LONG TERM CARE OMBUDSMAN PROGRAM
The Long Term Care Ombudsman Program works to advance the rights of consumers of long term care services. State certified staff and volunteers advocate on behalf of residents of nursing homes, residential care facilities, adult care facilities, and individuals receiving home and community based services.
Q. What is the goal of the Long Term Care Ombudsman Program?
A. The goal of the Long Term Care Ombudsman Program is to provide a voice for the concerns of consumers of long-term care.
Q. Who can call the Long Term Care Ombudsman Program?
A. Anyone may call the Long Term Care Ombudsman Program to voice a concern or obtain information about long-term care. There is no requirement to speak with another agency or the provider first. The Long Term Care Ombudsman Program provides free and confidential information.
Q. Where does the Long Term Care Ombudsman serve the consumer?
A. The Ombudsman addresses the concerns of consumers in a variety of long-term care settings:
Institutional long-term care such as nursing homes
Residential long-term care such as residential care facilities and adult care facilities
Group care settings such as adult foster homes; and
Home and community-based care such as home health nursing, personal care, transportation, and meal services.
Q. How does the Long Term Care Ombudsman Program work in nursing homes and residential care facilities?
A. The Long Term Care Ombudsman Program can assist in resolving complaints about the quality of care and quality of life in the long-term care settings.
The Long Term Care Ombudsman Program can help ensure that your rights under Ohio law are understood. and upheld by the nursing home and residential care facility providers.
The long Term Care Ombudsman Program can assist you if you are denied admission or threatened with transfer or discharge from a facility.
The Ombudsman can ensure that you are involved in the planning of your care and can answer questions about Medicare and Medicaid benefits.
The Long Term Care Ombudsman Program can assist in resolving concerns about all aspects of long-term care including abuse, restraints, dietary, activities, staffing, environment, policies, social services, access to information and more.
Q. How does the Long Term Care Ombudsman Program work in adult care facilities?
A. Sometimes these facilities are called board and care homes, group homes, family homes, or foster care homes.
The Long term Care Ombudsman Program can help ensure that your rights under Ohio law are understood and upheld by the adult care facility providers.
The Long Term Care Ombudsman Program can help in resolving complaints about the quality of care and quality of life in these long-term care facilities.
Q. How does the long Term Care Ombudsman Program work in community-based long-term care settings?
A. Community based long-term care settings are different from other types of long-term care in one important way - the setting is often your home, not an institution. However, as a consumer of these services, you also have rights, and we can help ensure that these rights are respected.
The Long Term Care Ombudsman Program can help negotiate disputes you have in regard to quality of these services. We can help resolve concerns you may have in regard to billing and access to these services.
The Long Term Care Ombudsman Program can advocate for you with the agencies that administer the Medicare, Medicaid, and other funding programs.
Q. How does the Long Term Care Ombudsman Program work for you?
A. The Long Term Care Ombudsman Program handles complaints about long-term services. and serves as a liaison voicing the needs and concerns of the consumer to providers of long-term care.
The Long Term Care Ombudsman Program does not enforce public policy for long-term care facilities or providers. Where the enforcement of a state or federal law or rule is necessary, the Ombudsman will work on your behalf to involve the proper state agency that has enforcement authority. However, the Ombudsman can work with the long-term care provider and you, your family, or other representative to resolve problems and concerns you may have about the quality of the services you receive.
Q. What should I do if I have a complaint?
A. First, you may wish to address your concerns to the provider of the long-term care services. Often, your expression of concern is the first step toward resolving a problem.
If you are unable to solve the problem yourself, the Long Term Care Ombudsman can help. Remember that if you contact the Long Term Care Ombudsman Program your call will be treated confidentially. We will not act without consulting you and we will involve you in the resolution process.
Q. How does the Long Term Care Ombudsman Program handle your complaints?
A. First, you control the complaint process. You determine the extent to which we become involved in solving your problem.
When a consumer cannot speak for himself or herself, the Ombudsman may assist the consumer's legal representative, family member or sponsor on behalf of the consumer.
The Ombudsman first investigates to verify and document your complaint. The findings of the investigation will be shared with you. The Long Term Care Ombudsman Program will provide you with options for resolving your concern and will assist you in achieving a resolution. The Ombudsman will take only those actions that you authorize.
The Ombudsman will then follow-up to ensure that any agreement reached to resolve the complaint is actually carried out and remains effective.
Your complaints can be handled confidentially. The Ombudsman does not disclose your identity without your consent, unless ordered to do so by a court. Even if the ombudsman cannot resolve your complaint without revealing your identity, you make the choice as to whether the Ombudsman proceeds.
Q. What other state agencies are responsible for different aspects of long-term care?
A. The Ohio Department of Health is responsible for inspecting nursing homes, residential care facilities, and adult care facilities for compliance with state and federal law. The Department of Health is also responsible for inspecting home health agencies certified under the Medicare and Medicaid programs. In addition, the department of Health maintains a registry of personnel who have abused or exploited residents of a nursing home. Call 1-800-342-0553.
The Ohio Department of Job and Family Services is responsible for Ohio's Medicaid program. The Department of Job and Family Services sets the Medicaid rate paid to nursing homes. In addition, the department of Job and Family Services monitors nursing facility admissions practices and the use of nursing home residents' personal needs allowance funds. Your right to Medicaid benefits is determined through the county departments of human services. The Department of Job and Family Services is also responsible for administering Ohio's adult protective services law designed to intervene when older persons are abused, neglected, or financially exploited. Call 1-800-324-8680.
The Ohio Attorney General's Office is responsible for investigating allegations of criminal abuse, neglect, and financial exploitation in care facilitates. This office also investigates Medicaid fraud and operates a separate consumer protection division. Call 1-800-642-2873.
The Ohio Department of Aging, through its network of regional Area Agencies on Aging, provides funding for community-based long-term care services. These include home-delivered meals, transportation, and information, about and referral to other community resources you may need to remain independent and living in your community as long as possible. Besides operating the long Term Care Ombudsman Program, the Department of Aging is responsible for the PASSPORT program. Call 1-800-282-1206.
Q. What are your rights as a consumer of long-term care services?
A. Nursing Facility Residents' Bill of Rights from the Ohio Revised Code section 3721.13.
Q. What can I do to advocate for consumers of long-term care services?
A. You can become a Long Term Care Ombudsman volunteer. The Long Term Care Ombudsman Program recruits, trains, and places volunteers in nursing homes to make the program even more accessible to residents.
* from the booklet Questions an Answers distributed by the Ohio Department of Aging
Copyright © 2001 Joint Office of Citizen Complaints. All Rights Reserved.