{"text_format":"1","workbook":"xlsx","n_sheets":5,"sheets":["Rubric","Criteria","Summary","SummaryCode","Settings"],"not_rendered":{"charts":0,"images":4,"macros":1,"external_links":0,"defined_names":103,"comments":0,"pivot_tables":0},"unopened":[],"bounds":{"document_bytes":16777216,"sheet_cells":100000,"rows_first":2000,"rows_last":500,"rows_between":2000,"halvings":0,"cell_chars":16384,"cell_head_chars":4096},"cells_cut":0,"cells_raw":0,"read":"whole","date_system":"1900"}

{"sheet":"Rubric","index":0,"n_rows":86,"n_cols":32,"rows_kept":86,"cut":false,"hidden":false,"merged":[[0,19,0,23],[20,1,20,20],[19,1,19,20],[19,21,19,22],[19,23,19,24],[19,25,19,26],[0,2,0,4],[0,24,0,25],[1,24,1,25],[0,5,0,10],[1,5,1,10],[1,11,1,16],[0,11,0,16],[0,26,0,30],[1,17,1,18],[20,21,20,22],[7,27,7,28],[18,25,18,26],[16,25,16,26],[7,25,7,26],[17,27,17,28],[12,29,12,30],[9,29,9,30],[10,29,10,30],[40,25,40,26],[23,29,23,30],[29,29,29,30],[28,29,28,30],[31,27,31,28],[25,29,25,30],[26,29,26,30],[38,29,38,30],[27,29,27,30],[31,25,31,26],[32,29,32,30],[31,29,31,30],[30,29,30,30],[32,27,32,28],[39,29,39,30],[30,27,30,28],[37,25,37,26],[37,27,37,28],[25,27,25,28],[41,27,41,28],[46,29,46,30],[42,25,42,26],[41,25,41,26],[37,29,37,30],[38,27,38,28],[41,29,41,30],[35,29,35,30],[33,27,33,28],[33,29,33,30],[34,29,34,30],[40,27,40,28],[34,27,34,28],[35,25,35,26],[33,25,33,26],[45,25,45,26],[44,25,44,26],[44,27,44,28],[42,29,42,30],[43,29,43,30],[46,27,46,28],[38,25,38,26],[39,25,39,26],[39,27,39,28],[42,23,42,24],[43,27,43,28],[47,29,47,30],[42,27,42,28],[44,29,44,30],[45,29,45,30],[69,1,69,20],[69,21,69,22],[69,23,69,24],[69,25,69,26],[69,27,69,28],[55,1,55,20],[55,23,55,24],[58,21,58,22],[56,1,56,20],[56,23,56,24],[56,25,56,26],[56,27,56,28],[58,27,58,28],[55,21,55,22],[60,1,60,20],[58,1,58,20],[55,27,55,28],[56,21,56,22],[57,21,57,22],[78,17,78,20],[78,21,78,22],[78,23,78,24],[78,25,78,26],[78,27,78,28],[78,29,78,30],[75,1,75,20],[75,21,75,22],[75,23,75,24],[75,25,75,26],[75,27,75,28],[75,29,75,30],[76,1,76,20],[76,21,76,22],[76,23,76,24],[76,25,76,26],[76,27,76,28],[76,29,76,30],[74,29,74,30],[73,1,73,20],[73,21,73,22],[73,25,73,26],[73,27,73,28],[73,29,73,30],[77,1,77,20],[77,21,77,22],[77,23,77,24],[77,25,77,26],[77,27,77,28],[77,29,77,30],[74,1,74,20],[74,21,74,22],[74,23,74,24],[74,25,74,26],[74,27,74,28],[64,29,64,30],[69,29,69,30],[68,29,68,30],[65,25,65,26],[71,25,71,26],[71,27,71,28],[71,29,71,30],[72,1,72,20],[72,21,72,22],[72,23,72,24],[72,25,72,26],[72,27,72,28],[72,29,72,30],[71,1,71,20],[56,29,56,30],[51,21,51,22],[51,23,51,24],[54,25,54,26],[70,25,70,26],[70,27,70,28],[70,29,70,30],[67,29,67,30],[59,1,59,20],[59,23,59,24],[59,25,59,26],[59,27,59,28],[59,29,59,30],[59,21,59,22],[65,27,65,28],[66,1,66,20],[66,21,66,22],[68,21,68,22],[68,23,68,24],[68,25,68,26],[68,27,68,28],[67,23,67,24],[67,25,67,26],[67,27,67,28],[37,0,37,20],[39,21,39,22],[37,21,37,22],[37,23,37,24],[24,27,24,28],[51,27,51,28],[51,29,51,30],[60,21,60,22],[60,23,60,24],[60,25,60,26],[60,27,60,28],[60,29,60,30],[54,21,54,22],[54,23,54,24],[54,27,54,28],[54,29,54,30],[58,23,58,24],[58,25,58,26],[57,25,57,26],[57,27,57,28],[55,25,55,26],[58,29,58,30],[57,29,57,30],[55,29,55,30],[32,1,32,20],[31,23,31,24],[30,23,30,24],[32,23,32,24],[35,17,35,20],[35,23,35,24],[33,1,33,20],[33,21,33,22],[33,23,33,24],[11,29,11,30],[8,29,8,30],[7,1,7,20],[16,1,16,20],[18,1,18,20],[17,1,17,20],[17,21,17,22],[14,1,14,20],[14,21,14,22],[8,1,8,20],[8,21,8,22],[9,1,9,20],[15,1,15,20],[15,21,15,22],[13,1,13,20],[17,29,17,30],[18,23,18,24],[16,23,16,24],[18,29,18,30],[16,29,16,30],[17,25,17,26],[15,29,15,30],[7,29,7,30],[14,29,14,30],[6,1,6,20],[4,23,4,24],[5,23,5,24],[12,25,12,26],[12,27,12,28],[14,23,14,24],[15,25,15,26],[8,23,8,24],[8,25,8,26],[8,27,8,28],[9,27,9,28],[6,23,6,24],[6,27,6,28],[14,25,14,26],[14,27,14,28],[5,27,5,28],[5,25,5,26],[10,27,10,28],[12,23,12,24],[13,27,13,28],[6,29,6,30],[5,29,5,30],[4,29,4,30],[4,27,4,28],[4,25,4,26],[3,21,3,22],[3,23,3,24],[3,25,3,26],[3,27,3,28],[3,29,3,30],[3,0,3,20],[82,10,82,11],[82,8,82,9],[82,6,82,7],[6,25,6,26],[9,23,9,24],[9,25,9,26],[24,23,24,24],[24,25,24,26],[10,1,10,20],[10,21,10,22],[10,23,10,24],[10,25,10,26],[11,1,11,20],[11,21,11,22],[25,21,25,22],[26,1,26,20],[26,23,26,24],[4,1,4,20],[5,1,5,20],[71,21,71,22],[9,21,9,22],[46,25,46,26],[47,25,47,26],[88,10,88,11],[86,10,86,11],[85,10,85,11],[84,10,84,11],[83,10,83,11],[86,8,86,9],[85,8,85,9],[84,8,84,9],[83,8,83,9],[86,2,86,3],[83,21,83,30],[84,21,84,30],[85,21,85,30],[82,14,82,17],[82,21,82,30],[85,14,85,17],[84,14,84,17],[83,14,83,17],[85,18,85,20],[84,18,84,20],[83,18,83,20],[82,18,82,20],[86,4,86,5],[86,6,86,7],[85,1,85,5],[85,6,85,7],[84,1,84,5],[18,27,18,28],[16,27,16,28],[20,29,20,30],[19,27,19,28],[23,0,23,20],[23,21,23,22],[23,23,23,24],[23,25,23,26],[23,27,23,28],[21,17,21,20],[20,23,20,24],[20,25,20,26],[20,27,20,28],[21,29,21,30],[21,27,21,28],[21,25,21,26],[21,23,21,24],[24,1,24,20],[45,1,45,20],[27,21,27,22],[28,25,28,26],[35,27,35,28],[42,1,42,20],[42,21,42,22],[41,1,41,20],[30,25,30,26],[29,25,29,26],[45,21,45,22],[45,23,45,24],[44,21,44,22],[43,23,43,24],[43,21,43,22],[45,27,45,28],[43,25,43,26],[39,1,39,20],[39,23,39,24],[40,1,40,20],[40,23,40,24],[25,25,25,26],[30,1,30,20],[31,1,31,20],[87,6,87,7],[87,8,87,9],[87,10,87,11],[84,6,84,7],[83,6,83,7],[38,1,38,20],[38,23,38,24],[29,23,29,24],[28,23,28,24],[28,21,28,22],[29,21,29,22],[70,1,70,20],[70,21,70,22],[70,23,70,24],[71,23,71,24],[73,23,73,24],[46,1,46,20],[46,21,46,22],[46,23,46,24],[65,23,65,24],[52,21,52,22],[52,17,52,20],[57,1,57,20],[54,0,54,20],[52,23,52,24],[52,25,52,26],[52,27,52,28],[52,29,52,30],[50,29,50,30],[4,21,4,22],[5,21,5,22],[6,21,6,22],[7,21,7,22],[16,21,16,22],[18,21,18,22],[21,21,21,22],[24,21,24,22],[11,23,11,24],[15,23,15,24],[17,23,17,24],[7,23,7,24],[11,25,11,26],[11,27,11,28],[15,27,15,28],[13,21,13,22],[19,29,19,30],[29,27,29,28],[28,27,28,28],[47,1,47,20],[47,21,47,22],[48,29,48,30],[49,29,49,30],[50,23,50,24],[50,25,50,26],[49,23,49,24],[49,25,49,26],[47,23,47,24],[48,1,48,20],[48,21,48,22],[48,23,48,24],[48,25,48,26],[87,2,87,3],[87,4,87,5],[35,21,35,22],[38,21,38,22],[81,14,81,30],[61,17,61,20],[61,23,61,24],[61,25,61,26],[61,27,61,28],[61,29,61,30],[65,29,65,30],[66,29,66,30],[43,1,43,20],[44,1,44,20],[44,23,44,24],[68,1,68,20],[66,23,66,24],[66,25,66,26],[66,27,66,28],[61,21,61,22],[47,27,47,28],[51,1,51,20],[51,25,51,26],[48,27,48,28],[25,23,25,24],[41,21,41,22],[41,23,41,24],[29,1,29,20],[13,23,13,24],[83,1,83,5],[27,1,27,20],[26,25,26,26],[26,27,26,28],[27,23,27,24],[27,25,27,26],[27,27,27,28],[26,21,26,22],[64,21,64,22],[49,1,49,20],[64,0,64,20],[64,23,64,24],[64,25,64,26],[57,23,57,24],[49,27,49,28],[50,27,50,28],[50,21,50,22],[50,1,50,20],[49,21,49,22],[0,17,0,18],[24,29,24,30],[25,1,25,20],[67,1,67,20],[40,29,40,30],[40,21,40,22],[13,25,13,26],[13,29,13,30],[12,1,12,20],[12,21,12,22],[34,1,34,20],[34,21,34,22],[34,23,34,24],[34,25,34,26],[30,21,30,22],[31,21,31,22],[32,25,32,26],[32,21,32,22],[28,1,28,20],[1,26,1,30],[64,27,64,28],[65,1,65,20],[65,21,65,22],[67,21,67,22]]}
["Case #:",null,null,null,null,"Intake Ombudsman:",null,null,null,null,null,null,null,null,null,null,null,"Status:",null,null,null,null,null,null,"Date:"]
[null,null,null,null,null,"Assigned Ombudsman:",null,null,2,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Reviewer:"]
[]
["A.  Intake (Gateway representative)",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"Level0Name","v":"NA"},null,{"$f":"Level1Name","v":"Unacceptable"},null,{"$f":"Level2Name","v":"Essential"},null,{"$f":"Level3Name","v":"Exemplary"},null,"Comment",null,"Comments"]
["1. ","Complaint documented timely (e.g., date and method of contact accurately reported, date received is accurate).",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,false,null,false,null,false,null,false]
["2. ","Role of ombudsman positively explained, sufficient information obtained to determine conflicts of interest.  All conflicts fully revealed and documented as appropriate.",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,false,null,false,null,false,null,false]
["3. ","In determining response time for initiating investigation, representative analyzed urgency and determined response time commensurate with potential harm posed to client. ",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,false,null,false,null,false,null,false]
["4. ","Complaint(s) screen was accurately applied and documented (i.e., probable harm, COI, decline to investigate).",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,false,null,false,null,false,null,false]
["5. ","Consent to reveal complainant’s identity properly obtained and supported by narrative.",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,false,null,false,null,false,null,false]
