A BILL TO BE ENTITLED
AN ACT updating and strengthening the system of volunteers supporting the office of state long‑term care ombudsman program.
The General Assembly of North Carolina enacts:

PART I. VOLUNTEER NURSING HOME OMBUDSMAN REPRESENTATIVES
SECTION 1.  G.S. 131E‑101 reads as rewritten:
"§ 131E‑101.  Definitions.
As used in this Part, unless otherwise specified:
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(9)	"Volunteer nursing home ombudsman representative" means a volunteer designated by the Office of the State Long‑Term Ombudsman in accordance with G.S. 131E‑128 to work toward maintaining the intent of the Nursing Home Patients' Bill of Rights (Chapter 131E, Article 6, Part 2) within the nursing homes in this State, including nursing homes operated by hospitals licensed under Article 5 of this Chapter."
SECTION 2.  G.S. 131E‑102(e) reads as rewritten:
"(e)	In order for a nursing home to maintain its license it shall not intentionally impede the proper performance of the duties of a lawfully designated volunteer ombudsman representative, as set forth in G.S. 131E‑128."
SECTION 3.  G.S. 131E‑117(12) reads as rewritten:
"(12)	To present grievances and recommend changes in policies and services, personally or through other persons or in combination with others, on the patient's personal behalf or that of others to the facility's staff, a volunteer ombudsman representative designated under G.S. 131E‑128, the administrator, the Department, or other persons or groups without fear of reprisal, restraint, interference, coercion, or discrimination;"
SECTION 4.  G.S. 131E‑128 reads as rewritten:
"§ 131E‑128.  Volunteer nursing home ombudsman representatives.
(a)	Statement of Purpose. – It is the purpose of the General Assembly that designated volunteer ombudsman representatives of the Office of the State Long‑Term Care Ombudsman work to maintain the intent of the Nursing Home Resident's Bill of Rights within the nursing homes in this State, including nursing homes operated by hospitals licensed under Article 5 of this Chapter. It is the further purpose of the General Assembly that volunteer ombudsman representatives promote community involvement and cooperation with nursing homes and an integration of these homes into a system of care for the elderly.
(b)	Nominations and Designation. – Each board of county commissioners that has at least one nursing home operating in the county, including a nursing home operated by a hospital licensed under Article 5 of this Chapter, is encouraged to nominate volunteer ombudsman representatives who are willing and able to serve all the nursing homes in the county and work with each nursing home for the best interest of the residents. Notwithstanding any other provision of this Article, designation as a volunteer ombudsman representative is contingent upon designation of the nominee by the Office of the State Long‑Term Care Ombudsman in accordance with G.S. 143B‑181.18. A designated volunteer ombudsman representative is directly accountable to the State Long‑Term Care Ombudsman Program in order to perform the duties as a representative of the Office of the State Long‑Term Care Ombudsman.

	
	
(c)	Terms of Office. – Each person designated as a volunteer ombudsman representative by the Office of the State Long‑Term Care Ombudsman may serve for as long as the volunteer ombudsman representative remains in compliance with training, certification, and other applicable requirements of the Office of the State Long‑Term Care Ombudsman. Removal of the nominee's designation as a volunteer ombudsman representative by the Office of the State Long‑Term Care Ombudsman automatically rescinds the designation and ends the term of a volunteer ombudsman representative.
(c1)	List of Volunteer Ombudsman Representatives. – The names of all designated volunteer ombudsman representatives and the dates of expiration of their terms shall be filed with the Office of the State Long‑Term Care Ombudsman, which shall supply a copy of the names of all volunteer nursing home ombudsman representatives to the Division of Health Service Regulation.

(f)	Minimum Qualifications for Designation. – Each person nominated to serve as a volunteer ombudsman representative under this section is required to meet all of the following criteria prior to being designated to serve in this capacity by the Office of the State Long‑Term Care Ombudsman:
(1)	Is a resident of the county in which he or she serves.
(2)	Does not have a financial interest in any nursing home served by the volunteer ombudsman representative and is not an immediate family member of a person with a financial interest in a nursing home served by the volunteer.
(3)	Is not an employee or governing board member or an immediate family member of an employee or governing board member of a nursing home the volunteer.
(4)	Is not an immediate family member of a resident in a nursing home served by the volunteer.
(f1)	County Commissioners as Volunteers. – Any county commissioner who is appointed as a volunteer ombudsman representative shall be deemed to be serving in an ex officio capacity.
(f2)	No Compensation for Volunteers. – Volunteer ombudsman representatives shall serve without compensation, but may be reimbursed for the amount of actual expenses incurred by them in the performance of their duties.
(g)	Training, Certification, and Designation. – The Office of the State Long‑Term Care Ombudsman shall develop training requirements for certification and designation of volunteer ombudsman representatives in accordance with 45 C.F.R. § 1324.13(c)(2). Each volunteer ombudsman representative shall complete certification training as specified by the State Long‑Term Care Ombudsman Program Policies and Procedures and be designated as a representative of the State Long‑Term Care Ombudsman Program prior to exercising any power under subsection (h) of this section. The State Long‑Term Care Ombudsman Program shall provide volunteer ombudsman representatives with information, guidelines, training, and consultation to direct them in the performance of their duties.
(h)	Powers, Duties, and Responsibilities. – Volunteer ombudsman representatives have the following powers, duties, and responsibilities and nursing homes shall cooperate with them in carrying out these powers, duties, and responsibilities:
(1)	Each volunteer ombudsman representative shall apprise himself or herself of the general conditions under which persons are residing in the nursing homes in that county and shall work for the best interests of the persons in those nursing homes, which may include assisting residents who have a grievance with a nursing home and facilitating the resolution of grievances at the local level.
	
