House File 278 - Introduced HOUSE FILE 278 BY COMMITTEE ON HUMAN RESOURCES (SUCCESSOR TO HSB 46) (COMPANION TO SF 184 BY COMMITTEE ON HUMAN RESOURCES) A BILL FOR An Act relating to programs and services under the purview of 1 the department on aging. 2 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA: 3 TLSB 1225HV (2) 85 pf/nh

H.F. 278 Section 1. Section 10A.402, subsection 5, Code 2013, is 1 amended by striking the subsection. 2 Sec. 2. Section 16.182, subsections 1 and 2, Code 2013, are 3 amended to read as follows: 4 1. A senior living revolving loan program fund is created 5 within the authority to further the goal of the senior living 6 program as specified in section 249H.2 . The moneys in the 7 senior living revolving loan program fund shall be used by the 8 authority for the development and operation of a revolving loan 9 program to provide financing to construct affordable assisted 10 living and service-enriched affordable housing for seniors and 11 persons with disabilities, including through new construction 12 or acquisition and rehabilitation. 13 2. Moneys received by the authority from the senior living 14 trust fund, transferred by the authority for deposit in the 15 senior living revolving loan program fund, moneys appropriated 16 to the senior living revolving loan program, and any other 17 moneys available to and obtained or accepted by the authority 18 for placement in the senior living revolving loan program fund 19 shall be deposited in the fund. Additionally, payment of 20 interest, recaptures of awards, and other repayments to the 21 senior living revolving loan program fund shall be deposited 22 in the fund. Notwithstanding section 12C.7, subsection 23 2 , interest or earnings on moneys in the senior living 24 revolving loan program fund shall be credited to the fund. 25 Notwithstanding section 8.33 , moneys that remain unencumbered 26 or unobligated at the end of the fiscal year shall not 27 revert but shall remain available for the same purpose in the 28 succeeding fiscal year. 29 Sec. 3. Section 16.183, subsection 2, Code 2013, is amended 30 to read as follows: 31 2. Moneys received by the authority from the senior living 32 trust fund, transferred by the authority for deposit in the 33 home and community-based services revolving loan program fund, 34 moneys appropriated to the home and community-based services 35 -1- LSB 1225HV (2) 85 pf/nh 1/ 24

H.F. 278 revolving loan program, and any other moneys available to and 1 obtained or accepted by the authority for placement in the home 2 and community-based services revolving loan program fund shall 3 be deposited in the fund. Additionally, payment of interest, 4 recaptures of awards, and other repayments to the senior living 5 home and community-based services revolving loan program fund 6 shall be deposited in the fund. Notwithstanding section 12C.7, 7 subsection 2 , interest or earnings on moneys in the home and 8 community-based services revolving loan program fund shall be 9 credited to the fund. Notwithstanding section 8.33 , moneys 10 that remain unencumbered or unobligated at the end of the 11 fiscal year shall not revert but shall remain available for the 12 same purpose in the succeeding fiscal year. 13 Sec. 4. Section 22.7, subsection 62, Code 2013, is amended 14 to read as follows: 15 62. Records of maintained by the department on aging 16 pertaining to clients served by the prevention of elder abuse, 17 neglect, and exploitation program or office of long-term 18 care ombudsman that disclose the identity of a complainant, 19 resident, tenant, or individual receiving services provided by 20 the department on aging, an area agency on aging, or the office 21 of long-term care ombudsman, unless disclosure is otherwise 22 allowed under section 231.42, subsection 12, paragraph “a” . 23 Sec. 5. Section 135C.1, Code 2013, is amended by adding the 24 following new subsections: 25 NEW SUBSECTION . 1A. “Certified volunteer long-term care 26 ombudsman” means a volunteer long-term care ombudsman certified 27 pursuant to section 231.45. 28 NEW SUBSECTION . 13A. “Office of long-term care ombudsman” 29 means the office of long-term care ombudsman established 30 pursuant to section 231.42. 31 NEW SUBSECTION . 20A. “State long-term care ombudsman” 32 means the state long-term care ombudsman appointed pursuant to 33 section 231.42. 34 Sec. 6. Section 135C.11, subsection 2, Code 2013, is amended 35 -2- LSB 1225HV (2) 85 pf/nh 2/ 24