["6. ","Ombudsman asked complainant probing questions to obtain relevant information (e.g., identify relevant people – who/what/when/how, impact on consumers, and underlying issues).",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,false,null,false,null,false,null,false]
["7. ","All complaints accurately identified and reported based on information received at intake (e.g., all complaints in narrative were coded with complaint statement and goal).",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,false,null,false,null,false,null,false]
["8. ","Each complaint included a clear and concise statement of the problem.",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,false,null,false,null,false,null,false]
["9. ","Each complaint had a measurable, achievable, and client-focused goal within the scope of the Office.",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,false,null,false,null,false,null,false]
["10.","Ombudsman identified and documented the complainant’s prior actions taken to resolve complaint(s).",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,false,null,false,null,false,null,false]
["11.","Ombudsman provided relevant information related to the complaints (e.g., complainant advised of residents’ rights, relevant regulations, ombudsman knowledge of facility, etc).",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,false,null,false,null,false,null,false]
["12.","Complainant advised of ombudsman process (i.e., applicable to all complaints) and options for handling the specific complaint including, but not limited to, empowering the client to handle the complaint directly with the provider, interviewing other residents, visiting at meal time, facilitating a plan of care meeting, referrals to various agencies, or educating the provider.",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,false,null,false,null,false,null,false]
["13.","Complainant aware of next steps, when they will occur, and by whom.  ",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,false,null,false,null,false,null,false]
["14.","Intake case note ends with next steps.  ",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,false,null,false,null,false,null,false]
["15.","Client-focused and positive customer service was provided – timely response, genuine desire to help expressed, assigned ombudsman (if different) notified timely of case.",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,false,null,false,null,false,null,false]
["16.","Intake ombudsman clearly documented whether or not a volunteer was assigned or available to assist with the case.",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,false,null,false,null,false,null,false]
["17.","Intake was documented contemporaneously.",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,false,null,false,null,false,null,false]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Area Totals:",null,null,null,{"$f":"IF( (COUNTIF(V5:W21, TRUE)*1) > 0, 17-(COUNTIF(V5:W21, TRUE)*1), \"17\")","v":"17"},null,{"$f":"IF( (COUNTIF(X5:Y21, TRUE)*Level1Points) > 0, COUNTIF(X5:Y21, TRUE)*Level1Points, \"\")","v":""},null,{"$f":"IF( (COUNTIF(Z5:AA21, TRUE)*Level2Points) > 0, COUNTIF(Z5:AA21, TRUE)*Level2Points, \"\")","v":""},null,{"$f":"IF( (COUNTIF(AB5:AC21, TRUE)*2) > 0, COUNTIF(AB5:AC21, TRUE)*Level3Points, \"\")","v":""},null,{"$f":"SUM(AreaATotalsNew)","v":0}]
[]
["B.  Consumer Driven (Assigned Representative)",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"Level0Name","v":"NA"},null,{"$f":"Level1Name","v":"Unacceptable"},null,{"$f":"Level2Name","v":"Essential"},null,{"$f":"Level3Name","v":"Exemplary"},null,"Comment",null,"Comments"]
["1. ","Face-to-face interview with client was completed.",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,false,null,false,null,false,null,false]
["2. ","Ombudsman determined client’s capacity and acted accordingly.",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,false,null,false,null,false,null,false]
["3. ","Ombudsman shared information from intake in accordance with complainant’s consent, obtained complaint statements and measurable goals (if different), and identified new complaints and consumer-focused goals as appropriate.  ",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,false,null,false,null,false,null,false]
["4. ","Consent to reveal client’s identity properly obtained and supported by narrative.",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,false,null,false,null,false,null,false]
["5. ","Ombudsman asked client probing questions to obtain relevant information (e.g., identify relevant people – who/what/when/how, impact on consumers and underlying issues).",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,false,null,false,null,false,null,false]
["6. ","Client advised of ombudsman process (i.e., applicable to all complaints) and options for handling the specific complaint including, but not limited to, empowering the client to handle the complaint directly with the provider, interviewing other residents, visiting at meal time, facilitating a plan of care meeting, referrals to various agencies, or educating the provider.",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,false,null,false,null,false,null,false]
["7. ","Client goals were driving force for advocacy efforts.  Ombudsman representative focused on attaining consumer satisfaction.  ",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,false,null,false,null,false,null,false]
["8. ","Client and representative were included in complaint handling process, ongoing communication about the status of client’s goals was part of the action plan.  ",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,false,null,false,null,false,null,false]
["9. ","The ombudsman analyzed data and information and developed an action plan for investigation, resolution, and follow-up in conjunction with the client.  The action plan included timelines.",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,false,null,false,null,false,null,false]
["10.","Good customer service was provided – timely response, genuine desire to help expressed.",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,false,null,false,null,false,null,false]
["11.","Ombudsman adherence to the Ombudsman Code of Ethics was supported by actions (e.g., did not advise on guardianship, advocated against locked units, did not advise on discharge, etc).",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,false,null,false,null,false,null,false]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Area Totals:",null,null,null,{"$f":"IF( ((COUNTIF(V25:W35, TRUE))*1) > 0, 11-((COUNTIF(V25:W35, TRUE))*1), \"11\")","v":"11"},null,{"$f":"IF( ((COUNTIF(X25:Y35, TRUE))*Level1Points) > 0, (COUNTIF(X25:Y35, TRUE))*Level1Points, \"\")","v":""},null,{"$f":"IF( ((COUNTIF(Z25:AA35, TRUE))*Level2Points) > 0, (COUNTIF(Z25:AA35, TRUE))*Level2Points, \"\")","v":""},null,{"$f":"IF( ((COUNTIF(AB25:AC35, TRUE))*Level3Points) > 0, (COUNTIF(AB25:AC35, TRUE))*Level3Points, \"\")","v":""},null,{"$f":"SUM(AreaBTotalsNew)","v":0}]
[]
["C. Ombudsman Approach to Problem Solving (Assigned representative)",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"Level0Name","v":"NA"},null,{"$f":"Level1Name","v":"Unacceptable"},null,{"$f":"Level2Name","v":"Essential"},null,{"$f":"Level3Name","v":"Exemplary"},null,"Comment",null,"Comments"]
["1. ","Response time was appropriate to complaint(s) (e.g., date started was appropriate to complaint).",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,false,null,false,null,false,null,false]
["2. ","Ombudsman familiarity with provider was evident and/or they  analyzed data prior to initial visit (i.e., familiarized self with recent history, activity, data, and reports) and handled complaints in context of ombudsman knowledge of and relationship with provider.",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,false,null,false,null,false,null,false]
["3. ","Ombudsman visited site where services are delivered and deployed effective investigative strategies appropriate to the complaint (i.e., observations, interviews, record review, etc.)",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,false,null,false,null,false,null,false]
["4. ","The ombudsman conducted investigative interviews with appropriate parties including other consumers.  Interviewees are identified by name.",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,false,null,false,null,false,null,false]
["5. ","The ombudsman asked appropriate probing questions in an attempt to identify the root cause and extent of problems.",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,false,null,false,null,false,null,false]
["6. ","The action plan and pace of activity was appropriate to the complaint(s).",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,false,null,false,null,false,null,false]
["7. ","There were no gaps in activity that unnecessarily delayed resolution (e.g., planned delays were not arbitrary or reflective of time management issues but were appropriate to the complaint).",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,false,null,false,null,false,null,false]
