Ombudsman Program Activities May 29, 2019 National Ombudsman Reporting System (NORS) Training Part IV Ombudsman Program Activities May 29, 2019 Welcome to our final webinar for the revised National Ombudsman Reporting System (NORS) Training series. We will review the Part IV training materials on NORS Ombudsman Program Activities, specifically the activities in Part H of the Administration for Community Living (ACL) NORS Table 3. Attendees include State Ombudsmen and Representatives of the Office of the State Long-Term Care Ombudsman. Representatives of the Office, often called local or regional ombudsmen, are our target audience today. Our speakers today are Louise Ryan, Ombudsman Program Specialist, Administration on Aging (AoA)/Administration for Community Living (ACL) and Maria Greene, NORC Consultant. Attendees are muted. If you have questions, please submit those in the control panel on your screen. We will address as many questions as we can throughout the webinar.

Agenda Administration for Community Living’s perspective Part IV Training Materials Part IV Basic Principles NORS Table 3: State Program Information Quiz Quiz Answer Sheet Quiz Activity Questions and Answers Resources Today’s agenda includes a few remarks from ACL, a review of Part IV training materials, the Part IV quiz, time for questions, and a reminder of available resources on the NORC website. For today’s webinar we are focusing on the basics of NORS reporting. We updated our training materials to reflect the changes in NORS data collection, effective October 1. The purpose of these webinars is to review the new training materials and talk about the basics of reporting to improve reporting consistency. We are developing FAQs for the revised NORS and will address gray areas of reporting in the FAQs and future training.

ACL’s Perspective Louise Ryan Ombudsman Program Specialist Administration on Aging /Administration for Community Living

ACL’s Perspective We are shifting to a new way of receiving your states’ data but the fundamentals of NORS are the same. We have changed some language, such as Residential Care Community (RCC), but it does not change what you call RCC’s in your state. We are asking for additional data on visits to better reflect the important work that you do. We also want to have more data on the activities and services provided to residents and staff in Residential Care Communities

ACL’s Perspective Data is used by ACL/AoA to describe and promote the Ombudsman program Important to not over count activities NORS does not (and never has) capture all program activities. States may choose to collect additional state-level data Ombudsman programs conduct a range of important activities and report these activities in NORS. ACL/AoA uses this data to describe and promote the work of the Ombudsman program. It is important that Ombudsman programs are accurate in their activity reporting (e.g., not over counting activities when two representatives participate in the same activity). NORS does not capture all program activities and states may choose to collect additional state-level data on topics such as, individual training sessions, systems advocacy activities, working with the media, etc.

ACL’s Perspective Future NORS training All recorded webinars and training materials are available on the NORC site You are encouraged to use these NORS materials to train representatives Future NORS training Revised NORS FAQs and webinar On-demand NORS training course In-depth technical assistance and training for State Ombudsmen .

NORS Training Part IV: Ombudsman Program Activities The three documents for the revised Part IV NORS training materials are: Basic Principles Quiz Quiz Answer Sheet https://ltcombudsman.org/omb_support/nors/revised-nors-data-collection NOTE: The NORS codes and definitions used in these materials are taken from the ACL tables 1-3 and are not to be modified. There are three training documents for Part IV, Basic Principles, the quiz, and the quiz answers. You will also need the NORS Table 3 for today’s webinar. The materials were emailed to registrants last week; however, after sending them we realized there were some errors. I sincerely apologize for the confusion and inconvenience, but please use the materials that are attached as handouts in your toolbox and that are currently available on the NORC website. Each person taking the quiz needs to have NORS, Table 3 State Program Information, Part H, as a reference for the definitions of terms, the codes and values, and examples and reporting tips. This Quiz covers sections S-51 through S-68. If questions arise regarding the Part IV quiz answers, refer to Table 3 for additional information.   Some of the answers in the quiz will be easy and obvious to code when entering data into your software system. They are included in the quiz to introduce some of the reporting data elements that are being collected in this version of NORS. As Louise discussed NORS Table 3 contains information that the State LTCOP will complete and provide with the NORS annual data submission to the Administration for Community Living. The information that we will not cover today includes the Complaint examples, Systems Issues, Ombudsman program organization structure, staffing and volunteer data, conflict of interest issues, budgeting, facility data elements, state and local coordination activities, This information with be covered at another time with staff of the Office of the SLTCOs.

