173-14-25. Program review for continued designation

(A) The SLTCO shall conduct an annual program review, no less frequently than every two years, to determine whether the regional program may continue its designation as a regional long-term care ombudsman program. In addition to the regular program review, the SLTCO may conduct additional program reviews whenever service delivery problems occur within the region served by a regional program.

The AAA having jurisdiction in the designated region may participate in the program review to the extent possible without access to confidential information.

Nothing in this rule shall prohibit the AAA from conducting a fiscal review independent of the SLTCO's program review, except that the AAA shall inform the SLTCO of the results of any such review.

(B)

(1) When conducting any program review, the SLTCO shall review the following:

(a) The program's continued compliance with the structural standards established in paragraph (B) of rule 173-14-22 of the Administrative Code.

(b) The program's continued compliance with all state and federal laws, regulations, policies, and procedures governing the office of the SLTCO.

(c) The program's continued compliance with the requirements pertaining to the maintenance of program policies and procedures as established in paragraph (B)(6) of rule 173-14-22 of the Administrative Code.

(d) The program's complaint case records to determine the quality of the program's complaint-handling efforts and to determine whether the program complies with the case handling protocol established in rule 173-14-16 of the Administrative Code.

(e) The program's attainment of the outcomes and objectives provided for under its current ombudsman plan.

(f) The program's ombudsman plan for the ensuing year. The plan shall be prepared according to paragraph (A) of rule 173-14-24 of the Administrative Code.

(g) The program's performance on quality measures established by the SLTCO with input from regional program directors.

(h) The program's advocacy and information service.

(2) If the AAA chooses to participate in a program review, the AAA may take the lead in conducting the reviews required under paragraphs (B)(1)(a) to (B)(1)(c) of this rule and the SLTCO may be present and offer comments. The SLTCO shall take the lead in conducting the reviews required under paragraphs (B)(1) (d) to (B)(1)(f) of this rule and the AAA may be present and offer comments, except that the AAA may not be present or offer comments during any part of the review includes confidential information.

(3) The AAA involved in the program review shall have access to all necessary program administrative records and the SLTCO shall have access to all necessary records. Program administrative records include, but are not limited to, governing board minutes; conflict of interest screening forms; quality assurance documents; client satisfaction surveys; and professional development documents.

(4) When conducting reviews under paragraph (B)(1)(d) of this rule, the SLTCO shall review a minimum of fifteen cases, drawn from a random sampling of cases documented by the regional program.

(C) If appropriate, upon the completion of any program review the SLTCO shall develop an action plan for quality (APQ) in conjunction with the regional program. The APQ shall be developed according to paragraph (C) of rule 173-14-23 of the Administrative Code.

(D)

(1) Within twenty business days after completing any program review, the SLTCO shall provide the regional program and the AAA having jurisdiction in the designated region with written notification of the results. The date of notification shall begin the new designation period which shall not exceed one year.

(2) If the SLTCO withdraws the regional program's designation or grants the regional program only provisional designation status, the SLTCO and the AAA shall follow the notice and hearing requirements set forth in Chapter 119. of the Revised Code. The sponsoring agency may appeal the SLTCO's decision.

Replaces: 173-14-24

Effective: 5/1/2018
Five Year Review (FYR) Dates: 05/01/2023
Promulgated Under: 119.03
Statutory Authority: 173.01, 173.02, 173.16 ; 42 U.S.C. 3025(a)(1)(C), 3058g(a)(5)(D); 45 C.F.R. 1321.11, 1324.11(e), 1324.13(b)(1), 1324.15(b)
Rule Amplifies: 173.16 , 173.18 ; 42 U.S.C. 3058g; 45 C.F.R. 1321.11, 1324.11(e)
Prior Effective Dates: 06/15/1997, 12/27/2001, 12/28/2006, 02/13/2009, 08/01/2015