["8. ","The ombudsman sought independent verification of facts presented by the provider and others.",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,false,null,false,null,false,null,false]
["9. ","All complaints were identified and documented during the course of handling the case.",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,false,null,false,null,false,null,false]
["10.","Representative made an appropriate decision regarding review of client records (i.e., records were only reviewed if imperative to investigation or resolution of complaint).",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,false,null,false,null,false,null,false]
["11.","Referral were appropriate (e.g., law enforcement, ODH, ODMHAS, legal services, etc.).  The ombudsman only referred complaints for resolution when all appropriate and necessary efforts by the ombudsman have been exhausted.  ",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,false,null,false,null,false,null,false]
["12.","Ombudsman took assertive action in pursuit of client’s goals (i.e., made sure things were happening rather than waiting for them to happen, took charge of action plan rather than waiting for things to self-resolve).",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,false,null,false,null,false,null,false]
["13.","Follow-up was done to determine if resolution remained effective (i.e., timed and appropriate to the complaint).",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,false,null,false,null,false,null,false]
["14.","Ombudsman sought opportunities to improve care for all residents.  Ombudsman helped put systems in place that will benefit resident’s long term.",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,false,null,false,null,false,null,false]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Area Totals:",null,null,null,{"$f":"IF( (COUNTIF(V39:W52, TRUE)*1) > 0, 14-(COUNTIF(V39:W52, TRUE)*1), \"14\")","v":"14"},null,{"$f":"IF( (COUNTIF(X39:Y52, TRUE)*Level1Points) > 0, COUNTIF(X39:Y52, TRUE)*Level1Points, \"\")","v":""},null,{"$f":"IF( (COUNTIF(Z39:AA52, TRUE)*Level2Points) > 0, COUNTIF(Z39:AA52, TRUE)*Level2Points, \"\")","v":""},null,{"$f":"IF( (COUNTIF(AB39:AC52, TRUE)*Level3Points) > 0, COUNTIF(AB39:AC52, TRUE)*Level3Points, \"\")","v":""},null,{"$f":"SUM(AreaCTotalsNew)","v":0}]
[]
["D.  Volunteer Engagement (Assigned representative)",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"Level0Name","v":"NA"},null,{"$f":"Level1Name","v":"Unacceptable"},null,{"$f":"Level2Name","v":"Essential"},null,{"$f":"Level3Name","v":"Exemplary"},null,"Comment",null,"Comments"]
["1. ","Ombudsman documented whether a volunteer was assigned or was available to assist with complaint.  (If it was documented as yes, select essential and answer D2-D6.  If it was documented as no, select essential then select NA for D2-D6.  If it was not documented, select unacceptable then select NA for questions D2-D6)",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,false,null,false,null,false,null,false]
["2. ","Ombudsman engages volunteer throughout investigation, resolution, and follow-up (i.e., more than notification, ombudsman engages volunteer to participate and provide ombudsman services relevant to the complaint).  ",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,false,null,false,null,false,null,false]
["3. ","Ombudsman initiates communication, direction, and support throughout the case (e.g., tasks and communication with volunteer are part of the action plan).   Ombudsman provides sufficient information and technical assistance for the volunteer to carry out requested tasks.",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,false,null,false,null,false,null,false]
["4. ","Ombudsman took appropriate action to ensure volunteer performs agreed upon actions and reports back within established timeframes.",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,false,null,false,null,false,null,false]
["5. ","Ombudsman documents whether or not a volunteer is assigned or available to assit with complaint. All interaction and attempted interaction with volunteer is documented and if/when a volunteer is not available, this is documented in the case detail.",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,false,null,false,null,false,null,false]
["6. ","Activity performed by a volunteer was summarized in case notes (not attached) and is accurately reported under volunteer's name.",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,false,null,false,null,false,null,false]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Area Totals:",null,null,null,{"$f":"IF( (COUNTIF(V56:W61, TRUE)*1) > 0, 6-(COUNTIF(V56:W61, TRUE)*1), \"6\")","v":"6"},null,{"$f":"IF( (COUNTIF(X56:Y61, TRUE)*Level1Points) > 0, COUNTIF(X56:Y61, TRUE)*Level1Points, \"\")","v":""},null,{"$f":"IF( (COUNTIF(Z56:AA61, TRUE)*Level2Points) > 0, COUNTIF(Z56:AA61, TRUE)*Level2Points, \"\")","v":""},null,{"$f":"IF( (COUNTIF(AB56:AC61, TRUE)*Level3Points) > 0, COUNTIF(AB56:AC61, TRUE)*Level3Points, \"\")","v":""},null,{"$f":"SUM(AreaDTotalsNew)","v":0}]
[]
[]
["E.  Documentation Compliance (Assigned representative)",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"Level0Name","v":"NA"},null,{"$f":"Level1Name","v":"Unacceptable"},null,{"$f":"Level2Name","v":"Essential"},null,{"$f":"Level3Name","v":"Exemplary"},null,"Comment",null,"Comments"]
["1. ","Documentation was consistently contemporaneous as identified in ombudsman rules or RP policy.",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,false,null,false,null,false,null,false]
["2. ","The documentation was clear, understandable, and reflected a clear chronology of events (i.e., documentation stands on its own and included who, what, when, where, and how).",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,false,null,false,null,false,null,false]
["3. ","Ombudsman documented activity by day or as appropriate to the activity (i.e., activities that occurred on different dates are not lumped into one note).",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,false,null,false,null,false,null,false]
["4. ","Required demographic information is obtained.",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,false,null,false,null,false,null,false]
["5. ","Consent is clearly supported by narrative.",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,false,null,false,null,false,null,false]
["6. ","Deviations are included in documentation as appropriate.",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,false,null,false,null,false,null,false]
["7. ","Complaint types are accurate.",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,false,null,false,null,false,null,false]
["8. ","Selected verification was supported by narrative.",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,false,null,false,null,false,null,false]
["9. ","Selected status was supported by narrative.",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,false,null,false,null,false,null,false]
["10.","Date started is correct.",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,false,null,false,null,false,null,false]
["11.","Date closed is correct.",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,false,null,false,null,false,null,false]
["12.","The administrative or legal assistance remedy selected at closing was accurate and supported by narrative.",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,false,null,false,null,false,null,false]
["13.","Closing summary is complete (e.g., summarizes outcome and supports decision to close complaint).  ",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,false,null,false,null,false,null,false]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Area Totals:",null,null,null,{"$f":"IF( (COUNTIF(V66:W78, TRUE)*1) > 0, 13-(COUNTIF(V66:W78, TRUE)*1), \"13\")","v":"13"},null,{"$f":"IF( (COUNTIF(X66:Y78, TRUE)*Level1Points) > 0, COUNTIF(X66:Y78, TRUE)*Level1Points, \"\")","v":""},null,{"$f":"IF( (COUNTIF(Z66:AA78, TRUE)*Level2Points) > 0, COUNTIF(Z66:AA78, TRUE)*Level2Points, \"\")","v":""},null,{"$f":"IF( (COUNTIF(AB66:AC78, TRUE)*Level3Points) > 0, COUNTIF(AB66:AC78, TRUE)*Level3Points, \"\")","v":""},null,{"$f":"SUM(AreaETotalsNew)","v":0}]
[]
[]
[]
[null,null,null,null,null,null,"Total Points",null,"Max Points",null,"Score",null,null,null,"Assessment",null,null,null,"Score Range",null,null,"Summary"]
[null,"Intake Score",null,null,null,null,{"$f":"AD22","v":0},null,50.5,null,{"$f":"IF(G84+I84=0,0,ROUND(G84/I84,2))","v":0},null,null,null,{"$f":"Level1Name","v":"Unacceptable"},null,null,null,{"$f":"CONCATENATE(TEXT(Level1MinScore,\"0%\"),\"—\",TEXT(Level1MaxScore,\"0%\"))","v":"0%—60%"},null,null,"Ombudsman services do not comply with requirements."]