H.F. 278 to read as follows: 1 2. The procedure governing hearings authorized by this 2 section shall be in accordance with the rules promulgated by 3 the department. A full and complete record shall be kept 4 of all proceedings, and all testimony shall be reported but 5 need not be transcribed unless judicial review is sought 6 pursuant to section 135C.13 . Copies of the transcript may be 7 obtained by an interested party upon payment of the cost of 8 preparing the copies. Witnesses may be subpoenaed by either 9 party and shall be allowed fees at a rate prescribed by the 10 department’s rules. The director may, after advising the 11 resident advocate committee established pursuant to section 12 135C.25 certified volunteer long-term care ombudsman , either 13 proceed in accordance with section 135C.30 , or remove all 14 residents and suspend the license or licenses of any health 15 care facility, prior to a hearing, when the director finds that 16 the health or safety of residents of the health care facility 17 requires such action on an emergency basis. The fact that no 18 resident advocate committee a certified volunteer long-term 19 care ombudsman has not been appointed for a particular facility 20 shall not bar the director from exercising the emergency powers 21 granted by this subsection with respect to that facility. 22 Sec. 7. Section 135C.13, Code 2013, is amended to read as 23 follows: 24 135C.13 Judicial review. 25 Judicial review of any action of the director may be sought 26 in accordance with the terms of the Iowa administrative 27 procedure Act, chapter 17A . Notwithstanding the terms of said 28 Act chapter 17A , petitions for judicial review may be filed in 29 the district court of the county where the facility or proposed 30 facility is located, and pending final disposition of the 31 matter the status quo of the applicant or licensee shall be 32 preserved except when the director, with the advice and consent 33 of the resident advocate committee established pursuant to 34 section 135C.25 certified volunteer long-term care ombudsman , 35 -3- LSB 1225HV (2) 85 pf/nh 3/ 24

H.F. 278 determines that the health, safety or welfare of the residents 1 of the facility is in immediate danger, in which case the 2 director may order the immediate removal of such residents. 3 The fact that no resident advocate committee a certified 4 volunteer long-term care ombudsman has not been appointed for a 5 particular facility shall not bar the director from exercising 6 the emergency powers granted by this subsection section with 7 respect to that facility. 8 Sec. 8. Section 135C.14, subsection 8, paragraph d, Code 9 2013, is amended to read as follows: 10 d. The notification of resident advocate committees 11 certified volunteer long-term care ombudsmen by the department 12 of all complaints relating to health care facilities and the 13 involvement of the resident advocate committees certified 14 volunteer long-term care ombudsmen in resolution of the 15 complaints. 16 Sec. 9. Section 135C.20A, subsection 2, Code 2013, is 17 amended to read as follows: 18 2. The report card form shall be developed by the department 19 in cooperation with representatives of the department on 20 aging, the state long-term care resident’s advocate ombudsman , 21 representatives of resident advocate committees certified 22 volunteer long-term care ombudsmen , representatives of 23 protection and advocacy entities, consumers, and other 24 interested persons. 25 Sec. 10. Section 135C.20B, subsection 2, paragraph c, Code 26 2013, is amended to read as follows: 27 c. Any information submitted by care review committee 28 members or residents with regard to the quality of care of the 29 facility. 30 Sec. 11. Section 135C.37, Code 2013, is amended to read as 31 follows: 32 135C.37 Complaints alleging violations —— confidentiality. 33 A person may request an inspection of a health care facility 34 by filing with the department, resident advocate committee of 35 -4- LSB 1225HV (2) 85 pf/nh 4/ 24

