Code of Massachusetts Regulations
101 CMR - EXECUTIVE OFFICE FOR HEALTH AND HUMAN SERVICES
Title 101 CMR 30.00 - Statewide Long-term Care Ombudsman Program
Section 30.11 - Access to Facilities and Related Records

Universal Citation: 101 MA Code of Regs 101.30

Current through Register 1518, March 29, 2024

(1) Right of Entry. The State Ombudsman or their designee will have the right of entry into any facility located in Massachusetts as necessary to carry out the duties of the Ombudsman Program. An ombudsman representative will have the right of entry into any facility within the geographic area assigned to a local ombudsman program with which the representative is associated as necessary to carry out the duties of the local ombudsman program. The right of entry includes the forms of access set forth below.

(2) Access to a Resident. The State Ombudsman and an ombudsman representative will have access to a consenting resident of a facility, in private, when the State Ombudsman or ombudsman representative determines it is necessary and reasonable for the purpose of:

(a) investigating and resolving complaints;

(b) interviewing residents; or

(c) offering the services of the Ombudsman Program to a resident.

(3) Access to a Facility. The State Ombudsman and ombudsman representatives may access a facility when they determine access is necessary and reasonable for the purpose of:

(a) investigating and resolving complaints;

(b) interviewing employees or agents of the facility;

(c) consulting regularly with the facility administrator; or

(d) providing services authorized by law or regulation.

(4) Access to Resident Records. The State Ombudsman and ombudsman representatives will have access to a resident's records and the records of a public agency as necessary to carry out their respective duties in the Ombudsman Program, including resident medical, social, and other records relating to a resident, and records concerning complaints, provided the resident or resident representative has communicated their informed consent to the Ombudsman Program to access to such records.

(5) Access to Contact Information. The State Ombudsman or ombudsman representative will have access to a resident representative's contact information if necessary to perform the functions and duties of the Ombudsman Program.

(6) Access to Resident Records if a Resident is Unable to Give Informed Consent. The State Ombudsman and ombudsman representative will have access to the records of a resident who is unable to give informed consent if access is necessary to perform the duties of the Ombudsman Program, provided:

(a) there is no resident representative, or a resident representative refuses permission and the State Ombudsman or the ombudsman representative has reasonable cause to believe the resident representative is not acting in the best interest of the resident; and

(b) the State Ombudsman authorizes access due to the circumstances.

(7) Access to Facility Policies. The State Ombudsman and ombudsman representatives will have access to the facility's administrative records, policies, and documents, to which the residents or the general public have access.

(8) HIPAA Requirements. The Health Insurance Portability and Accountability Act of 1996 (HIPAA) Privacy Rule does not preclude the release of health or identifying information to the Ombudsman Program, provided the Ombudsman Program received informed consent.

(9) Visitation Procedures. The State Ombudsman and ombudsman representative will make solicited or unsolicited visits to a resident of a facility. Solicited and unsolicited visits will proceed as follows.

(a) When entering a facility, the State Ombudsman, or ombudsman representative will notify staff of their presence and produce identification upon request by the staff.

(b) The State Ombudsman or ombudsman representative will be allowed to visit common areas of the facility and the doorway thresholds of the room(s) of a resident(s) without escort by facility personnel.

(c) Prior to entering the room of a resident(s), the State Ombudsman or ombudsman representative will knock on the door or door frame, identify themselves, and explain the purpose of the visit.

(d) The State Ombudsman or ombudsman representative may not enter the room(s) of a resident(s) unless the resident gives consent orally, in writing, or by a sign of affirmation by the resident.

(e) The facility will permit the State Ombudsman or ombudsman representative to enter a consenting resident's room without escort by facility personnel.

(f) During a visit to a resident's room, the State Ombudsman or ombudsman representative will respect the rights of other residents present in the room.

Disclaimer: These regulations may not be the most recent version. Massachusetts may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
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