[null,"Assigned Score",null,null,null,null,{"$f":"SUM(AD36,AD53,AD62,AD79)","v":0},null,131.5,null,{"$f":"ROUND(G85/I85,2)","v":0},null,null,null,{"$f":"Level2Name","v":"Essential"},null,null,null,{"$f":"CONCATENATE(TEXT(Level2MinScore,\"0%\"),\"—\",TEXT(Level2MaxScore,\"0%\"))","v":"61%—84%"},null,null,"Ombudsman services meet or sometimes exceed requirements and expectations."]
[null,"Total Score",null,null,null,null,{"$f":"SUM(AD22,AD36,AD53,AD62,AD79)","v":0},null,182,null,{"$f":"IF(G86+I86=0,0,ROUND(G86/I86,2))","v":0},null,null,null,{"$f":"Level3Name","v":"Exemplary"},null,null,null,{"$f":"CONCATENATE(TEXT(Level3MinScore,\"0%\"),\" and \",TEXT(Level3MaxScore,\"0%\"))","v":"85% and above"},null,null,"Ombudsman services often exceed requirements and expectations."]

{"sheet":"Criteria","index":1,"n_rows":6,"n_cols":4,"rows_kept":6,"cut":false,"hidden":false,"merged":[]}
[null,"Unacceptable","Essential Practices","Exemplary"]
["A.\n\nIntake\n","The representative failed to obtain a clear problem statement and goal for each complaint expressed.\n\nThe intake narrative had gaps in information, such that the assigned representative needed to complete the intake prior to initiating investigation.\n\nConsent was not obtained per rule OAC 173-14-16.\n\nThe representative did not educate on LTCOP process, options, or what to expect next and when.\n\nThe representative failed to identify a conflict of interest or probable harm.\n","The representative advised of consumer rights, options for resolving complaints with the provider, and the role of the Long-Term Care Representative Program (LTCOP).\n\nThe representative screened for probable harm and conflict of interest.\n\nThe representative obtained a clear problem statement and measureable goal, within the scope of the (LTCOP), for every complaint expressed.\n\nThe representative asked probing questions to identify relevant people involved, impact on consumers, chronology of events, and prior actions taken to this point to try and resolve. \n\nThe representative explained the LTCOP investigative process, and possible next steps in investigation.  Representative explained what to expect next from the LTCOP and when.\n\nThe representative obtained consent per rule OAC 173-14-16.\n\nThe representative concluded the entry with an action plan, taking into consideration the urgency of the complaint; the method of advising the assigned representative of the new case; and the availability of volunteer coverage.\n\nThe representative used education to empower those complainants who demonstrate the ability and desire to participate in, or lead, the attempts to resolve the complaint.  \n","The representative expressed a clear desire to help throughout the dialog with the complainant.\n\nThe representative used established rapport with the complainant to assuaged any fears voiced during the intake, and laid the groundwork for visible engagement of the complainant in the complaint-handling process.\n\nThe representative demonstrated a comprehensive understanding of the LTCOP role and process; rules and regulations; and knowledge of the provider to articulate a full range of options to resolve the complaints with the provider.\n\nThe intake narrative enabled the assigned representative to swiftly initiate investigation without repeating any required component of the intake.\n\nThe representative used knowledge of resident rights to educate and embolden the complainant to expect excellence in the service and supports from the long-term care provider.   \n"]
["B.\n\nConsumer\nDriven\n","The representative did not meet with consumer face-to-face, to provide education and empowerment, or ascertain his/her wishes when separate from the complainant’s.\n\nThe representative failed to obtain consent per rule OAC 173-14-16, or protect the confidentiality of the consumer as requested.\n\nRepresentative did not engage the consumer or the representative in the complaint-handling process, or proposed resolution strategies that were contrary to the consumer’s wishes.\n\nRepresentative did not demonstrate a desire to attain consumer satisfaction and advocacy did not promote the consumer’s rights, individuality or autonomy.\n\n","The representative meets face-to-face with the consumer, and makes every reasonable effort to ascertain and act in accordance with the consumer’s wishes. \n\nThe representative views the consumer, regardless of pathology or limitation, as valuable, resourceful and resilient, and promoted autonomy and quality of life.\n\nThe representative demonstrated the ability to empathize with the concerns of the consumer and/or representative and ensured that their voice was heard.\n\nThe representative provided advocacy services unrestricted by his/her personal belief or opinion, and demonstrated a desire to attain consumer satisfaction.\n\nThe representative educated consumer about rights and regulations as appropriate.  The representative advised the consumer of options for resolving the complaint with the provider.  The representative used education to empower those clients who demonstrate the ability and desire to participate in, or lead, the attempts to resolve the complaint.\n\nThe representative obtained consumer consent (written) and communicated and consulted with the consumer or their representative throughout the complaint handling process. \n\nThe representative acted to protect vulnerable individuals from abuse and neglect, and participated in efforts to promote a quality, long-term care system.\n\n","The representative displayed competent interviewing skills when the consumer has cognitive impairment, and artfully identified the consumer’s wishes, goals, and chosen sponsor despite the limits on his/her capacity.\n\nThe representative used the established rapport to creatively bridge barriers presented by the consumer’s request to remain anonymous during the complaint-handling process. \n\nThe representative engaged the consumer in the complaint-handling process using holistic approaches which capitalized on the consumer’s strengths. The consumer was empowered to take a new and active approach to working with the provider(s) of service.\n\nThe representative successfully challenged decisions driven by surplus safety, and used individualized care planning for resident choice and the right to the dignity of risk. The representative facilitated a supportive network for the consumer that enabled the right to autonomy and self-determination without the undo oversight of guardianship.  \n"]
["C.\n\nRepresentative\nApproach\nto Problem\nSolving\n","The representative failed to identify and resolve conflicts of interest.\n\nThe representative did not identify relevant participants, conduct interviews, or make observations.  The representative did not review information in preparation for, or during, the investigation.\n\nThe representative approach was not effective in achieving the consumer’s goal, or resulted in an adversarial interaction with the provider or consumer.\n\nThe representative conducted an unnecessary review of the consumer’s records.\n\nThe representative closed the case without notification to the consumer or the representative, or without adequate follow-up to ensure the resolution was effective.\n","The representative took assertive action throughout the complaint-handling process, including initiating investigation based on the urgency of the complaint and the probability of harm.\n\nThe representative conducted a quality investigation by; reviewing relevant data prior to starting the case, and throughout investigation; interviewing other residents, pertinent staff, and family members, and identifying them by name; and making observations that are relevant to the complaint.  Action steps with timelines are identifiable which illuminated the thought process or strategies used for complaint investigation and resolution.\n\nThe representative demonstrated critical thinking while analyzing the information obtained during investigation to identify the root cause of the problem.\n\nThe representative demonstrated initiative and desire to broaden knowledge by researching applicable regulation, law and educational materials. Furthermore, the representative used these resources to strengthen advocacy.\n\nRepresentative proposed resolution strategies that addressed the root cause of the problem and put systems in place to benefit all residents long term.  The representative employed education, empowerment, negotiation, brokering, medication, referral, and legal remedies as appropriate.\n\nThe representative conducted follow-up activities to ensure the resolution strategies remained effective.\n","The representative’s approach to problem solving demonstrated creativity and imagination, challenging conventional practices. \n\nAdvocacy efforts produced tangible and positive results which advance overall service and care delivery, promoting long-term, person-centered and person-directed attention.\n\nThe representative’s working relationship with the provider promotes the integrity of the LTCOP, resulting in an eager desire for collaborative resolution.\n\nThe representative used knowledge of consumer rights to identify and engage partners in resolution. Examples include, but are not limited to, legal services, government service agencies, and social service agencies. \n\nThe representative consults with, and makes referrals to, condition-specific organizations (Alzheimer’s Association, MS Society, Ohio Valley Center for Brain Injury, Spinal Cord Injury Association) to elevate the expertise of the representative’s advocacy.\n\nThe representative strengthened existing processes in place through the course of complaint-handling.  Examples include the care planning process, the grievance process, and resident council.\n\nThe representative brings together all the disciplines involved with the consumer to orchestrate their efforts toward achieving resolution in a manner that is sustainable beyond the conclusion of the case.\n"]
["D.\n\nVolunteer\nEngagement\n","The representative completed the complaint handling process without notifying or collaborating with the volunteer, when a volunteer is available.","The representative informed the volunteer of the complaint and when available, engaged the volunteer (within their scope of certification) in the complaint handling process which included; investigation, resolution and follow-up.\n\nThe representative provided instruction and technical assistance to the volunteer and included this in the case record.  \n\nTimelines for volunteer activity were established, communicated, and followed.\n\n","The representative recognized the value of volunteer engagement and developed collaborative, creative strategies which promoted enhancement of the volunteer’s skills through mentorship and technical assistance.\n\n"]