H.F. 278 the facility certified volunteer long-term care ombudsman , or 1 the office of long-term care resident’s advocate as established 2 pursuant to section 231.42 ombudsman , a complaint of an alleged 3 violation of applicable requirements of this chapter or the 4 rules adopted pursuant to this chapter . A person alleging 5 abuse or neglect of a resident with a developmental disability 6 or with mental illness may also file a complaint with the 7 protection and advocacy agency designated pursuant to section 8 135B.9 or section 135C.2 . A copy of a complaint filed with the 9 resident advocate committee a certified volunteer long-term 10 care ombudsman or the office of long-term care resident’s 11 advocate ombudsman shall be forwarded to the department. The 12 complaint shall state in a reasonably specific manner the 13 basis of the complaint, and a statement of the nature of the 14 complaint shall be delivered to the facility involved at the 15 time of the inspection. The name of the person who files a 16 complaint with the department, resident advocate committee 17 certified volunteer long-term care ombudsman , or the office 18 of long-term care resident’s advocate ombudsman shall be kept 19 confidential and shall not be subject to discovery, subpoena, 20 or other means of legal compulsion for its release to a person 21 other than department employees involved in the investigation 22 of the complaint. 23 Sec. 12. Section 135C.38, subsection 1, paragraphs a and c, 24 Code 2013, are amended to read as follows: 25 a. Upon receipt of a complaint made in accordance with 26 section 135C.37 , the department or resident advocate committee 27 certified volunteer long-term care ombudsman shall make a 28 preliminary review of the complaint. Unless the department 29 or committee certified volunteer long-term care ombudsman 30 concludes that the complaint is intended to harass a facility 31 or a licensee or is without reasonable basis, the department or 32 committee certified volunteer long-term care ombudsman shall 33 make or cause to be made an on-site inspection of the health 34 care facility which is the subject of the complaint within the 35 -5- LSB 1225HV (2) 85 pf/nh 5/ 24

H.F. 278 time period determined pursuant to the following guidelines, 1 which period shall commence on the date of receipt of the 2 complaint: 3 (1) For nursing facilities, an on-site inspection shall be 4 initiated as follows: 5 (a) Within two working days for a complaint determined by 6 the department or committee certified volunteer long-term care 7 ombudsman to be an alleged immediate jeopardy situation. 8 (b) Within ten working days for a complaint determined by 9 the department or committee certified volunteer long-term care 10 ombudsman to be an alleged high-level, nonimmediate jeopardy 11 situation. 12 (c) Within forty-five calendar days for a complaint 13 determined by the department or committee certified volunteer 14 long-term care ombudsman to be an alleged nonimmediate jeopardy 15 situation, other than a high-level situation. 16 (2) For all other types of health care facilities, an 17 on-site inspection shall be initiated as follows: 18 (a) Within two working days for a complaint determined by 19 the department or committee certified volunteer long-term care 20 ombudsman to be an alleged immediate jeopardy situation. 21 (b) Within twenty working days for a complaint determined by 22 the department or committee certified volunteer long-term care 23 ombudsman to be an alleged high-level, nonimmediate jeopardy 24 situation. 25 (c) Within forty-five calendar days for a complaint 26 determined by the department or committee certified volunteer 27 long-term care ombudsman to be an alleged nonimmediate jeopardy 28 situation, other than a high-level situation. 29 c. The department may refer to the resident advocate 30 committee certified volunteer long-term care ombudsman of a 31 facility any complaint received by the department regarding 32 that facility, for initial evaluation and appropriate action by 33 the committee certified volunteer long-term care ombudsman . 34 Sec. 13. Section 135C.38, subsection 2, paragraphs a and d, 35 -6- LSB 1225HV (2) 85 pf/nh 6/ 24

