Friday, March 29, 2019
Volume 5, Issue 3
Navigating the National Ombudsman Resource Center Website
The National Ombudsman Resource Center (NORC) website is filled with information, resources, and news from Ombudsman programs to support and inform programs across the country. Based on your feedback, NORC updated the website in an effort to simplify the organization of resources. We archived or revised older materials, reorganized webpages, removed webpages, and added more visuals.
NORC convened a workgroup of 25 members which included both State Long-Term Care Ombudsmen and representatives of the Office (local/regional ombudsmen). The workgroup made suggestions for improvements and provided feedback on changes. Some of the key suggestions from the workgroup that influenced changes include:
- Use more symbols and pictures.
- Make it obvious what resources were created before and after implementation of the LTCOP Final Rule.
- Make it obvious what resources are from NORC, Consumer Voice, the federal government, and Ombudsman programs.
- Add titles to the NORC webinar page.
- Add a picture of the resource rather than just the title of the document.
- Remove pages that include information that is already on another page, the less pages the better.
- Reduce the number of words on each page.
Based on the workgroup suggestions and responses from our annual evaluation, NORC made the following changes.
- Updated several core resources to ensure the content is consistent with the LTCOP Final Rule, the reauthorized Older Americans Act, and/or the revised nursing home regulations (e.g., Resident-to-Resident Mistreatment: Long-Term Care Ombudsman Program Advocacy; Role and Responsibilities of Ombudsman Programs Regarding Systems Advocacy; Responding to Allegations of Abuse: Role and Responsibilities of the Ombudsman Program).
- Enchanced visual interest by using more images and icons in our emails and website pages. For example, our training page has icons and we added a feature where you can click on an image to take you to a resource or webpage, see here.
- We added an archive section to several pages of the website for outdated resources and information, see here.
- We added titles to the webinar page so you do not have to click on the page to see what webinars were held in each year.
- To clarify which resources are from NORC, we separated materials into sections, such as “Resources Produced by NORC,” “Resources Produced by Ombudsman Programs,” see our training page as an example.
- We consolidated all NORS materials, data, and training on one page.
- Added a page for Ombudsman program examples in order to make issue pages shorter and only have NORC and Federal Resources on issue pages. See the Ombudsman program examples page here.
- We created a site map that lists every page within the NORC website.
- We reduced the number of program management sub-pages from 14 to 7.
- Edited the content on a total of 129 pages.
- Deleted a total of 28 pages.
Can't See the Updates?
In order to see these changes, you must clear your browser's cache history. Clearing your cache is simple. In Google Chrome click the three dots that indicate "More" in the top right corner. Then click "More tools" and "Clear browsing data." At the top, choose a time range and be sure to check the box "Cached images and files."
Save the date for the Navigating the National Ombudsman Resource Center Website webinar on April 24, 2019 from 3:00 – 4:00pm ET. This presentation will walk through the NORC website and new On-Demand Training Center. The presentation will show how resources and information are organized on the website and where to go if you need help.
Learn about the different sections of the website and how to better navigate the pages with these helpful tips and visit the site map to see all pages within our website. Watch this short video as an introduction to the NORC website. If you have any questions, email firstname.lastname@example.org.
Back to top
New and Updated NORC Resources
NEW! Revised National Ombudsman Reporting System (NORS) Training and Webinar Materials
The purpose of this webinar series is to introduce the new training materials to help programs prepare for the transition to new codes, definitions, and activities on October 1, 2019. The Introduction to the revised National Ombudsman Reporting System (NORS) was held February 5, 2019, view the materials here; Part I: Case, Complaint, Complainant, and Information and Assistance was held February 27, 2019, view the materials here; and Part II: Complaint Coding was held March 19, 2019, view the materials here.
NEW! Individual Conflict of Interest Screening Template
This document contains information based on the LTCOP Rule, §1324.21(d), Conflicts of Interest. The template is intended for use as a guide when Ombudsman programs develop or revise individual conflict of interest screening tools. Additional information on individual conflicts of interest, the provisions in the Rule, and examples of screening tools used by Ombudsman programs can be accessed here.