["E.\n\nDocumentation/\nCompliance\nwith\nODIS\nInstructions\n","Activity is documented beyond the limits of RP policy. \n\nThe reader does not have a clear picture of advocacy efforts and compliance with ODIS instructions is not demonstrated.\n\nThe documentation extensive contains technical errors, typing errors, or inconsistencies.  \n","The documentation is completed within five business days of the activity.\n\nThe documentation is accurate and concise, and reflects a clear chronology of events.\n\nThe documentation answers six questions, who, what, where, when, how, and stands on its own without verbal explanation.  \n\nThe representative obtained relevant demographic information regarding resident, complainant and legal representative.\n\nThe representative uses only standard or representative defined abbreviations.\n\nThe representative documented volunteer engagement and activity appropriately.  \n\nThe representative obtained all required case details as required in ODIS instructions which includes, but is not limited to, appropriate complaint codes, status codes, verification, sub-types as appropriate, and selections can be supported in case detail. \n\nThe closing summary identifies the outcome, and supports the decision to close the complaint.\n","The writer demonstrates remarkable clarity and consistency. \n\nThe documentation masterfully provides the “whole picture” in a summary.\n\nThe case details are complete, and every pertinent field contains details to fulfill its intended purpose.  Documents received during the course of case-handling are attached to the case.  The completeness of the documentation provides the reviewer with the information necessary to achieve understanding equivalent to the representative assigned. \n"]

{"sheet":"Summary","index":2,"n_rows":95,"n_cols":8,"rows_kept":95,"cut":false,"hidden":false,"merged":[]}
[null,"Case #",null,null,null,null,null,0]
[null,"Intake Ombudsman:",null,null,null,null,null,0]
[null,"Assigned Ombudsman:",null,null,null,null,null,0]
[null,"Status:",null,null,null,null,null,0]
[null,"Date:",null,null,null,null,null,"00:00:00"]
[null,"Reviewer:",null,null,null,null,null,0]
[]
[]
[null,"A.  Intake (Gateway representative)","NA","Un","Es","Ex","C","Comments"]
[1,"Complaint documented timely (e.g., date and method of contact accurately reported, date received is accurate).","","","","",""]
[2,"Role of ombudsman positively explained, sufficient information obtained to determine conflicts of interest.  All conflicts fully revealed and documented as appropriate.","","","","","",0]
[3,"In determining response time for initiating investigation, representative analyzed urgency and determined response time commensurate with potential harm posed to client. ","","","","","",0]
[4,"Complaint(s) screen was accurately applied and documented (i.e., probable harm, COI, decline to investigate).","","","","","",0]
[5,"Consent to reveal complainant’s identity properly obtained and supported by narrative.","","","","","",0]
[6,"Ombudsman asked complainant probing questions to obtain relevant information (e.g., identify relevant people – who/what/when/how, impact on consumers, and underlying issues).","","","","","",0]
[7,"All complaints accurately identified and reported based on information received at intake (e.g., all complaints in narrative were coded with complaint statement and goal).","","","","","",0]
[8,"Each complaint included a clear and concise statement of the problem.","","","","","",0]
[9,"Each complaint had a measurable, achievable, and client-focused goal within the scope of the Office.","","","","","",0]
[10,"Ombudsman identified and documented the complainant’s prior actions taken to resolve complaint(s).","","","","","",0]
[11,"Ombudsman provided relevant information related to the complaints (e.g., complainant advised of residents’ rights, relevant regulations, ombudsman knowledge of facility, etc).","","","","","",0]
[12,"Complainant advised of ombudsman process (i.e., applicable to all complaints) and options for handling the specific complaint including, but not limited to, empowering the client to handle the complaint directly with the provider, interviewing other residents, visiting at meal time, facilitating a plan of care meeting, referrals to various agencies, or educating the provider.","","","","","",0]
[13,"Complainant aware of next steps, when they will occur, and by whom.  ","","","","","",0]
[14,"Intake case note ends with next steps.  ","","","","","",0]
[15,"Client-focused and positive customer service was provided – timely response, genuine desire to help expressed, assigned ombudsman (if different) notified timely of case.","","","","","",0]
[16,"Intake ombudsman clearly documented whether or not a volunteer was assigned or available to assist with the case.","","","","","",0]
[17,"Intake was documented contemporaneously.","","","","","",0]
[]
[]
[null,"B. Consumer Driven (Assigned Representative)","NA","Un","Es","Ex","C","Comments"]
[1,"Face-to-face interview with client was completed.","","","","","",0]
[2,"Ombudsman determined client’s capacity and acted accordingly.","","","","","",0]
[3,"Ombudsman shared information from intake in accordance with complainant’s consent, obtained complaint statements and measurable goals (if different), and identified new complaints and consumer-focused goals as appropriate.  ","","","","","",0]
[4,"Consent to reveal client’s identity properly obtained and supported by narrative.","","","","","",0]
[5,"Ombudsman asked client probing questions to obtain relevant information (e.g., identify relevant people – who/what/when/how, impact on consumers and underlying issues).","","","","","",0]
[6,"Client advised of ombudsman process (i.e., applicable to all complaints) and options for handling the specific complaint including, but not limited to, empowering the client to handle the complaint directly with the provider, interviewing other residents, visiting at meal time, facilitating a plan of care meeting, referrals to various agencies, or educating the provider.","","","","","",0]
[7,"Client goals were driving force for advocacy efforts.  Ombudsman representative focused on attaining consumer satisfaction.  ","","","","","",0]
[8,"Client and representative were included in complaint handling process, ongoing communication about the status of client’s goals was part of the action plan.  ","","","","","",0]
[9,"The ombudsman analyzed data and information and developed an action plan for investigation, resolution, and follow-up in conjunction with the client.  The action plan included timelines.","","","","","",0]
[10,"Good customer service was provided – timely response, genuine desire to help expressed.","","","","","",0]
[11,"Ombudsman adherence to the Ombudsman Code of Ethics was supported by actions (e.g., did not advise on guardianship, advocated against locked units, did not advise on discharge, etc).","","","","","",0]
[]
[]
[null,"C. Ombudsman Approach to Problem Solving (Assigned representative)","NA","Un","Es","Ex","C","Comments"]
[1,"Response time was appropriate to complaint(s) (e.g., date started was appropriate to complaint).","","","","","",0]
[2,"Ombudsman familiarity with provider was evident and/or they  analyzed data prior to initial visit (i.e., familiarized self with recent history, activity, data, and reports) and handled complaints in context of ombudsman knowledge of and relationship with provider.","","","","","",0]
[3,"Ombudsman visited site where services are delivered and deployed effective investigative strategies appropriate to the complaint (i.e., observations, interviews, record review, etc.)","","","","","",0]
[4,"The ombudsman conducted investigative interviews with appropriate parties including other consumers.  Interviewees are identified by name.","","","","","",0]
[5,"The ombudsman asked appropriate probing questions in an attempt to identify the root cause and extent of problems.","","","","","",0]
[6,"The action plan and pace of activity was appropriate to the complaint(s).","","","","","",0]
[7,"There were no gaps in activity that unnecessarily delayed resolution (e.g., planned delays were not arbitrary or reflective of time management issues but were appropriate to the complaint).","","","","","",0]
[8,"The ombudsman sought independent verification of facts presented by the provider and others.","","","","","",0]
[9,"All complaints were identified and documented during the course of handling the case.","","","","","",0]
[10,"Representative made an appropriate decision regarding review of client records (i.e., records were only reviewed if imperative to investigation or resolution of complaint).","","","","","",0]
[11,"Referral were appropriate (e.g., law enforcement, ODH, ODMHAS, legal services, etc.).  The ombudsman only referred complaints for resolution when all appropriate and necessary efforts by the ombudsman have been exhausted.  ","","","","","",0]
[12,"Ombudsman took assertive action in pursuit of client’s goals (i.e., made sure things were happening rather than waiting for them to happen, took charge of action plan rather than waiting for things to self-resolve).","","","","","",0]
[13,"Follow-up was done to determine if resolution remained effective (i.e., timed and appropriate to the complaint).","","","","","",0]
[14,"Ombudsman sought opportunities to improve care for all residents.  Ombudsman helped put systems in place that will benefit resident’s long term.","","","","","",0]
[]
[]
[null,"D. Volunteer Engagement (Assigned representative)","NA","Un","Es","Ex","C","Comments"]
[1,"Ombudsman documented whether a volunteer was assigned or was available to assist with complaint.  (If it was documented as yes, select essential and answer D2-D6.  If it was documented as no, select essential then select NA for D2-D6.  If it was not documented, select unacceptable then select NA for questions D2-D6)","","","","",""]
[2,"Ombudsman engages volunteer throughout investigation, resolution, and follow-up (i.e., more than notification, ombudsman engages volunteer to participate and provide ombudsman services relevant to the complaint).  ","","","","","",0]
[3,"Ombudsman initiates communication, direction, and support throughout the case (e.g., tasks and communication with volunteer are part of the action plan).   Ombudsman provides sufficient information and technical assistance for the volunteer to carry out requested tasks.","","","","","",0]
[4,"Ombudsman took appropriate action to ensure volunteer performs agreed upon actions and reports back within established timeframes.","","","","","",0]
[5,"Ombudsman documents whether or not a volunteer is assigned or available to assit with complaint. All interaction and attempted interaction with volunteer is documented and if/when a volunteer is not available, this is documented in the case detail.","","","","","",0]
[6,"Activity performed by a volunteer was summarized in case notes (not attached) and is accurately reported under volunteer's name.","","","","","",0]
[]
[]
[null,"E. Documentation Compliance (Assigned representative)","NA","Un","Es","Ex","C","Comments"]
[1,"Documentation was consistently contemporaneous as identified in ombudsman rules or RP policy.","","","","","",0]
