What Is a Healthcare Ombudsman? Maine Guide for Facilities

Residents in long-term care facilities often face challenges that interfere with their ability to make decisions for themselves. Whether caused by physical or mental limitations — or simple misunderstandings — it’s important for those involved in residents’ care to take every measure to address resident concerns. Ensuring an individual’s holistic needs are met can be done with the support of a long-term care ombudsman.

Maine volunteers and staff are trained to establish relationships with residents to identify and investigate complaints related to their care or living conditions. Find out how ombudspeople in the state of Maine can support residents at your facility today.

What Is the Maine Long-Term Care Ombudsman Program?

The Maine Long-Term Care Ombudsman Program (LTCOP) is a nonprofit organization that advocates for elders and adults with disabilities across the state. The program supports individuals living in residential or long-term care facilities, including:

• Nursing homes
• Residential care
• Assisted living facilities
• Home care
• Adult daycare
• Hospice

Ombudspeople visit individuals in these settings to observe their living situations and provide support where needed. Through their free and confidential services, ombudsmen identify issues and help resolve them. This often involves having informal conversations with residents, families, and staff in long-term care facilities.

Ombudspeople help ensure facilities are compliant with state regulations and CMS conditions of participation. Although they don’t perform surveys — this is done by state agencies — ombudsmen can identify issues that need to be addressed so a facility is compliant with CMS guidelines.

What Does a Maine Ombudsman Do?

The Maine ombudsman program plays a crucial role in safeguarding the rights and safety of elders in long-term care. By conducting regular visits, ombudspeople ensure residents receive proper care and treatment as healthcare recipients. They’re committed to serving as a voice for those who are unable to self-advocate or who may not understand their rights. Key aspects of their role include:

• Empowerment — An ombudsman empowers residents and families to voice their concerns to caregivers and long-term care staff. They help individuals navigate the healthcare system, including assistance finding long-term care placement.
• Education — By explaining their legal protections, ombudspeople help residents understand and exercise their resident rights. They also provide community education about factors affecting the quality of life in nursing homes, elder rights, and issues such as abuse and neglect.

• Investigation — Ombudsmen respond to resident complaints and conduct investigations to resolve them. An important part of an investigation is providing follow-up to ensure situations don’t reoccur in the future.

• Advocacy — Representatives advocate for change on a broader scale by participating in policy and ongoing advocacy. This may involve discussions, proposing reforms, and lobbying for better standards of care in long-term care.

Hospital patient advocacy is a priority for an ombudsman. Maine volunteers may also help patients find long-term care placement. They assist with identifying barriers to discharge from a hospital and into long-term care. These include the following:

• Financial concerns
• Complex medical needs
• A lack of bariatric beds
• Concerns related to geriatric behavioral health
• Dementia care challenges
• Treatment needs relating to substance use disorder

Who Does a Healthcare Ombudsman Work With?

If a resident of a long-term care facility has a concern about their care or living environment, they are encouraged to contact their state ombudsman. Maine representatives seek to resolve issues both professionally and confidentially. Here are some examples of the most common resident complaints:

• Quality of care
• Staffing issues
• Breach of resident rights
• Food or dietary concerns
• Barriers to admission and discharge

Due to the nature of these complaints, an ombudsman may collaborate with healthcare employees such as kitchen staff, caregivers, nursing administrators, and activities coordinators. They also collaborate with residents and their families during investigations.

Outside of the care setting, Maine representatives work with fellow ombudspeople committed to protecting elders at the state and federal levels. They may be found working with legal representatives and lawmakers advocating for systemic change in long-term care.

Tips for Facilities Working With a State Ombudsman

Maine ombudsman staff and volunteers are authorized to investigate complaints by communicating with staff in long-term care facilities. If they visit your facility, it’s important to prepare staff for what to expect during an interaction. Below are suggestions for how a facility leader can prepare staff for a visit.

• Allow in-person visits. Having a visit from a healthcare ombudsman is a fundamental resident right. Long-term care staff in charge of visitor entry should be advised to treat ombudsmen like any other visitor.

• Be compliant. Facility staff and administrators should answer questions as necessary to conduct an investigation. Compliance may involve allowing ombudspeople access to various parts of the facility, including patient or resident rooms. Leaders should advise staff to maintain HIPAA compliance if an ombudsman requests access to medical records.

• Be collaborative. Remind staff that the purpose of an ombudsman visit is to improve a resident’s living situation. By taking a person-centered approach, ombudsmen and staff can work together to improve conditions and resolve issues.

Find More Ways to Improve Resident Satisfaction

Healthcare facility leaders and staff can support residents by welcoming the support of a state ombudsman. Maine representatives are committed to finding solutions to issues and improving the resident experience. Discover more ways to boost resident satisfaction at your facility in IntelyCare’s free newsletter.