An Ombudsman is an advocate and problem solver for people over 60 years of age who are living in long-term care and assisted living residences. An Ombudsman is authorized to investigate any complaint which he or she determines to be an appropriate subject for investigation under federal or Idaho laws.
For example, an Ombudsman can help:
- Identify, investigate, and resolve complaints by, or on behalf of, the residents of long-term care and assisted living facilities.
- Resolve problems and concerns residents may have with living and care issues, or with agencies of government, home care programs and other services for seniors.
- Promote and protect the rights of the residents.
- Provide pre-placement counseling for those considering long-term care options.
- Provide services such as community education and information and assistance to the public.
- Represent the interests of residents before governmental agencies.
- Provide support services to the resident’s family members and loved ones.
- Inform residents about obtaining services.
Who can use the services of an Ombudsman?
- Residents of nursing homes and assisted living facilities;
- The families of residents;
- Staff of long-term care facilities who may be aware of problems; and
- Anyone with a concern for the health and well-being of elderly individuals.
- The resident’s name, address or location, telephone number, age, race and sex;
- The names and contact information of others with information about the situation.
- If the complainant is willing to be contacted again.
- You will also be asked for your name and number or some way of contacting you if the Ombudsman has follow-up questions.
- The Ombudsman will not repeat your conversation to anyone unless you give him or her permission to do so. The State Office of the Ombudsman at the Idaho Commission on Aging is the only entity with the authority to authorize disclosure of Ombudsmen files except when it is subpoenaed by a court to disclose pertinent records.
How to contact the Ombudsman for the Elderly:
|For Ada, Boise, and Elmore Counties:||Stephanie Persinger
|For Adams, Canyon, Gem, Owyhee, Payette,
Valley and Washington Counties:
The Ombudsmen visit each long-term care facility not less often than once per quarter. During this visit, Ombudsman are allowed to visit common areas of the facility and the rooms of residents (if consent is given by the resident). Additionally, they are authorized to communicate privately and without restriction with any resident who consents to the communication. The Ombudsmen are visiting primarily to give residents the opportunity to express in person any concerns they may have.
When an ombudsman investigates a violation of a resident’s rights or a complaint lodged by a resident or third party, he or she will first notify the complainant, if any, of the investigation and will also notify the long-term care facility or the state or county department or agency affected by the investigation of the ombudsman’s intent to investigate. However, if no investigation takes place, the Ombudsman will let the complainant know why.
In conducting the investigation, the Ombudsman may undertake, but is not limited to, any of the following actions:
- Make the necessary inquiries and obtain any information he or she feels is necessary to perform a thorough investigation.
- Hold private hearings.
- Enter during regular business hours, the premises of a long-term care or residential assisted living facility.
Following the investigation, the Ombudsman can report his or her opinions and recommendations to the interested parties. For example, the Ombudsman can recommend that:
- A particular issue should be further considered by the long-term care or residential assisted living facility or state or county department or agency.
- A state agency’s administrative act should be modified or canceled.
- A statute or regulation on which an administrative act is based should be altered.
- Reasons should be given for an action taken by an administrative agency.
- Some other action should be taken by a long-term care facility or state or county department or agency.
The Ombudsman can request that the parties affected by the Ombudsman’s opinions or recommendations notify them within a specified time of any action taken by the parties on their recommendation. However, following an investigation, the Ombudsman may consult with the resident or legal representative before issuing any opinion or recommendation that is critical to them.
In 1987, Congress enacted the Nursing Home Reform Law, which has since been incorporated into the Medicare and Medicaid regulations. In its broadest terms, it requires that every resident be given whatever services are necessary to function at the highest level possible. The law gives residents a number of specific rights:
- To be free from abuse, neglect, exploitation and from chemical or physical restraints.
- To participate in the planning of medical treatment.
- Privacy during medical exams, treatment and while caring for personal needs.
- To be treated with dignity, respect, kindness and consideration.
- The facility must provide a written description of resident rights and a list of the required advocacy groups, together with a copy of the admission agreement and negotiated service agreement (care plan).