[2,"The documentation was clear, understandable, and reflected a clear chronology of events (i.e., documentation stands on its own and included who, what, when, where, and how).","","","","","",0]
[3,"Ombudsman documented activity by day or as appropriate to the activity (i.e., activities that occurred on different dates are not lumped into one note).","","","","","",0]
[4,"Required demographic information is obtained.","","","","","",0]
[5,"Consent is clearly supported by narrative.","","","","","",0]
[6,"Deviations are included in documentation as appropriate.","","","","","",0]
[7,"Complaint types are accurate.","","","","","",0]
[8,"Selected verification was supported by narrative.","","","","","",0]
[9,"Selected status was supported by narrative.","","","","","",0]
[10,"Date started is correct.","","","","","",0]
[11,"Date closed is correct.","","","","","",0]
[12,"The administrative or legal assistance remedy selected at closing was accurate and supported by narrative.","","","","","",0]
[13,"Closing summary is complete (e.g., summarizes outcome and supports decision to close complaint).  ","","","","","",0]
[]
[null,null,"Total",null,null,"Max"]
[null,null,"Points",null,null,"Points",null,"Score"]
[null,"Intake Score",0,null,null,51,null,0]
[null,"Assigned Score",0,null,null,132,null,0]
[null,"Total Score",0,null,null,183,null,0]
[]
[null,"Legend"]
["NA","Not Applicable"]
["Un","Unacceptable"]
["Es","Essential"]
["Ex","Exemplary"]
["C","Comment"]

{"sheet":"SummaryCode","index":3,"n_rows":95,"n_cols":8,"rows_kept":95,"cut":false,"hidden":false,"merged":[]}
[null,"Case #",null,null,null,null,null,{"$f":"Rubric!C1","v":0}]
[null,"Intake Ombudsman:",null,null,null,null,null,{"$f":"Rubric!L1","v":0}]
[null,"Assigned Ombudsman:",null,null,null,null,null,{"$f":"Rubric!L2","v":0}]
[null,"Status:",null,null,null,null,null,{"$f":"Rubric!T1","v":0}]
[null,"Date:",null,null,null,null,null,{"$f":"Rubric!AA1","v":"00:00:00"}]
[null,"Reviewer:",null,null,null,null,null,{"$f":"Rubric!AA2","v":0}]
[]
[]
[null,"A.  Intake (Gateway representative)","NA","Un","Es","Ex","C","Comments"]
[1,{"$f":"Rubric!B5","v":"Complaint documented timely (e.g., date and method of contact accurately reported, date received is accurate)."},{"$f":"IF(Rubric!V5=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!X5=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!Z5=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!AB5=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!AD5=TRUE,\"X\",\"\")","v":""},{"$f":"Rubric!AF5","v":0}]
[2,{"$f":"Rubric!B6","v":"Role of ombudsman positively explained, sufficient information obtained to determine conflicts of interest.  All conflicts fully revealed and documented as appropriate."},{"$f":"IF(Rubric!V6=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!X6=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!Z6=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!AB6=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!AD6=TRUE,\"X\",\"\")","v":""},{"$f":"Rubric!AF6","v":0}]
[3,{"$f":"Rubric!B7","v":"In determining response time for initiating investigation, representative analyzed urgency and determined response time commensurate with potential harm posed to client. "},{"$f":"IF(Rubric!V7=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!X7=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!Z7=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!AB7=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!AD7=TRUE,\"X\",\"\")","v":""},{"$f":"Rubric!AF7","v":0}]
[4,{"$f":"Rubric!B8","v":"Complaint(s) screen was accurately applied and documented (i.e., probable harm, COI, decline to investigate)."},{"$f":"IF(Rubric!V8=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!X8=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!Z8=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!AB8=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!AD8=TRUE,\"X\",\"\")","v":""},{"$f":"Rubric!AF8","v":0}]
[5,{"$f":"Rubric!B9","v":"Consent to reveal complainant’s identity properly obtained and supported by narrative."},{"$f":"IF(Rubric!V9=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!X9=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!Z9=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!AB9=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!AD9=TRUE,\"X\",\"\")","v":""},{"$f":"Rubric!AF9","v":0}]
[6,{"$f":"Rubric!B10","v":"Ombudsman asked complainant probing questions to obtain relevant information (e.g., identify relevant people – who/what/when/how, impact on consumers, and underlying issues)."},{"$f":"IF(Rubric!V10=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!X10=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!Z10=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!AB10=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!AD10=TRUE,\"X\",\"\")","v":""},{"$f":"Rubric!AF10","v":0}]
[7,{"$f":"Rubric!B11","v":"All complaints accurately identified and reported based on information received at intake (e.g., all complaints in narrative were coded with complaint statement and goal)."},{"$f":"IF(Rubric!V11=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!X11=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!Z11=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!AB11=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!AD11=TRUE,\"X\",\"\")","v":""},{"$f":"Rubric!AF11","v":0}]
[8,{"$f":"Rubric!B12","v":"Each complaint included a clear and concise statement of the problem."},{"$f":"IF(Rubric!V12=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!X12=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!Z12=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!AB12=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!AD12=TRUE,\"X\",\"\")","v":""},{"$f":"Rubric!AF12","v":0}]
[9,{"$f":"Rubric!B13","v":"Each complaint had a measurable, achievable, and client-focused goal within the scope of the Office."},{"$f":"IF(Rubric!V13=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!X13=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!Z13=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!AB13=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!AD13=TRUE,\"X\",\"\")","v":""},{"$f":"Rubric!AF13","v":0}]
[10,{"$f":"Rubric!B14","v":"Ombudsman identified and documented the complainant’s prior actions taken to resolve complaint(s)."},{"$f":"IF(Rubric!V14=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!X14=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!Z14=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!AB14=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!AD14=TRUE,\"X\",\"\")","v":""},{"$f":"Rubric!AF14","v":0}]
[11,{"$f":"Rubric!B15","v":"Ombudsman provided relevant information related to the complaints (e.g., complainant advised of residents’ rights, relevant regulations, ombudsman knowledge of facility, etc)."},{"$f":"IF(Rubric!V15=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!X15=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!Z15=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!AB15=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!AD15=TRUE,\"X\",\"\")","v":""},{"$f":"Rubric!AF15","v":0}]
[12,{"$f":"Rubric!B16","v":"Complainant advised of ombudsman process (i.e., applicable to all complaints) and options for handling the specific complaint including, but not limited to, empowering the client to handle the complaint directly with the provider, interviewing other residents, visiting at meal time, facilitating a plan of care meeting, referrals to various agencies, or educating the provider."},{"$f":"IF(Rubric!V16=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!X16=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!Z16=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!AB16=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!AD16=TRUE,\"X\",\"\")","v":""},{"$f":"Rubric!AF16","v":0}]
[13,{"$f":"Rubric!B17","v":"Complainant aware of next steps, when they will occur, and by whom.  "},{"$f":"IF(Rubric!V17=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!X17=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!Z17=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!AB17=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!AD17=TRUE,\"X\",\"\")","v":""},{"$f":"Rubric!AF17","v":0}]
[14,{"$f":"Rubric!B18","v":"Intake case note ends with next steps.  "},{"$f":"IF(Rubric!V18=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!X18=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!Z18=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!AB18=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!AD18=TRUE,\"X\",\"\")","v":""},{"$f":"Rubric!AF18","v":0}]
[15,{"$f":"Rubric!B19","v":"Client-focused and positive customer service was provided – timely response, genuine desire to help expressed, assigned ombudsman (if different) notified timely of case."},{"$f":"IF(Rubric!V19=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!X19=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!Z19=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!AB19=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!AD19=TRUE,\"X\",\"\")","v":""},{"$f":"Rubric!AF19","v":0}]
[16,{"$f":"Rubric!B20","v":"Intake ombudsman clearly documented whether or not a volunteer was assigned or available to assist with the case."},{"$f":"IF(Rubric!V20=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!X20=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!Z20=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!AB20=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!AD20=TRUE,\"X\",\"\")","v":""},{"$f":"Rubric!AF20","v":0}]
[17,{"$f":"Rubric!B21","v":"Intake was documented contemporaneously."},{"$f":"IF(Rubric!V21=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!X21=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!Z21=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!AB21=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!AD21=TRUE,\"X\",\"\")","v":""},{"$f":"Rubric!AF21","v":0}]
[]
[]
[null,"B. Consumer Driven (Assigned Representative)","NA","Un","Es","Ex","C","Comments"]
[1,{"$f":"Rubric!B25","v":"Face-to-face interview with client was completed."},{"$f":"IF(Rubric!V25=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!X25=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!Z25=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!AB25=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!AD25=TRUE,\"X\",\"\")","v":""},{"$f":"Rubric!AF25","v":0}]
[2,{"$f":"Rubric!B26","v":"Ombudsman determined client’s capacity and acted accordingly."},{"$f":"IF(Rubric!V26=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!X26=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!Z26=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!AB26=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!AD26=TRUE,\"X\",\"\")","v":""},{"$f":"Rubric!AF26","v":0}]
