Department for Community Based Services

Standards of Practice Online Manual

20.7 Investigations in a Licensed Health Care Facility

Cabinet for Health and Family Services

Department for Community Based Services
Division of Protection and Permanency
Standards of Practice Online Manual
Chapter:
Chapter 20-APS Investigations and Assessment
Effective:
1/6/2017
Section:
20.7 Investigations in a Licensed Health Care Facility
Version:
6

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Legal Authority/Introduction

LEGAL AUTHORITY:

Procedure

When an investigation is conducted in a licensed health care facility that receives Medicaid/Medicare, the SSW: 

  1. Sends the DPP-115-Confidential Suspected Abuse/Neglect, Dependency or Exploitation Reporting Form to law enforcement, the Office of the Inspector General (OIG), the Medicaid Fraud and Abuse Control Division in the Office of the Attorney General and the state long term care ombudsman's office, county and commonwealth attorney;
  2. Is permitted to share preliminary findings and recommendations with representatives from all of the above named agencies;
  3. Sends a copy of the Notification of Protective Services Investigative Findings Reporting Form upon completion of the investigation to a representative of all the above named agencies; and
  4. Notifies the alleged perpetrator of the finding using the DPP-247 APS Unsubstantiated Investigation Notification Letter or DPP-248 Adult Protective Services Substantiated Investigation Notification Letter;
  5. Sends notice of the finding, via the DPP-248 APS Substantiated Investigation Notification to the perpetrator by certified mail;
  6. Sends a copy of the DPP-248 APS Substantiated Investigation Notification to:

    Office of the Ombudsman
    Performance Enhancement Branch
    Quality Assurance Section
    275 East Main Street, 1E-B
    Frankfort, KY 40621 

    Or via e-mail
    APS.Appeals@ky.gov
  7. Shares a copy of the full investigation upon a faxed, electronic or other written request from any of the above named agencies.

When an investigation is conducted in a licensed health care facility that does not receive Medicaid/Medicare, the SSW:

  1. Sends the DPP-115 to law enforcement, the Office of the Inspector General, Office of the Attorney General, county and commonwealth attorney and the state long term care ombudsman; 
  2. Is permitted to share preliminary findings and recommendations with representatives from all of the authorized agencies;
  3. Sends a copy of the Notification of Protective Services Investigative Findings Reporting Form upon completion of the investigation to a representative of all the above named sources;
  4. Notifies the alleged perpetrator of the finding using the DPP-247 APS Unsubstantiated Investigation Notification Letter or DPP-248 Adult Protective Services Substantiated Investigation Notification Letter;
  5. Sends notice of the finding, via the DPP-248 APS Substantiated Investigation Notification to the perpetrator: 
    1. By certified mail; or
    2. In person, with a witness signature to document that the perpetrator received the notice; 
  6. Sends a copy of the DPP-248 APS Substantiated Investigation Notification to:

    Office of the Ombudsman
    Performance Enhancement Branch
    Quality Assurance Section
    275 East Main Street, 1E-B
    Frankfort, KY 40621 

    Or via e-mail
    APS.Appeals@ky.gov


  7. Shares a copy of the full investigation upon a verbal, faxed or other written request from any of the above named agencies; and
  8. Submits a full copy of the investigation to the OIG, when abuse, neglect or exploitation is substantiated and a certified nurse aide is involved. 1  

Practice Guidance 

  • The Office of the Inspector General (OIG) licenses all Kentucky facilities that provide health care.  Many, but not all, of these licensed health care facilities receive Medicaid/Medicare funds. 
  • Facilities That Receive Medicaid/Medicare Funds include most:
    • Nursing facilities;
    • Hospitals;
    • Intermediate care facilities; and
    • Home health agencies. 
  • Facilities Not Receiving Medicaid/Medicare Funds:
    • Licensed health care facilities that do not receive Medicaid/Medicare funds include, but are not limited to:
      • Personal care homes; and
      • Family care homes.

 

 

Footnotes

  1. The OIG requires documentation of the investigation in order to enter the name of the alleged perpetrator to the alleged victim on the nurse aide abuse registry.

 

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