NORS Training Part IV: Basic Principles Most of the data elements for the State Program Information in the ACL Table 3: State Program Information is compiled and written by the Office of the State Ombudsman As a reminder, most of the data elements for the State Program Information in the ACL Table 3: State Program Information is compiled and written by the Office of the State Ombudsman. We are only focusing on reporting the Ombudsman program activities that are most applicable to representatives of the Office.

NORS Training Part IV: Basic Principles NORS does not capture all program activities. States may choose to collect additional data on training, facility visits, survey participation, participation in resident and family councils, and community education. As we mentioned earlier, NORS does not capture all program activities and states may choose to collect additional data on training, facility visits, survey participation, participation in resident and family councils, and community education. However, states will need to determine how to document all activities to ensure there isn’t duplication and over counting.

Basic Principles - Training The Office of State Long-Term Care Ombudsman will report the following data elements for training provided to representatives annually. Certification Training Hours: The total hours of training required for an individual (paid or volunteer) to achieve certification which allows an individual to be eligible for designation as a representative of the Office of State LTC Ombudsman. Continuing Education: The annual number of hours of in-service hours required for all representatives of the Office to maintain designation. Individuals Completing Certification Training: The total number of individuals (paid or volunteer) completing certification training within the federal fiscal year. The Office of State Long-Term Care Ombudsman will report the following data elements for training provided to representatives of the Office annually in the Older American’s Act Performance System (OAAPS). Certification Training Hours: States are required to report the total hours of training required for an individual (paid or volunteer) to achieve certification which allows an individual to be eligible for designation as a representative of the Office of State LTC Ombudsman. Continuing Education: States must report the annual number of hours of in-service hours required for all representatives of the Office to maintain designation. Individuals Completing Certification Training: States must also report the total number of individuals (paid or volunteer) completing certification training within the federal fiscal year. State Ombudsmen may choose to collect detailed training information that is not required to report in NORS, such as attendance, types of training, and the training topics for program management purposes.

Basic Principles - Training Training for Facility Staff by Ombudsmen Report the number of sessions conducted, and the type of facility (nursing facility or residential care community) based on the facility affiliation of most of the participants for each session. In-Person Training Report each training instance as a separate session even if repeated at the same facility, such as at different shifts, or when repeated at a conference. Examples: The program provided an abuse prevention training to the morning and evening shift at a nursing home this equals two sessions. The program provided morning and afternoon residents’ rights training at an assisted living provider conference over two days. This equals four sessions. Training for Facility Staff by Ombudsmen Report the number of sessions conducted, and the type of facility (nursing facility or residential care community) based on the facility affiliation of most of the participants for each session. NORS does not count the number of participants. In-Person Training Report each training instance as a separate session even if repeated at the same facility, such as at different shifts, or when repeated at a conference. Examples: The program provided an abuse prevention training to the morning and evening shift at a nursing home this equals two sessions. The program provided morning and afternoon residents’ rights training at an assisted living provider conference over two days. This equals four sessions.

Basic Principles - Training Distance Learning (webinar, online courses, conference calls) To report distance learning there must be a way to track that participants completed the training and their facility affiliation. Regardless of the number of attendees, a distance learning training program that tracks completion numbers and facility affiliation counts as one session. If an Ombudsman program offers distance learning on a variety of topics, each training topic at least one person completes counts as one session. Example: There are two online training programs on residents’ rights, one is for nursing facilities and the other is for residential care communities. The content of each is specific to the facility type. Therefore, the state will report two sessions in NORS, one under each facility type, provided at least one person completed each online training program. To report distance learning, such as webinars, conference calls, or an on-demand course, as a session in NORS, there must be a way to track that participants completed the training and their facility affiliation. In other words, a state needs to be able to verify that at least one person attended and completed the distance learning in order to report the training session. Regardless of the number of attendees, a distance learning training program that tracks completion numbers and facility affiliation counts as one session. If an Ombudsman program offers distance learning on a variety of topics, each training topic at least one person completes counts as one session. Example: There are two online training programs on residents’ rights, one is for nursing facilities and the other is for residential care communities. The content of each is specific to the facility type. Therefore, the state will report two sessions in NORS, one under each facility type, provided at least one person completed each online training program.

