Complaints

(a) Complaints to the residential care home. The home shall make available to each resident or the resident's representative a copy of the home's complaint procedure. The home shall ensure that all employees comply with the home's complaint procedure. The home's complaint procedure shall include at least the following requirements. (1) The home shall list in its procedures and shall require to be posted in a conspicuous place outside the administrator's office area the following information: (A) The names, addresses and telephone numbers of staff persons designated to receive complaints for the home; (B) Notice that a good faith complaint made against the home shall not result in reprisal against the person making the complaint; and (C) Notice that any person with a complaint is encouraged to attempt to resolve the complaint with the home's designated complaint staff, but that the person may submit a complaint to the Department without prior notice to the home. (2) If a resident, resident's representative or home employee submits to the administrator or designated complaint staff a written complaint concerning resident abuse, neglect or misappropriation of resident's property, the home shall comply with the Protective Services for Vulnerable Adults Act, Title 43A O.S. Sections 10-101 through 10-110. (b) Complaints to the Department. The following requirements apply to complaints filed with the Department. (1) The Department shall provide to each home a notice identifying the telephone number and location of the Department's central call center to which complaints may be submitted. The home shall post such notice in a conspicuous place outside the administrator's office area. (2) Any person may submit a complaint to the Department in writing, OAC 310:680 OKLAHOMA STATE DEPARTMENT OF HEALTH 11 October 01, 2017 by phone, or personally. The Department shall reduce to writing a verbal complaint received by phone or in person. (3) If the complainant is a resident, the resident's representative, or a current employee of the home, the Department shall keep the complainant's identity confidential. For other complaints, the Department shall ask the complainants preference regarding confidentiality. (4) The Department shall receive and triage complaints at a central call center. The complaints shall be classified and investigated according to the following priorities: (A) A complaint alleging a situation in which the home's noncompliance with state requirements relating to residential care homes has caused or is likely to cause serious injury, harm, impairment or death to a resident shall be classified as immediate jeopardy and shall be investigated by the Department within two (2) working days; (B) A complaint alleging minimal harm or more than minimal harm to a resident but less than an immediate jeopardy situation shall be classified as actual harm and shall be investigated by the Department within ten (10) working days; and (C) A complaint alleging other than immediate jeopardy or actual harm shall be scheduled for an onsite survey and investigated during the next onsite survey or sooner if deemed necessary by the Department; and (D) A complaint alleging a violation that caused no actual harm but the potential for more than minimal harm to a resident, that repeats a violation cited by the Department within the preceding twelve (12) months, and that is alleged to have occurred after the Department determined the facility corrected the previous violation, shall be classified as continuing and investigated the earlier of the next onsite survey or ninety (90) calendar days. (5) In addition to scheduling investigations as provided in paragraph (4) of this subsection, the Department shall take necessary immediate action to remedy a situation that alleges a violation of the Residential Care Act or any rules promulgated under authority of the Act if that situation represents a serious threat to the health, safety and welfare of a resident. (6) In investigating complaints, the Department shall: (A) Protect the identity of the complainant if a current or past resident or resident's representative or designated guardian or a current or past employee of the home by conforming to the following: (i) The investigator shall select at least three (3) records for review, including the record of the resident identified in the complaint. The three records shall be selected based on residents with similar circumstances as detailed in the complaint if possible. All three (3) records shall be reviewed to determine whether the complaint is substantiated and if the alleged deficient practice exists; and (ii) The investigator shall interview or observe at least three (3) residents during the home observation or tour, which OAC 310:680 OKLAHOMA STATE DEPARTMENT OF HEALTH 12 October 01, 2017 will include the resident referenced in the complaint if identified and available in the home. If no resident is identified, then the observations used of the three residents shall be used to assist in either substantiating or refuting the complaint; (B) Review surveys completed within the last survey cycle to identify tendencies or patterns of non-compliance by the home; (C) Attempt to contact the State or Local Ombudsman and the complainant, if identified, prior to the survey; and (D) Interview the complainant, the resident, if possible, and any potential witness, collateral resource or affected resident. (7) The Department shall limit the complaint report to the formal report of complaint investigation. The formal report of complaint investigation shall be issued to the home and the complainant, if requested, within ten (10) business days after completion of the investigation. The formal report of investigation shall include at least the following: (A) Nature of the allegation(s); (B) Written findings; (C) Deficiencies, if any, related to the complaint investigation; (D) Warning notice, if any; (E) Correction order, if any; and (F) Other relevant information.