H.F. 278 Code 2013, are amended to read as follows: 1 a. The complainant shall be promptly informed of the 2 result of any action taken by the department or committee 3 certified volunteer long-term care ombudsman in the matter. 4 The complainant shall also be notified of the name, address, 5 and telephone number of the designated protection and advocacy 6 agency if the alleged violation involves a facility with one 7 or more residents with developmental disabilities or mental 8 illness. 9 d. A person who is dissatisfied with any aspect of the 10 department’s handling of the complaint may contact the office 11 of long-term care resident’s advocate, established pursuant to 12 section 231.42 ombudsman , or may contact the protection and 13 advocacy agency designated pursuant to section 135C.2 if the 14 complaint relates to a resident with a developmental disability 15 or a mental illness. 16 Sec. 14. Section 135C.38, subsections 3 and 4, Code 2013, 17 are amended to read as follows: 18 3. An inspection made pursuant to a complaint filed under 19 section 135C.37 need not be limited to the matter or matters 20 included in the complaint. However, the inspection shall 21 not be a general inspection unless the complaint inspection 22 coincides with a scheduled general inspection or unless in the 23 course of the complaint investigation a violation is evident to 24 the inspector. Upon arrival at the facility to be inspected, 25 the inspector shall show identification to the person in charge 26 of the facility and state that an inspection is to be made, 27 before beginning the inspection. Upon request of either the 28 complainant or the department or committee certified volunteer 29 long-term care ombudsman , the complainant or the complainant’s 30 representative or both may be allowed the privilege of 31 accompanying the inspector during any on-site inspection 32 made pursuant to this section . The inspector may cancel the 33 privilege at any time if the inspector determines that the 34 privacy of any resident of the facility to be inspected would 35 -7- LSB 1225HV (2) 85 pf/nh 7/ 24

H.F. 278 otherwise be violated. The protection and dignity of the 1 resident shall be given first priority by the inspector and 2 others. 3 4. If upon an inspection of a facility by its resident 4 advocate committee certified volunteer long-term care ombudsman 5 pursuant to this section , the committee certified volunteer 6 long-term care ombudsman advises the department of any 7 circumstance believed to constitute a violation of this chapter 8 or of any rule adopted pursuant to it, the committee certified 9 volunteer long-term care ombudsman shall similarly advise the 10 facility at the same time. If the facility’s licensee or 11 administrator disagrees with the conclusion of the committee 12 certified volunteer long-term care ombudsman regarding the 13 supposed violation, an informal conference may be requested and 14 if requested shall be arranged by the department as provided in 15 section 135C.42 before a citation is issued. If the department 16 thereafter issues a citation pursuant to the committee’s 17 certified volunteer long-term care ombudsman’s finding, the 18 facility shall not be entitled to a second informal conference 19 on the same violation and the citation shall be considered 20 affirmed. The facility cited may proceed under section 135C.43 21 if it so desires. 22 Sec. 15. Section 225C.4, subsection 1, paragraph m, Code 23 2013, is amended to read as follows: 24 m. Provide consultation and technical assistance to 25 patients’ advocates appointed pursuant to section 229.19 , in 26 cooperation with the judicial branch and the resident advocate 27 committees appointed for health care facilities certified 28 volunteer long-term care ombudsmen certified pursuant to 29 section 135C.25 231.45 . 30 Sec. 16. Section 227.2, subsection 2, Code 2013, is amended 31 to read as follows: 32 2. A copy of the written report prescribed by subsection 1 33 shall be furnished to the county board of supervisors, to the 34 county mental health and intellectual disability coordinating 35 -8- LSB 1225HV (2) 85 pf/nh 8/ 24

H.F. 278 board or to its advisory board if the county board of 1 supervisors constitutes ex officio the coordinating board, to 2 the administrator of the county care facility inspected and to 3 its resident advocate committee certified volunteer long-term 4 care ombudsman , and to the department on aging. 5 Sec. 17. Section 227.4, Code 2013, is amended to read as 6 follows: 7 227.4 Standards for care of persons with mental illness or an 8 intellectual disability in county care facilities. 9 The administrator, in cooperation with the department of 10 inspections and appeals, shall recommend and the mental health 11 and disability services commission created in section 225C.5 12 shall adopt standards for the care of and services to persons 13 with mental illness or an intellectual disability residing in 14 county care facilities. The standards shall be enforced by 15 the department of inspections and appeals as a part of the 16 licensure inspection conducted pursuant to chapter 135C . The 17 objective of the standards is to ensure that persons with 18 mental illness or an intellectual disability who are residents 19 of county care facilities are not only adequately fed, clothed, 20 and housed, but are also offered reasonable opportunities for 21 productive work and recreational activities suited to their 22 physical and mental abilities and offering both a constructive 23 outlet for their energies and, if possible, therapeutic 24 benefit. When recommending standards under this section , 25 the administrator shall designate an advisory committee 26 representing administrators of county care facilities, county 27 mental health and developmental disabilities regional planning 28 councils, and county care facility resident advocate committees 29 certified volunteer long-term care ombudsmen to assist in the 30 establishment of standards. 31 Sec. 18. Section 231.4, subsection 1, Code 2013, is amended 32 to read as follows: 33 1. For purposes of this chapter , unless the context 34 otherwise requires: 35 -9- LSB 1225HV (2) 85 pf/nh 9/ 24