[3,{"$f":"Rubric!B27","v":"Ombudsman shared information from intake in accordance with complainant’s consent, obtained complaint statements and measurable goals (if different), and identified new complaints and consumer-focused goals as appropriate.  "},{"$f":"IF(Rubric!V27=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!X27=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!Z27=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!AB27=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!AD27=TRUE,\"X\",\"\")","v":""},{"$f":"Rubric!AF27","v":0}]
[4,{"$f":"Rubric!B28","v":"Consent to reveal client’s identity properly obtained and supported by narrative."},{"$f":"IF(Rubric!V28=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!X28=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!Z28=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!AB28=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!AD28=TRUE,\"X\",\"\")","v":""},{"$f":"Rubric!AF28","v":0}]
[5,{"$f":"Rubric!B29","v":"Ombudsman asked client probing questions to obtain relevant information (e.g., identify relevant people – who/what/when/how, impact on consumers and underlying issues)."},{"$f":"IF(Rubric!V29=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!X29=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!Z29=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!AB29=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!AD29=TRUE,\"X\",\"\")","v":""},{"$f":"Rubric!AF29","v":0}]
[6,{"$f":"Rubric!B30","v":"Client advised of ombudsman process (i.e., applicable to all complaints) and options for handling the specific complaint including, but not limited to, empowering the client to handle the complaint directly with the provider, interviewing other residents, visiting at meal time, facilitating a plan of care meeting, referrals to various agencies, or educating the provider."},{"$f":"IF(Rubric!V30=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!X30=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!Z30=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!AB30=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!AD30=TRUE,\"X\",\"\")","v":""},{"$f":"Rubric!AF30","v":0}]
[7,{"$f":"Rubric!B31","v":"Client goals were driving force for advocacy efforts.  Ombudsman representative focused on attaining consumer satisfaction.  "},{"$f":"IF(Rubric!V31=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!X31=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!Z31=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!AB31=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!AD31=TRUE,\"X\",\"\")","v":""},{"$f":"Rubric!AF31","v":0}]
[8,{"$f":"Rubric!B32","v":"Client and representative were included in complaint handling process, ongoing communication about the status of client’s goals was part of the action plan.  "},{"$f":"IF(Rubric!V32=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!X32=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!Z32=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!AB32=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!AD32=TRUE,\"X\",\"\")","v":""},{"$f":"Rubric!AF32","v":0}]
[9,{"$f":"Rubric!B33","v":"The ombudsman analyzed data and information and developed an action plan for investigation, resolution, and follow-up in conjunction with the client.  The action plan included timelines."},{"$f":"IF(Rubric!V33=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!X33=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!Z33=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!AB33=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!AD33=TRUE,\"X\",\"\")","v":""},{"$f":"Rubric!AF33","v":0}]
[10,{"$f":"Rubric!B34","v":"Good customer service was provided – timely response, genuine desire to help expressed."},{"$f":"IF(Rubric!V34=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!X34=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!Z34=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!AB34=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!AD34=TRUE,\"X\",\"\")","v":""},{"$f":"Rubric!AF34","v":0}]
[11,{"$f":"Rubric!B35","v":"Ombudsman adherence to the Ombudsman Code of Ethics was supported by actions (e.g., did not advise on guardianship, advocated against locked units, did not advise on discharge, etc)."},{"$f":"IF(Rubric!V35=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!X35=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!Z35=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!AB35=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!AD35=TRUE,\"X\",\"\")","v":""},{"$f":"Rubric!AF35","v":0}]
[]
[]
[null,"C. Ombudsman Approach to Problem Solving (Assigned representative)","NA","Un","Es","Ex","C","Comments"]
[1,{"$f":"Rubric!B39","v":"Response time was appropriate to complaint(s) (e.g., date started was appropriate to complaint)."},{"$f":"IF(Rubric!V39=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!X39=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!Z39=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!AB39=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!AD39=TRUE,\"X\",\"\")","v":""},{"$f":"Rubric!AF39","v":0}]
[2,{"$f":"Rubric!B40","v":"Ombudsman familiarity with provider was evident and/or they  analyzed data prior to initial visit (i.e., familiarized self with recent history, activity, data, and reports) and handled complaints in context of ombudsman knowledge of and relationship with provider."},{"$f":"IF(Rubric!V40=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!X40=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!Z40=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!AB40=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!AD40=TRUE,\"X\",\"\")","v":""},{"$f":"Rubric!AF40","v":0}]
[3,{"$f":"Rubric!B41","v":"Ombudsman visited site where services are delivered and deployed effective investigative strategies appropriate to the complaint (i.e., observations, interviews, record review, etc.)"},{"$f":"IF(Rubric!V41=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!X41=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!Z41=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!AB41=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!AD41=TRUE,\"X\",\"\")","v":""},{"$f":"Rubric!AF41","v":0}]
[4,{"$f":"Rubric!B42","v":"The ombudsman conducted investigative interviews with appropriate parties including other consumers.  Interviewees are identified by name."},{"$f":"IF(Rubric!V42=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!X42=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!Z42=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!AB42=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!AD42=TRUE,\"X\",\"\")","v":""},{"$f":"Rubric!AF42","v":0}]
[5,{"$f":"Rubric!B43","v":"The ombudsman asked appropriate probing questions in an attempt to identify the root cause and extent of problems."},{"$f":"IF(Rubric!V43=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!X43=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!Z43=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!AB43=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!AD43=TRUE,\"X\",\"\")","v":""},{"$f":"Rubric!AF43","v":0}]
[6,{"$f":"Rubric!B44","v":"The action plan and pace of activity was appropriate to the complaint(s)."},{"$f":"IF(Rubric!V44=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!X44=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!Z44=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!AB44=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!AD44=TRUE,\"X\",\"\")","v":""},{"$f":"Rubric!AF44","v":0}]
[7,{"$f":"Rubric!B45","v":"There were no gaps in activity that unnecessarily delayed resolution (e.g., planned delays were not arbitrary or reflective of time management issues but were appropriate to the complaint)."},{"$f":"IF(Rubric!V45=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!X45=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!Z45=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!AB45=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!AD45=TRUE,\"X\",\"\")","v":""},{"$f":"Rubric!AF45","v":0}]
[8,{"$f":"Rubric!B46","v":"The ombudsman sought independent verification of facts presented by the provider and others."},{"$f":"IF(Rubric!V46=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!X46=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!Z46=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!AB46=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!AD46=TRUE,\"X\",\"\")","v":""},{"$f":"Rubric!AF46","v":0}]
[9,{"$f":"Rubric!B47","v":"All complaints were identified and documented during the course of handling the case."},{"$f":"IF(Rubric!V47=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!X47=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!Z47=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!AB47=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!AD47=TRUE,\"X\",\"\")","v":""},{"$f":"Rubric!AF47","v":0}]
[10,{"$f":"Rubric!B48","v":"Representative made an appropriate decision regarding review of client records (i.e., records were only reviewed if imperative to investigation or resolution of complaint)."},{"$f":"IF(Rubric!V48=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!X48=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!Z48=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!AB48=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!AD48=TRUE,\"X\",\"\")","v":""},{"$f":"Rubric!AF48","v":0}]
[11,{"$f":"Rubric!B49","v":"Referral were appropriate (e.g., law enforcement, ODH, ODMHAS, legal services, etc.).  The ombudsman only referred complaints for resolution when all appropriate and necessary efforts by the ombudsman have been exhausted.  "},{"$f":"IF(Rubric!V49=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!X49=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!Z49=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!AB49=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!AD49=TRUE,\"X\",\"\")","v":""},{"$f":"Rubric!AF49","v":0}]
[12,{"$f":"Rubric!B50","v":"Ombudsman took assertive action in pursuit of client’s goals (i.e., made sure things were happening rather than waiting for them to happen, took charge of action plan rather than waiting for things to self-resolve)."},{"$f":"IF(Rubric!V50=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!X50=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!Z50=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!AB50=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!AD50=TRUE,\"X\",\"\")","v":""},{"$f":"Rubric!AF50","v":0}]
[13,{"$f":"Rubric!B51","v":"Follow-up was done to determine if resolution remained effective (i.e., timed and appropriate to the complaint)."},{"$f":"IF(Rubric!V51=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!X51=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!Z51=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!AB51=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!AD51=TRUE,\"X\",\"\")","v":""},{"$f":"Rubric!AF51","v":0}]
