What Is a Healthcare Ombudsman? Wisconsin Guide for Facilities
In 1972, Congress amended the Older Americans Act and established a national Long-Term Care (LTC) Ombudsman Program to help improve subpar conditions across long-term care facilities. Under this program, each state is required to address issues reported by residents using the services of an ombudsman. Wisconsin in particular has established a comprehensive program that advocates for individuals receiving LTC services, while helping facilities make necessary improvements.
If you’re an LTC facility leader in Wisconsin, you can improve your care delivery by working collaboratively with your local ombudsman. To help you to get the most out of their guidance, we’ll walk you through what an LTC ombudsman in Wisconsin does and how to prepare for potential interactions with one.
What Is the Wisconsin Ombudsman Program?
In the state of Wisconsin, ombudsman services are overseen by the Board on Aging and Long Term Care. The state’s program works to advocate for the rights of residents over the age of 60 and improve conditions at the following types of LTC settings:
- Adult family homes
- Community-based residential facilities
- Assisted living facilities
- Residential care apartment complexes
- Nursing homes
Wisconsin also has a separate ombudsman office housing the Family Care and IRIS (Include, Respect, I Self-Direct) Ombudsman program, providing services to adults ages 18-59 who have disabilities and require LTC services within their own homes. Similar to the LTC ombudsmen who monitor facilities, the Family Care and IRIS ombudsmen work to uphold the rights, safety, and wellbeing of individuals receiving these at-home services.
What Does a Long-Term Care Ombudsman Do?
An ombudsman is defined as a person who investigates and resolves complaints made by individuals against organizations. In long-term care settings, this involves any complaints that patients, their friends or families, or other concerned parties make about an LTC facility. All complaints received by Wisconsin’s ombudsman office are kept confidential, and an investigation on a facility is carried out only with the consent of the resident/family.
Beyond receiving and addressing complaints, there are many other responsibilities carried out by a long-term care ombudsman. Wisconsin also trains their staff and volunteers to:
- Provide residents and families with helpful information about long-term care services.
- Offer referrals and consultations to seniors seeking LTC services.
- Monitor and improve quality of care in long-term facilities and for related services.
- Work with providers, regulators, adult protective services, and resource centers to improve policies shaping LTC delivery.
Who Can Seek Help From an Ombudsman?
While ombudsmen are primarily trained to advocate for the rights of residents receiving LTC services, they also offer general guidance to anyone who has questions or concerns about long-term care. This includes facility administrators, staff, and leaders. Examples of individuals who may want to reach out to their local ombudsman include:
- Residents have been wrongfully denied LTC services.
- Residents who feel that they are being abused or neglected by LTC staff.
- Individuals who would like to start a resident and family council.
- LTC facility staff who have questions about LTC visitation rights.
- LTC facility leaders who need help improving care protocols based on local laws.
Who Is Your Ombudsman? Wisconsin Phone Number and Contact Information
Ombudsmen are spread throughout the state, representing each specific county or region in Wisconsin. To connect with your local ombudsman, you can call the state’s office and provide your county, zip code, and/or facility name. The information for the state’s office is provided below.
| Wisconsin Ombudsman Contact Information | |
|---|---|
| State Ombudsman | Kelly Gochenaur |
| State Ombudsman Phone Number | 1-800-815-0015 |
| State Ombudsman Address | 1402 Pankratz Street #111, Madison, WI 53704 |
| State Ombudsman Website | https://longtermcare.wi.gov/Pages/Ombudsman.aspx |
| State Ombudsman Email | BOALTC@wisconsin.gov |
Tips for Facilities Undergoing Investigations
If you’re an LTC facility leader, you can reach out to your ombudsman for regulatory guidance at any time. However, they’ll need to conduct a more formal investigation if someone files a complaint about your facility. While this may seem like a stressful situation, it’s important to understand that your local ombudsman would rather work with you than against you. Their overarching goal is to find a fair resolution for both you and your residents.
This is why it’s important to remain cooperative with your ombudsman and help them resolve any potential issues before they become bigger problems. Follow these tips to allow the investigation to go as smoothly as possible:
- Comply: If your ombudsman asks you about the situation at hand, cooperate by providing all relevant information. This will help them better understand why a complaint was filed and increase the likelihood of coming to a fair resolution.
- Engage: Your ombudsman may invite you to discuss ways to improve your care services. If they do, engage with them appropriately to find a practical solution. Keep your staff in the loop and provide any necessary training that will help resolve and prevent any future issues.
- Act: If the ombudsman identifies a problem, take this as an opportunity to improve the quality of your care services. Act on the advice provided by your ombudsman to ensure that all issues are resolved in a timely manner.
Take Additional Steps to Improve Care for Your Residents
Need help acting on the advice of your ombudsman? Wisconsin facility leaders can stay informed through IntelyCare’s free newsletter. Our expert team offers dozens of facility management tips that can help you optimize your services and keep your residents satisfied.