89 Ill. Adm. Code 270.152
Complaint Investigations
Section 270.152 Complaint Investigations
a) Policies
and procedures of the State Ombudsman provide standards to assure a prompt
response to complaints and the prioritization of complaints.
b) Complaints
may be initiated by anyone who has personal knowledge of an action, inaction or
decisions that may adversely affect the health, safety, welfare or rights of
one or more residents or participants.
c) The Ombudsman
may identify, investigate and attempt to resolve a complaint impacting an individual
resident or participant or multiple residents or participants.
d) Regardless
of the source of the complaint (i.e., the complainant), including when the
source is the Ombudsman, the Ombudsman shall support and maximize resident or
participant participation in the process of resolving the complaint in
accordance with 45 CFR 1324.19(b) (2016). These processes include, but are not
limited to, the following:
1) The
Ombudsman shall offer privacy to the resident or participant for the purpose of
confidentiality.
2) The
Ombudsman shall personally discuss the complaint with the resident or
participant and, if the resident or participant is unable to communicate
informed consent, his or her representative. The Ombudsman shall:
A) Determine
the perspective of the resident or participant;
B) Obtain
informed consent to investigate the complaint;
C) Determine the wishes of the resident or
participant with respect to the resolution of the complaint, including whether
the allegations are to be reported and, if so, whether the Ombudsman may
disclose resident or participant identifying information or other relevant
information to the facility or appropriate agencies or both;
D) Advise
the resident or participant of his or her rights;
E) Work
with the resident or participant to develop a plan of action for resolution of
the complaint;
F) Investigate
the complaint to determine whether the complaint can be verified; and
G) Determine
whether the complaint is resolved to the satisfaction of the resident or participant.
e) To
determine the degree of reliance of the resident or participant on the
representative, the Ombudsman shall consider the extent of the authority that
has been granted to the representative under court order (in the case of a
guardian or conservator), by power of attorney or other document by which the
resident or participant has granted authority to the representative to
communicate or make determinations on behalf of the resident or participant
related to complaint processing.
f) The
Ombudsman may provide information regarding the complaint to another agency so
that agency can substantiate the facts for regulatory, protective services, law
enforcement, or other purposes. The Ombudsman shall adhere to the disclosure
requirements of section 712(d) of the Older Americans Act, 45 CFR 1324.11(e)(2)
(2016), and this Section.