NEW! 2019 NORC Evaluation Results
In December 2018, NORC sent a planning and evaluation questionnaire to all State Ombudsmen and program representatives and we received over 90 responses. The responses help NORC evaluate the success of its activities and materials and provide NORC staff with key information in planning for future tasks. This email is based on the results of this questionnaire and includes common responses and links to what we have available.
NEW! Button to Quickly Access Key NORC Resources
The new button on the NORC website homepage serves as a shortcut to access key NORC resources quickly. To access additional resources and information about the topic areas visit the individual issue pages or specific program management main pages. If you have trouble finding a resource visit the site map to view all web pages. View Key NORC Resources.
NEW! January, February, and March NORC Notes
NORC Notes is a monthly email reminder of available resources on the NORC website and tips for how your program can use them. The January issue shared training tips for the Ombudsman program, the February issue reviewed resources for Ombudsmen to assist residents with mental health needs, and the March issue highlighted updates to the NORC website. If you would like to sign-up to receive the NORC Notes, email NORC.
UPDATED! Online NORC Curriculum Updated Format
This training translates the NORC curriculum, Equipping Long-Term Care Ombudsmen for Effective Advocacy: A Basic Curriculum into an online form. The teaching methods found in this training are based on principles of adult learning and grounded in Ombudsman program values. The online format was recently updated for a fresher, more user-friendly appearance. The curriculum content will be updated in the future.
Back to top
News from the Network
Texas Ombudsman Program Supports Bill in a Hearing on Improper Nursing Facility Discharges
The Texas State Ombudsman and a representative of the Office testified in a hearing held by the Texas House of Human Services for HB 2285 regarding improper nursing facility discharges. The bill author is Representative Sarah Davis. Patty Ducayet, Texas State Long-Term Care Ombudsman; Wendy Lee, family member of a resident affected by improper discharge; and Darla Bower, staff ombudsman for the Capital Area presented compelling testimony about how improper discharges impact nursing home residents. Read the bill summary and written testimony from local representatives of the Office. Watch the recording. Note: begin at the 36:00 minute mark.
Michigan Ombudsmen Serve on Elder Abuse Task Force
Michigan Attorney General Dana Nessel and Supreme Court Justices Richard Bernstein and Megan Cavanagh announced the formation of the Michigan Elder Abuse Task Force. The task force goals include addressing guardianship and getting a proposal to certify professional guardians to the Michigan Legislature by June. The State Long Term Care Ombudsman, Assistant SLTCO and three senior program representatives are serving on the Task Force, along with additional partners. Read the Attorney General's press release here.
Dallas County Texas Long-Term Care Ombudsman, Karen Magruder, was the Lead Author of the Journal Article, “Abuse, neglect and exploitation in assisted living: an examination of long-term care ombudsman complaint data”
According to the article abstract, given that long-term care residents are vulnerable to elder abuse, neglect and exploitation (ANE), and existing gaps in the literature addressing ANE in AL, more research is needed to understand the prevalence of ANE in these communities. Ombudsman complaint data (n = 140,497 complaints) in 3,171 Texas long-term care facilities were analyzed using proportion Z tests. Findings showed that SNF had higher rates of ANE per resident. For both AL and SNF, verbal/psychological abuse was the most reported type of ANE and sexual abuse was the least reported. AL residents had disproportionately high rates of financial exploitation. More information here.
Assistant Secretary for Aging, Lance Robertson, wrote a blog post on the 40th year of the LTCOP
ACL Administrator and Assistant Secretary for Aging, Lance Robertson wrote a blog post commemorating the 40th year of the Long-Term Care Ombudsman Program. The post highlights accomplishments of ombudsman programs across the country, presents ACL's ombudsman program data from fiscal year 2017, and highlights priority areas on which to focus the future. Read the full blog post here.
Kentucky held a Senior Advocacy Day
Senior Advocacy Day began with various speakers from AARP, Area Agencies on Aging and Independent Living (AAAIL), and Denise Wells of the Nursing Home Ombudsman Agency (NHOA) providing education and information about issues legislators could address including sufficient staffing in nursing homes. A panel of legislators consisting of Rep. Chris Fugate, Rep. Rothenburger, Rep. Russ Meyer, Sen. Alice Forgy Kerr, and Sen. Reginald Thomas began addressing the crowd of approximately 150 attendees. Read more information here.