(3)	Each volunteer ombudsman representative has the right to enter into any nursing home the volunteer ombudsman representative services, with prior notice to the administrator of the facility, in order to carry out his or her responsibilities.
(4)	Volunteer ombudsman representatives may communicate with the Department or any other agency in relation to the interest of any resident. The identity of any complainant or resident involved in a complaint shall not be disclosed except as permitted under the Older Americans Act of 1965, as amended, 42 U.S.C. § 3001 et seq.
	
(6)	Before entering into any nursing home, a volunteer ombudsman representative shall identify himself or herself to the person present at the facility who is in charge of the facility at that time.
(i)	Privilege. – Any written communication made by a volunteer ombudsman representative within the course and scope of the volunteer's duties, as specified in G.S. 131E‑128, is privileged to the extent provided in this subsection. All communications by volunteer ombudsman representatives are the property of the Office of the State Long‑Term Care Ombudsman and subject to the Office's disclosure policies. This privilege is a defense in a cause of action for libel if the volunteer ombudsman representative was acting in good faith and the statements or communications do not amount to intentional wrongdoing.
(j)	Waiver of Qualified Immunity. – To the extent that any volunteer ombudsman representative is covered by liability insurance, that volunteer ombudsman representative shall be deemed to have waived the qualified immunity of this subsection to the extent of indemnification by insurance."

PART II. VOLUNTEER ADULT CARE HOME OMBUDSMAN REPRESENTATIVES
SECTION 5.  G.S. 131D‑2.4(e) reads as rewritten:
"(e)	In order for an adult care home to maintain its license, it shall not hinder or interfere with the proper performance of duty of a lawfully designated volunteer ombudsman representative, as defined by G.S. 131D‑31 and G.S. 131D‑32."
SECTION 6.  G.S. 131D‑31 reads as rewritten:
"§ 131D‑31.  Volunteer adult care home ombudsman representatives.
(a)	Statement of Purpose. – It is the intention of the General Assembly that designated volunteer ombudsman representatives of the Office of the State Long‑Term Care Ombudsman work to maintain the intent of the Adult Care Home Residents' Bill of Rights within the licensed adult care homes in this State. It is the further intent of the General Assembly that volunteer ombudsman representatives promote community involvement and cooperation with adult care homes to ensure quality care for the elderly and adults with disabilities.
(b)	Nomination and Designation. – Each board of county commissioners that has at least one licensed adult care home operating in the county is encouraged to nominate volunteer ombudsman representatives who are willing and able to serve all the adult care homes in the county, and work with each of the adult care homes for the best interests of the residents. Notwithstanding any other provision of this Article, designation as a volunteer ombudsman representative is contingent upon designation of the nominee by the Office of the State Long‑Term Care Ombudsman in accordance with G.S. 143B‑181.18. A designated volunteer ombudsman representative is directly accountable to the State Long‑Term Care Ombudsman Program in order to perform the duties of a representative of the Office of the State Long‑Term Care Ombudsman.

	

	
(c)	Joint Nursing and Adult Care Home Volunteer Ombudsman Representatives. – Designation as a volunteer ombudsman representative under G.S. 131E‑128 precludes designation as a volunteer ombudsman representative under this section, unless the Office of the State Long‑Term Care Ombudsman provides written approval to combine these volunteer functions. Upon approval by the Office of the State Long‑Term Care Ombudsman, any person appointed as a joint nursing and adult care home volunteer ombudsman representative shall exercise their statutory rights and responsibilities with respect to both nursing homes and adult care homes.
(c1)	List of Volunteer Ombudsman Representatives. – The names of all designated volunteer ombudsman representatives and joint nursing and adult care home volunteer ombudsman representatives and the dates of expiration of their terms shall be filed with the Office of the State Long‑Term Care Ombudsman, which shall supply a copy of the names of all volunteer ombudsman representatives and joint nursing and adult care home volunteer ombudsman representatives to the Division of Health Service Regulation.
(d)	Terms of Office. – Each volunteer ombudsman representative shall serve for as long as the volunteer ombudsman representative remains in compliance with training, certification, and other applicable requirements of the Office of the State Long‑Term Care Ombudsman. Removal of the nominee's designation as a volunteer ombudsman representative by the Office of the State Long‑Term Care Ombudsman automatically rescinds the designation and ends the term of a volunteer ombudsman representative.