H.F. 278 a. “Administrative action” means an action or decision made 1 by an owner, employee, or agent of a long-term care facility, 2 assisted living program, elder group home, or by a governmental 3 agency, which affects the service provided to residents or 4 tenants covered in this chapter . 5 b. “Assisted living program” means a program which provides 6 assisted living as defined pursuant to section 231C.2 and which 7 is certified under chapter 231C . 8 c. “Certified volunteer long-term care ombudsman” or 9 “certified volunteer” means a volunteer long-term care ombudsman 10 certified pursuant to section 231.45. 11 c. d. “Commission” means the commission on aging. 12 d. e. “Department” means the department on aging. 13 e. f. “Director” means the director of the department on 14 aging. 15 f. g. “Elder group home” means elder group home as defined 16 in section 231B.1 which is certified under chapter 231B . 17 g. h. “Equivalent support” means in-kind contributions 18 of services, goods, volunteer support time, administrative 19 support, or other support reasonably determined by the 20 department as equivalent to a dollar amount. 21 h. i. “Federal Act” means the Older Americans Act of 1965, 22 42 U.S.C. § 3001 et seq., as amended. 23 i. j. “Home and community-based services” means a continua 24 of services available in an individual’s home or community 25 which include but are not limited to case management, 26 homemaker, home health aide, personal care, adult day, 27 respite, home delivered meals, nutrition counseling, and other 28 medical and social services which contribute to the health and 29 well-being of individuals and their ability to reside in a home 30 or community-based care setting. 31 j. k. “Legal representative” means a tenant’s legal 32 representative as defined in section 231B.1 or 231C.2 , or a 33 guardian, conservator, or attorney in fact of a resident. 34 k. l. “Long-term care facility” means a long-term care 35 -10- LSB 1225HV (2) 85 pf/nh 10/ 24

H.F. 278 unit of a hospital or a facility licensed under section 135C.1 1 whether the facility is public or private. 2 m. “Long-term care ombudsman” means an advocate for 3 residents and tenants of long-term care facilities, assisted 4 living programs, and elder group homes who carries out duties 5 as specified in this chapter. 6 l. n. “Older individual” means an individual who is sixty 7 years of age or older. 8 o. “Options counseling” means a service involving an 9 interactive process, which may include a needs assessment, 10 directed by the recipient individual and which may include 11 other participants of the individual’s choosing and the 12 individual’s legal representative, in which the individual 13 receives guidance to make informed choices about long-term 14 living services and supports in order to sustain independent 15 living. 16 m. p. “Resident” means a resident or tenant of an 17 individual residing in a long-term care facility, assisted 18 living program, or elder group home, excluding facilities 19 licensed primarily to serve persons with an intellectual 20 disability or mental illness. 21 q. “Tenant” means an individual who receives assisted living 22 services through an assisted living program or an individual 23 who receives elder group home services through an elder group 24 home. 25 n. r. “Unit of general purpose local government” means the 26 governing body of a city, county, township, metropolitan area, 27 or region within the state that has a population of one hundred 28 thousand or more, that is recognized for areawide planning, and 29 that functions as a political subdivision of the state whose 30 authority is general and not limited to only one function or 31 combination of related functions, or a tribal organization. 32 Sec. 19. Section 231.23A, subsection 2, Code 2013, is 33 amended to read as follows: 34 2. The senior internship older American community service 35 -11- LSB 1225HV (2) 85 pf/nh 11/ 24

