(a) Complaints may be initiated by:

1. (1) Residents;
2. (2) Legal representatives;
3. (3) Family and friends of residents;
4. (4) Long-term care facility staff;
5. (5) Any other person;

6. (6)

   1. (A) Complainants who wish to remain anonymous.
   2. (B) Ombudsman representatives may proceed without knowing the complainant's or resident's identity.
   3. (C) If the ombudsman representative receiving the complaint is able to communicate directly with the anonymous complainant, the ombudsman representative shall explain to the complainant that, in some circumstances, anonymity could limit the ability of the program to investigate and resolve the complaint; or
7. (7) Ombudsman representatives, when they have personal knowledge of an action, inaction, or decision that may adversely affect the health, safety, welfare, or rights of residents.

(b)

1. (1) When information regarding a complaint or problem is received, the ombudsman representative shall:

   1. (A) Collect all relevant information from the complainant;
   2. (B) Discuss attempts that have been made to resolve the complaint;
   3. (C) Determine the resident’s desired outcome or outcomes;
   4. (D) Discuss alternatives for handling the complaint;
   5. (E) Explain the ombudsman representative’s role is to act in accordance with resident wishes and maintain confidentiality;
   6. (F) Encourage the complainant to personally take appropriate action, with ombudsman representative assistance, if appropriate; and
   7. (G)

(i) Determine whether the complaint is appropriate for ombudsman services.

1. (ii) The following complaints are not appropriate for ombudsman activity:

(b) (b) Complaints that are outside the scope of the mission or authority of the program.

1. (2) Note. The program may seek resolution of complaints in which the rights of one (1) resident and the rights of another resident or residents appear to be in conflict or in dispute.

   1. (c)
2. (1) Special consideration shall be given when the program receives a complaint on a deceased resident.

3. (2) The ombudsman representative shall:

   1. (A)

      1. (i) Determine if the case should be opened as a systemic case on behalf of a group of residents.
      2. (ii) If the ombudsman representative determines the case should not be opened as a systemic case, the ombudsman representative will inform the complainant that the ombudsman representative will not open a case as there is no resident for which an issue can be resolved;
   2. (B) Refer the complainant to the Office of Long-Term Care; and/or
   3. (C) Suggest to the complainant other referral options including police, private attorneys, coroner, etc.
4. (3) Note. If the resident dies during the time that a case is open, refer to 20 CAR § 432-1003.