Advocating for Consumers in East Tennessee
The Ombudsman program represents residents of long-term facilities and assists at their direction. The Older Americans Act (OAA) requires the Ombudsman program to have resident consent prior to investigating a complaint or referring a complaint to another agency. When someone other than the resident files a complaint, the Ombudsman must determine, to the extent possible, what the resident wants.
If someone other than a resident contacts the Ombudsman program with a complaint, the Ombudsman will attempt to see if the resident has similar concerns and wants to pursue the complaint. The Ombudsman will explain the role of the program, the investigation process, and seek to understand the resident’s capacity to make decisions. Many residents, even those with dementia, are able to express their wishes. If the resident wants the Ombudsman to act on the problem, the Ombudsman will investigate the complaint, continue to communicate with the resident, and seek to find a resolution. If the resident cannot provide consent, the Ombudsman will work with the resident’s representative.
The Ombudsman handles a wide variety of complaints about quality of life and care. Not all complaints are about the facility. Some are about outside agencies, services, or individuals (e.g. Medicaid eligibility, exploitation, etc.)
Yes. Under the OAA, the Ombudsman program investigates and resolves complaints that “relate to action, inaction or decisions that may adversely affect the health, safety, welfare, or rights of the residents” and that includes complaints about abuse, neglect, and exploitation. The Ombudsman’s role in investigating allegations of abuse is unique, and differs from other entities such as Adult Protective Services, Department of Health, and law enforcement. The Ombudsman attempts to resolve complaints to the residents’ satisfaction and does not gather evidence to substantiate prosecution or litigation.
There are strict federal requirements regarding disclosure of Ombudsman program information. Resident-identifying information cannot be disclosed without resident consent, the consent of the resident representative, or a court order. Therefore, these disclosure requirements prohibit Ombudsman programs from being mandatory reporters of suspected abuse.
Most nursing homes participate in Medicare and Medicaid, and therefore must meet federal requirements, including facility responsibilities and residents’ rights. For more information about residents’ rights visit http://ltcombudsman.org/issues/residents-rights and http://theconsumervoice.org/issues/recipients/nursing-home-residents/residents-rights.
Rights and care standards for assisted living facilities and residential homes for the aged are regulated, licensed or certified at the state level (some assisted living facilities provide services for residents receiving Medicaid benefits and must meet federal standards). For more information visit http://ltcombudsman.org/assisted-living and http://theconsumervoice.org/issues/recipients/assisted-living.
Regardless of the type of facility, all residents have the right to be protected from abuse and mistreatment and facilities are required to ensure the safety of all residents and investigate reports of mistreatment.