H.F. 278 employment program. 1 Sec. 20. Section 231.23A, subsection 7, Code 2013, is 2 amended by striking the subsection. 3 Sec. 21. Section 231.32, Code 2013, is amended by adding the 4 following new subsection: 5 NEW SUBSECTION . 5. Upon designation, an area agency on 6 aging shall be considered an instrumentality of the state and 7 shall adhere to all state and federal mandates applicable to an 8 instrumentality of the state. 9 Sec. 22. Section 231.33, Code 2013, is amended by adding the 10 following new subsection: 11 NEW SUBSECTION . 21. Comply with all applicable 12 requirements of the Iowa public employees’ retirement system 13 established pursuant to chapter 97B. 14 Sec. 23. Section 231.41, Code 2013, is amended to read as 15 follows: 16 231.41 Purpose. 17 The purpose of this subchapter is to establish and provide 18 for the operation of the office of long-term care resident’s 19 advocate ombudsman; to carry out, through the office, a state 20 long-term care ombudsman program within the department in 21 accordance with the requirements of the federal Act , ; and to 22 adopt the supporting federal regulations and guidelines for its 23 operation. 24 Sec. 24. Section 231.42, Code 2013, is amended to read as 25 follows: 26 231.42 Office of long-term care resident’s advocate ombudsman 27 —— duties —— penalties for violations. 28 1. Office established. The office of long-term care 29 resident’s advocate ombudsman is established within the 30 department, in accordance with section 712 of the federal 31 Act, as codified at 42 U.S.C. § 3058g and state law . The 32 office shall consist of the state long-term care resident’s 33 advocate and ombudsman, any local long-term care resident’s 34 advocates ombudsmen, and any certified volunteer long-term care 35 -12- LSB 1225HV (2) 85 pf/nh 12/ 24

H.F. 278 ombudsmen . 1 2. State long-term care resident’s advocate ombudsman . The 2 director of the department shall appoint the state long-term 3 care resident’s advocate ombudsman who shall do all of the 4 following: 5 a. Establish and implement a statewide confidential 6 uniform reporting system for receiving, analyzing, referring, 7 investigating, and resolving complaints about administrative 8 actions and the health, safety, welfare, and rights of 9 residents or tenants of long-term care facilities, assisted 10 living programs, and elder group homes, excluding facilities 11 licensed primarily to serve persons with an intellectual 12 disability or mental illness. 13 b. Publicize the office of long-term care resident’s 14 advocate ombudsman and provide information and education to 15 consumers, the public, and other agencies about issues related 16 to long-term care in Iowa. 17 c. Monitor the development and implementation of federal, 18 state, and local laws, regulations, and policies that relate to 19 long-term care in Iowa. 20 d. Annually report to the governor and general assembly 21 on the activities of the office and make recommendations for 22 improving the health, safety, welfare, and rights of residents 23 and tenants of long-term care facilities, assisted living 24 programs, and elder group homes . 25 e. Cooperate with persons and public or private agencies 26 with regard to, and participate in, inquiries, meetings, 27 or studies that may lead to improvements in the health, 28 safety, welfare, and rights of residents and tenants and the 29 functioning of long-term care facilities, assisted living 30 programs, and elder group homes . 31 f. Recruit, train, educate, support, and monitor volunteers 32 associated with the office. 33 3. Local long-term care resident’s advocates ombudsmen . The 34 local long-term care resident’s advocates ombudsmen established 35 -13- LSB 1225HV (2) 85 pf/nh 13/ 24

