What Does an LTC Ombudsman Do?
"Ombudsman" is a funny sounding word, and many people don't know what it means. According to one ombudsman it means "being an advocate for residents."
A long-term care (LTC) ombudsman listens to and addresses the concerns of nursing home and assisted living facility residents. Issues can range from the food service to problems with therapy. At all times, residents decide on the ombudsman's level of involvement. They can be counted on to respect residents' privacy and confidentiality.
LTC ombudsmen also represent residents' interests by speaking out to government agencies and legislators for increased consumer protections in state and federal laws and regulations.
Ombudsmen help residents by allowing them to voice their concerns. I can try to find the right people to talk to about getting the issue resolved.
— Joyce, ombudsman
Ombudsmen can be volunteers who have been specially trained to help residents solve problems or they can be paid staff of a local ombudsman program. Each nursing home or assisted living facility has a volunteer or paid ombudsman available to residents.
Some of the ways in which LTC ombudsmen serve residents include:
- Telling residents about their rights
- Empowering and supporting residents and their families to discuss concerns with facility staff
- Identifying gaps in facility, government or community services and trying to help fix those gaps
- Protecting resident health, safety, welfare and rights
- Providing information about and help with finding long-term care
- Receiving and investigating complaints
What You Need to Know
Note: Click on an item below to reveal the information.
There are times that things come up that need a mediator. And it gives us a level of comfort to know mom can call Greg.
— Judy, family member
Anyone may call an ombudsman to voice a concern or get information about long-term care. However, ombudsmen only take action with the consent of the resident or their representative. Ombudsmen work with:
- Nursing home or assisted living facility residents
- Family members or friends of residents
- Facility employees who are concerned about a resident
- Any person interested in the welfare of residents
- Someone considering long-term care placement
No. Ombudsman services are free, confidential and available statewide.
No. Ombudsmen help resolve issues and investigate complaints, but they do not regulate facilities.
Texas Health and Human Services (HHS) licenses and certifies facilities, including assisted living facilities and nursing homes. HHS staff inspects, surveys, makes follow-up visits and complaint investigations and other visits to ensure these facilities are operating according to state and federal regulations. Staff, known as surveyors:
- Determine if facilities meet minimum standards, if conditions endanger health and safety, or if poor practices are being followed
- Check that facilities have corrected past problems
- Investigate complaints
Ombudsmen can help resolve complaints about many aspects of long-term care. They work to uphold the rights of residents, including those facing an involuntary transfer or discharge.
Ombudsmen work closely with residents to address complaints. The resident decides the ombudsman's level of involvement in resolving the complaint. We collect facts about the complaint first. Ombudsmen then suggest options for resolution to the resident. The ombudsman works with the resident to resolve the problem and will follow up to confirm continued resolution. Ombudsmen can work with family and friends of residents too. Some concerns an ombudsman can address include:
- Violation of residents' rights
- Poor quality of care, including inadequate personal hygiene and slow response to requests for help
- Improper transfer or discharge
- Inappropriate use of chemical or physical restraints
- Any resident concern about quality of care or quality of life
- Support to residents who are abused or neglected
- Tips for residents and their families in addressing complaints and concerns
Residents have the same rights as people who don't live in a nursing home or assisted living facility. This includes the right to:
- Be treated with respect, dignity and consideration
- Exercise their rights and civil liberties as a resident of Texas and citizen of the United States and observe their religious beliefs
- Confidentiality of personal and clinical records
- Be informed of their medical condition and participate in treatment planning
- Plan activities in the facility
- Choose their own attending physician and the source of pharmacy service
- Be free from mental, physical, or verbal abuse and chemical and physical restraints
- Have privacy, including visits with anyone of their choice in or outside of the facility, mail and telephone services, participation in resident council activities, access to their records and access to state inspection reports
- Be told about Medicaid or Medicare services and informed of other items or services and any costs that may be charged
- Not be transferred or discharged without cause and notice
- Be treated without discrimination regardless of source of payment
- Make complaints and express grievances without fear of discrimination or reprisal
- Manage personal and financial affairs and make choices and independent decisions
- Issue advance directives, including directive to physician, medical power of attorney, and out-of-hospital do-not-resuscitate
You can learn more on our resident's rights page.
- Know your rights.
- Tell the nursing home or assisted living facility staff of concerns as soon as possible. Follow up with the appropriate staff.
- Be familiar with your admission agreement, resident handbook, facility policies and other information provided at move-in.
- As a resident, stay involved with family and friends. Make them aware of your care and activities.
- Understand and use the care planning process. Ask for a care plan or service plan meeting and invite your ombudsman if you need help.
- Participate actively in the facility's resident council. Your family is encouraged to participate in the family council. The voice of many residents can be more influential than one person. The facility should:
- provide private space to meet;
- designate staff to assist and respond to written requests; and
- listen to the views and act upon grievances and recommendations affecting resident care and life.
- Consult your physician with any concerns about medical care. A physician directs the medical care of each resident.
- Support community involvement and interaction. You have the right to participate in activities in and out of the facility.
- Talk to your ombudsman and HHS surveyors when they visit.
There are several levels of intervention, and attempts to resolve problems may be informal or formal, inside or outside of the facility. The following options can happen one at a time or simultaneously.
- Talk with staff in the facility.
- Ask for a facility grievance form and turn in a written grievance.
- Call or write to the owner of the home.
- Bring your concern to the resident council if you are a resident.
- Bring your concern to the family council if you are family or a friend of the resident.
- Call an LTC ombudsman for help with any of these options, or to work on the problem with you. Find an ombudsman.
- Contact the Office of the State LTC Ombudsman by email at email@example.com or call 1-800-252-2412.
- Contact Complaint and Incident Intake (Regulatory) at 1-800-458-9858 or email a complaint to firstname.lastname@example.org.
Updated: April 22, 2019
The Office of the State Long-Term Care Ombudsman is independent of the Texas Health and Human Services system. This ensures the state ombudsman and all program representatives advocate for resident interests. Ombudsmen work to solve individual problems and to change policy and law to protect residents.