What is a Nursing Home Ombudsman and How can They Help Me?

A. A nursing home ombudsman can help resolve complaints that residents and their family may have against the facility.

There is a federal law that requires each state to have an ombudsman program. The law was passed in 1978 in recognition of the fact that seniors who live in nursing homes are perhaps the most vulnerable population, and need some help advocating for their rights. With that in mind, the ombudsman office acts as a proponent for the resident when it is necessary.

In order to understand how the ombudsman program can help you and your loved one, it is important to know how it works. While each state has its own program, the generally principles of the ombudsman programs are the same.

Sometimes, it is best to work through the ombudsman rather than filing a complaint with the state regulators. The ombudsman will generally work to resolve the problem while the state will investigate and punish the nursing home if necessary.

Many families are not familiar with federal and state laws when it comes to nursing home care. The ombudsman will have this familiarity and while they are not your lawyer, they can advise you what the laws are.

Families have the ability to file a complaint with the ombudsman if there is a deficiency in care or if they feel that their loved one’s rights are being violated. Ombudsmen handle a variety of different complaints about either day-to-day life in the facility or more serious issues such as resident abuse. Families can file complaints with the ombudsman against the nursing home or even against other outside agencies. The ombudsman will hear practically any complaint even if they ultimately cannot do anything about it. When the ombudsman receives a complaint, they may launch their own investigation of it to learn the necessary facts. Given the legal necessity of the ombudsman program, the nursing home will have to cooperate with the ombudsman to an extent. When the ombudsman is done investigating the facts, they can act as the resident’s advocate if necessary. They can formally call upon the nursing home and its staff to meet its obligations to the resident. The ombudsman knows the regulations and can point out to the facility what laws their conduct is violating. They can act as the resident’s advocate when it comes to requesting change or action from regulatory agency. If the ombudsman feels that it is necessary, they can even file a complaint with the government regulators on the resident’s behalf.

It is important to know that, while the ombudsman can be the senior’s advocate, it does not have the legal power to compel the nursing home to do anything. It can point out the nursing home’s shortcomings, but it cannot fine the nursing home or punish it. The ombudsman works to resolve problems, but its mandate does not mean that it is in the role of evidence gatherer or that it will attempt to prove that a legal violation actually happened.

Some skilled nursing facilities will work with the ombudsman since the alternative is a complaint to the state or federal government which can result in a fine. Other nursing homes are apathetic and will not generally pay much attention to the ombudsman’s recommendation or advocacy for the residents.

In many cases, the ombudsman is a viable first step to address a problem with a nursing home. This will at least bring the issue to the nursing home’s attention in a forum that is more formal than simply having a conversation with the administrator. While there is no guarantee of results, it may help you later on if there is the need to document the case for a possible lawsuit. Of course, if the situation is more time-pressing and critical, it may be better to immediately go to the state regulators. However, many problems are nipped in the bud and lives improved because of effective complaints to the ombudsman.

In 2016, ombudsmen resolved nearly 200,000 complaints nationally. They are also able to help nursing homes resolve problems with residents and their families should the facility need some sort of action. The ombudsman program is often effective at heading off some problems and keeping smaller issues from getting worse. Consider availing yourself of the program as a first step in addressing your problem.