Basic Principles – Facility Visits Number of facilities visited regardless of the purpose (complaint or non-complaint). Definition: Total number of nursing facilities or residential care community facilities that received at least one visit by a representative of the Office during the reporting year, regardless of the purpose of the visit. The total number of all visits. Definition: Total number of nursing facility and residential care community facility visits no matter the purpose of visit (complaint or non-complaint related) by representatives of the Office. Number of facilities that had routine access. Definition: Total number of nursing facilities and residential care community facilities visited, not in response to a complaint, in all four quarters by representatives of the Office. States are required to report the following three types of data elements related to facility visits for each facility type. Number of facilities visited regardless of the purpose (complaint or non-compliant). Definition: Total number of nursing facilities or residential care community facilities that received at least one visit by a representative of the Office during the reporting year, regardless of the purpose of the visit. The total number of all visits. Definition: Total number of nursing facility and residential care community facility visits no matter the purpose of visit (complaint or non-complaint related) by representatives of the Office. Number of facilities that had routine access. Definition: Total number of nursing facilities and residential care community facilities visited, not in response to a complaint, in all four quarters by representatives of the Office.

Basic Principles – Survey Participation Report each distinct type of survey activity as one instance by facility type. Definition: Report the total number of instances of survey activity by representatives of the Office. Example: Include participation in both standard surveys and complaint surveys. You may have more than one survey participation activity associated with one survey in one facility. Example: A surveyor calls you prior to entering the building, and you provide information about your observations during your visits and the type of complaints you’ve handled. You also attend the exit survey. This would count as two instances of survey participation. Report each distinct type of survey activity as one instance by facility type. Definition: Report the total number of instances of survey activity by representatives of the Office. Example: Include participation in both standard surveys and complaint surveys. Survey participation includes but is not limited to pre-survey information to surveyors, sharing complaint summary reports, participation in exit conferences and informal dispute resolution. It must be a whole number. You may have more than one survey participation activity associated with one survey in one facility. Example: A surveyor calls you prior to entering the building, and you provide information about your observations during your visits and the type of complaints you’ve handled. You also attend the exit survey. This would could as two instances of survey participation.

Basic Principles – Resident Council and Family Council Participation Report each distinct type of resident or family council participation as one instance by facility type. Participation includes meeting with council leadership, training the council, and/or attending a council meeting. Tips If technical support, consultation, or resource information is provided to a resident council or family council outside of a council meeting, report that activity as an information and assistance activity (S-55). If two Ombudsmen attend the same resident or family council meeting that participation should be reported as one instance. Report each distinct type of resident or family council participation as one instance by facility type. Participation includes meeting with council leadership, training the council, and attending a council meeting. Tips • If technical support, consultation, or resource information is provided to a resident council or family council outside of a council meeting, report that activity as an information and assistance activity (S-55). • If two Ombudsmen attend the same resident or family council meeting that participation should be reported as one instance. States will need to determine how to document this in their system to avoid over counting. For example, one Ombudsman could count it as attendance at resident council and the other Ombudsman counts it as a facility visit.

Basic Principles – Community Education Report each instance of community education outreach sessions by Ombudsmen. Tips Use for attendance at health fairs, community events, general presentations, etc. The number of individuals attending the community education event is not collected in NORS. If a community education session is provided by distance learning (such as a webinar, on-demand course, or conference call) there must be a way to track that participants completed the session in order to report it as a session in NORS. Newsletters, blogs, and other forms of media do not count as community education. If two Ombudsmen participate in the same community education event, it counts as one instance.

Part IV Quiz Directions Refer to NORS, Table 3 State Program Information, Part H, as a reference for the definitions of terms, the codes and values, and examples and reporting tips, to answer the quiz questions. This Quiz covers sections S-51 through S-68. Refer to NORS, Table 3 State Program Information, Part H, as a reference for the definitions of terms, the codes and values, and examples and reporting tips, to answer the quiz questions. This Quiz covers sections S-51 through S-68. Some of the answers in the quiz will be easy and obvious to code when entering data into your software system. They are included in the quiz to introduce some of the reporting data elements that are being collected in this version of NORS.

Training for facility staff The first few scenarios cover training for staff of nursing facilities and residential care communities, codes S-51 and S-52 of Table 3. Codes S-51 and S-52 (ACL NORS Table 3)

Scenario 1 - Example You conduct an in-service training at a nursing facility in your area. To make the training available to all staff, you present the training at two different times during the day. The audience is nursing facility staff. Two Sessions are documented. Each quiz question for Part IV has at least two questions, but due to time, we will only ask one question and share the second answer. We are using Scenario 1 as an example and then we will ask poll questions for the rest of the quiz questions. You conduct an in-service training at a nursing facility in your area. To make the training available to all staff, you present the training at two different times during the day. Report each training instance as a separate session even if repeated at the same facility, such as at different shifts, or when repeated at a conference. You provided two training sessions with the staff attendance split between two sessions on the same day.  