(g)	Minimum Qualifications for Designation. – Each nominee is required to meet all of the following criteria prior to being designated as a volunteer ombudsman representative by the Office of the State Long‑Term Care Ombudsman:
(1)	Is a resident of the county where he or she serves.
(2)	Does not have a financial interest in any adult care home served by the volunteer ombudsman representative and does not have an immediate family member with a financial interest in a home served by the volunteer ombudsman representative.
(3)	Is not an employee or governing board member of a home served by the volunteer ombudsman representative.
(4)	Is not an immediate family member of a resident in a home served by the volunteer ombudsman representative.
(g1)	County Commissioner Volunteers. – Any county commissioner who is designated as a volunteer ombudsman representative shall serve in an ex officio capacity.
(g2)	No Compensation for Volunteers. – Volunteer ombudsman representatives shall serve without compensation, but may be reimbursed for actual expenses incurred by them in the performance of their duties.
(h)	Training, Certification, and Designation. – The Office of the State Long‑Term Care Ombudsman shall develop training requirements for certification and designation of volunteer ombudsman representatives in accordance with 45 C.F.R. § 1324.13(c)(2). Each volunteer ombudsman representative is required to complete certification training as specified by the State Long‑Term Care Ombudsman Program Policies and Procedures and be designated as a representative of the State Long‑Term Care Ombudsman Program prior to exercising any power under G.S. 131D‑32. The State Long‑Term Care Ombudsman Program shall provide volunteer ombudsman representatives with information, guidelines, training, and consultation to direct them in the performance of their duties.
(i)	Privilege. – Any written communication made by a volunteer ombudsman representative within the course and scope of the volunteer's duties, as specified in G.S. 131D‑32, is privileged to the extent provided in this subsection. All communications by volunteer ombudsman representatives are the property of the Office of the State Long‑Term Care Ombudsman and are subject to the Office's disclosure policies. This privilege is a defense in a cause of action for libel if the volunteer ombudsman representative was acting in good faith and his or her statements and communications do not amount to intentional wrongdoing.
(j)	Waiver of Qualified Immunity. – To the extent that any volunteer ombudsman representative is covered by liability insurance, that volunteer shall be deemed to have waived the qualified immunity provided in this subsection to the extent of indemnification by insurance."
SECTION 7.  G.S. 131D‑32 reads as rewritten:
"§ 131D‑32.  Functions of volunteer adult care home ombudsman representatives.
(a)	Volunteer adult care home ombudsman representatives shall promote increased community involvement with adult care homes and their residents.
(b)	Volunteer adult care home ombudsman representatives shall promote community education and awareness of the needs of aging and disabled persons who reside in adult care homes, and shall work towards keeping the public informed about aspects of long‑term care and the operation of adult care homes in North Carolina.
	
(d)	Volunteer adult care home ombudsman representatives shall establish linkages with the adult care home administrators and the county department of social services for the purpose of maintaining the intent of the Adult Care Home Residents' Bill of Rights.
(e)	Volunteer adult care home ombudsman representatives shall apprise themselves of the general conditions under which the persons are residing in the homes, and shall work for the best interests of the persons in the homes. This may include assisting persons who have grievances with the home and facilitating the resolution of grievances at the local level. The identity of any complainant or resident involved in a complaint shall not be disclosed except as permitted under the Older Americans Act of 1965, as amended, 42 U.S.C. § 3001 et seq. The Volunteer adult care home ombudsman representatives shall notify the enforcement agency of all verified violations of the Adult Care Home Residents' Bill of Rights.
(f)	The Volunteer adult care home ombudsman representatives may communicate with the Department of Health and Human Services, the county department of social services, or any other agency in relation to the interest of any resident.
	
(h)	With prior notice to the administrator of an adult care home, volunteer ombudsman representatives have the right to enter a facility he or she serves whenever the volunteer ombudsman representative deems it necessary to carry out his or her responsibilities. Before entering any adult care home, the volunteer ombudsman representative shall identify himself or herself to the person present at the facility who is in charge of the facility at that time. When a volunteer ombudsman representative visits a group home for developmentally disabled adults, rules concerning confidentiality as adopted by the Commission for Mental Health, Developmental Disabilities, and Substance Abuse Services apply.
(i)	The volunteer ombudsman representative shall prepare reports as required by the Department of Health and Human Services containing an appraisal of the problems of adult care homes facilities as well as issues affecting long‑term care in general. Copies of the report shall be sent to the board of county commissioners, county department of social services and the Division of Aging.
(j)	Nothing contained in this section shall be construed to require the expenditure of any county funds to carry out the provisions in this section."

PART III. CONFORMING CHANGES
SECTION 8.  G.S. 143B‑181.18 reads as rewritten:
"§ 143B‑181.18.  Office of State Long‑Term Care Ombudsman Program/State Ombudsman duties.
The State Ombudsman shall perform the duties provided below:
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(3b)	Designate and refuse, suspend, or remove designation of volunteer representatives of the Office of the State Long‑Term Care Ombudsman, including any volunteer ombudsman representatives designated under G.S. 131E‑128 or G.S. 131D‑31 in accordance with the State Long‑Term Care Ombudsman Program Policies and Procedures.
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SECTION 9.  G.S. 143‑157.1(2) and (21) are repealed.

PART IV. EFFECTIVE DATE
SECTION 10.  This act becomes effective October 1, 2025.