A Kentucky state senator wants to force local nursing homes to establish minimum staff-to-patient ratios as a condition of receiving their operating licenses
Sen. Tom Buford (R-Nicholasville) recently introduced his Senate Bill 206, which would impose penalties on facilities caught without enough staffers on hand, the Lexington Herald Leader reported. The bill does not yet establish a specific ratio, but is tasking the Kentucky Cabinet for Health and Family Services with working out the math. “It’s not rocket science,” Buford told the newspaper. “When you have elderly people in your care, you need to be checking on them regularly, and if you don’t have enough people on staff, you simply can’t do that.” Read the full article here.
Resident Council Handbook from the Florida Ombudsman Program
This new resident council handbook from the Florida Ombudsman program serves as a guide to building a strong resident council. Share with NORC any materials your program has created related to resident councils by emailing email@example.com!
Back to top
TA Hot Topic
Individual Conflict of Interest
How can programs screen individuals for potential or actual conflicts of interest?
According to the LTCOP Final Rule, the State Agency and the Ombudsman are responsible for identifying conflicts that "may impact the effectiveness and credibility of the work of the Office" [§1324.21(c)(1)].
The LTCOP Rule requires four steps regarding individual conflicts of interest (COI):
- Establish and implement policies and procedures related to conflicts of interest.
- Identify conflicts of interest.
- Avoid appointing or designating individuals with conflicts of interest.
- Remove or remedy the conflict.
The new NORC resource, Long-Term Care Ombudsman Program Individual Conflict of Interest Screening Template, was designed to help Ombudsman programs identify conflicts of interest (this resource is available as a fillable PDF and in black and white).
The template is intended for use as a guide when Ombudsman programs develop or revise individual conflict of interest screening tools. States are responsible for adding any state specific requirements, definitions, or processes that may not be included in this document.
Additional information on individual conflicts of interest, the provisions in the Rule, and examples of screening tools used by Ombudsman programs can be accessed here, specifically the LTCOP Rule Issue Brief on individual conflicts of interest, a related webinar, and this article from a 2016 issue of the Ombudsman Outlook.
Reminder: Ombudsman programs will start using the revised NORS data collection on October 1, 2019. Links to an introduction to the NORS revisions, tables, and crosswalks are below and on the NORC and ACL websites. In the meantime, programs are to continue using the current approved NORS form and instructions to ensure consistent reporting. Prior to implementation NORC will share new training materials for the revised NORS data tables. For more information visit the NORS FAQs or email firstname.lastname@example.org.
Revised National Ombudsman Reporting System (NORS) Training
This training is a five-part webinar series on the revised National Ombudsman Reporting System (NORS) training materials created by NORC. State Ombudsman programs submit data regarding program activities to the Administration for Community Living (ACL)/Administration on Aging (AoA), using the codes, definitions, and activities outlined in the instructions for the National Ombudsman Reporting Systems (NORS). The data has been collected since 1996 and this is the first comprehensive revision. The revised NORS data collection is effective October 1, 2019.
NORC has updated the four-part NORS training materials to reflect the updated codes, definitions, and activities and instruct programs on how to record the work they do. States are to continue to use the current approved NORS codes and instructions and training materials to ensure consistent reporting until the updated data collection is effective on October 1, 2019.
The purpose of this webinar series is to introduce the new training materials to help programs prepare for the transition to new codes, definitions, and activities on October 1, 2019. The first webinar introduced the revised new NORS data collection and the following four webinars cover each part of the revised four-part training.
The recording and materials from the Introduction to the Revised NORS webinar, Part I: Case, Complaint, Complainant AND Information and Assistance webinar, and Part II: Complaint Codes webinar are available here.
The Part III: Closing the Case – Verification, Referral, and Disposition webinar will be held April 30 at 3:00pm ET and the Part IV: Activities webinar will be held May 29 at 3:00pm ET. Register here, participants only need to register once for both webinars.
You are encouraged to review the materials and take the quizzes prior to attending the webinars. All materials are available on the NORC website here.
