OMBUDS-WHO? Office of Ombudsman for Long-Term Care

Ombudsman Mission Enhance the Quality of Life and Quality of Care for Adults by Promoting the Rights of Long-Term Care Residents, Home Care Consumers and Medicare Beneficiaries through Advocacy, Education and Empowerment.

Ombudsman Philosophy Person Centered Consumer Driven Individualized Care and Service

Ombudsman Duties Educate for Self-Advocacy Information and Consultation Consumer Resources Investigate & Resolve Complaints Recruit, Train & Manage Volunteers Conduct Regular On-Site Visits Represent Client Interests to Government Agencies Inform Public & Policy Makers of Consumer Concerns Recommend Policy & Legislative Changes Monitor Laws & Rules

Ombudsman Access Access to LTC residences Access to Clients/Meet Privately Access to Records Facility Records State Records

Confidentiality Identity of Client & Related Data Identity of Complainant & Related Data Prohibition Against Discrimination or Retaliation Against Employees, Volunteers, Patients, Residents, Guardians, Family Members Rebuttable Presumption within 90 Days of a Report

Ombudsman Volunteers Conflict of Interest (Disqualifying & Declared) Application, Background Study & Reference Check Interview, Orientation & Assignment Visit Designation as “Volunteer Advocate” Visit Residents 6 Hours Monthly Monthly Contact with Regional Ombudsman 12 Annual Hours of Continuing Education –Bi-Monthly or Quarterly Regional Meetings –Annual Statewide Meeting Annual Renewal of Designation

Who Does the Ombudsman Serve? Nursing Home Residents Housing With Services Tenants Assisted Living Tenants Home Care Clients (adults receiving in-home support services & health-related services for a fee) Adult Foster Care Clients (age 55 & older) Hospice Clients Hospital Patients (Medicare Beneficiaries) Adult Day Program Participants

Who Contacts the Ombudsman? 2006 (10/1/05 to 9/30/06) Family/Friends39% Consumers24% Provider Staff17% Social Service Staff & Others13% Unknown 7%

Ombudsman Complaint Data 2000 Complaints Closed in 2006 Rights 47% Admission/Discharge/Move Out, Autonomy, Finances, Access to Information/Ombudsman Care/Services 33% Direct care, Staffing, Abuse, Rehab, Restraints, Policies/Procedures Factors Outside Facility/Agency 11% Certification/Licensing, State Medicaid Agency, Legal Issues (POA, Guardianship) Quality of Life 9% Environment, Dietary, Activities

Outcome of Complaints 2006 Resolved56% Partially Resolved27% Withdrawn 3% No Action 4% Other 5% Not Resolved 5%

Ombudsman Complaint Investigation Obtain informed consent Obtain facts and verify the complaint Who is involved What happened Where did the situation happen When did the situation happen Why did the situation happen

Ombudsman Complaint Investigation Formulate an action plan How will the problem be resolved? Who is responsible for implementing the plan? When will the plan be implemented? Monitor Implementation of the action plan Is the client satisfied with the outcome? Follow up with client to ensure continued satisfaction. Follow up with staff responsible for implementation.

Fostering Positive Systems Change Consultation to providers Share resources and information Periodic meetings with administrator to discuss systemic issues being raised by residents, families or staff Assist in implementing person-centered, relationship-based care Assist in developing and maintaining resident and family councils