- Facilities must fully inform residents of the services available in the facility, and of related charges. Residents have the right to manage their own financial affairs. If the resident gives the facility permission to manage his/her funds, they must maintain a written record of all financial transactions.
- To be visited by, and communicate privately with, the resident’s family; the state ombudsman; or the resident’s physician at any time.
- To share a room with a spouse, gather with other residents without staff present, and may organize and participate in resident and family groups.
- To wear their own clothing and determine their own dress and hairstyle. Facilities must offer an alternate choice at meal times. Residents may practice the religion of their choice and may abstain from religious services.
- To retain and control personal property and know personal possessions are safe and secure.
- To voice grievances without fear of retaliation and expect any transfers or discharges to be appropriate.
- To exercise their rights as a citizen, including their right to vote.
The Ombudsmen follow the National Code of Ethics developed by the National Association of Long-Term Care Ombudsmen:
- The ombudsman provides services with respect for human dignity and the individuality of the client, unrestricted by considerations of social or economic status, personal characteristics or lifestyle choices.
- The ombudsman respects and promotes the client‘s right to self-determination.
- The ombudsman makes every reasonable effort to ascertain and act in accordance with the client‘s wishes.
- The ombudsman acts to protect vulnerable individuals from abuse and neglect.
- The ombudsman maintains competence in areas relevant to long-term care and aging benefit and entitlement programs, especially regulatory and legislative information and long-term care service options.
- The ombudsman acts in accordance with the standards and practices of the Office and with respect for the policies of the sponsoring organization.
- The ombudsman provides professional advocacy services unrestricted by his or her personal belief or opinion.
- The ombudsman participates in efforts to promote a quality long-term care system.
- The ombudsman participates in efforts to maintain and promote the integrity of the Office.
- The ombudsman supports a strict conflict-of-interest standard, which prohibits any financial interest in delivery or provision of nursing home or residential care services.
- The ombudsman conducts him/herself in a manner that will strengthen the statewide and national ombudsman network.
Learn More About the Ombudsman Program
The Ombudsman program offers in-service presentations to agencies, groups, businesses, and organizations. Please call your local Ombudsman to schedule a free presentation.
Volunteer to Help Residents of Long-Term Care Facilities
The Ombudsman Program in Area 3 is currently accepting applications for the volunteer program. Click here for the Volunteer Ombudsman Application
Federal Older Americans Act, Title VII-Allotments for Vulnerable Elder Rights Protection Activities
Idaho Senior Services Act
Rules Governing the Ombudsman for the Elderly Program
Department of Health & Welfare Bureau of Facility Standards
The National Long-Term Care Ombudsman Resource Center
National Center on Elder Abuse
Medicare Find and Compare
Social Security Administration
FREQUENTLY ASKED QUESTIONS AND ANSWERS
Q. I received a discharge notice from the facility. What do I do?
A. You have the right to appeal the discharge, except for the reason of non-payment for services. The discharge letter will provide you the information on how to appeal the discharge and how to contact the ombudsman, if needed.
Q. A family member has power of attorney for financial and health care decisions. Can I still make my own decisions?
A. Yes, until you can no longer make your own decisions, you have the right to make all decisions regarding your finances and health care.
Q. My doctor has prescribed for me a medication I don’t want to take. Can I refuse this medication?
A. Yes, you can refuse to take any medication that is prescribed by your doctor. Contact your doctor to see if there are any substitute medications that can be prescribed or other options available to you. Call your local ombudsman if needed.
Q. I live in an assisted living facility and my doctor has ordered home health services for me. Who decides which home health agency to use?
A. The resident has the right to choose which agency to use. Your doctor can provide you with a list of agencies to choose from.
Q. I have a complaint against the facility, but I would like to remain anonymous. Is that possible?
A. Yes, you can remain anonymous and your conversation with the ombudsman will remain confidential. If your complaint is specific to you, the ombudsman will try to resolve the complaint without using your name.