Scenario 2 - Poll You conduct a training for staff in a residential care community. Another residential care community requests the same training program and you conduct the session for that community. The audience is residential care community staff. Question: How many sessions? 1 session 2 sessions  

Scenario 2 - Answer You conduct a training for staff in a residential care community. Another residential care community requests the same training program and you conduct the session for that community. The audience is residential care community staff. Question: How many sessions? 1 session 2 sessions You conduct a training for staff in a residential care community. Another residential care community requests the same training program and you conduct the session for that community.   Who’s the audience? Residential care community staff How many sessions? 2 You conduct training at two different facilities and this counts as two sessions even though the content was the same.

Scenario 3 - Poll Your local Ombudsman program developed a web-based, on-demand training on residents’ rights for facility staff that tracks information about each person who completes the course. When you review the information report on the course, you see that some of the training was viewed by 100 people. By the end of the year, 50 people completed the entire course. More than half of the individuals who completed the course were nursing facility staff. The audience is nursing facility staff. Question: How many sessions? 1 100 50  

Scenario 3 - Answer Your local Ombudsman program developed a web-based, on-demand training on residents’ rights for facility staff that tracks information about each person who completes the course. When you review the information report on the course, you see that some of the training was viewed by 100 people. By the end of the year, 50 people completed the entire course. More than half of the individuals who completed the course were nursing facility staff. The audience is nursing facility staff. Question: How many sessions? 1 100 50 Your local Ombudsman program developed a web-based, on-demand training on residents’ rights for facility staff that tracks information about each person who completes the course. When you review the information report on the course, you see that some of the training was viewed by 100 people. By the end of the year, 50 people completed the entire course. More than half of the individuals who completed the course were nursing facility staff.   Who’s the audience? Nursing facility staff How many sessions? 1 Decide which staff type to select based on the affiliation of most individuals who completed the session. If the Ombudsman program has a web-based, on-line or on-demand, training session, the program needs a way to determine if anyone completes the course and their facility type to be able to report it in NORS. If a course is available but no one completes it, that course cannot be reported as a training session in the NORS report. The number of individuals completing the course is not reported in NORS although a state may choose to collect that data.

Scenario 4 - Poll Your local Ombudsman program creates an abuse reporting training and offers it as a web-based training on the program’s website. No registration is required. You can see a report of the number of times the abuse reporting training page is viewed but no other user data is available. The audience is Unknown. Question: How many sessions? 1 session 0 sessions

Scenario 4 - Answer Your local Ombudsman program creates an abuse reporting training and offers it as a web-based training on the program’s website. No registration is required. You can see a report of the number of times the abuse reporting training page is viewed but no other user data is available. The audience is Unknown. Question: How many sessions? 1 session 0 sessions Your local Ombudsman program creates an abuse reporting training and offers it as a web-based training on the program’s website. No registration is required. You can see a report of the number of times the abuse reporting training page is viewed but no other user data is available. Who’s the audience? Unknown How many sessions? 0   Posting training information without a method to determine if anyone completes the course and the type of facility that the trainees represent, does not count as a training in NORS. There is no way to determine if anyone received the training.

Information and assistance The next few scenarios cover providing information and assistance, codes S-53 through S-55 in Table 3. Codes S-53 through S-55 (ACL NORS Table 3)

Scenario 5 - Poll Mrs. Petro emails the Ombudsman program asking for information regarding a nursing home care plan conference for her husband. You respond and attach information about how to prepare for a care plan conference. A couple of days later, Mrs. Petro emails you with another request asking how to learn what the current care plan says and how to get the home to include her ideas in a new plan. You respond with detailed answers to Mrs. Petro’s questions and include links to specific resources. The facility type is nursing facility. Question: How many information and assistance (I&A) instances? It’s a complaint 1 I&A 2 I&A  

Scenario 5 - Answer Mrs. Petro emails the Ombudsman program asking for information regarding a nursing home care plan conference for her husband. You respond and attach information about how to prepare for a care plan conference. A couple of days later, Mrs. Petro emails you with another request asking how to learn what the current care plan says and how to get the home to include her ideas in a new plan. You respond with detailed answers to Mrs. Petro’s questions and include links to specific resources. The facility type is nursing facility. Question: How many information and assistance (I&A) instances? It’s a complaint 1 I&A 2 I&A Mrs. Petro emails the Ombudsman program asking for information regarding a nursing home care plan conference for her husband. You respond and attach information about how to prepare for a care plan conference. A couple of days later, Mrs. Petro emails you with another request asking how to learn what the current care plan says and how to get the home to include her ideas in a new plan. You respond with detailed answers to Mrs. Petro’s questions and include links to specific resources.   How many information and assistance instances? 2 Facility type: Nursing facility The two requests count as two instances because they were received and responded to, on different days. This data element (S-55) is intended to capture the number of instances when the Ombudsman provided information and assistance. It is not a count of the number of individuals who received information and assistance.

