Long Term Care Investigation (LTCI) Steps

1. Accept the Referral.

Important: If the case priority is urgent, initial contact should be within 24 hours or sooner if the situation warrants (urgent cases should be immediately staffed with your supervisor to determine plan for response). Priority can be determined under Referral Details on the Report tab.

2. Review the specific situation reported and the reporter’s details. Pay attention to any safety concerns noted. Also, review the collaterals and relationship to AV.
   1. If needed, the reporter can be contacted to clarify any information in the specific situation reported.

3. Review the Notes specifically Screening Note. Look for Safety concerns regarding visit.

4. Review AV Vulnerabilities.

5. Research AV and AP details and update (seek training from supervisor)
   1. Research OSCN
   2. Research ODCR
   3. Research AVA
   4. Research IMS / Workflow / FACS / OnBase
   5. Research Harmony
   6. Research Google Maps

6. Plan your field visit.

7. Prepare Records Request.

8. Utilize your supervisor’s preferred method of contact to let them know that you are going into the field.

9. Drive to the Long-Term Care Facility. Upon arrival, contact Long Term Care facility authorities to make them aware of your presence in their facility.

10. Request to interview AV(s).
    1. If AV is available for interview, proceed to step 11.
    2. If AV is not available for interview, schedule a time to return to complete interview with AV at which time step 11 will be completed.

11. Interview AV and document interview. Things to consider during interview:
    1. Build rapport with client.
    2. Discuss reported concerns/address all allegations/complete capacity assessment tools.
    3. Ensure all listed AV(s) are interviewed. Continue to request interviews with AV(s) until all have been interviewed.

12. Once interviews with AV(s) have been completed, return to the Long-Term Care facility authority.
    1. If Long-Term Care facility authority is available for interview, proceed to Step 13.
    2. If Long-Term Care facility authority is not available, schedule a time for the interview and then at scheduled time return to step 13.

13. Interview the Long-Term Care facility authority and document interview.

14. Issue Records Request to Long-Term Care facility authority.

15. Prepare to interview AP(s).
    1. If AP(s) are at work on the date of visit and available for interview, proceed to Step 16.
    2. If AP(s) are not available for interview, schedule a time to interview AP(s).

Note: Things to consider when preparing to interview the AP(s)

• Determine the AP’s caretaker role based on what was reported.
• Review the allegations being investigated- Exploitation may require an interview later in the investigation if specialist needs to request bank records, documents, etc. 
• If the allegation is Caretaker Neglect or abuse, request home health, doctor, or hospital records, take pictures of injuries, bruising, etc. prior to interview.

16. Interview the AP(s).
    1. Determine AP’s caretaker role
    2. Address each allegation reported with AP
    3. Once the interview has been completed, specialist should document interview in AVA.
    4. Ensure all AP(s) have been interviewed

17. Determine if any collaterals need to be contacted. If so, continue to Step 17a. If no collaterals need to be contacted, proceed to Step 18.
    1. Determine which collaterals should be contacted. When talking with collaterals, the specialist should use caution in sharing only details that the collateral will be involved. Collaterals should only be contacted after visiting with the AV, unless contacting the reporter to locate AV. Once the interview is completed with collateral, the interview should be documented in AVA under the Interview tab.

18. Receive record request.
    1. Review the records that are received. Determine if follow up interviews or further records are needed.
    2. If more interviews or further records are needed, determine what is needed and proceed to obtaining the needed data and/or interviews. Documenting the interviews under the Interview tab in AVA and storing any data collected under the Files tab.

19. Create LTCI Report in AVA.

20. Complete the Findings. If findings are Substantiated, continue to Step 21. If findings are Unsubstantiated, skip to Step 22.

21. If the allegation is substantiated, mark the disposition Substantiated.

22. If the allegation is unsubstantiated, mark the disposition Unsubstantiated.

23. Complete the Allegation Finding narrative.

24. Review allegations. If they are complete, proceed to Step 25. If they are not complete, return to Step 20.

25. Submit complete allegations to the supervisor for approval. If allegations are approved, proceed to Step 26. If allegations are not approved, return to update allegations to make needed changes for approval.

26. Complete the Report Findings section: This is found on the Report tab of the referral in AVA.

Complete the Report Findings field to include Determination, Prosecution Recommendation, Routing, Medical Records, and LTCI Concerns.

27. Complete APS-2 and upload APS-2 and LTC report to referral under the Files tab.

28. Review referral to ensure that it is ready for submission to supervisor. Submit to supervisor for closure.

29. Supervisor will review referral for closure.
    1. If approved for closure, proceed to Step 30.
    2. If not approved for closure, proceed to steps related to needed information for approval. The supervisor will provide a note in the approval process regarding what is needed for referral to be approved for closure.

30. Once the referral is approved, the case record will be locked.

31. If allegations are substantiated or unsubstantiated, the following five letters are sent on all cases: Letter to Administrator, NOK (except in case of death), OSDH, Ombudsman and District Attorney.

32. If allegations are substantiated, in addition to above-referenced letters, send letter to the Licensing Board (i.e. Board of Nursing, CNA Registry, OSBELTCA, etc.)