1 / 19

COMPLAINT INVESTIGATION UNIT(CIU)

COMPLAINT INVESTIGATION UNIT(CIU). Bureau of Health Systems Division of Operations Department of Community Health. Complaint Unit Functions . Receive complaints against the following facilities: Nursing Homes Hospitals Hospice. Complaint Unit Functions: continued. Home Health Agencies

december
Download Presentation

COMPLAINT INVESTIGATION UNIT(CIU)

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. COMPLAINT INVESTIGATION UNIT(CIU) Bureau of Health Systems Division of Operations Department of Community Health

  2. Complaint Unit Functions Receive complaints against the following facilities: • Nursing Homes • Hospitals • Hospice

  3. Complaint Unit Functions:continued • Home Health Agencies • Free Standing Surgical Clinics • Clinical Laboratories • End Stage Renal Disease Units

  4. How to file a complaint: • Any person may file a complaint: Resident, Family Member, Guardian, Friend. • Hot Line: (800) 882-6006 a) Hot line is monitored 24/7 b) Calls are processed in the order received

  5. How to file a complaint:continued Mailing Address: Michigan Department of Community Health Bureau of Health Systems/Complaint Investigation Unit P.O. Box 30664, Lansing, MI 48909 • Processed within 3 days of receipt

  6. How to file a complaint:continued • Fax #: (517) 241-0093 • Processed within 3 days of receipt. • On line: http://www.michigan.gov/bhs • Processed within 3 days of receipt.

  7. Internal Complaint Processing • Data entered into the computer • Acknowledgement letter sent to complainant • Files are created • Reviewed by manager • Assigned to an investigator • Investigator attempts to make initial contact with the complainant prior to investigation

  8. Internal Complaint Processing:continued • Unannounced on-site investigation is conducted • Report is written • Attempt is made to contact the Complainant to relate findings • Copy of report mailed to complainant/facility • Hearing option – To review completeness of investigation; not an appeal of citations or penalties

  9. Complainant rights • Hearing option – MCL 333.21799a(10) • Dissatisfied with the findings • Request a hearing in writing within 30 days of mailing of the investigation results • Department forwards request to Hearing Agency • Hearing Agency sends notice of date, time and place of the hearing to the complainant and nursing facility • Either party may be represented by an attorney

  10. Nursing Home Responsibility For Complaint Resolution • State Law MCL 333.21723 • Requires Nursing Homes to post the name of the individual who is responsible for: a) receiving complaints b) investigating complaints c) communicating outcome of the investigation to the complainant • An individual must be identified for each shift to be available on duty 24/7

  11. Nursing Home Responsibility:continued • List of long term care contact phone numbers are to be available to the public/residents for the following: • Department of Community Health Hot Line • Department of Community Health Nursing Home Monitoring Division – for contact during Standard (Annual) Surveys Detroit – (313) 456-0340 Gaylord – (989) 732-8062 Lansing – (517) 334-8408

  12. Nursing Home Responsibility:continued • Provider Groups Health Care Association of Michigan (HCAM) (517) 627-1561; www.HCAM.org Michigan Association of Homes and Services for the Aging (MAHSA) (517) 323-3687; www.mahsahome.org County Medical Care Facility (CMCF) Council (517) 371-5303; www.McMcfc.org

  13. Nursing Home Responsibility:continued State Long Term Care Ombudsman 1-866-485-9393 Nursing Home Patient Care Advocacy Group 1-800-288-5923

  14. Complaint vs. FRI Intake History

  15. Investigation Time Line • All complaints filed must be related to issues that have occurred within the past 12 months. • All complaints received are investigated. • Currently complaint investigation time line average is 90 days.

  16. FY 2007 Top Nursing Home Citations Based on Complaints • F323: Facility is free of accident hazards and provide supervision of residents to prevent accidents • F223: Residents are free from abuse • F309: Provide necessary care for “highest practical well being” • F225: Not report, abuse, neglect, misappropriation of property and suspicious injuries to the State Agency as required

  17. Top Nursing Home Citations Based on Complaints- continued • F281: Services provided meet professional standards • F157: Inform family, guardian and physician of accidents/significant changes/transfers • F314: Proper treatment to prevent/heal pressure sores (bed sores) • F241: Dignity

  18. Top Nursing Home Citations Based on Complaints- continued • F246: Accommodations of needs & preferences • F279: Develop comprehensive care plans • F224: Facility prohibits abuse, neglect

More Related