Scenario 6 - Poll Kathy Perez, the social worker at Peaceful Acres Assisted Living, calls you asking for a residents’ rights poster and tips on how to keep residents informed of their rights. You share a few tips over the phone. That day, you mail the poster to the facility address. Later, you remember a resource list of ideas related to keeping residents informed of their rights and you send that resource to Kathy. This counts as one information and assistance instance. Question: What type of facility? Nursing facility Residential care community Board and care  

Scenario 6 - Answer Kathy Perez, the social worker at Peaceful Acres Assisted Living, calls you asking for a residents’ rights poster and tips on how to keep residents informed of their rights. You share a few tips over the phone. That day, you mail the poster to the facility address. Later, you remember a resource list of ideas related to keeping residents informed of their rights and you send that resource to Kathy. This counts as one information and assistance instance. Question: What type of facility? Nursing facility Residential care community Board and care Kathy Perez, the social worker at Peaceful Acres Assisted Living, calls you asking for a residents’ rights poster and tips on how to keep residents informed of their rights. You share a few tips over the phone. That day, you mail the poster to the facility address. Later, you remember a resource list of ideas related to keeping residents informed of their rights and you send that resource to Kathy. How many information and assistance instances? 1 Facility type: Residential Care Community   Your follow-up with an additional resource is in response to the initial request, so it counts as one information and assistance. Sending the resource list was not in response to an additional request for information and assistance. Peaceful Acres is an assisted living facility; therefore, you report it as one information and assistance, residential care community.

Ombudsman visits Codes S-57, S-58, S-60, and S-61 (ACL NORS Table 3)

For these scenarios… Assume all visits in each scenario are to the same facility. Document all visits by the type of facility: nursing home or residential care community. Visits may be associated with additional activities also documented as NORS codes such as complaint investigation, information and assistance, resident council participation, or family council participation. Ombudsman visits: nursing facilities and residential care communities: Codes S-57 and S-58, S-60 and S-61 Assume that all visits in each scenario are to the same facility. Document all visits to facilities by the type of facility: nursing home or residential care community. The visits may be associated with additional activities that are also documented as NORS codes such as complaint investigation, information and assistance, resident council participation, or family council participation. This section of the quiz focuses on how to report the number of facility visits and whether the visit was complaint related.

Scenario 7 - Example You make one visit to a facility in response to three complaints. This would be recorded as one visit related to complaints. Discuss as an example – no poll. You make one visit to a facility in response to three complaints. How many visits? 1 Complaint related? ­­­Y

Scenario 8 - Poll You make one visit to a facility to visit residents to provide them with access to the Ombudsman program. This visit was not related to a complaint. Question: How many visit(s) would be recorded? 110 visits 11 visits 1 visit  

Scenario 8 - Answer You make one visit to a facility to visit residents to provide them with access to the Ombudsman program. This visit was not related to a complaint. Question: How many visit(s) would be recorded? 110 visits 11 visits 1 visit You make one visit to a facility to visit residents to provide them with access to the Ombudsman program. How many visits? 1 Complaint related? ­­­N   The data element reported is the number of visits to a facility, not the number of residents visited. The reason for your visit was not in response to a complaint.

Scenario 9 - Poll You visit a facility to follow-up on a complaint. While you are there, you visit other residents and observe interactions between residents and staff that are not related to the complaint. Record as one visit to the facility. Question: Is the visit complaint related? Yes No  

Scenario 9 - Answer You visit a facility to follow-up on a complaint. While you are there, you visit other residents and observe interactions between residents and staff that are not related to the complaint. Record as one visit to the facility. Question: Is the visit complaint related? Yes No You visit a facility to follow-up on a complaint. While you are there, you visit other residents and observe interactions between residents and staff that are not related to the complaint.   How many visits? 1 Complaint related? ­­­Y You made one visit to one facility. The complaint is your primary reason for the visit.

