RESIDENT RIGHTS

GRIEVANCES AND COMPLAINTS

HIPAA

SOCIAL SERVICES DEPARTMENT

Amber Dictus, CSW - Director of Admissions and Community Relations

Megan Ketter, MSW-CAPSW - Long-term Care Social Worker

Travis Nienhaus, CSW - Rehab Social Worker

March 2015

TRAINING AGENDA Prayer Service Excellence Moments Resident Rights Ombudsman Caregiver Misconduct Misconduct Reporting Reporting Suspicion of a Crime Misconduct Prevention HIPAA Recycle or Shred? Questions?

SERVICE EXCELLENCE MOMENTS

RESIDENT RIGHTS DIGNITY - To be valued as an individual, to maintain and enhance your

self-worth

PRIVACY - To personal privacy during care and treatment

GRIEVANCES - To voice grievances about care or services without

discrimination or reprisal

ACCESS - To be fully informed, both orally and in writing, of your rights and

the facility’s rules before admission and during your stay in the facility.

TRANSFER OR DISCHARGE - To remain in the

facility unless there is a valid, legal reason for your transfer or discharge

SELF-DETERMINATION - To be offered choices and

allowed to make decisions important to you.

OMBUDSMAN – A VOICE FOR RESIDENTS

ADVOCATE / Helper Protects and promotes the rights of the

elderly and disabled in their homes, CBRF, and SNF

Responsibilities include: Answer questions about care options Investigate complaints Help residents and families resolve problems Promote the rights of residents Provides consultation services Educates facility staff

Our Ombudsman is AMY PANOSH

CAREGIVER MISCONDUCT

Abuse of a resident- Intentional act meant to cause harm (physical, sexual, verbal,

emotional)

Neglect of a resident- A careless or negligent act that fails to follow the facility procedures

or care plan -unintentional act, could cause pain, injury, or death

Misappropriation of a resident’s property- Intentional act meant to permanently deprive a resident of property

or the use of a resident’s personal property and is done without the resident’s consent.

NO ONE MAY ABUSE A RESIDENT IN ANY WAY

WHAT DO I DO??MISCONDUCT REPORTING

PROTECT RESIDENT(S)!

Without hesitation ensure the safety of all residents

IMMEDIATELY report the incident to your supervisor!

Communication must be with a LIVE person…no voicemails or written notices (email, note, or leaving the start of the investigation paperwork.)

- Timing is critical as we only have 24 hours to report the incident to the DHS if applicable.

REVIEW your surroundings to help provide a clear picture as to what happened.

DETAILS! DETAILS! DETAILS! DETAILS! DETAILS!FACTS! FACTS! FACTS! FACTS! FACTS!

Include: Time, Date, Who was there, around, could’ve heard, where did this take place, reactions of all involved including bystanders. Any little thing you can think of

has a potential of helping us when investigating this situation.

Write it down.

We are not interested in your opinions/feelings about the situation. The witness statement should only contain facts.

MISCONDUCT REPORTING Complete the Grievance/Complaint form and the Investigation

Notification Protocol need to be started (Managers, Supervisors, Directors)

Complete witness statements including personal information incase we need to gather more information from you. If there is an accused caregiver – this person MUST complete a

witness statement and be SENT HOME, they may not work until told otherwise. If the person is not currently working, they must be notified they should not report to work until the investigation is cleared.

NEVER keep information to yourself regarding an incident. Your information may prevent a future incident from happening.

The safety of residents is all our responsibility; we are all mandated reporters of misconduct.

WHAT HAPPENS AFTER IT’S REPORTED?

Paperwork is completed – facts gathered Staff/Resident interviews CP reviews/updates Body Audits MD and Family updates Police? Review of charting/checklists/audits/etc

24 hours to determine if it needs to be sent to state. IF sent to state, we then have 5 days to wrap it up and

submit our interpretation of the events and what we are doing to ensure it doesn’t happen again – education/discipline. They could do a desk review OR come in to check things

out for themselves.

REPORTING SUSPICION OF A CRIME

Federal law requires that “covered individuals” report to both law enforcement AND the state survey agency if there is a reasonable suspicion that a crime has been committed against a resident. “covered individuals” are: Owner(s), operators, employees,

managers, agents, or contractors of this facility. The facility cannot punish/retaliate against for lawfully reporting

suspicion of a crime under this law. Employees can file a complaint with the state survey agency

against the facility if there is retaliation for reporting, causing a report to be made, or for taking steps in furtherance of making a report of a reasonable suspicion of a crime to the appropriate authorities. To file a complaint because you believe you have been retaliated against for

reporting the suspicion of a crime contact;Wisconsin Department of Health Services, DQA

1-800-642-6552

REPORTING SUSPICION OF A CRIME

REAL clock timeBodily Harm – Immediately but no longer

than 2 hours after forming the suspicion.No bodily harm – Report must be made no

later than 24 hours after forming the suspicion

Individuals who fail to report under section1150B(b) shall be subject to

various penalties including civil monetary penalties

MISCONDUCT PREVENTION

Attend orientation and education opportunities Obtain information through memos, emails, and

department meetings Employee screenings and background checks Appropriate recruiting and retaining of sufficient

staff for all shifts Review resident care plans frequently Residents and families are educated on Resident

Rights at time of admission and throughout their stay

Corrective action plans to modify unacceptable behaviors

Encourage residents, families, and staff to share concerns

HIPAA – HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT OF

1996 Resident Right - to protect medical, social, and

financial information of residents All information should be kept private and secure

(Verbal, Written, and Electronic)You will overhear confidential information as you do your day to day work. As long as you keep it to yourself, you have nothing to worry about.

Confidentiality is ensuring that information is accessible only to those authorized to have access

Even the trash is private, never throw resident information into an unlocked trash can. All private information should be put into red confidential bins or locked trash cans.

Supports the Residents Right to privacy through the “need to know” principle.

QUESTION: Do you need to know this to do your job?

Recycle it OR Shred

it???

Questions?