H.F. 278 pursuant to this section shall do all of the following: 1 a. Accept, investigate, verify, and work to resolve 2 complaints , whether reported to or initiated by a long-term 3 care resident’s advocate, relating to any action or inaction 4 that may adversely affect the health, safety, welfare, or 5 rights of residents or tenants of a long-term care facility, 6 assisted living program, or elder group home . 7 b. Provide information about long-term care, the rights of 8 residents and tenants, payment sources for care, and selection 9 of a long-term care facility, assisted living program, or elder 10 group home to providers, consumers, family members, volunteers, 11 and the public. 12 c. Make referrals to appropriate licensing, certifying, and 13 enforcement agencies to assure appropriate investigation of 14 abuse complaints and corrective actions. 15 d. Assist in the recruitment, training , and education , 16 support, and monitoring of certified volunteers associated with 17 the office of the long-term care resident’s advocate ombudsman . 18 e. Make noncomplaint-related visits to long-term care 19 facilities, assisted living programs, and elder group homes 20 to observe daily routines, meals, and activities, and work to 21 resolve complaints if any are identified during these visits. 22 4. Referrals of abuse, neglect, or exploitation. 23 a. If abuse, neglect, or exploitation of a resident 24 or tenant of a long-term care facility, assisted living 25 program, or elder group home is suspected, the state or a 26 local long-term care resident’s advocate ombudsman shall, with 27 the permission of the resident or tenant as applicable under 28 federal law, make an immediate referral to the department of 29 inspections and appeals , or the department of human services as 30 applicable, and to , the department on aging, or the appropriate 31 law enforcement agency , as applicable . The state or a local 32 long-term care resident’s advocate ombudsman shall cooperate, 33 if requested, with the department of inspections and appeals, 34 department of human services, department on aging, or any law 35 -14- LSB 1225HV (2) 85 pf/nh 14/ 24

H.F. 278 enforcement agency pursuant to any investigation of such abuse, 1 neglect, or exploitation. 2 b. If the department of inspections and appeals responds 3 to a complaint referred by the state or a local long-term 4 care resident’s advocate ombudsman against a long-term care 5 facility, assisted living program, elder group home, or 6 an employee of such entity, copies of related inspection 7 reports, plans of correction, and notice of any citations and 8 sanctions levied against the facility, program, or home shall 9 be forwarded to the office of the long-term care resident’s 10 advocate ombudsman . 11 5. Access to long-term care facility, assisted living 12 program, or elder group home and residents and tenants . The 13 state or a local long-term care resident’s advocate ombudsman 14 or a trained certified volunteer may enter any long-term care 15 facility, assisted living program, or elder group home at any 16 time with or without prior notice or complaint and shall be 17 granted access to residents and tenants at all times for the 18 purpose of carrying out the duties specified in this section . 19 As used in this section , “access” means the right to do all of 20 the following: 21 a. Enter any long-term care facility, assisted living 22 program, or elder group home and provide identification. 23 b. Seek consent from the resident, tenant, or legal 24 representative to communicate privately and without restriction 25 with any resident , or tenant , or legal representative . 26 c. Communicate privately and without restriction with 27 any resident, tenant, or legal representative , or other 28 representative who consents to communication . 29 d. Review the clinical medical, social, or other records of 30 a resident or tenant. 31 e. Observe all resident or tenant areas of a long-term care 32 facility, assisted living program, or housing establishment 33 elder group home except the living area of any resident or 34 tenant who protests the observation. 35 -15- LSB 1225HV (2) 85 pf/nh 15/ 24

H.F. 278 6. Access to medical and personal social records. 1 a. The state or a local long-term care resident’s advocate 2 ombudsman shall have access to the medical and personal social 3 records of an individual who is a resident or tenant of a 4 long-term care facility, assisted living program, or elder 5 group home retained by the facility, program, or home. , if any 6 of the following applies: 7 (1) The state or local long-term care ombudsman or certified 8 volunteer long-term care ombudsman has the permission of the 9 resident or tenant, or the legal representative of the resident 10 or tenant. 11 (2) The resident or tenant is unable to consent to the 12 access and has no legal representative. 13 (3) Access to the records is necessary to investigate a 14 complaint if all of the following apply: 15 (a) A legal representative of the resident or tenant refuses 16 to give the permission. 17 (b) The state or local long-term care ombudsman or a 18 certified volunteer long-term care ombudsman has reasonable 19 cause to believe that the legal representative is not acting in 20 the best interest of the resident or tenant. 21 (c) The local long-term care ombudsman or a certified 22 volunteer long-term care ombudsman obtains the approval of the 23 state long-term care ombudsman. 24 b. Records may be reproduced by the state or a local 25 long-term care resident’s advocate ombudsman . 26 c. Upon request of the state or a local long-term care 27 resident’s advocate ombudsman , a long-term care facility, 28 assisted living program, or elder group home shall provide the 29 name, address, and telephone number of the legal representative 30 or next of kin of any resident or tenant. 31 d. A long-term care facility, assisted living program, or 32 elder group home or personnel of such a facility, program, or 33 home who discloses records in compliance with this section and 34 the procedures adopted pursuant to this section shall not be 35 -16- LSB 1225HV (2) 85 pf/nh 16/ 24