[14,{"$f":"Rubric!B52","v":"Ombudsman sought opportunities to improve care for all residents.  Ombudsman helped put systems in place that will benefit resident’s long term."},{"$f":"IF(Rubric!V52=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!X52=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!Z52=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!AB52=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!AD52=TRUE,\"X\",\"\")","v":""},{"$f":"Rubric!AF52","v":0}]
[]
[]
[null,"D. Volunteer Engagement (Assigned representative)","NA","Un","Es","Ex","C","Comments"]
[1,{"$f":"Rubric!B56","v":"Ombudsman documented whether a volunteer was assigned or was available to assist with complaint.  (If it was documented as yes, select essential and answer D2-D6.  If it was documented as no, select essential then select NA for D2-D6.  If it was not documented, select unacceptable then select NA for questions D2-D6)"},{"$f":"IF(Rubric!V56=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!X56=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!Z56=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!AB56=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!AD56=TRUE,\"X\",\"\")","v":""}]
[2,{"$f":"Rubric!B57","v":"Ombudsman engages volunteer throughout investigation, resolution, and follow-up (i.e., more than notification, ombudsman engages volunteer to participate and provide ombudsman services relevant to the complaint).  "},{"$f":"IF(Rubric!V57=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!X57=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!Z57=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!AB57=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!AD57=TRUE,\"X\",\"\")","v":""},{"$f":"Rubric!AF56","v":0}]
[3,{"$f":"Rubric!B58","v":"Ombudsman initiates communication, direction, and support throughout the case (e.g., tasks and communication with volunteer are part of the action plan).   Ombudsman provides sufficient information and technical assistance for the volunteer to carry out requested tasks."},{"$f":"IF(Rubric!V58=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!X58=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!Z58=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!AB58=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!AD58=TRUE,\"X\",\"\")","v":""},{"$f":"Rubric!AF57","v":0}]
[4,{"$f":"Rubric!B59","v":"Ombudsman took appropriate action to ensure volunteer performs agreed upon actions and reports back within established timeframes."},{"$f":"IF(Rubric!V59=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!X59=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!Z59=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!AB59=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!AD59=TRUE,\"X\",\"\")","v":""},{"$f":"Rubric!AF58","v":0}]
[5,{"$f":"Rubric!B60","v":"Ombudsman documents whether or not a volunteer is assigned or available to assit with complaint. All interaction and attempted interaction with volunteer is documented and if/when a volunteer is not available, this is documented in the case detail."},{"$f":"IF(Rubric!V60=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!X60=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!Z60=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!AB60=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!AD60=TRUE,\"X\",\"\")","v":""},{"$f":"Rubric!AF59","v":0}]
[6,{"$f":"Rubric!B61","v":"Activity performed by a volunteer was summarized in case notes (not attached) and is accurately reported under volunteer's name."},{"$f":"IF(Rubric!V61=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!X61=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!Z61=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!AB61=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!AD61=TRUE,\"X\",\"\")","v":""},{"$f":"Rubric!AF60","v":0}]
[]
[]
[null,"E. Documentation Compliance (Assigned representative)","NA","Un","Es","Ex","C","Comments"]
[1,{"$f":"Rubric!B66","v":"Documentation was consistently contemporaneous as identified in ombudsman rules or RP policy."},{"$f":"IF(Rubric!V66=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!X66=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!Z66=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!AB66=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!AD66=TRUE,\"X\",\"\")","v":""},{"$f":"Rubric!AF66","v":0}]
[2,{"$f":"Rubric!B67","v":"The documentation was clear, understandable, and reflected a clear chronology of events (i.e., documentation stands on its own and included who, what, when, where, and how)."},{"$f":"IF(Rubric!V67=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!X67=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!Z67=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!AB67=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!AD67=TRUE,\"X\",\"\")","v":""},{"$f":"Rubric!AF67","v":0}]
[3,{"$f":"Rubric!B68","v":"Ombudsman documented activity by day or as appropriate to the activity (i.e., activities that occurred on different dates are not lumped into one note)."},{"$f":"IF(Rubric!V68=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!X68=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!Z68=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!AB68=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!AD68=TRUE,\"X\",\"\")","v":""},{"$f":"Rubric!AF68","v":0}]
[4,{"$f":"Rubric!B69","v":"Required demographic information is obtained."},{"$f":"IF(Rubric!V69=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!X69=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!Z69=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!AB69=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!AD69=TRUE,\"X\",\"\")","v":""},{"$f":"Rubric!AF69","v":0}]
[5,{"$f":"Rubric!B70","v":"Consent is clearly supported by narrative."},{"$f":"IF(Rubric!V70=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!X70=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!Z70=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!AB70=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!AD70=TRUE,\"X\",\"\")","v":""},{"$f":"Rubric!AF70","v":0}]
[6,{"$f":"Rubric!B71","v":"Deviations are included in documentation as appropriate."},{"$f":"IF(Rubric!V71=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!X71=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!Z71=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!AB71=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!AD71=TRUE,\"X\",\"\")","v":""},{"$f":"Rubric!AF71","v":0}]
[7,{"$f":"Rubric!B72","v":"Complaint types are accurate."},{"$f":"IF(Rubric!V72=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!X72=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!Z72=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!AB72=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!AD72=TRUE,\"X\",\"\")","v":""},{"$f":"Rubric!AF72","v":0}]
[8,{"$f":"Rubric!B73","v":"Selected verification was supported by narrative."},{"$f":"IF(Rubric!V73=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!X73=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!Z73=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!AB73=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!AD73=TRUE,\"X\",\"\")","v":""},{"$f":"Rubric!AF73","v":0}]
[9,{"$f":"Rubric!B74","v":"Selected status was supported by narrative."},{"$f":"IF(Rubric!V74=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!X74=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!Z74=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!AB74=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!AD74=TRUE,\"X\",\"\")","v":""},{"$f":"Rubric!AF74","v":0}]
[10,{"$f":"Rubric!B75","v":"Date started is correct."},{"$f":"IF(Rubric!V75=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!X75=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!Z75=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!AB75=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!AD75=TRUE,\"X\",\"\")","v":""},{"$f":"Rubric!AF75","v":0}]
[11,{"$f":"Rubric!B76","v":"Date closed is correct."},{"$f":"IF(Rubric!V76=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!X76=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!Z76=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!AB76=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!AD76=TRUE,\"X\",\"\")","v":""},{"$f":"Rubric!AF76","v":0}]
[12,{"$f":"Rubric!B77","v":"The administrative or legal assistance remedy selected at closing was accurate and supported by narrative."},{"$f":"IF(Rubric!V77=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!X77=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!Z77=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!AB77=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!AD77=TRUE,\"X\",\"\")","v":""},{"$f":"Rubric!AF77","v":0}]
[13,{"$f":"Rubric!B78","v":"Closing summary is complete (e.g., summarizes outcome and supports decision to close complaint).  "},{"$f":"IF(Rubric!V78=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!X78=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!Z78=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!AB78=TRUE,\"X\",\"\")","v":""},{"$f":"IF(Rubric!AD78=TRUE,\"X\",\"\")","v":""},{"$f":"Rubric!AF78","v":0}]
[]
[null,null,"Total",null,null,"Max"]
[null,null,"Points",null,null,"Points",null,"Score"]
[null,"Intake Score",{"$f":"Rubric!G84","v":0},null,null,{"$f":"Rubric!I84","v":50.5},null,{"$f":"Rubric!K84","v":0}]
[null,"Assigned Score",{"$f":"Rubric!G85","v":0},null,null,{"$f":"Rubric!I85","v":131.5},null,{"$f":"Rubric!K85","v":0}]
[null,"Total Score",{"$f":"Rubric!G86","v":0},null,null,{"$f":"Rubric!I86","v":182},null,{"$f":"Rubric!K86","v":0}]
[]
[null,"Legend"]
["NA","Not Applicable"]
["Un","Unacceptable"]
["Es","Essential"]
["Ex","Exemplary"]
["C","Comment"]

{"sheet":"Settings","index":4,"n_rows":8,"n_cols":14,"rows_kept":8,"cut":false,"hidden":false,"merged":[[0,2,0,4],[0,6,0,9]]}
["Intake Status Options","Reviewers","Area Score Variables",null,null,null,"Assessment Level Variables"]
["Paid","Teresa Teeple","Area","Max Points","Weight",null,"Level Name","Points","Min Score","Max Score","Questions","Min","Max"]
["Volunteer","Erin Pettegrew","A",45,0.25,null,"Unacceptable",1,0,0.6,17,{"$f":"K3*Level1Points","v":17},{"$f":"K3*Level3Points","v":68}]
[null,"Hilary Stai","B",33,0.2,null,"Essential",2.5,0.61,0.84,11,{"$f":"K4*Level1Points","v":11},{"$f":"K4*Level3Points","v":44}]
[null,"Lauren Simmons","C",39,0.21,null,"Exemplary",4,0.85,"above",14,{"$f":"K5*Level1Points","v":14},{"$f":"K5*Level3Points","v":56}]
[null,"Tessa Burton","D",15,0.08,null,"NA",0,null,null,6,{"$f":"K6*Level1Points","v":6},{"$f":"K6*Level3Points","v":24}]
[null,"Regional Program","E",48,0.26,null,null,null,null,null,13,{"$f":"K7*Level1Points","v":13},{"$f":"K7*Level3Points","v":52}]
[null,null,null,null,null,null,null,null,null,null,{"$f":"SUM(K4:K7)","v":44},{"$f":"SUM(L3:L7)","v":61},{"$f":"SUM(M3:M7)","v":244},{"$f":"SUM(M4:M7)","v":176}]