| (27) Ombudsman Program--The State Long-Term Care Ombudsman
Program as defined in 45 CFR §1324.1. The program through which
the functions of the Office are carried out by the State Ombudsman
and representatives of the Office.
(28) Ombudsman Program records--The files, records,
and other information created or maintained by the State Ombudsman
or a representative of the Office in the performance of functions
of the Ombudsman Program, including:
(A) information relating to complaint investigations;
(B) emails and documentation of phone conversations;
(C) documentation related to the budget and expenditures
for the Ombudsman Program; and
(D) information contained in the ombudsman database.
(29) Ombudsman service area--The county or counties,
specified in the contract between HHSC and a host agency, in which
the local ombudsman entity performs functions of the Ombudsman Program.
(30) Organizational conflict of interest--A situation
in which an organization is involved in multiple interests, financial
or otherwise, that could affect the effectiveness and credibility
of the Ombudsman Program and includes an organization:
(A) having any ownership, operational, or investment
interest in, or receiving grants or donations from, an LTC facility;
(B) being an association of LTC facilities or an affiliate
of such an association;
(C) having responsibility for licensing, surveying,
or certifying LTC facilities;
(D) having a governing board member with an ownership,
investment, or employment interest in an LTC facility;
(E) providing long-term care to residents of LTC facilities,
including the provision of personnel for LTC facilities or the operation
of programs that control access to, or services of, LTC facilities;
(F) providing long-term care coordination or case management
for residents of LTC facilities;
(G) setting reimbursement rates for LTC facilities;
(H) providing adult protective services, as described
in Texas Human Resources Code, Chapter 48;
(I) determining eligibility regarding Medicaid or other
public benefits for residents of LTC facilities;
(J) conducting PASRR screening for LTC facility placements;
(K) making decisions regarding admission of residents
to, or discharge of residents from, LTC facilities; or
(L) providing guardianship, conservatorship, or other
fiduciary or surrogate decision-making services for residents of LTC
facilities.
(31) PASRR--Preadmission Screening and Resident Review.
A review performed in accordance with 42 CFR Part 483, Subpart C.
(32) Private and unimpeded access--Has the following
meanings:
(A) as used in §88.201(a)(1) of this chapter (relating
to Access to Facilities, Residents, and Resident Records), access
to enter an LTC facility without interference or obstruction from
facility employees, volunteers, or contractors; and
(B) as used in §88.201(a)(2) of this chapter,
access to communicate with a resident outside of the hearing and view
of other persons without interference or obstruction from facility
employees, volunteers, or contractors.
(33) Representative of the Office--A staff ombudsman,
volunteer ombudsman, or ombudsman intern.
(34) Resident--A person of any age who resides in an
LTC facility.
(35) Resident representative--A person chosen by a
resident, through formal or informal means, to act on behalf of the
resident to:
(A) support the resident in decision-making;
(B) access medical, social, or other personal information
of the resident;
(C) manage financial matters; or
(D) receive notifications.
(36) Staff ombudsman--A person who meets the following
criteria, including a managing local ombudsman:
(A) is certified as a staff ombudsman in accordance
with §88.102 of this chapter;
(B) performs functions of the Ombudsman Program; and
(C) is an employee or independent contractor of:
(i) a host agency;
(ii) a governmental entity or nonprofit organization
that contracts with a host agency, as described in paragraph (16)(B)
of this section; or
(iii) HHSC.
(37) State Ombudsman--The State Long-term Care Ombudsman,
as defined in 45 CFR §1324.1. The person who heads the Office
and performs the functions, responsibilities, and duties described
in §88.101 of this chapter (relating to Responsibilities of the
State Ombudsman and the Office).
(38) Volunteer ombudsman--A person who:
(A) is certified as a volunteer ombudsman in accordance
with §88.102 of this chapter;
(B) performs functions of the Ombudsman Program; and
(C) is not an employee or independent contractor of:
(i) HHSC;
(ii) a host agency; or
(iii) a governmental entity or nonprofit organization
that contracts with a host agency, as described in paragraph (16)(B)
of this section.
(39) Willfully interfere--To act or not act to intentionally
prevent, interfere with, or impede or to attempt to intentionally
prevent, interfere with, or impede.
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