Did you know Ohio has a program specifically designed to advocate for the rights of those who are currently receiving long-term (LTC) care services, those who have received them in the past or those who expect to receive them in the future? The program includes individuals in nursing homes, residential care (assisted living) facilities and other adult care facilities as well as those receiving in-home services and community-based care such as a disabled person in a supportive living facility. The service is called the State Long-term Care Ombudsman Program and all of its benefits are free of charge to Ohio residents.
Mandated by the federal Older Americans Act passed by Congress more than 30 years ago, the ombudsman program is coordinated by the Ohio Department of Aging and receives revenue from the state’s General Fund. Per bed fees are paid by care providers to support continuance of the service. Any adult in the community can voice a concern to an ombudsman or obtain information about long-term care in Ohio. Ombudsmen have a hands-on working relationship with the residents and staff of the care facilities in their area. They pay regular visits to these facilities. Their job is to protect and promote the quality of life of all of the residents using a person-centered approach.
How many ombudsmen are there in Ohio?
The state ombudsman designates 12 regional certified ombudsmen to serve local consumers. Along with several volunteer associate ombudsmen, the group provides three important services:
- Complaint investigation and resolution
- Dissemination of information
How do the ombudsmen handle complaints?
The volunteers’ priority is to regularly visit various LTC facilities where they work with resident councils, inform residents and their families of their rights, provide community contact for residents, help handle uncomplicated complaints and assist residents and their families in advocating for themselves. In 2013, Ohio ombudsmen received 8,992 complaints and verified 75.5% of them. The most frequent complaints presented to ombudsmen (in descending order) concerned:
- A needlessly restrictive environment
- Lack of a care plan or care plan not being followed
- Disrespectful attitudes from staff
- Failure to respond to requests
- Lost or stolen personal property
- Injuries such as falls
- Improper handling
- Lack of choice of exercise
- Poor personal hygiene
More than 54% of the ombudsmen’s time is spent handling these complaints. Although the ombudsmen have no regulatory powers, they have been very successful over the years in problem solving and negotiating a resolution to care concerns while maintaining confidentiality and professionalism. Complaints range from unappetizing food and inadequate cleanliness of a resident to violations of civil rights, abuse, neglect and admission and discharge problems. A complaint alleging physical harm is responded to within one business day. The average time between submission of a complaint and initiating an investigation averages about 3.8 days.
It is not the ombudsman’s role to police the nursing home but to work with families, residents and LTC providers to resolve problems. Empowering the consumer is a top priority of the Ombudsman Program in Ohio. The ombudsman documents the complaint, presents the consumer with options to resolve the issue, seeks consumer input on how much assistance from the ombudsman the consumer is seeking in the matter, and in many instances investigates the matter. The ombudsman works with regulatory agencies, and follows up to find out if the complaint was actually resolved.
What information does the ombudsman offer?
Information services include unbiased information on the rights of those in long-term care, information on the rules and laws which apply to LTC services in Ohio and information and guidance in using performance and quality data to help select the right service provider (such as a nursing home).
An ombudsman can advise a consumer looking for a nursing home, or trying to decide if their loved one needs a nursing home, by utilizing:
- Survey information from the Ohio Department of Health
- Reports from official inspections of care facilities, standardized and produced in electronic format
- Complaint activity gathered by ombudsmen investigators.
Data files from the Department of Aging can be displayed on the web for consumers to view. Consumers are also advised to go to caregiverlist.com and view the Caregiver Checklists which can be linked from the right hand side of the home page.
Counseling is also a role of the ombudsman. In 2013, the Ohio ombudsmen helped 909 consumers select a long term care residence. In addition to providing information about an adult care or residential facility or nursing home, ombudsmen provide information relating to Medicaid and Medicare as well as other state and federal programs affecting long-term care services.
As mandated by Ohio legislation, LTC residents’ rights include:
- A safe, clean living environment
- The right to be treated with dignity and respect
- Adequate and appropriate care
- A prompt response to all reasonable requests
- The right to be free from all chemical and physical restraint
What does the ombudsman do in the advocacy role?
In their advocacy role, ombudsmen educate groups, providers and caregivers about various long-term care issues. They monitor and support laws and legal issues affecting older persons and inform all LTC-involved persons how they can take action on a particular issue. The ombudsmen periodically testify on state and federal legislation. They offer resources that link residents with services and agencies. Ombudsmen also provide assistance with benefits and insurance.
In 2013, ombudsmen in Ohio spent 41,597 hours providing advocacy services. Advocacy takes many forms including the above-mentioned areas and:
- Reviewing, analyzing, and commenting on enforcement of laws and regulations
- Staying current with regulatory processes and sharing information gleaned from regular presence in long-term care facilities
- Training staff and volunteers to be more effective advocates
- Recommending policy and advising the public, consumers, providers and policy makers on LTC issues
When do you need an ombudsman?
In review, you need to contact a long-term care ombudsman when you need:
- Feedback prior to choosing a nursing home
- A complaint resolved
- To request better individualized care for a loved one
- To confidentially communicate problems and concerns related to LTC
Currently there are nursing home and residential care facility regulations concerning the staff’s responsibility to inform residents about the ombudsman program. Facilities must post information about the ombudsman program in an accessible location. The state office should provide care managers with information that can be used to remind residents of the various facilities about the ombudsman’s availability and the many services offered.