Scenario 10 - Poll You visit a facility because you know there is a new administrator and the facility is due for a routine visit. You speak with several residents and some staff members. While speaking with a resident she shares a complaint and asks for your assistance in addressing it with staff. This is recorded as one facility visit. Question: Is the visit complaint related? Yes No  

Scenario 10 - Answer You visit a facility because you know there is a new administrator and the facility is due for a routine visit. You speak with several residents and some staff members. While speaking with a resident she shares a complaint and asks for your assistance in addressing it with staff. This is recorded as one facility visit. Question: Is the visit complaint related? Yes No You visit a facility because you know there is a new administrator and the facility is due for a routine visit. You speak with several residents and some staff members. While speaking with a resident she shares a complaint and asks for your assistance in addressing it with staff.   How many visits? 1 Complaint related?­­­­­­­­­­­­­­ N The primary purpose of the visit was to provide routine access to residents and meet the new administrator, so it would count as a routine visit. The visit was not initiated in response to a complaint, to provide further investigation on an existing complaint, or to provide follow-up. Remember the original purpose for the visit.

Scenario 11 - Poll You and another Ombudsman visit a facility together after a family member asks you to help resolve a problem with her mother’s care. This is a complaint related visit. Question: How do you record the visit? One visit Two visits  

Scenario 11 - Answer You and another Ombudsman visit a facility together after a family member asks you to help resolve a problem with her mother’s care. This is a complaint related visit. Question: How do you record the visit? One visit Two visits You and another Ombudsman visit a facility together after a family member asks you to help resolve a problem with her mother’s care.   How many visits? 1 Complaint related? ­­­Y One visit is reported because both Ombudsmen visit together to address the same problem. NORS collects the number of facility visits in response to complaints or to give residents access to the Ombudsman program (non-complaint related). The number of individuals making those visits is not reported in NORS. Your State Ombudsman may have additional guidance regarding how to enter the data on visits by two Ombudsmen to the same facility at the same time.

Scenario 12 - Poll You visit a facility to work on a complaint. Later that day, someone calls with a different complaint on the same facility. Another Ombudsman takes that complaint and makes a visit in the afternoon. This is recorded as a complaint related visit. Question: How should visit(s) be recorded? Two visits One visit  

Scenario 12 - Answer You visit a facility to work on a complaint. Later that day, someone calls with a different complaint on the same facility. Another Ombudsman takes that complaint and makes a visit in the afternoon. This is recorded as a complaint related visit. Question: How should visit(s) be recorded? Two visits One visit You visit a facility to work on a complaint. Later that day, someone calls with a different complaint on the same facility. Another Ombudsman takes that complaint and makes a visit in the afternoon.   How many visits? 2 Complaint related? ­­­Y This counts as two visits because there were two residents with two separate complaints and two different Ombudsmen visited the facility.

Scenario 13 - Poll You stop at a facility and drop off residents’ rights posters and brochures. While you are there, you are invited to attend the residents’ council meeting that afternoon. Although you cannot attend the meeting, another Ombudsman goes to the meeting. This is not a complaint related visit. Question: How many visit(s) are documented? One visit Two visits  

Scenario 13 - Answer You stop at a facility and drop off residents’ rights posters and brochures. While you are there, you are invited to attend the residents’ council meeting that afternoon. Although you cannot attend the meeting, another Ombudsman goes to the meeting. This is not a complaint related visit. Question: How many visit(s) are documented? One visit Two visits You stop at a facility and drop off residents’ rights posters and brochures. While you are there, you are invited to attend the residents’ council meeting that afternoon. Although you cannot attend the meeting, another Ombudsman goes to the meeting.   How many visits? 2 Complaint related? ­­­N There are two visits, two Ombudsmen going to the same facility at different times and for different purposes. Although the first visit was brief, its purpose was to promote access to the Ombudsman program and it resulted in a request to attend the resident council meeting. Neither visit is complaint related. The second visit would also be coded as a resident council participation (S-64 or S-65 depending on the facility type).

Participation in facility survey, resident council, family council The next scenarios pertain to Table 3 codes S62-S67 regarding participation in facility surveys, resident councils, and family councils. Codes S-62 through S-67

Scenario 14 - Poll You share pre-survey information with the assisted living surveyors and participate in the exit conference. The facility type is residential care community. Question: How many survey activities should be documented? Two activities One activity  

Scenario 14 - Answer You share pre-survey information with the assisted living surveyors and participate in the exit conference. The facility type is residential care community. Question: How many survey activities should be documented? Two activities One activity You share pre-survey information with the assisted living surveyors and participate in the exit conference.   How many survey activities? 2 Facility type: Residential Care Community Although both activities relate to one survey, it is reported as two activities. NORS instruction is to count the number of instances, not the number of residential care communities (RCC) that had survey activity. Therefore, it is permissible to have multiple survey activities associated with one RCC.

