majority of those on the task
force thought the directive
should be deleted because it
causes confusion and
inaccuracies in reporting
complaints and problems
experienced by residents.)
[[Page 9281]]
The instructions clarify the
distinctions between complaint
categories B.14, D.29, and
M.96, all of which involve
communication/language
barriers and yet are different
types of problems (as
explained. in the ``Complaint
Codes'' attachment to the
instructions).
The instructions emphasize that
supplies not provided as part
of the daily rate should be
coded under E.36, ``Billing,
etc.''
The instructions as well as the
form emphasize that problems
with a referral agency failing
to substantiate a complaint
should be coded under the Part
III E.2.d.2) disposition
category.
The instructions emphasize in
that complaints about
``nutrients out-of-date''
should be categorized under
J.71 dealing with food
quality.
The instructions clarify that
``percentage of staff time
spent on technical assistance
for volunteers'' under ``other
ombudsman activities''
includes staff resources
devoted to the management and
administration of the
volunteer program as a whole.
Add the following to the
narrative issues section, Part
II:
B. Facility Closures: If your
program has worked on facility
closures, please include a
description of these
activities, including reasons
for the closure(s) and
outcomes of ombudsman
activities.''
C. Alternative Care Systems: If
your program has been involved
in planning for alternatives
to institutional care and/or
has assisted individual
residents to move to less
restrictive settings of their
choice, please describe these
activities and provide an
approximate number of the
individuals who have been
assisted.
OMB-approved form for certifying Add a form for state
compliance with minimum funding certification of compliance
requirement expired in FY 1997. with the ombudsman minimum
funding and non-supplantation
provisions in the Act and to
confirm expenditures reported
in the NORS.
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[FR Doc. 02-4800 Filed 2-27-02; 8:45 am]
BILLING CODE 4154-01-P