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Earlier this afternoon I received a very important reminder from an individual who inspects (a/k/a surveys) nursing homes. Each state has a “survey agency” that is in charge of inspecting nursing homes. The name of the agency is different in each state (in Kentucky this agency works through the Office of Inspector General, while in Indiana and many other states this agency is part of the state Board of Health). Whatever they call this agency in your state, these folks need to hear from family members of nursing home residents and nursing home staff regarding unsafe staffing level and any other care concerns. Your calls to your state agency (and regional Long-Term Care Ombudsman) are essential in order for problems to be identified and corrective action to be taken! The state survey manager who contacted me wrote,
“When you (and this goes for both families of nursing home residents and nursing home staff) have concerns about the care of a resident or unsafe staffing levels, be sure to CALL your state survey agency! Their number is REQUIRED to be posted in all Medicare / Medicaid-certified nursing homes. We surveyors (inspectors) are here to protect the residents of nursing homes and assure they are getting quality care.
We surveyors (inspectors) are on the side of the residents and staff. Although we are constantly lied to by facility staff and Administrators, we can get to the truth.
In addition to contacting your state survey agency, be sure to get the Ombudsmen involved too! They can be a great resource.
The bottom line is that if we (regulators) don’t know about your concerns, we may not be able to pick up on these issues. Complain to your State survey agency to get your issues investigated and also help prevent others from receiving poor care!”
Some nursing homes have signs posted that ask family members to speak to the facilities administrator when they have concerns (I’ve seen one such sign that practically begged family members to NOT call the state survey agency before talking to the administrator). While this is an appropriate action to take in most circumstances, I believe the state survey agency and Ombudsman should be contacted FIRST when resident safety and well-being is at risk. If speaking to the nursing home’s administrator doesn’t resolve your concern, then by all means call the state agency and Ombudsman!
I can’t speak for foreign countries, but here in the United States every part of every state has someone (sometimes several persons) to help nuring home residents and concerned loved ones to assist when concerns about nursing home care (or lack of care) arrise. These helpful individuals, known as long-term care ombudsmen, are often times underpaid and overworked. Some ombudsmen are unpaid volunteers who are supervised by paid ombudsmen. Their service is FREE to nursing home residents, family members and concerned friends of residents.
When is it appropriate to contact an ombudsman? In a non-emergency situation, it is best to contact them after the concerned party has been unable to resolve their concerns with nursing home management.
If you feel you have an urgent or emergency situation involving the safety or welfare of a nursing home resident, then immediately contacting an ombudsman (without trying to resolve matters with the facility) may be entirely appropriate. However when you have an emergency situation and time is of the essence, the best place to turn for help is the state agency responsible for regulating nursing homes within their jurisdictions (in Indiana the agency is the state Board of Health, within Kentucky it is the Office of the Inspector General — all nursing homes must provide those who ask with contact information for the state agency responsible for regulating them. Nursing homes must also provide the phone number for the nearest long-term care ombudsman. Most states require nursing homes post this information in a prominent place, such as near the main entrance of a facility or at/near a nurse’s station. The bottom line is that if you ask facility staff for contact information for the ombudsman or state nursing home regulatory agency, they MUST provide you with that information, which should include a phone number.
In many states it is also entirely appropriate to contact the local office of Adult Protective Services when you feel the safety, rights or welfare of a nursing home resident is threatened. Call your local police or sheriff’s department to find the number for the Adult Protective Services office that serves your area.
My experience (and that of many other loved ones of nursing home residents) is that nursing home staff and management will often feel threatened and become overtly hostile when they become aware that an ombudsman, state regulartory agency or an Adult Protective Services office has been contacted about problems at their facility. Big deal! If they (e.g., nursing home staff and managment) are doing their job (let alone doing it correctly), then they have NO reason to fear the state’s intervention! Please don’t allow nursing home staff or management to intimidate you into silence! You have a legal right and a moral responsibility to request state intervention on behalf of a nursing home resident!
To find contact information for the Long-Term Care Ombudsman in your corner of the United States, please visit the website of the National Citizen’s Coalition for Nursing Home Reform (www.nccnhr.org). On the left side of every major page of their website you’ll find a button with the words “Locate An Ombudsman”. Click on that button to find the information you need. In addition to ombudsmen, you’ll also find listings for each state’s nursing home regulatory agency and other agencies that respond to concerns related to nursing home care.
I need to point out that while ombudsmen are available to investigate concerns and offer advice, they do not have the legal authority to force nursing homes to do anything. Only the state agency entrusted with long-term care facility oversight has such power. Adult Protective Services employees also have legal authority that ombudsmen do not have. At the same time, ombudsmen will be able to render a responsible opinion regarding when it is appropriate to contact the state, in case you aren’t sure if this the right option to pursue. Their wisdom and experience is an invaluable tool in protecting your loved one.