Scenario 15 - Poll You participate in the exit conference for a survey at a nursing facility and several weeks later, you participate in the informal dispute resolution regarding the same facility. The facility type is nursing facility. Question: How many survey activities? One Two  

Scenario 15 - Answer You participate in the exit conference for a survey at a nursing facility and several weeks later, you participate in the informal dispute resolution regarding the same facility. The facility type is nursing facility. Question: How many survey activities? One Two You participate in the exit conference for a survey at a nursing facility and several weeks later, you participate in the informal dispute resolution regarding the same facility.   How many survey activities? 2 Facility type: Nursing Facility NORS instruction is to count the number of instances, not the number of facilities that had survey activity. Therefore, it is permissible to have multiple survey activities associated with one facility.

Scenario 16 - Poll The president of the resident council at Happy Acres Nursing Home asks you to join their meeting. Afterwards, the president asks you to provide training to their council leadership. You do that a week later. The facility type is nursing facility. Question: How many resident council activities? Two activities Three activities  

Scenario 16 - Answer The president of the resident council at Happy Acres Nursing Home asks you to join their meeting. Afterwards, the president asks you to provide training to their council leadership. You do that a week later. The facility type is nursing facility. Question: How many resident council activities? Two activities Three activities The president of the resident council at Happy Acres Nursing Home asks you to join their meeting. Afterwards, the president asks you to provide training to their council leadership. You do that a week later.   How many resident council activities? 2 Facility type: Nursing Facility It is two activities because they occurred at different times and were different in purpose.

Scenario 17 - Poll A family council is beginning to develop at a residential care community (RCC). One of the members invites you to their meeting as a resource and you attend. The next week, the newly elected president asks you to share resources to help the council’s effectiveness. You send the president some information. Later that month, another RCC family council asks you to speak at their meeting and you do. The facility type is residential care community. Question: How many family council activities? Three Two One  

Scenario 17 - Answer A family council is beginning to develop at a residential care community (RCC). One of the members invites you to their meeting as a resource and you attend. The next week, the newly elected president asks you to share resources to help the council’s effectiveness. You send the president some information. Later that month, another RCC family council asks you to speak at their meeting and you do. The facility type is residential care community. Question: How many family council activities? Three Two One A family council is beginning to develop at a residential care community (RCC). One of the members invites you to their meeting as a resource and you attend. The next week, the newly elected president asks you to share resources to help the council’s effectiveness. You send the president some information. Later that month, another RCC family council asks you to speak at their meeting and you do.   How many family council activities? 2 Facility type: Residential Care Community There are two family council activities: attending a meeting at one RCC and speaking at a different family council meeting. Sending information to the family council president is an Information and Assistance activity to report under code S-55. If you provide technical support, consultations, or resource information, to a resident or family council outside of a council meeting, that activity is an Information and Assistance.

Community education sessions Community education sessions: Code S-68 NORS Table 3 Code S68 addresses how to document Community Education instances. Code S68 should be used for attendance at health fairs, community events, general presentations, etc. If education is web-based or on-line/on-demand the Ombudsman program must have a way to count the number of individuals who completed the session in order to report in NORS. Newsletters, blogs and other forms of media do not count as community education. It must be a whole number. Code S-68

Scenario 18 - Example You spend the morning staffing a booth during a health fair providing information about the Ombudsman program to 150 people. In the afternoon, you make a presentation on long-term care facilities and residents’ rights at a senior center. Fifty people attended. Two different community education sessions were conducted; this counts as two instances. The number of instances (or activities) is reported in NORS, not the number of individual contacts. No poll. Discuss as an example of how to document S68. You spend the morning staffing a booth during a health fair providing information about the Ombudsman program to 150 people. In the afternoon, you make a presentation on long-term care facilities and residents’ rights at a senior center. Fifty people attended.   How many community education activities? 2 Two different instances were conducted. The number of activities is reported in NORS, not the number of individual contacts. State Ombudsman programs may choose to collect the number of participants. Reminder: A state LTCO may request reps to report additional information such as number of trainees or attendees, but this level of detail is not required in NORS.

