1. 1 The Ombudsman Guide to Writing Effective Monthly Activity Reports Hands On! The Hudson Valley Ombudsman Program January 2013

2. 2 Objective Provide a step-by-step guide for creating effective Monthly Activity Reports.

3. 3 Agenda Overview of Monthly Activity Reports A Sample Monthly Activity Report How To Complete a Monthly Activity Report Reference Materials

4. 4 Overview of the Monthly Activity Report Activity Reports are required on a monthly basis and are due on the 15 th of the following month. Facilities are considered “uncovered” when there is no Monthly Activity Report for that facility. The Monthly Activity Report is a record of all time the Ombudsman has spent on visitation, complaint investigation*, council participation, consultations, meetings and training. Submit a separate report for each facility covered. E-mail completed monthly reports to Hands On! The Hudson Valley at ReportHOHV@gmail.com ReportHOHV@gmail.com * Please Note: A complaint investigation requires a completed Complaint Form to be attached to the Monthly Activity Report. For assistance with Complaint Form Documentation, please see “The Ombudsman Guide to Writing Effective Complaint Reports”

5. 5 Sample Monthly Activity Report

6. 6 How to Create the Monthly Activity Report - Identification A: Enter Ombudsman name. B: Enter the Facility Name. C: Enter the reporting month/year.

7. 7 How to Create the Monthly Activity Report - Date D: Enter date activity was performed.

8. 8 How to Create the Monthly Activity Report - Activity E: Choose the letter of the corresponding Program Activity. Note that Activity B,D,H require a Topic. Use Activity I for activities such as HOHV training and meetings.

9. 9 How to Create the Monthly Activity Report - Topics F: Choose the applicable topic for Program Activities B, D, H only.

10. 10 How to Create the Monthly Activity Report – Activity Time G: Enter all time Ombudsman spent on the activity. (Exclude Travel Time). Jot down dates/times on personal calendar for easy reporting.

11. 11 How to Create the Monthly Activity Report – Travel Time H: Enter Travel Time Record time spent traveling to and from facility. Combine multiple trips (if same day) into one entry.

12. 12 How to Create the Monthly Activity Report - Notes I: Use this area to record contact persons and other notes to describe the activity. Do Not record case information. (Complaint details are entered on the Complaint Form)

13. 13 Reference Materials Exhibit A: Activity Definitions (Definition Program Activity Report Revised ~ 11/10) Exhibit B: A Month In the Life of an Ombudsman (A Month in the Life of an Ombudsman Revised ~ 8/12) Exhibit C: Blank Monthly Activity Reporting Form ( Report Activity Revised ~ 12/09)