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<br />D EPARTMENT OF H EALTH AND H UMAN S ERVICES <br />DIVISION OF AGING AND ADULT SERVICES <br />OFFICE OF THE STATE LONG-TERM CARE OMBUDSMAN <br /> <br /> <br />NOTIFICATION REQUESTING REMOVAL OF <br />COMMUNITY ADVISORY COMMITTEE MEMBER(S) <br /> <br />TO: Clerk/County Manager: Lauren Linker <br />FROM: Cindy Kincaid, Regional Ombudsman Region: F <br />Volunteer Name: Annette Swick County Served: Cabarrus <br />Date: February 14, 2022 <br />County Committee Assignment: Adult Care Home Nursing Home Joint <br />Date of Appointment: 4-20-2015 <br /> <br />Reason for Request Summary: Resignation, not safe to return in buildings <br /> <br />COVID-19 Related: YES NO <br /> <br />Volunteers are a vital part of the services that support older adults in your county. However, the <br />volunteer indicated above has been de-designated by the Office of the State Long-Term Care Ombudsman <br />and is no longer eligible for continued service for the following reason: <br /> ____ Conflict of Interest <br />1. G.S. 131 E-128 (f) Nursing Home <br />2. G.S. 131 D-31 (g) Adult Care Home <br />3. 45 CFR §1324.21 <br /> <br />____ Failure to attend required on-going training or complete required orientation and <br />training. <br />1. G.S. 131 E- 128 (g) Nursing Home <br />2. G.S. 131 D- 31 (h) Adult Care Home <br /> Dates offered: ______________ ______________ ______________ <br /> <br /> 3 Other (Non-attendance at quarterly meetings and facility visits) <br />1. As determined by the Long-Term Care Ombudsman Program Policies <br />and Procedures <br />2. As determined by the committee by-laws <br />3. As determined by resignation of the member <br />4. As determined by removal of designation by the Office of the State <br />Long-Term Care Ombudsman <br />5. Expiration of term <br />6. Committee member is deceased <br /> <br />This is an official notification to the Board of Commissioners to remove named individual from <br />service on the above-mentioned committee (HB 248, July 2017). Should you have any questions, <br />please contact Cindy Kincaid, Regional Ombudsman, 704-348-2715. Thank you in advance for your <br />prompt attention to this matter. <br /> <br />Centralina Area Agency on Aging <br />Phone: 704-348-2715 Fax: 704-348-4710 <br /> <br />Revised 08/25/2021 <br /> <br />