Back to top
Volunteer Appreciation Week is April 7 - 13, 2019
The theme for the 2019 National Volunteer Week is Celebrate Service. The LTCOP could not be its best without the 6,625 certified volunteers, and other volunteers who carry out the mission of advocating for long-term care residents. In federal fiscal year 2017, these volunteers contributed 591,363 hours of service to Ombudsman programs across in the country (according to the NORS data). The Independent Sector determined the estimated value of a volunteer hour in 2018 was $24.69. For the Ombudsman program, that is $14.6 million of assets due to volunteer service!
During 2017, staff and volunteers:
- Worked to resolve 201,460 complaints initiated by residents, their families, and other concerned individuals;
- Provided 402,000 instances of information and assistance to individuals;
- Visited 68% of all nursing homes and 30% of all board and care, assisted living, and similar homes at least quarterly;
- Conducted 4,426 training sessions in facilities on such topics as resident rights;
- Provided 127,068 instances of information and assistance to LTC facility managers and staff; and
- Participated in 21,211 resident council and 1,788 family council meetings.
Thank your volunteers and recognize their work publicly by sending NORC brief messages of appreciation for their dedicated advocacy (e.g., examples of their advocacy, years of service, photos). We will post your message on our website and highlight the submissions on our home page. Email your submissions to email@example.com. Ideas for volunteer recognition are on the NORC website here.
Comments from residents about volunteers for the Kentucky Ombudsman program are below, see additional messages from 2017 and 2018 here.
- "I don't know what I would do without my buddy (ombudsman). She comes to check on me and if things aren't going right, I can depend on her to help me get it worked out."
- "I don't have any family around here. He's just about the only person who comes to visit me. We've got a lot in common. We both like the Wildcats (UK) and grew up around the same place. He's good to talk to."
Back to top
Training for Ombudsman Programs
Training for Ombudsman program staff and volunteers is critical for maintaining an effective long-term care ombudsman program. The National Long-Term Care Ombudsman Resource Center develops and collects materials and information that enhance and strengthen the Ombudsman program training.
On-Demand Training Center
The new Training Center is an on-demand education platform for all individuals interested in achieving quality long-term care and is available through your computer or mobile device. The training center allows you to delve into important topics through online courses. Courses are available for consumers, representatives of long-term care, Ombudsman programs, advocates, and family members.
At this point in time, the Training Center only houses continuing education materials that are also located on the NORC website such as webinars, fact sheets, Prezi presentations, and more. Interactive, on-demand training for the revised National Ombudsman Reporting System (NORS) and the NORC Curriculum (which is currently housed on a Google platform) will be available in the future.
Share information about the Training Center using this flyer.
Training materials on the NORC website
NORC has created training materials for Ombudsman programs on a variety of topics and also collects training materials from states. Materials created by NORC are available on the website here and materials created by Ombudsman programs are available here.
Read the January 2019 NORC Notes issue for additional adult learning techniques, sample training agendas, training videos, training topics, role play topics, and additional information on the NORC online curriculum.
Back to top
Opioid misuse has become a national epidemic. There has been significant attention and action at the federal, state, and local level to address opioid misuse in communities, health care centers, treatment centers, and hospitals. However, the impact of the opioid epidemic in long-term care facilities hasn’t received as much media attention and isn’t as clearly defined as the crisis in the aformentioned settings. For information about opioid misuse, visit the CMS website.
The National Ombudsman Resource Center (NORC) was awarded a grant from the Administration for Community Living to learn about the resident experience with opioids in long-term care.
As part of this project, Consumer Voice and NORC have created a questionnaire in order to learn more about the resident experience with opioids in long-term care. This information will help us understand the scope of the opioid crisis in long-term care facilities and better assist ombudsman programs with advocacy in this area. We are asking all State Ombudsmen and representatives (local/regional ombudsmen) to respond. Please help us obtain this information by completing this questionnaire by Friday, April 19.
Click here to access the online survey: https://www.surveymonkey.com/r/opioidsLTC.
The questionnaire will take only 10-20 minutes to complete. You may want to review and print or save the PDF version of the questionnaire in order to plan your responses in advance. In addition, it may be helpful to review your program data and have it readily accessible as you answer the questions.
Click here to access the PDF of the survey: https://theconsumervoice.org/uploads/files/issues/opioids-ltc-questionnaire.pdf.
If you have any questions, contact Alisha Lineswala at firstname.lastname@example.org.