What Is a Healthcare Ombudsman? New Mexico Guide for Facilities

Living in a long-term care facility can be challenging for elderly residents. Isolation from family and friends puts them at an increased risk for neglect, whether intentional or not. Advocates working with the New Mexico health ombudsman program work with facilities to help protect these individuals and ensure they get the dignity and respect they deserve.

By partnering with their state ombudsman, New Mexico patients, their families, and healthcare staff can work to ensure safety and high-quality care in facilities across the state. So, what exactly is a health ombudsman, and how do they improve patient satisfaction and outcomes?

In this article, we’ll provide a background on federal and state health ombudsman programs, outline the role of a New Mexico health ombudsman, and provide tips for facilities looking to collaborate with these advocates and help their residents live life to the fullest.

What Is the New Mexico Long-Term Care Ombudsman Program?

New Mexico senior citizens, along with elderly individuals across the nation, often lack access to social support services like transportation, healthy food choices, and healthcare. The Older Americans Act (OAA) was enacted to help these vulnerable individuals access and pay for these essential services.

Under the OAA, the federal Long-Term Care Ombudsman Program (LTCOP) was established to protect elderly individuals living in residential care facilities. At the initiation of the federal LTCOP, each state was mandated to build their own statewide health ombudsman program to assist with regulatory oversight and ensure patient safety.

New Mexico ombudsmen work to protect the rights of patients served by long-term care facilities like:

• Nursing homes
• Hospice centers
• Assisted living facilities
• Adult day care
• Long-term rehabilitation centers

Prior to the program’s initiation, there was little formalized oversight in these facilities. Patients and their family members didn’t know where to turn when they had complaints or care concerns. Now, as part of the New Mexico LTCOP, state employees and volunteers work to represent patient needs and help them receive the best care possible.

What Is the Role of a Health Ombudsman?

New Mexico state representatives called ombudsmen partner with facility leaders, political representatives, and the New Mexico Department of Health to lobby for healthcare reform. They also collaborate with other New Mexico Senior Services departments on initiatives like seasonal immunization clinics and food distribution programs that improve the health and wellbeing of elderly residents across the state.

These health advocates don’t provide direct patient care in LTC facilities, but serve residents by:

• Educating them, their families, and their care teams about the services and resources available to them.
• Assisting with complaints like abuse, neglect, improper discharge planning, quality and choice of food, and poor medication distribution.
• Advocating for change at the government level to improve each individual’s care.
• Helping them choose a facility that meets their care needs.
• Providing information on legal rights and policy changes to patients and facilities, and suggesting changes to governmental agencies when appropriate.
• Serving as a liaison for patients and their families to address grievances and identify possible solutions.

Who Should Partner With a Health Ombudsman?

New Mexico state ombudsmen are required to annually visit each residential care facility to inspect care quality, facility cleanliness, and staff compliance. They audit facility policies and procedures to ensure care is provided according to rules and regulations mandated by the Centers for Medicare and Medicaid Services (CMS)

While these oversight representatives primarily serve patients and their needs, they’re trained to help any community member who may have questions or concerns about care quality. Examples of individuals who may benefit by reaching out to their local ombudsman include:

• Healthcare administrators looking for information on federal and state LTC regulations.
• Citizens who may be looking to get involved as paid or volunteer ombudsman representatives.
• Family members who believe their loved one is receiving substandard care.
• Local politicians looking to help seniors access social resources and better care.
• Care providers (nurses, medical assistants, therapists, etc.) who have inquiries about state policies or standards of care.

How Can Facilities Prepare for Visits With a State Ombudsman?

For nursing home staff, collaborating with an ombudsman can be daunting. They may falsely assume that reaching out to ombudsmen will spark punitive or accusatory action against them or their workplace.

It’s important for healthcare teams to remember that ombudsmen don’t exist to punish care providers or shut down facilities. In actuality, their goal is to make the caregiving experience better for everyone. When preparing for a health ombudsman, New Mexico care teams can utilize these three strategies to get the most out of each site visit.

1. Provide Education and Training on the New Mexico State Ombudsman Program

Transparency is key when partnering with state oversight agencies. Educating residents and their families on the role and function of ombudsmen is the first step to establishing a meaningful patient-provider relationship.

New Mexico LTC facilities should orient all key stakeholders to the state ombudsman program and provide resources on the offerings of these health advocates. Educate them on the role of ombudsmen and review the steps involved in filing an ombudsman (New Mexico) incident report.

Helping stakeholders raise awareness of care deficiencies can show them that you care about their opinions and concerns. Patients and staff who feel involved in the caregiving process have higher satisfaction and engagement scores.

2. Solicit Patient Experience Feedback to Optimize Care Quality

Patients and family members often appreciate being involved in the caregiving process. Asking for their feedback creates a sense of unity among all parties and highlights opportunities for change. You can request feedback and suggestions by:

• Distributing paper or email surveys.
• Hosting resident and family council meetings.
• Placing an anonymous feedback box at the front desk.

Being proactive in addressing care concerns can keep small problems from becoming more significant down the line.

3. Distribute Ombudsman Contact Information

Facility leaders should post ombudsman program resources in public places and distribute informational brochures during every new patient admission.

Empower patients, family members, and healthcare staff to reach out directly to the state ombudsman office with questions or concerns. The following New Mexico Ombudsman contact information should be publicly posted or emailed for easy reference:

Want to Keep Ahead of the Compliance Curve?

For healthcare leaders, adhering to strict healthcare rules and regulations is an ongoing challenge. By partnering with their state health ombudsman, New Mexico facilities can keep their policies up-to-date. You can also get our latest updates and tips on optimizing your regulatory practices in our free newsletter — delivered straight to your inbox.