Illinois Administrative Code
Title 89 - SOCIAL SERVICES
Part 270 - ADULT PROTECTION AND ADVOCACY SERVICES
Subpart B - LONG TERM CARE OMBUDSMAN PROGRAM
Section 270.142 - Access to Resident and Participant Information and Records
Universal Citation: 89 IL Admin Code ยง 270.142
Current through Register Vol. 48, No. 38, September 20, 2024
a) Ombudsmen and representatives of the Office shall have access to:
1) The name and contact information of the
resident's or participant's representative.
2) Administrative records, policies and
documents of long-term care facilities, medical assistance waiver services, and
managed care organizations to which residents, participants or the general
public has access.
3) Copies of all
licensing and certification records maintained by the State or long-term care
facility with respect to long-term care facilities.
4) A resident's or participant's medical,
social or other records relating to the resident or participant if:
A) The resident, participant or
representative communicates informed consent to the access and the consent is
given in writing or through the use of auxiliary aids and services;
B) The resident, participant or
representative communicates informed consent orally, visually or through the
use of auxiliary aids and services, and that consent is documented
contemporaneously by a representative of the Office in accordance with its
policies and procedures.
5) The Health Insurance Portability and
Accountability Act of 1996 (HIPPA) Privacy Rule ( 45 CFR 160 and 164), does
not preclude release by covered entities of resident or participant private
health information or other resident or participant identifying information to
the Ombudsman Program, including but not limited to residents' or participants'
medical, social or other records, a list of resident names and room numbers, or
information collected in the course of a State or federal survey or inspection
process. (See
45
CFR
1324.11(e)(2)(vii).)
b) In limited circumstances, the State Ombudsman or his/her designee may grant access to resident or participant records to investigate a complaint when:
1)
the resident or participant representative refuses to consent; and
2) a representative of the Office has
reasonable cause to believe that the resident's or participant's representative
is not acting in the best interests of the resident or participant.
c) Failure to provide access to records or information, in accordance with this Subpart, may result in a finding of willful interference.
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