Verifying and Defining the Problem When a Complaint Is Verified A complaint is verified if it is determined after work (interviews, record inspection, observation, etc.) that the circumstances described in the complaint are generally accurate. You have been gathering information in order to determine the facts of the case. Formal verification is simply a matter of reviewing those facts, ensuring that you have proper documentation, and deciding if the information supports the allegations in the complaint. The amount of documentation and formal verification you need will be determined by the complexity of the issue, the willingness of the facility to accommodate the resident, and in some cases, the resident’s cognitive and communication abilities. When a Complaint Cannot Be Verified There will be times when a complaint cannot be verified. There may be no corroborating statements, or the facts may even contradict the complaint. Example: Mr. Johnson tells you that the Pleasant Manor assisted living facility didn’t have enough staff to bathe and dress his mother on Tuesday two weeks ago. His mother has Alzheimer’s. When you visit the facility, the residents all appear clean and appropriately dressed. Mrs. Johnson, the complainant’s mother, does not recall any problems with dressing and bathing. Your casual conversations with other residents reveal nothing pertinent to this issue: there are no issues with insufficient staff or with residents not receiving assistance with bathing and dressing. Survey reports from this facility as well as your complaint documentation do not mention anything relevant to this issue. The residents’ council and family council meetings have not expressed complaints that are similar. You have nothing to proceed on except Mr. Johnson’s statement. Handling these situations will require tact, as the resident/complainant may still be convinced that the problem is valid. Here are some tips: Be careful that you do not make the complainant believe you think he/she is foolish. A factual, detailed presentation is especially important when telling the complainant that
nothing else can be done. Explain that not being able to verify the complaint does not mean that you question the honesty or sincerity of the complainant. Discuss any alternative steps that might be available. For example, there may be another agency better suited to deal with the complainant’s concern. Suggest that the complainant begin to document his or her observations and other information relevant to the problem. In some cases, you can still pursue resolution without objective verification. You may believe that a case has merit although you have been unable to verify it. It is also possible that you have been unable to get access to records or materials that might verify the complaint. In such cases,
consider the following actions. Help the resident or complainant represent himself/herself. Explain that there is little
you can do at this time without further proof. Show the person how to document problems as they occur. If needed, explain the “chain of command” in the facility so the individual will know who to talk with if the problem comes up again. Leave telephone numbers and addresses of the LTCOP and other appropriate agencies for future contact. Do whatever you can to resolve the complaint. Complaints can be resolved without verification in many cases. If the resident complains that the staff is slow to answer his/her call light, you can always discuss the problem with the Director of Nursing (DON), if the resident approves. This may cause the DON to initiate her own investigation or quietly resolve the problem. R E M E M B E R : You should never represent something as a fact without verification. At the same time, verification should never be used as a tool for limiting attempts to resolve complaints. Rather, it is a self-protective device to prevent a too vigorous pursuit of unfounded complaints. Defining the Problem What is the problem? Your investigation may reveal that the root problem is not the one that was reported to you. For example, you may have been told that articles of clothing are being stolen. During your investigation you may learn that clothing is simply not being returned from the laundry room. Accurately determining the root problem is essential to finding a lasting solution. Examine the information you gained by interviewing, observing, and reviewing documents. Ask yourself, “What is the problem?” Be clear about the root, or the underlying, problem before you try to resolve the issue.