Fla. Admin. Code Ann. R. 58L-1.0011 - Definitions

In addition to the terms defined in Section 400, Part I, F.S., the following terms are defined in this rule chapter:

(1) COMPLAINT INVESTIGATION DEFINITIONS.

(a) CASE: Each inquiry brought to, or initiated by, the ombudsman on behalf of a resident, or group of residents, involving one or more complaints, which requires opening a case and includes ombudsman investigation, strategy to resolve and follow-up.

(b) CASE CLOSED: A case where none of the complaints within the case require any further action on the part of the ombudsman and every complaint has been assigned the appropriate disposition code. For purposes of this rule, each complaint must be reviewed and approved by the long-term care district ombudsman manager, or designee, before it meets this definition.

(c) COMPLAINT: A concern brought to, or initiated by, the ombudsman for investigation and action by, or on behalf of, one or more residents of a long-term care facility relating to health, safety, welfare or rights of a resident. One or more complaints constitute a case.

(d) COMPLAINANT: An individual or a party who files one or more complaints made by, or on behalf of, residents with the ombudsman program.

(2) COMPLAINT INVESTIGATION DISPOSITION CODES.

(a) NO ACTION NEEDED: The complaint/problem required no action.

(b) NOT RESOLVED: The complaint/problem was not addressed to the satisfaction of the resident or complainant.

(c) PARTIALLY RESOLVED: The complaint/problem has been addressed to some degree to the satisfaction of the resident or complainant, but not completely.

(d) REFERRED, AGENCY DID NOT SUBSTANTIATE: The complaint/problem was referred to an agency having jurisdiction over the complaint/problem, but the complaint/problem was not substantiated.

(e) REFERRED, AGENCY FAILED TO ACT: The complaint/problem was referred to an agency having jurisdiction over the complaint/problem, but the agency failed to act.

(f) REFERRED, NO REPORT: The complaint/problem was referred to an agency having jurisdiction over the complaint/problem, but no report of final outcome by the agency was obtained.

(g) REQUIRES GOVERNMENT POLICY, REGULATORY OR LEGISLATIVE CHANGE TO RESOLVE: The complaint/problem may be resolved only by governmental order or enactment of changes in law, regulation or policy.

(h) RESOLVED: The complaint/problem was addressed to the satisfaction of the resident or complainant.

(i) WITHDRAWN: The complaint was withdrawn by the complainant or resident, the case was discontinued at the option of the ombudsman, or the resident or complainant died before final disposition of the complaint investigation.

(3) COMPLAINT INVESTIGATION VERIFICATION CODES.

(a) NOT VERIFIED: It is determined after work (interviews, record inspection, and observation, etc.) that the circumstances described in the complaint are not accurate.

(b) VERIFIED: It is determined after work (interviews, record inspection, and observation, etc.) that the circumstances described in the complaint are accurate.

(4) CONFLICT OF INTEREST DEFINITIONS.

(a) CONFLICT OF INTEREST: A conflict of interest is a competing interest, obligation or duty which compromises, influences, interferes with (or gives the appearance of compromising, influencing or interfering with) the integrity, the activities or the conduct of the program's representatives, including the State Long-Term Care Ombudsman, in faithfully and effectively fulfilling his or her official duties. Types of conflicts include:

1. Conflicts of loyalty, which involve issues of judgment and objectivity, including, but not limited to, financial incentives that shape an individual's judgment or behavior in such a way that is contrary to residents' interests.

2. Conflicts of commitment, which involve issues of time and attention that direct an individual's time and attention away from the residents' interests.

3. Conflicts of control, which involve issues of independence, including limitations or restrictions that effectively prevent an individual's ability to advocate for residents' interests.

(b) IMMEDIATE FAMILY: Father, mother, husband, wife, son, daughter, brother, sister, or any other individual residing in the household.

(c) INDIRECT REMUNERATION: Receiving remuneration from a company providing a service to a long-term care facility, such as a consulting pharmacist.

(d) LONG-TERM CARE SERVICES: Services provided by a long-term care facility, home health agency, adult day care center, hospice, intermediate care facility, home for special services or transitional living facility as those terms are defined in Chapters 400 and 429, F.S. Long-term care services also include services provided to residents by non-immediate family members who are geriatric care managers, guardians or representative payees.

(5) OTHER DEFINITIONS:

(a) DISTRICT: A geographic area in which the ombudsman program is administered and services are delivered.

(b) DOM: Abbreviation for the Long-Term Care Program's district ombudsman manager.

(c) PROGRAM: The Office of the State Long-Term Care Ombudsman, its representatives and employees, the State Long-Term Care Ombudsman Council, and the district long-term care ombudsman councils as established in Chapter 400, Part I, F.S.

Notes

Fla. Admin. Code Ann. R. 58L-1.0011

Rulemaking Authority 400.0070, 400.0071 FS. Law Implemented 400.0070, 400.0071, 400.0073, 400.0075 FS.

New 3-18-10.

New 3-18-10.