58L-1.007. Complaint Procedures

This rule outlines the procedures for receiving and conducting complaint investigations on behalf of residents in long-term care facilities.

(1) RECEIVING COMPLAINTS.

(a) Any person may make a written or verbal complaint to the Office of State Long-Term Care Ombudsman or its representatives. A complaint may be anonymous.

(b) The receipt of a complaint by the DOM, or designee, triggers the opening of a case as defined in Rule 58L-1.0011, F.A.C.

1. The DOM, or designee, must code complaints based on the requirements of the National Ombudsman Reporting System published by the U.S. Department of Health and Human Services, Administration on Aging.

2. The DOM, or designee, must complete and provide a Case Investigation Form to the ombudsman conducting the investigation.

(2) INVESTIGATIVE PROTOCOL.

(a) An investigation is initiated when an ombudsman makes contact with the complainant or resident. The investigation must be initiated no later than 7 business days after the district ombudsman manager (DOM) receives the complaint.

(b) To the extent possible, the ombudsman must make every effort to visit the resident, or representative or immediate family member on whose behalf the complaint was filed. If unable to do so, the ombudsman must document the reason why he or she was unable to visit the resident, or representative or immediate family member.

(c) The complaint investigation must focus on the rights, health, safety and welfare of the resident or residents and may include direct observation, interviews with residents and other individuals, and record reviews, as permitted in Section 400.0081, F.S.

(d) Investigations must be closed within 120 calendar days after receiving the complaint unless additional time is requested by the ombudsman and granted by the regional office manager (ROM), or designee. The ROM, or designee, may grant an extension of the 120 calendar day period when the ombudsman is unable to complete the investigation due to circumstances beyond his or her control. Such circumstances may be:

1. The investigation is undergoing legal or administrative proceedings,

2. One of the parties is ill and cannot participate in the investigation,

3. There is an act of God or a designated threat to public safety that warrants an extension, or

4. Any other circumstance that warrants an extension in the opinion of the ROM, or designee.

(e) At the conclusion of a case investigation, the ombudsman must:

1. Complete a Case Investigation Form, using disposition codes referenced in subparagraph (1)(b)1., of this rule.

2. Contact the resident, or representative, to inform him or her of the preliminary disposition, pending the review and final approval of the DOM, or designee, pursuant to paragraph (f), of this subsection.

3. Conduct an exit interview with the facility administrator, or designee, to discuss preliminary complaint findings, if any; to discuss preliminary remedial action to be taken, if any; to discuss preliminary target dates for the remedial action to be corrected, if warranted.

4. Submit the complaint investigation form and documentation to the DOM, or designee, within 14 calendar days after the exit interview.

(f) The DOM, or designee, must review and approve the complaint investigation.

Rulemaking Authority 400.0071 FS. Law Implemented 400.0071, 400.0073, 400.0075 FS. History–New 3-18-10, Amended 7-4-17, 9-2-24.