H.F. 278 liable for such disclosure. 1 7. Access to administrative records. 2 a. Pursuant to the federal Act, the state or a local 3 long-term care ombudsman or a certified volunteer shall have 4 access to the administrative records, policies, and documents 5 of the long-term care facility, assisted living program, or 6 elder group home, which are accessible to residents, tenants, 7 or the general public. 8 b. Pursuant to the federal Act, the state or a local 9 long-term care ombudsman or a certified volunteer shall have 10 access to, and upon request, copies of, all licensing and 11 certification records maintained by the state with respect to 12 a long-term care facility, assisted living program, or elder 13 group home. 14 7. 8. Interference prohibited —— penalties. 15 a. An officer, owner, director, or employee of a long-term 16 care facility, assisted living program, or elder group home who 17 intentionally prevents, interferes with, or attempts to impede 18 the work of the state or a local long-term care resident’s 19 advocate ombudsman or a certified volunteer is subject to a 20 penalty imposed by the director of not more than one thousand 21 five hundred dollars for each violation. If the director 22 imposes a penalty for a violation under this paragraph, 23 no other state agency shall impose a penalty for the same 24 interference violation. Any moneys collected pursuant to this 25 subsection shall be deposited in the general fund of the state. 26 b. The office of the long-term care resident’s advocate 27 ombudsman shall adopt rules specifying procedures for notice 28 and appeal of penalties imposed pursuant to this subsection . 29 c. The director, in consultation with the office of the 30 long-term care resident’s advocate ombudsman , shall notify 31 the county attorney of the county in which the long-term care 32 facility, assisted living program, or elder group home is 33 located, or the attorney general, of any violation of this 34 subsection . 35 -17- LSB 1225HV (2) 85 pf/nh 17/ 24

H.F. 278 8. 9. Retaliation prohibited —— penalties. An officer, 1 owner, director, or employee of a long-term care facility, 2 assisted living program, or elder group home shall not 3 retaliate against any person for having filed a complaint with, 4 or provided information to, the state or a local long-term 5 care resident’s advocate ombudsman or a certified volunteer . 6 A person who retaliates or discriminates in violation of this 7 subsection is guilty of a simple misdemeanor. 8 9. 10. Change in operations. A long-term care facility, 9 assisted living program, or elder group home shall inform the 10 office of the long-term care resident’s advocate ombudsman 11 in writing at least thirty days prior to any change in 12 operations, programs, services, licensure, or certification 13 that affects residents or tenants, including but not limited 14 to the intention to close, decertify, or change ownership. In 15 an emergency situation, or when a long-term care facility, 16 assisted living program, or elder group home is evacuated, the 17 department of inspections and appeals shall notify the office 18 of the state long-term care resident’s advocate ombudsman . 19 10. 11. Immunity. The state or a local long-term care 20 resident’s advocate ombudsman, certified volunteer, or any 21 representative of the office participating in the good faith 22 performance of their official duties shall have immunity from 23 any civil or criminal liability that otherwise might result by 24 reason of taking, investigating, or pursuing a complaint under 25 this section . 26 11. 12. Confidentiality. 27 a. Information relating to any complaint made to or 28 investigation by the state or a local long-term care resident’s 29 advocate ombudsman or certified volunteer that discloses the 30 identity of a complainant, resident, or tenant , or ; information 31 related to a resident’s or tenant’s personal social or medical 32 records , ; or files maintained by the state long-term care 33 ombudsman program that disclose the identity of a complainant, 34 resident, or tenant, shall remain confidential except as 35 -18- LSB 1225HV (2) 85 pf/nh 18/ 24