Scenario 19 - Poll You finish an article on the Ombudsman program for the Area Agency on Aging’s (AAA) newsletter, post a few photos of the recent Ombudsman recognition ceremony on the Ombudsman program’s Facebook account and tweet about it, and attend a caregivers’ meeting to share information about the Ombudsman program. The AAA newsletter has a circulation of 1,000 addresses. You know it will take a few days to determine the reach of your social media posts. Question: How many community education activities? Five activities One activity Unknown  

Scenario 19 - Answer You finish an article on the Ombudsman program for the Area Agency on Aging’s (AAA) newsletter, post a few photos of the recent Ombudsman recognition ceremony on the Ombudsman program’s Facebook account and tweet about it, and attend a caregivers’ meeting to share information about the Ombudsman program. The AAA newsletter has a circulation of 1,000 addresses. You know it will take a few days to determine the reach of your social media posts. Question: How many community education activities? Five activities One activity Unknown You finish an article on the Ombudsman program for the Area Agency on Aging’s (AAA) newsletter, post a few photos of the recent Ombudsman recognition ceremony on the Ombudsman program’s Facebook account and tweet about it, and attend a caregivers’ meeting to share information about the Ombudsman program. The AAA newsletter has a circulation of 1,000 addresses. You know it will take a few days to determine the reach of your social media posts.   How many community education activities? 1 The caregivers’ meeting counts as one community education activity (S-68). Newsletters, blogs and other forms of media communication are not reported as community education activities in NORS. State Ombudsman programs may choose to collect the data even though it is not reported in NORS. NORS Table 3: Tip If education is web-based or on-line/on-demand the Ombudsman program must have a way to count the number of individuals who completed the session in order to report in NORS. Newsletters, blogs and other forms of media do not count as community education. It must be a whole number.

Scenario 20 - Example The Ombudsman program has a web-based training program for consumers that tracks information about each person who completes the course throughout the year. When you review the information on attendees, there are 65 people who viewed part of the course and 30 who completed the entire course, including the quiz. This is documented as one community education activity. No poll. Discuss as example. The Ombudsman program has a web-based training program for consumers that tracks information about each person who completes the course throughout the year. When you review the information on attendees, there are 65 people who viewed part of the course and 30 who completed the entire course, including the quiz.   How many community education activities? 1 One training program was developed and posted. The program has a way to determine that people completed the course, so the community education course can be reported in NORS. The number of individuals who take a course is not reported in NORS.

Questions?

Quiz Resources and Directions NORS Table 3:State Program Information, Part H Pages 27 – 35 and element numbers S-51 through S-68 https://ltcombudsman.org/uploads/files/support/NORS_Table_3__Program_Information_04-30-2021-1.pdf Use Part H of NORS, Table 3: State Program Information, pages 27 – 35 and code numbers S-51 through S-68 and the materials we discussed today.  

Summary Administration for Community Living’s perspective Part IV Training Materials Basic Principles in the NORS Ombudsman Program Activity Quiz NORS Table 3: State Program Information Quiz Answer Sheet Quiz Activity Questions and Answers Resources

resources Amity

NORS Instructions, Training, and Materials https://ltcombudsman Here is the landing page for NORS on the NORC website. The blue bulleted listing identifies the types of resources available to you. As you can see the last bullet is the link that will take you to the Revised NORS Data Collection information which is where this webinar recording and training materials are posted.

Revised NORS Data Collection https://ltcombudsman

Start Using Revised NORS – October 1, 2019 Ombudsman programs will begin using the revised NORS codes, definitions, and activities on October 1, 2019 (Federal Fiscal Year 2020). The Office of the State Ombudsman will submit federal fiscal year 2020 data in January 2021. There are several components of NORS, such as narrative examples of advocacy work, that the Office of the State Ombudsman writes and submits along with data to the Administration for Community Living. This webinar series will highlight areas of the revised NORS that are pertinent to you. Please remember do not use the new codes or definitions until October 1, 2019.

Contact Information Amity Overall Laib, NORC Director aoveralllaib@theconsumervoice.org (202) 332 2275 ext. 207 Louise Ryan, Ombudsman Program Specialist, AoA/ACL louise.ryan@acl.hhs.gov 206-615-2514 Maria Greene NORC Consultant margreene@outlook.com (770) 668 6366

The National Long-Term Care Ombudsman Resource Center (NORC) www.ltcombudsman.org Connect with us: The National LTC Ombudsman Resource Center @LTCombudcenter This project was supported, in part, by grant number 90OMRC0001-01-00, from the U.S. Administration for Community Living, Department of Health and Human Services, Washington, D.C. 20201. Grantees undertaking projects under government sponsorship are encouraged to express freely their findings and conclusions. Points of view or opinions do not, therefore, necessarily represent official Administration for Community Living policy.