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Effective March 23, 2011, directs the Secretary of HHS to develop a standardized complaint form for use by a resident (or a person acting on the resident’s behalf) in filing a complaint with a state survey and certification agency and a state long-term care ombudsman program. Requires states to establish a complaint resolution process.
Prior to January 2013, it does not appear that HHS released a standardized complaint form pursuant to this provision.
On a related note, on June 18, CMS issued guidance to state Medicaid directors clarifying the availability of Medicaid funding for certain administrative costs incurred by state long-term care ombudsman programs. Also, on June 14, the Administration on Aging (AoA) issued a proposed rule regarding the State Long-Term Care Ombudsman program under the Older Americans Act, replacing a 1994 proposed rule that had never been finalized. Comments are due August 19, 2013.
SEC. 6105. STANDARDIZED COMPLAINT FORM. (a) IN GENERAL.—Section 1128I of the Social Security Act, as added and amended by this Act, is amended by adding at the end the following new subsection: ‘‘(f) STANDARDIZED COMPLAINT FORM.— ‘‘(1) DEVELOPMENT BY THE SECRETARY.—The Secretary shall develop a standardized complaint form for use by a resident (or a person acting on the resident’s behalf) in filing a complaint with a State survey and certification agency and a State long-term care ombudsman program with respect to a facility. ‘‘(2) COMPLAINT FORMS AND RESOLUTION PROCESSES.— ‘‘(A) COMPLAINT FORMS.—The State must make the standardized complaint form developed under paragraph (1) available upon request to— ‘‘(i) a resident of a facility; and ‘‘(ii) any person acting on the resident’s behalf. ‘‘(B) COMPLAINT RESOLUTION PROCESS.—The State must establish a complaint resolution process in order to ensure that the legal representative of a resident of a facility or other responsible party is not denied access to such resident or otherwise retaliated against if they have complained about the quality of care provided by the facility or other issues relating to the facility. Such complaint resolution process shall include— ‘‘(i) procedures to assure accurate tracking of complaints received, including notification to the complainant that a complaint has been received; ‘‘(ii) procedures to determine the likely severity of a complaint and for the investigation of the complaint; and ‘‘(iii) deadlines for responding to a complaint and for notifying the complainant of the outcome of the investigation. ‘‘(3) RULE OF CONSTRUCTION.—Nothing in this subsection shall be construed as preventing a resident of a facility (or a person acting on the resident’s behalf) from submitting a complaint in a manner or format other than by using the standardized complaint form developed under paragraph (1) (including submitting a complaint orally).’’. (b) EFFECTIVE DATE.—The amendment made by this section shall take effect 1 year after the date of the enactment of this Act.
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